The Annals of thoracic surgery
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Randomized Controlled Trial Comparative Study
Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery.
Previous studies have reported an 11% to 75% incidence of postoperative cognitive decline among cardiac surgery patients. The INVOS Cerebral Oximeter (Somanetics Corp, Troy, MI) is a Food and Drug Administration approved device that measures regional cerebral oxygen (rSo(2)) saturation. The purpose of this study is to examine whether decreased rSo(2) predicts cognitive decline and prolonged hospital stay after coronary artery bypass grafting (CABG). ⋯ Intraoperative cerebral oxygen desaturation is significantly associated with an increased risk of cognitive decline and prolonged hospital stay after CABG.
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We report the case of an 18-year-old patient who underwent Ravitch procedure for pectus carinatum and subsequently had septic shock develop with severe cardiac dysfunction requiring treatment with extracorporeal membrane oxygenation. We advocate the use of extracorporeal membrane oxygenation in adult patients with intractable cardiorespiratory failure due to sepsis post-thoracic surgery unresponsive to conventional therapy.
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Review Meta Analysis
N-acetylcysteine in cardiovascular-surgery-associated renal failure: a meta-analysis.
Clinical trials with N-acetylcysteine (NAC) in perioperative cardiovascular settings have shown inconsistent effects for renal endpoints. We aimed to systematically review these trials to ascertain its role in prevention of post-cardiovascular surgery acute renal failure. ⋯ Overall analysis of the existent literature shows that NAC is not beneficial in the prevention of post-cardiovascular surgery renal dysfunction. Routine use of NAC for this indication should be avoided.
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Randomized Controlled Trial Comparative Study
Intracoronary shunt prevents ischemia in off-pump coronary artery bypass surgery.
The purpose of this study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery. ⋯ Intracoronary shunt prevents ischemia during grafting of the left anterior descending coronary artery and provides satisfactory immediate- and short-term graft patency.