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When does life end? New organ donation strategy fuels debate
On a chilly holiday Monday in January 2020, a medical milestone passed largely unnoticed. In a New York City operating room, surgeons gently removed the heart from a 43-year-old man who had died and shuttled it steps away to a patient in desperate need of a new one. More than 3500 people in the United States receive a new heart each year. But this case was different—the first of its kind in the country. “It took us 6 months to prepare,” says Nader Moazami, surgical head of heart transplantation at New York University (NYU) Langone Health, where the operation took place. The run-up included oversight from an ethi...
Source: ScienceNOW - May 11, 2023 Category: Science Source Type: news

Impact of Early, Low-Dose Factor VIIa on Subsequent Transfusions and Length of Stay in Cardiac Surgery
OFF-LABEL USE of recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark) for perioperative cardiac surgical bleeding has been shown to reduce bleeding,1-4 blood product administration,1,5,6 and the rate of reoperations.4,6,7 However, there also has been an association with increased mortality,8 thrombosis,9-11 stroke,7,11,12 and renal morbidity.8,9 These inconsistent outcomes may be a function of variations in both timing and dosing of rFVIIa.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 6, 2021 Category: Anesthesiology Authors: Lauren Sutherland, Abigail Houchin, Tian Wang, Shuang Wang, Vivek Moitra, Akshit Sharma, Trip Zorn, Brigid C. Flynn Tags: Original Article Source Type: research

Does General Anesthesia Compared With Conscious Sedation Result in Better Outcomes in Acute Stroke Patients Undergoing Endovascular Therapy?
Conclusions: GA does not result in worse tissue outcomes or worse clinical outcomes when compared with CS in acute stroke patients with large vessel occlusion undergoing mechanical thrombectomy.
Source: The Neurologist - March 1, 2021 Category: Neurology Tags: Critically Appraised Topics Source Type: research

Goal-directed therapy with bolus albumin 5% is not superior to bolus ringer acetate in maintaining systemic and mesenteric oxygen delivery in major upper abdominal surgery: A randomised controlled trial
CONCLUSION Bolus human albumin 5% was not superior to bolus ringer acetate in maintaining systemic or mesenteric oxygen delivery in elective major upper gastrointestinal cancer surgery, despite the administration of larger volumes of trial fluid in the ringer acetate group. No significant difference was seen in fluid-related complications or LOS. TRIAL REGISTRATION https://eudract.ema.europa.eu/ Identifier: 2013-002217-36.
Source: European Journal of Anaesthesiology - May 11, 2020 Category: Anesthesiology Tags: Haemodynamics Source Type: research

Janssen Highlights Continued Commitment to Cardiovascular & Metabolic Healthcare Solutions with Late-Breaking Data at the First Fully Virtual American College of Cardiology Scientific Session
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to Tweet: Jan...
Source: Johnson and Johnson - March 20, 2020 Category: Pharmaceuticals Source Type: news

Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Raising the Alarm on Brain Attacks in Surgical Patients: Are We Doing Enough to Prevent and Treat Postoperative Strokes?
(Abstracted from Anesthesiology, 127(1):3–5, 2017) This editorial provides an overview of the study by Christiansen et al,1 which demonstrates that a history of acute ischemic stroke within 3 months of emergency noncardiac, nonintracranial surgery significantly increased the risk of a postoperative stroke using data from the Danish National Patient Registry.
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research

Risks of Cardiovascular Adverse Events and Death in Patients With Previous Stroke Undergoing Emergency Noncardiac, Nonintracranial Surgery: The Importance of Operative Timing
(Abstracted from Anesthesiology 127(1):9–19, 2017) The purpose of this study was to assess the risk of adverse events after emergency noncardiac, noncranial surgery in association with time elapsed after ischemic stroke by retrospectively analyzing the data from a nationwide study population from Denmark that covered patients older than 20 years undergoing the aforementioned emergency surgeries between 2005 and 2011. The primary outcomes measured were the 30-day all-cause mortality and a combined end point of 30-day major adverse cardiovascular events (MACEs), such as nonfatal myocardial infarction and ischemic stroke, ...
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research

Raising the Alarm on Brain Attacks in Surgical Patients: Are We Doing Enough to Prevent and Treat Postoperative Strokes?
(Abstracted from Anesthesiology, 127(1):3–5, 2017) This editorial provides an overview of the study by Christiansen et al,1 which demonstrates that a history of acute ischemic stroke within 3 months of emergency noncardiac, nonintracranial surgery significantly increased the risk of a postoperative stroke using data from the Danish National Patient Registry.
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research

Risks of Cardiovascular Adverse Events and Death in Patients With Previous Stroke Undergoing Emergency Noncardiac, Nonintracranial Surgery: The Importance of Operative Timing
(Abstracted from Anesthesiology 127(1):9–19, 2017) The purpose of this study was to assess the risk of adverse events after emergency noncardiac, noncranial surgery in association with time elapsed after ischemic stroke by retrospectively analyzing the data from a nationwide study population from Denmark that covered patients older than 20 years undergoing the aforementioned emergency surgeries between 2005 and 2011. The primary outcomes measured were the 30-day all-cause mortality and a combined end point of 30-day major adverse cardiovascular events (MACEs), such as nonfatal myocardial infarction and ischemic stroke, ...
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research

Raising the Alarm on Brain Attacks in Surgical Patients: Are We Doing Enough to Prevent and Treat Postoperative Strokes?
(Abstracted from Anesthesiology, 127(1):3–5, 2017) This editorial provides an overview of the study by Christiansen et al,1 which demonstrates that a history of acute ischemic stroke within 3 months of emergency noncardiac, nonintracranial surgery significantly increased the risk of a postoperative stroke using data from the Danish National Patient Registry.
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research

Low vs. high haemoglobin trigger for transfusion in vascular surgery: protocol for a randomised trial
DiscussionThis trial is expected to determine whether a RBC transfusion triggered by hb < 9.7 g/dl compared with hb < 8 g/dl results in adequate separation of postoperative hb levels, transfusion of more RBC units and maintains a higher tissue oxygenation. The results will inform the design of a multicentre trial for evaluation of important postoperative outcomes.
Source: Acta Anaesthesiologica Scandinavica - August 6, 2017 Category: Anesthesiology Authors: A. M øller, H. B. Nielsen, J. Wetterslev, O. B. Pedersen, D. Hellemann, S. Shahidi Tags: Special Article Source Type: research