Comparison of Screening Scores for Heparin- Induced Thrombocytopenia After Cardiopulmonary Bypass.

Objectives: To compare screening scores for heparin-induced thrombocytopenia (HIT) after cardiopulmonary bypass (CPB).

Design: Retrospective cohort study.

Setting: Cardiothoracic surgery units within a large tertiary healthcare facility from September 2010 to January 2020.

Use of Lactulose to Treat Hyperammonemia in ICU Patients Without Chronic Liver Disease or Significant Hepatocellular Injury.

Objectives: To review ICU patients with elevated ammonia without a clear hepatic etiology, to compare outcomes between those who received lactulose and those who did not.

Design: Retrospective observational study.

Setting: Medical, surgical, and subspecialty intensive care units at Wake Forest Baptist Medical Center, Winston-Salem, North Carolina between December 2012 and August 2016.

Catecholamine-Sparing Effect of Angiotensin II in an Anephric Patient With Mixed Shock After Cardiac Revascularization Surgery: A Case Report.

Vasodilatory shock is common following cardiac surgery, caused by an inflammatory response to cardiopulmonary bypass (CPB). Some cases are refractory to volume resuscitation, high-dose catecholamines, arginine vasopressin, and established adjunctive therapies. Angiotensin II (ANG-2), an endogenous hormone in the renin-angiotensin-aldosterone system (RAAS), has several direct and indirect vasoconstrictive properties that make it a promising potential treatment.

Angiotensin II for Critically Ill Patients With Shock After Heart Transplant.

Patients undergoing heart transplant are at high risk for vasodilatory shock in the postoperative period, due to a combination of vascular dysfunction from end-stage heart failure and inflammatory response to cardiopulmonary bypass and, increasingly, long-term exposure to nonpulsatile blood flow in those who have received a left ventricular assist device as a bridge to transplant. Patients who have this vasoplegic syndrome, which may be refractory to traditional agents used in the treatment of shock, are vulnerable to organ dysfunction and death. Angiotensin II (ANG-2) is of increasing interest as an adjunct to traditional therapy, both for improvement in blood pressure and for sparing the use of high-dose catecholamine vasopressors.