Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Surgical Site Infections and Inflammatory Reaction After Cardiac Surgery; Bedside Artificial Pancreas Versus Conventional Insulin Therapy: A Propensity Score-Matched Analysis.
Perioperative hyperglycemia is associated with poor postoperative recovery, including compromised immune function and increased risk of infection. A closed-loop glycemic control system (artificial pancreas) has demonstrated strict safe perioperative glycemic control without hypoglycemia risk. The authors hypothesized that the artificial pancreas would reduce surgical site infections (SSIs) and postoperative inflammatory reactions. This study aimed to assess the effect of the artificial pancreas on SSIs and C-reactive protein (CRP) levels after cardiac surgery. ⋯ The artificial pancreas did not demonstrate a significant reduction in the incidence of SSIs. However, the artificial pancreas was safe and suppressed postoperative inflammation compared with conventional insulin therapy.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Core-Peripheral Temperature Gradient and Skin Temperature as Predictors of Major Adverse Events Among Postoperative Pediatric Cardiac Patients.
During episodes of low cardiac output, sympathetic neurohumoral responses with peripheral vasoconstriction result in an increase in the core-peripheral temperature gradient (CPTG). However, assessment of CPTG as a surrogate of low cardiac output and a predictor of outcomes in pediatric cardiac patients rarely has been performed. In this retrospective study, the authors assessed the prognostic abilities of CPTG, skin temperature, and serum lactate level for predicting clinical outcomes. ⋯ Both CPTG and skin temperature had low performance for prediction of MAEs in children after cardiac surgery. Either of those markers, especially at admission, should not be used as a single marker for assessing the condition of a patient.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Laparoscopic Surgery Requiring Abdominal Insufflation in Patients With Congenital Heart Disease.
To determine if patients with congenital heart disease are undergoing laparoscopic surgery requiring abdominal insufflation and to compare the outcomes of these procedures with those who underwent an open surgical approach. ⋯ Individuals with congenital heart disease are being offered laparoscopic surgery that requires abdominal insufflation. All-cause mortality and length of stay were higher for patients who underwent open surgical operations.