scholarly journals Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Emad Al Jaaly ◽  
Mustafa Zakkar ◽  
Francesca Fiorentino ◽  
Gianni D. Angelini
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Dysfunction ◽  
Common Complication ◽  
Level Of Evidence ◽  
The Poor ◽  
Wide Acceptance ◽  
Protection Strategies ◽  
Multistep Process ◽  
Pulmonary Protection ◽  
And Oxidative Stress

Pulmonary dysfunction is a common complication of cardiac surgery. The mechanisms involved in the development of pulmonary dysfunction are multifactorial and can be related to the activation of inflammatory and oxidative stress pathways. Clinical manifestation varies from mild atelectasis to severe respiratory failure. Managing pulmonary dysfunction postcardiac surgery is a multistep process that starts before surgery and continues during both the operative and postoperative phases. Different pulmonary protection strategies have evolved over the years; however, the wide acceptance and clinical application of such techniques remain hindered by the poor level of evidence or the sample size of the studies. A better understanding of available modalities and/or combinations can result in the development of customised strategies for the different cohorts of patients with the potential to hence maximise patients and institutes benefits.

Pulmonary Protection During Cardiac Surgery: Systematic Literature Review

2008 ◽  
Vol 16 (6) ◽  
pp. 503-507 ◽  
Author(s):  
Enisa MF Carvalho ◽  
Edmo A Gabriel ◽  
Tomas A Salerno
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Literature Review ◽  
Heart Surgery ◽  
Ischemia Reperfusion Injury ◽  
Current Knowledge ◽  
Ischemia Reperfusion ◽  
Pulmonary Dysfunction ◽  
Pulmonary Protection ◽  
Postoperative Pulmonary Dysfunction

Ischemia-reperfusion injury occurs during heart surgery in which cardiopulmonary bypass is used. Current knowledge of the factors contributing to postoperative pulmonary dysfunction and the measures to avoid it are reviewed.

Nurse-Led Preoperative Screening and Targeted Optimization of Pulmonary Dysfunction in Patients Undergoing Cardiac Surgery

2007 ◽  
Vol 84 (2) ◽  
pp. 683-685 ◽  
Author(s):  
Sivakumar Sivalingam ◽  
Sridhar Rathinam ◽  
Adam Ajis ◽  
Christopher M.R. Satur
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Dysfunction ◽  
Preoperative Screening

Combined intraoperative use of Diltiazem and N-acetylcystein increases myocardial damage and oxidative stress during off-pump cardiac surgery

2013 ◽  
Vol 168 (3) ◽  
pp. 3107-3109 ◽  
Author(s):  
Annick Steib ◽  
Olivier Collange ◽  
Astrid Quessard ◽  
François Levy ◽  
Michèle Zeisser ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cardiac Surgery ◽  
Myocardial Damage ◽  
Off Pump ◽  
And Oxidative Stress

An Evidence-Based Review on Guided Imagery Utilization in Adult Cardiac Surgery

2010 ◽  
Vol 3 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Jesus Casida ◽  
Suzanne A. Lemanski
Keyword(s):  
Cardiac Surgery ◽  
Psychological Health ◽  
Guided Imagery ◽  
Well Being ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Research Quality ◽  
Therapeutic Modality ◽  
Level Of Evidence ◽  
Adult Cardiac Surgery

This article illustrates a comprehensive review, synthesis, and critical appraisal of the research evidence surrounding guided imagery utilization in cardiac surgery. By adding guided imagery in the “usual care” of adult cardiac surgery patients, pre- and postoperative anxiety and pain, as well as hospital length of stay may be reduced. However, in spite of fairly strong “level” of evidence, the limited number of studies and low research quality deter the full acceptance of guided imagery as a standard therapeutic modality in this population. Acute and critical care nurses can offer guided imagery to their patients based on the documented safety of its use and clinically significant findings that it may have a direct impact on patients’ recovery outcomes. Higher quality, methodologically rigorous, and larger-scale studies are warranted to establish the efficacy and standard utilization of guided imagery during perioperative and rehabilitative periods. Future studies should also address long-term outcomes, specifically on physical and psychological health, well-being, and overall quality of life after cardiac surgery.

The Trajectory of Postoperative Pulmonary Dysfunction in Adults After Cardiac Surgery

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 507A
Author(s):  
Rochelle Wynne ◽  
Mari Botti ◽  
James Tatoulis
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Dysfunction ◽  
Postoperative Pulmonary Dysfunction

scholarly journals Postoperative Pulmonary Dysfunction and Mechanical Ventilation in Cardiac Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rafael Badenes ◽  
Angels Lozano ◽  
F. Javier Belda
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Pulmonary Inflammation ◽  
Protective Ventilation ◽  
Pulmonary Dysfunction ◽  
Gas Exchange Parameters ◽  
Ventilatory Strategy ◽  
Protective Ventilation Strategy ◽  
Postoperative Pulmonary Dysfunction

Postoperative pulmonary dysfunction (PPD) is a frequent and significant complication after cardiac surgery. It contributes to morbidity and mortality and increases hospitalization stay and its associated costs. Its pathogenesis is not clear but it seems to be related to the development of a systemic inflammatory response with a subsequent pulmonary inflammation. Many factors have been described to contribute to this inflammatory response, including surgical procedure with sternotomy incision, effects of general anesthesia, topical cooling, and extracorporeal circulation (ECC) and mechanical ventilation (VM). Protective ventilation strategies can reduce the incidence of atelectasis (which still remains one of the principal causes of PDD) and pulmonary infections in surgical patients. In this way, the open lung approach (OLA), a protective ventilation strategy, has demonstrated attenuating the inflammatory response and improving gas exchange parameters and postoperative pulmonary functions with a better residual functional capacity (FRC) when compared with a conventional ventilatory strategy. Additionally, maintaining low frequency ventilation during ECC was shown to decrease the incidence of PDD after cardiac surgery, preserving lung function.

Advances in Perioperative Pulmonary Protection Strategies

2014 ◽  
Vol 32 (1) ◽  
pp. 89-117 ◽  
Author(s):  
J. Kyle Bohman ◽  
Daryl J. Kor
Keyword(s):  
Protection Strategies ◽  
Pulmonary Protection

scholarly journals ASSIST DEVICES IN CARDIAC SURGERY

2018 ◽  
Vol 25 (12) ◽  
pp. 1796-1804
Author(s):  
Saad B. Zakai ◽  
Iqbal Hussain Pathan ◽  
Sohail K Bangash ◽  
Tariq A. Siddiqi ◽  
Fazle Rabbi
Keyword(s):  
Cardiac Surgery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Balloon Catheter ◽  
Care Hospital ◽  
Assist Device ◽  
Balloon Catheters ◽  
The Poor ◽  
The Mean ◽  
Hospital Study

Objectives: IABP is the most frequently used assist device in cardiac surgery. However, due to the poor socioeconomic status in our country, it is not always possible to use a brand new IABP when required. In these circumstances we use re-sterilized IABP catheters. Our aim was to compare the outcome of re-sterilized versus new IABP catheters in the set of patients who were provided surgery for IHD free of cost in a tertiary care hospital. Study Design: Retrospective study. Period: January 2007 to December 2013. Setting: National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. Methods: 3560 CABG procedures were performed. Those patients who could not afford a new IABP catheter were provided with the resterilized balloon catheters, free of cost. Total IABP usage was 286(8%) patients, of which the new balloon catheter was used in 214patients [74.8% (groupI)]. Re-sterilized catheters were used in 72patients [25.2% (groupII)]. All patients were screened for HIV, Hepatitis- B and Hepatitis-C.12(16.6%) of the balloon catheters were resterilized more than once and 3(4.1%) of these on three occasions. Results: The mean age of the patients was 52.59±13.32 years. 69 (24.1%) of the patients were female. The mode of insertion (sheath less versus with sheath) was found tobe an independent risk factor for the development of complications. The overall incidence of complications (p=0.29) was 6.9%. The incidence of balloon catheter related complications was 1.75%. When the two groups were compared with regard to morbidity and mortality, the resultswere found to be statistically insignificant. Conclusion: Use of re-sterilized IABP catheters is safe. However, strict guidelines should be instituted and followed for this purpose. 

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