Implementing a systematic care pathway for management of dysphagia after cardiothoracic surgery.

Objectives: This longitudinal quality improvement study explored the impact of a new multidisciplinary dysphagia care pathway on swallow screening referrals, patient journeys and swallow outcomes in patients after cardiac surgery.

Research Methodology: The new dysphagia care pathway consisted of i) nurse chart review triaging using established risk factors, ii) nurse swallow screening (including a cough reflex test and water swallow test) and iii) rapid referral routes to speech pathology. All patients referred for swallow screening in 2020 after the commencement of the new dysphagia care pathway were included (n = 114).

A Multicenter, Open-Label, Randomized Controlled Trial of a Conservative Fluid Management Strategy Compared With Usual Care in Participants After Cardiac Surgery: The Fluids After Bypass Study.

Objectives: There is little evidence to guide fluid administration to patients admitted to the ICU following cardiac surgery. This study aimed to determine if a protocolized strategy known to reduce fluid administration when compared with usual care reduced ICU length of stay following cardiac surgery.

Design: Prospective, multicenter, parallel-group, randomized clinical trial.

Prominent eustachian valve: An uncommon cause of a common problem during extracorporeal membrane oxygenation support.

Suck down events in an extracorporeal membrane oxygenation (ECMO) circuit, due to vein wall being suctioned onto the cannula inflow ports, lead to low circuit flows. These low flow states can be reversed with fluid administration. We present a patient with a prominent eustachian valve (EV) which was encountered while managing the patient on ECMO post lung transplantation for pleuroparenchymal fibroelastosis.

Bottle-Weaning Recommendations Among Pediatricians and Pediatric Dentists.

The purpose of this study was to determine how pediatricians (MDs) and pediatric dentists (PDs) interpret professional associations' guidelines for weaning of bottle-fed infants and assess ensuing provider recommendations. A survey was sent to 11,479 MDs and PDs. 721 MDs and 1,005 PDs responded, yielding an overall response of 1,726 (15 percent).