Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2011
Randomized Controlled Trial Comparative StudyMini-cardiopulmonary bypass impact on blood conservation strategy in coronary artery bypass grafting.
Cardiopulmonary bypass (CPB) using a closed circuit system with minimal priming volume can be a solution to ameliorate adverse effects of CPB. We hypothesize that the use of mini-bypass in routine coronary artery bypass grafting (CABG) reduces homologous blood product use and postoperative bleeding. The study is designed to determine the differences in blood loss and transfusion requirements associated with a minimized CPB circuit vs. a standard bypass circuit. ⋯ The adoption of mini-bypass significantly reduces morbidity including donor blood usage and postoperative bleeding in routine CABG patients.
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Interact Cardiovasc Thorac Surg · Apr 2011
ReviewIs prophylactic minitracheostomy beneficial in high-risk patients undergoing thoracotomy and lung resection?
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether prophylactic minitracheostomy (PM) is beneficial in high-risk patients undergoing thoracotomy and lung resection. Altogether, 115 papers were found using the reported search, of which four represented the best evidence to answer the question. ⋯ All the studies reported some complications associated with minitracheostomy (MT) insertion, the incidence of which ranged from 5.6% to 57%. One percent of 227 patients who received MT in the studies experienced a life-threatening complication, the rest were minor and easily controlled. None of the complications resulted in death.
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Interact Cardiovasc Thorac Surg · Apr 2011
Case ReportsLate presentation of foreign body aspiration requiring extracorporeal membrane oxygenation support for surgical management.
We present the case of a near fatal aspiration of a foreign body requiring extracorporeal membrane oxygenation (ECMO) support. The use of ECMO to support treatment for a foreign body in the distal trachea is rare and there are only two cases reported in the literature. A 13-year-old male presented with a three-weeks' history of a cough and swinging fevers. ⋯ This is the first reported use of ECMO support for an acute presentation of a chronic problem. If the patient is too unstable for bronchoscopy, ECMO can be used to temporarily stabilise the patient allowing safe removal of the object. If the patient is acutely unwell and septic, ECMO should be more readily considered.