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The association between intraoperative cardiopulmonary bypass power and complications after cardiac surgery
CONCLUSIONS: This study suggests that MAP during cardiopulmonary bypass, but not power or flow, was an independent risk factor for adverse renal outcomes for cardiac surgical patients.PMID:37442644 | DOI:10.1177/02676591231187958
Source: Perfusion - July 13, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Victor Hui Kwok M Ho Rebecca Hahn Brian Wright Robert Larbalestier Warren Pavey Source Type: research

The Great Contrast Shortage of 2022 —Lessons learnt in Australia
ConclusionOur findings demonstrate that the IBCM shortage crisis had a very significant impact on the delivery of healthcare. While V/Q scans could (partially) substitute for CTPA studies in suspected pulmonary emboli, there appeared to be no valid alternative for CTNA studies in stroke calls. The unexpected and critical shortage of IBCM forced healthcare professionals to conserve resources, prioritise indications, triage patients based on risk, explore alternate imaging strategies and prepare for similar events recurring in the future.
Source: Journal of Medical Imaging and Radiation Oncology - May 18, 2023 Category: Radiology Authors: Giles Kisby, James H Seow, Greg Schie, Constantine C Phatouros, Kay ‐Vin Lam, Tracey Muir, Sally Burrows, Paul M Parizel Tags: Medical Imaging —Original Article Source Type: research

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

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
BMJ Open. 2022 Feb 11;12(2):e055461. doi: 10.1136/bmjopen-2021-055461.ABSTRACTINTRODUCTION: Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia's rural and remote populations in accessing EVT, but improved access can be facilitated by a 'drip and ship' approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aim...
Source: Rural Remote Health - February 12, 2022 Category: Rural Health Authors: Annika Ryan Christine L Paul Martine Cox Olivia Whalen Andrew Bivard John Attia Christopher Bladin Stephen M Davis Bruce C V Campbell Mark Parsons Rohan S Grimley Craig Anderson Geoffrey A Donnan Christopher Oldmeadow Sarah Kuhle Frederick R Walker Rebecc Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
Introduction Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia’s rural and remote populations in accessing EVT, but improved access can be facilitated by a ‘drip and ship’ approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary impleme...
Source: BMJ Open - February 11, 2022 Category: General Medicine Authors: Ryan, A., Paul, C. L., Cox, M., Whalen, O., Bivard, A., Attia, J., Bladin, C., Davis, S. M., Campbell, B. C. V., Parsons, M., Grimley, R. S., Anderson, C., Donnan, G. A., Oldmeadow, C., Kuhle, S., Walker, F. R., Hood, R. J., Maltby, S., Keynes, A., Delcou Tags: Open access, Health services research Source Type: research

Real-World Cost-Effectiveness of Late Time Window Thrombectomy for Patients With Ischemic Stroke
Conclusions: Treating patients not meeting the DAWN or DEFUSE 3 clinical trial criteria in the extended time window for EVT was associated with less gain in QALYs and higher cost. Caution should be exercised when considering this procedure for patients not satisfying the trial perfusion imaging criteria for EVT.
Source: Frontiers in Neurology - December 14, 2021 Category: Neurology Source Type: research

Telestroke Assessment With Perfusion CT Improves the Diagnostic Accuracy of Stroke vs. Mimic
Conclusions: In the telehealth setting, the absence of an ischaemic lesion on CTP adds to the diagnostic accuracy in distinguishing mimic from stroke, above that from clinical features.
Source: Frontiers in Neurology - December 3, 2021 Category: Neurology Source Type: research

Reduced Impact of Endovascular Thrombectomy on Disability in Real-World Practice, Relative to Randomized Controlled Trial Evidence in Australia
Conclusions: EVT for the treatment of LVO in a registry of routine care was associated with significantly lower DALYs lost than medical care alone, but the saved DALYs are less than those reported in clinical trials, as there were major differences in the baseline characteristics of the patients.
Source: Frontiers in Neurology - December 8, 2020 Category: Neurology Source Type: research

Acute kidney injury, stroke and death after cardiopulmonary bypass surgery: the role of perfusion flow and pressure.
CONCLUSIONS: Neither low perfusion pressure nor low perfusion flow during cardiopulmonary bypass were predictive of postoperative acute kidney injury, stroke or death. PMID: 32515271 [PubMed - as supplied by publisher]
Source: Perfusion - June 8, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Turner L, Hardikar A, Jose MD, Bhattarai K, Fenton C, Sharma R, Kirkland G, Jeffs L, Breslin M, Silva Ragaini B, Newland RF Tags: Perfusion Source Type: research

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