scholarly journals Parsonnet score and vasoactive drugs in cardiac surgery

2007 ◽  
Vol 54 (S1) ◽  
pp. 44357-44357
Author(s):  
André Y. Denault ◽  
André Y. Denault ◽  
Jean Bussières ◽  
P. Couture ◽  
S. Lévesque ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Vasoactive Drugs ◽  
Parsonnet Score

Validation of the 2000 Bernstein-Parsonnet Score Versus the EuroSCORE as a Prognostic Tool in Cardiac Surgery

2006 ◽  
Vol 81 (2) ◽  
pp. 537-540 ◽  
Author(s):  
Marius Berman ◽  
Alon Stamler ◽  
Gideon Sahar ◽  
Georgios P. Georghiou ◽  
Erez Sharoni ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prognostic Tool ◽  
Parsonnet Score

scholarly journals Early Enteral Nutrition Tolerance in Patients With Cardiogenic Shock Requiring Mechanical Circulatory Support

2021 ◽  
Vol 8 ◽  
Author(s):  
Wen-jun Liu ◽  
Jun Zhong ◽  
Jing-chao Luo ◽  
Ji-li Zheng ◽  
Jie-fei Ma ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Enteral Nutrition ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Early Enteral Nutrition ◽  
Vasoactive Drugs ◽  
Icu Stay ◽  
Significant Difference

Background: Enteral nutrition (EN) is recommended within the first 24–48 h for patients with hemodynamic stability, following admission to an intensive care unit (ICU). However, for patients with approximate stable hemodynamics requiring mechanical circulatory support and vasoactive drugs, the application of early EN remains controversial. We sought to evaluate the tolerance of early EN in patients with cardiogenic shock who required vasoactive drugs and mechanical circulatory support after cardiac surgery.Methods: This single-center, prospective observational study included patients with cardiogenic shock, requiring vasoactive drugs and mechanical circulatory support after cardiac surgery, undergoing EN. The primary endpoint was EN tolerance and secondary endpoints were mortality, length of mechanical ventilation, and length of ICU stay.Results: From February 2019 to December 2020, 59 patients were enrolled, of which 25 (42.37%) developed intolerance within 3 days of starting EN. Patients in the EN intolerant group had a longer median length of mechanical ventilation (380 vs. 128 h, p = 0.006), a longer median ICU stay (20 vs. 11.5 days, p = 0.03), and a higher proportion of bloodstream infections (44 vs. 14.71%, p = 0.018). The median EN calorie levels for all patients in the first 3 days of EN were 4.00, 4.13, and 4.28 kcal/kg/day, respectively. Median protein intake levels of EN in the first 3 days were 0.18, 0.17, and 0.17 g/kg/day, respectively. No significant difference was observed in the median dose of vasoactive drugs between the groups (0.035 vs. 0.05 μg/kg/min, p = 0.306).Conclusions: Patients with cardiogenic shock after cardiac surgery had a high proportion of early EN intolerance, and patients with EN intolerance had a worse prognosis, but no significant correlation was identified between EN tolerance and the dose of vasoactive drugs.

scholarly journals Prediction and Prevention of Upper Gastrointestinal Bleeding after Cardiac Surgery: A Case Control Study

2012 ◽  
Vol 26 (6) ◽  
pp. 340-344 ◽  
Author(s):  
Mamatha Bhat ◽  
Martin Larocque ◽  
Marcos Amorim ◽  
Karl Herba ◽  
Myriam Martel ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Case Control Study ◽  
Cardiovascular Surgery ◽  
International Normalized Ratio ◽  
Case Control ◽  
Acid Suppression ◽  
Gi Bleeding ◽  
Control Study ◽  
Parsonnet Score

BACKGROUND: Gastrointestinal (GI) complications of cardiovascular surgery, particularly bleeding, occur frequently.OBJECTIVE: To determine factors that predict upper GI bleeding (UGIB) after cardiac surgery to improve prognostication and, thus, outcomes.METHODS: The present case-control study reviewed institutional records spanning 2002 to 2005 for consecutive patients who developed in-hospital UGIB following cardiovascular surgery. Each case was matched to two to three controls for age, sex and date of hospital admission. Demographics, pharmacotherapy (including use of in-hospital acid suppression), endoscopic findings and outcomes were recorded. After adjustment for possible confounders, including Parsonnet score and demographic parameters, conditional logistic regression analysis identified independent significant predictors of the subsequent development of UGIB.RESULTS: The study population consisted of 131 cases (mean [± SD] age 68.8±10.2 years, 69.5% male, mean Parsonnet score 24.6±14.2) and 387 matched controls (mean age 68.8±10.8 years, 70.0% male, mean Parsonnet score 20.9±14.2). UGIB events occurred a mean of 10.3±7.7 days after cardiac surgery. Duration of mechanical ventilation (OR 3.01 [95% CI 1.44 to 6.28]), elevation of international normalized ratio (OR 1.91 [95% CI 1.31 to 2.78]) and occurrence ofClostridium difficilecolitis before bleeding (OR 3.15 [95% CI 1.19 to 8.36]) were independent risk factors. Use of histamine type 2 receptor antagonists (H2RAs) (OR 0.65 [95% CI 0.38 to 1.12]) or proton pump inhibitors (PPIs) (OR 0.60 [95% CI 0.27 to 1.32]) demonstrated trends toward protecting against UGIB after cardiac surgery.CONCLUSIONS: GI bleeding events occurred approximately 10 days after cardiac surgery in patients with a complicated postoperative course. Significant predictors of subsequent bleeding included increased duration of mechanical ventilation and elevation of international normalized ratio; routine acid suppression with PPIs should be considered in such patients.C difficilecolitis also significantly predicted UGIB, and H2RAs should be considered for acid suppression. Neither H2RAs nor PPIs were effective in preventing UGIB, although the small number of patients limits definitive conclusions regarding the role of acid suppression.

Impact of age and Parsonnet Score on incidence and outcome of cardiac arrest following cardiac surgery

2001 ◽  
Vol 18 (Supplement 22) ◽  
pp. 42
Author(s):  
C. Rozario ◽  
S. Powell ◽  
S. Charman ◽  
J. Osgathorp ◽  
G. King ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Parsonnet Score

scholarly journals Assessment of the Initial and Modified Parsonnet Score in Mortality Prediction of the Patients Operated in the Sarajevo Heart Center

2010 ◽  
Vol 10 (2) ◽  
pp. 165-168 ◽  
Author(s):  
Mirsad Kacila ◽  
Kaushal K. Tiwari ◽  
Nermir Granov ◽  
Edin Omerbašić ◽  
Slavenka Štraus
Keyword(s):  
Cardiac Surgery ◽  
Outcome Prediction ◽  
Prediction Models ◽  
Operative Mortality ◽  
Mortality Prediction ◽  
Scoring Model ◽  
Specific Outcome ◽  
Heart Center ◽  
Adult Cardiac Surgery ◽  
Parsonnet Score

This study has been conducted in an effort to establish more suitable and accurate scoring model we use in everyday practice. Among the specific outcome prediction models, in 1989 Parsonnet et al elaborated a method of uniform risk stratification for evaluation of the results of cardiac surgery procedures. We have tested two forms of the Parsonnet score, Initial and Modified Parsonnet score, in our patients.In the first half of the year 2007, 145 patients were operated in Sarajevo Heart center. All operated patients in that period, have participated in this study. The overall hospital mortality was 4,13 (6 deaths). This study shows that the initial and modified Parsonnet’s scores are predictive for operative mortality in adult cardiac surgery patients.

Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care

2017 ◽  
Vol 34 (8) ◽  
pp. 652-661 ◽  
Author(s):  
Sven Asmussen ◽  
Rene Przkora ◽  
Dirk M. Maybauer ◽  
John F. Fraser ◽  
Filippo Sanfilippo ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Troponin I ◽  
Meta Analysis ◽  
Open Heart Surgery ◽  
Cochrane Library ◽  
Vasoactive Drugs ◽  
Icu Stay ◽  
Anesthetic Drugs ◽  
Postoperative Dose

Background: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. Methods: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science—from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. Results: The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs ( P < .05), leading to shorter MV time ( P < .01) and ICU stay ( P < .05) as well as reduced postoperative dose of vasoactive drugs ( P < .001). In addition, significantly lower levels of troponin I ( P < .01) and tumor necrosis factor α ( P < .01) were observed. Conclusion: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.

scholarly journals Vascular Reactivity during Cardiopulmonary Bypass in Patients at Punjab Institute of Cardiology & Shalamar Hospital Lahore, Pakistan

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Muhammad Usman Rafique ◽  
Qandeel Rubnawaz ◽  
Ammar Hameed Khan ◽  
Muhammad Shoaib Akhtar
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Vascular Reactivity ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Vasoactive Drugs ◽  
Vasodilator Drugs ◽  
Hemodynamic Variables ◽  
General Terms ◽  
Suboptimal Outcome

Background: The operative treatment of cardiac diseases remains associated with systemic inflammation and a suboptimal outcome in many patients. These inflammatory changes are manifested by systemic hypotension, myocardial failure, increased vascular permeability and consequent dysfunction of organs such as the lungs, gut and brain. In general terms, sympathetic innervations of the small arteries and arterioles allows vasoconstriction, thereby increasing resistance to blood flow, whereas innervations of the large arteries and veins decreases the volume in these vessels, resulting in the redistribution of blood volume. This study was conducted to determine the effect of vasodilator drugs on duration of vasodilatation in patients undergoing coronary artery bypass grafting (CABG) with Cardiopulmonary bypass (CPB).Methods: We evaluated prospectively the effect of vasodilator medications before CABG surgery on hemodynamic variables and use of vasoactive drugs. We studied 30 patients with good left ventricular function allocated randomly to continue vasodilator drugs before cardiac surgery. Arterial pressure, Cardiac output, systemic vascular resistance and use of vasoactive drugs were recorded during anaesthesia, perioperative and in the early postoperative period.Results: Patients who using vasodilator drugs before cardiac surgery had not significant relationship between vasodilator drugs and vessels reactivity (vasoconstriction & vasodilatation). However, these patients required more vasodilator drugs to control hypertension after CPB and in the early postoperative period.Conclusion: There was no difference in hypotension at the onset of CPB or in the use of vasodilator drugs before cardiac surgery. We conclude that vasodilator drugs before cardiac surgery did not have sufficient effect to be recommended routinely.

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