European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2009
Review Meta AnalysisUse of N-acetylcysteine to reduce post-cardiothoracic surgery complications: a meta-analysis.
Post-cardiothoracic surgery (CTS) complications (e.g. myocardial injury, renal dysfunction, atrial fibrillation) may occur as a result of enhanced systemic inflammation, perhaps provoked by an oxidative stress response. N-acetylcysteine (NAC) is a free radical scavenger antioxidant agent that may attenuate this physiologic response and reduce post-CTS complications. Thus, a meta-analysis was performed to help characterize the potential beneficial effects of perioperative NAC administration in patients undergoing CTS. ⋯ The exclusion of the study utilizing only oral NAC therapy and the study with lower internal validity did not affect the overall conclusions of our meta-analysis. Currently, the most compelling data for using NAC in CTS patients is in post-CTS AF prevention. However, additional, larger randomized controlled trials evaluating this and other postoperative complication endpoints are needed.
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Eur J Cardiothorac Surg · Mar 2009
Computed tomography with volume rendering for the evaluation of parenchymal hyperinflation after bronchoscopic lung volume reduction.
To assess computed tomography with volume rendering (CT-VR) as a tool to evaluate parenchymal hyperinflation before and after bronchoscopic lung volume reduction (BLVR) in patients with advanced stage emphysema. ⋯ CT-VR is an excellent tool to confirm the efficacy of BLVR in reducing parenchymal hyperinflation. Functional advantages are proportional to the volume reduction as measured by CT-VR.
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Eur J Cardiothorac Surg · Mar 2009
Exercise capacity assessment in patients undergoing lung resection.
The value is examined of preoperative functional assessment, including exercise capacity measurement by a cycloergometric maximal exercise test, in the prediction of postoperative cardio-pulmonary complication after lobar resection. ⋯ Preoperative exercise capacity assessment helps in stratifying patients at risk for postoperative pulmonary complication. However, it does not appear to be an independent prognostic factor for postoperative outcome.
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Eur J Cardiothorac Surg · Mar 2009
Association of IL6 and IL10 with renal dysfunction and the use of haemofiltration during cardiopulmonary bypass.
Assessment of the effects of haemofiltration during cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) on the renal function and correlation with interleukin 6 (IL6) and interleukin 10 (IL10) levels. ⋯ Haemofilter use during cardiopulmonary bypass does not have a protective effect on postoperative kidney function. Haemofilter has no effect on the level of IL6 and IL10.
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Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled TrialNeuropsychological function in children with cyanotic heart disease undergoing corrective cardiac surgery: effect of two different rewarming strategies.
Hypothermia conventionally used in cardiopulmonary bypass necessitates rewarming to normothermic temperatures, which has been shown to be associated with neuropsychological injury. We studied the effects of two different rewarming strategies on postoperative neuropsychological function in cyanotic paediatric patients undergoing elective primary intracardiac repair of tetralogy of Fallot with the aid of cardiopulmonary bypass. ⋯ Weaning off bypass at 33 degrees C is associated with lesser postoperative neuropsychological dysfunction compared to rewarming to 37 degrees C before weaning off bypass. This may be used as a tool to decrease neurologic morbidity following cardiac surgery in children with congenital cyanotic heart disease.