The Annals of thoracic surgery
-
Case Reports
Respiratory support with venovenous extracorporeal membrane oxygenation during stenting of tracheobronchomalacia.
A subset of patients with severe airway disease cannot be adequately supported with conventional mechanical ventilation during complex airway procedures. We report the successful respiratory support of a patient with severe tracheobronchomalacia with venovenous extracorporeal membrane oxygenation during rigid bronchoscopy with stent removal and stent placement.
-
Vibration response imaging (VRI) is a new technique that captures lung sounds generated by the flow of air through the lungs. It predicts postoperative values for an intended lung resection. In this study, we measured the predicted postoperative pulmonary function as determined by a perfusion lung scan and the VRI, and compared with results from the postoperative pulmonary function. ⋯ The VRI was highly predictive of postoperative FEV(1) and Dlco for lung resection.
-
Cerebral hypoxia-ischemia remains a complication in children with congenital heart disease. Near-infrared spectroscopy can be utilized at the bedside to detect cerebral hypoxia-ischemia. This study aimed to calibrate and validate an advanced technology near-infrared cerebral oximeter for use in children with congenital heart disease. ⋯ This cerebral oximeter accurately measures the absolute value of cerebral saturation in children over a wide range of oxygenation and subject characteristics, offering advantages in assessment of cerebral hypoxia-ischemia in congenital heart disease.
-
As overall mortality rates have fallen in pediatric cardiac surgical procedures, complication monitoring is becoming an increasingly important metric of patient outcome. Currently there is no standardized method available to monitor severity-adjusted complications in congenital cardiac surgical procedures. ⋯ The O:E plot provides a simple and effective system to monitor complication rates over time based on severity-adjusted complication data. Grouping complications into classes allows us to identify specific subsets of complications that can be focused on to improve patient outcomes.