The incidence and effect of resternotomy following cardiac surgery on morbidity and mortality: a 1‐year national audit on behalf of the Association of Cardiothoracic Anaesthesia and Critical Care

Anaesthesia ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 19-26 ◽  
Author(s):  
S. Agarwal ◽  
S. W. Choi ◽  
S. N. Fletcher ◽  
A. A. Klein ◽  
R. Gill ◽  
...  
Keyword(s):  
Critical Care ◽  
Cardiac Surgery ◽  
Morbidity And Mortality ◽  
National Audit

scholarly journals Preoperative cigarette smoking and short-term morbidity and mortality after cardiac surgery: a meta-analysis

Heart Asia ◽  
2018 ◽  
Vol 10 (2) ◽  
pp. e011069 ◽  
Author(s):  
Nicholas Gregory Ross Bayfield ◽  
Adrian Pannekoek ◽  
David Hao Tian
Keyword(s):  
Cardiac Surgery ◽  
Smoking Status ◽  
Meta Analysis ◽  
Surgical Site Infections ◽  
Neurological Complications ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Surgical Patients ◽  
Short Term ◽  
Increased Risk

Currently, the choice of whether or not to electively operate on current smokers is varied among cardiothoracic surgeons. This meta-analysis aims to determine whether preoperative current versus ex-smoking status is related to short-term postoperative morbidity and mortality in cardiac surgical patients. Systematic literature searches of the PubMed, MEDLINE and Cochrane databases were carried out to identify all studies in cardiac surgery that investigated the relationship between smoking status and postoperative outcomes. Extracted data were analysed by random effects models. Primary outcomes included 30-day or in-hospital all-cause mortality and pulmonary morbidity. Overall, 13 relevant studies were identified, with 34 230 patients in current or ex-smoking subgroups. There was no difference in mortality (p=0.93). Current smokers had significantly higher risk of overall pulmonary complications (OR 1.44; 95% CI 1.27 to 1.64; p<0.001) and postoperative pneumonia (OR 1.62; 95%  CI 1.27 to 2.06; p<0.001) as well as lower risk of postoperative renal complications (OR 0.82; 95%  CI 0.70 to 0.96; p=0.01) compared with ex-smokers. There was a trend towards an increased risk of postoperative MI (OR 1.29; 95%  CI 0.95 to 1.75; p=0.10). No difference in postoperative neurological complications (p=0.15), postoperative sternal surgical site infections (p=0.20) or postoperative length of intensive care unit stay (p=0.86) was seen. Cardiac surgical patients who are current smokers at the time of operation do not have an increased 30-day mortality risk compared with ex-smokers, although they are at significantly increased risk of postoperative pulmonary complications.

scholarly journals Transfusion Requirements in Anemic Patients undergoing Cardiac Surgery

2017 ◽  
Vol 2 (1) ◽  
pp. 26-27
Author(s):  
Vaishali S Badge ◽  
Henry Skinner
Keyword(s):  
Cardiac Surgery ◽  
Morbidity And Mortality ◽  
Surgical Patients ◽  
Transfusion Rate ◽  
Allergic Reactions ◽  
Blood Products ◽  
Transfusion Requirements

ABSTRACT Cardiac surgery is one of the largest consumer of blood and blood products in medicine. The transfusion rate in cardiac surgery accounts to almost 40-90%. Although lifesaving, it still increases the risk of allergic reactions, risk of transmission of infection, increased morbidity and mortality. The aim of this study was to find out causes of anaemia and requirement of blood or blood products in cardiac surgical patients. How to cite this article Badge VS, Skinner H. Transfusion Requirements in Anemic Patients undergoing Cardiac Surgery. Res Inno in Anesth 2017;2(1):26-27.

scholarly journals Separate Consent for Anesthetic Practice: Need of the Moment

2020 ◽  
Vol 42 (3) ◽  
pp. 1-6
Author(s):  
Anil Shrestha ◽  
Gentle S Shrestha ◽  
Saurabh Pradhan ◽  
Pankaj Joshi
Keyword(s):  
Critical Care ◽  
Pain Management ◽  
Older Patients ◽  
Morbidity And Mortality ◽  
Daily Routine ◽  
Anaesthetic Practice ◽  
Patient Morbidity ◽  
Enormous Amount ◽  
Primary Physicians ◽  
The Moment

Decades of refinement and modifications have led the modern anaesthetic practice to be conducted so smoothly and safely, that sometimes we take for granted the enormous amount of risks involved with it. Furthermore, with the evolution of monitoring techniques, and discovery of safer drugs, anesthesia has facilitated the conduction of complex surgeries on sicker patients, and older patients. The expansion to critical care and pain management services has added another dimension to this field, with anesthesiologists not just working as facilitators for another procedure, but acting as primary physicians. Anesthesiologists are among the few clinicians, who are involved in patient morbidity and mortality in their daily routine. With the ever-changing ethical and legal background, the significance of obtaining a separate consent for anesthesia needs to be timely evaluated. In this review, we have discussed the significance of a separate consent for anesthesia and highlight its various aspects.

Impact of Preoperative Hypoalbuminemia On Morbidity and Mortality in Cardiac Surgery

1999 ◽  
Vol 99 (9) ◽  
pp. A124 ◽  
Author(s):  
A. Paison ◽  
S. Khuri ◽  
V. Birjiniuk ◽  
M. Crittenden
Keyword(s):  
Cardiac Surgery ◽  
Morbidity And Mortality

Morbidity and mortality of acute renal failure in the Critical Care Unit of a regional hospital

2018 ◽  
Vol 65 (6) ◽  
pp. 314-322
Author(s):  
M.E. Esteban Ciriano ◽  
J.M. Peña Porta ◽  
C. Vicente de Vera Floristán ◽  
S. Olagorta García ◽  
R. Álvarez Lipe ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Critical Care Unit ◽  
Regional Hospital ◽  
Morbidity And Mortality

Survey of Physiotherapy Practice in Ontario Cardiac Surgery Intensive Care Units

2021 ◽  
pp. e20200069
Author(s):  
Anastasia N.L. Newman ◽  
Michelle E. Kho ◽  
Jocelyn E. Harris ◽  
Alison Fox-Robichaud ◽  
Patricia Solomon
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Critically Ill ◽  
Outcome Measures ◽  
Median Number ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Physiotherapy Practice

Purpose: This article describes current physiotherapy practice for critically ill adult patients requiring prolonged stays in critical care (> 3 d) after complicated cardiac surgery in Ontario. Method: We distributed an electronic, self-administered 52-item survey to 35 critical care physiotherapists who treat adult cardiac surgery patients at 11 cardiac surgical sites. Pilot testing and clinical sensibility testing were conducted beforehand. Participants were sent four email reminders. Results: The response rate was 80% (28/35). The median (inter-quartile range) reported number of cardiac surgeries performed per week was 30 (10), with a median number of 14.5 (4) cardiac surgery beds per site. Typical reported caseloads ranged from 6 to 10 patients per day pe therapist, and 93% reported that they had initiated physiotherapy with patients once they were clinically stable in the intensive care unit. Of 28 treatments, range of motion exercises (27; 96.4%), airway clearance techniques (26; 92.9%), and sitting at the edge of the bed (25; 89.3%) were the most common. Intra-aortic balloon pump and extracorporeal membrane oxygenation appeared to limit physiotherapy practice. Use of outcome measures was limited. Conclusions: Physiotherapists provide a variety of interventions with critically ill cardiac surgery patients. Further evaluation of the limited use of outcome measures in the cardiac surgical intensive care unit is warranted.

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