Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction.
To investigate the impact of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develop a machine learning model to predict SIRS. ⋯ SIRS is significantly associated with increased 30-day mortality following cardiac surgery. Machine learning models effectively predict SIRS, paving the way for future investigations on potential targeted interventions that may mitigate adverse outcomes.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
ReviewMechanical Circulatory Support for Acute Myocardial Infarction Cardiogenic Shock: Review and Recent Updates.
Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations of mechanical circulatory support (MCS) exist to support patients, each with unique pathophysiological characteristics. The Intra-aortic balloon pump can improve coronary perfusion, decrease afterload, and indirectly augment cardiac output. ⋯ While venoarterial extracorporeal membrane oxygenation provides complete support, it has not demonstrated a mortality benefit in major trials and carries significant risks. In contrast, microaxial flow pumps have shown a mortality benefit but with higher complication rates. Ongoing research and advancements aim to refine MCS strategies, improve device safety, and enhance patient outcomes.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Role of del Nido Cardioplegia Solution in Prolonged Aortic Cross-clamp Cardiac Surgery: A Prospective Study.
The myocardial-protective effect of del Nido cardioplegia solution was evaluated in adult patients undergoing prolonged aortic cross-clamping during cardiac surgery. ⋯ The incidence of postoperative atrial fibrillation at 48 hours was significantly lower in the del Nido group than in the Buckberg group. del Nido cardioplegia solution can be safely used for high-risk patients undergoing prolonged aortic cross-clamping.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Unveiling Baseline Clinical Divergence in VA ECMO vs. ECPELLA: Tailoring Treatment for Distinct Patient Profiles. A Systematic Review and Meta-analysis.
The benefit of combining multiple mechanical circulatory support (MCS) systems in patients with cardiogenic shock (CS) is debated. This review examines patient characteristics across studies to identify differences and assesses if patients with a higher-risk clinical profile receive Impella unloading. ⋯ Patients who received a combination of MCS and VA ECMO have a greater prevalence of comorbidities.