Postoperative care of the adult cardiac surgical patient

Publication date: Available online 11 September 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): Christopher P. Press, Jonathan H. Rosser, Alison D. Parnell Most patients are ready to be transferred to a ward after 24–48 hours on a cardiac intensive care unit (CICU); however, several potential complications can occur during this period. The risks during transfer from theatre to CICU increase if a long distance is involved. A thorough handover to nursing staff is mandatory. Problems with blood pressure and arrhythmias are common on the CICU. Patients undergoing hypothermic cardiopulmonary bypass are at greater risk of hypothermia postoperatively. Multiple factors can cause postoperative cardiac surgical bleeding. Despite efforts to correct clotting abnormalities, patients occasionally need to return to theatre because of mediastinal bleeding or cardiac tamponade. The avoidance of multiorgan failure by maintaining good tissue perfusion and oxygenation is the main aim of perioperative care and through the initial postoperative period. Avoidance or treatment of a low cardiac output state often necessitates cardiac output monitoring and the use of inotropes, vasoactive drugs or mechanical assist devices such as an intra-aortic balloon pump. Established organ failure leads to a longer stay on a CICU, a growing proportion of patients having a protracted critical care stay.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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CONCLUSION: There is currently no uniform hospitalization strategy for postoperative care of children who undergo typical otorhinolaryngologic interventions in Germany. PMID: 31712876 [PubMed - as supplied by publisher]
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research
CONCLUSIONS: Our results suggest that T1AM and TAAR1 are part of an endogenous system that can be modulated to prevent synaptic and behavioral deficits associated with Aβ-related toxicity. PMID: 31709926 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
Conclusions: More than half the study patients received ibrutinib therapy at a submaximal dose without evidence of increased frequency of toxicities or disease progression. The rate of ibrutinib discontinuation was lower in our cohort than has been reported in other settings. Submaximal ibrutinib dosing will have to be further systematically evaluated. PMID: 31708654 [PubMed - in process]
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
Marco Vacante1, Antonio Biondi1, Francesco Basile1, Roberto Ciuni1, Salvatore Luca1, Salomone Di Saverio2, Carola Buscemi3, Enzo Saretto Dante Vicari3 and Antonio Maria Borzì3* 1Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy 2Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom 3Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy There is a high prevalence of hypothyroidism in the elderly population, mainly among women. The mo...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
CONCLUSION: This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis. PMID: 29526071 [PubMed]
Source: Journal of Korean Neurosurgical Society - Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
(Br J Anaesth. 2016;117(5):676) In this correspondence, the author addressed a few points regarding Sultan and colleagues’ article, which discussed the efficacy of actively warming patients during elective cesarean delivery. The Sultan article highlighted aggressive warming of parturients during cesarean section either with warmed intravenous fluid or warming blankets to provide comfort and prevent neuraxial blockade-related shivering. Warming patients not only improves a patient’s comfort, but also may avoid hypothermia-related complications such as bleeding, coagulopathy, myocardial arrhythmias or ischemia, ...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Short Takes Source Type: research
Conclusions Although TH appears to be safe in patients with STEMI, meta-analysis of published RCTs indicates that benefit is limited to reduction of infarct size in patients with anterior wall involvement with no demonstrable effect on all-cause mortality, recurrent myocardial infarction or HF/PO.
Source: Heart - Category: Cardiology Authors: Tags: Bradyarrhythmias and heart block, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Coronary artery disease Source Type: research
Conclusions: Cooling- and rewarming-related AEs were not associated with poor neurological outcome at hospital discharge. Sepsis, myoclonus, seizure, hypoglycemia within 72 hours and anticonvulsant use during the advanced critical care period were associated with poor neurological outcome at hospital discharge in our study.
Source: Critical Care - Category: Intensive Care Authors: Source Type: research
Conclusions: Early therapeutic hypothermia in children with severe traumatic brain injury does not improve outcome and should not be used outside a clinical trial. Recruitment rates were lower and outcomes were better than expected. Conventional randomized controlled trials in children with severe traumatic brain injury are unlikely to be feasible. A large international trials group and alternative approaches to trial design will be required to further inform practice.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research
Conclusions— Peritoneal hypothermia is feasible and achieves rapid cooling with only a modest increase in treatment times in the setting of ST-segment–elevation myocardial infarction. However, in the present randomized trial, peritoneal hypothermia was associated with an increased rate of adverse events without reducing infarct size. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01655433.
Source: Circulation: Cardiovascular Interventions - Category: Cardiology Authors: Tags: Catheter-based coronary interventions: stents, Other Treatment Myocardial Infarction Source Type: research
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