Comparison of Pulmonary Outcome in Minimally Invasive (TCRAT) and Full Sternotomy CABG.

Background:  Pulmonary complications are among the main causes of increased mortality, and morbidity, as well as prolonged intensive care unit (ICU) and hospital stay after cardiac surgery. Recently, a sternum-sparing concept of minimally invasive total coronary revascularization via anterior minithoracotomy (TCRAT) was introduced. A higher risk of pulmonary injury could be anticipated due to the thoracic incision and the longer duration of surgery.

The Impact of the COVID Pandemic on Adrenal Surgery at an Academic Endocrine Surgery Unit.

COVID-19 has severely affected the delivery of surgical care worldwide. The aim of the present study was to evaluate its impact on adrenal surgery at our academic endocrine center. All primary adrenal surgeries performed at the University Hospital of Cologne, Germany between 01.

End-tidal carbon dioxide in the early phase of cardiopulmonary exercise testing prior to major colorectal cancer surgery associates with postoperative outcome.

Background: Cardiopulmonary exercise testing (CPET) objectively informs preoperative risk stratification prior to major surgery. CPET facilities are resource intensive and therefore more cost-effective triage methods are desirable for scalability. We tested two dynamic CPET parameters (end-tidal CO2 (PetCO2) and heart rate (HR)) to early phase exercise and resting diffusion capacity (DLCO) as potential point of care assessments that could be used outside of formal CPET testing facilities.

Preoperative exercise induces endothelial progenitor cell mobilisation in patients undergoing major surgery - A prospective randomised controlled clinical proof-of-concept trial.

Introduction: Prehabilitation is increasingly recognised as a therapeutic option to reduce postoperative complications. Investigating the beneficial effects of exercise on cellular mechanisms, we have previously shown that a single episode of exhaustive exercise effectively stimulates endothelial progenitor cells (a cell population associated with vascular maintenance, repair, angiogenesis, and neovascularization) in correlation with fewer postoperative complications, despite the ongoing debate about the appropriate cell surface marker profiles of these cells (common phenotypical definitions include CD45dim, CD133+, CD34+ and/or CD31+). In order to translate these findings into clinical application, a feasible prehabilitation programme achieving both functional and cellular benefits in a suitable timeframe to expedite surgery is necessary.

Preoperative exercise and prehabilitation.

Purpose Of Review: The purpose of this narrative review is to give an overview about the effects of multimodal prehabilitation and current existing and prospectively planned studies. The potential efficacy of exercise in the context of prehabilitation ranges from preoperatively improving patients' functional capacity to inducing cellular mechanisms that affect organ perfusion via endothelial regeneration, anti-inflammatory processes and tumour defense.

Recent Findings: Current studies show that prehabilitation is capable of reducing certain postoperative complications and length of hospital stay in certain patient populations.

Omission of tranexamic acid does not increase the amount of perioperative blood transfusions in patients undergoing one-level spinal fusion surgery: a retrospective propensity score-matched noninferiority study.

Introduction: Application of tranexamic acid (TXA) in spine surgery is very frequent even without signs of hyperfibrinolysis, although its beneficial blood-saving effects are offset by harmful adverse events such as thromboembolic incidents. Thus, we investigated whether in relatively less invasive spinal procedures such as one-level posterior spinal fusion, omission of TXA affects the requirement for blood transfusions.

Methods: We conducted a retrospective propensity score-matched noninferiority study with 212 patients who underwent one-level posterior spine fusion and who were stratified according to whether they received TXA intraoperatively at our tertiary care center.

Clinical covariates that improve surgical risk prediction and guide targeted prehabilitation: an exploratory, retrospective cohort study of major colorectal cancer surgery patients evaluated with preoperative cardiopulmonary exercise testing.

Background: Preoperative risk stratification is used to derive an optimal treatment plan for patients requiring cancer surgery. Patients with reversible risk factors are candidates for prehabilitation programmes. This pilot study explores the impact of preoperative covariates of comorbid disease (Charlson Co-morbidity Index), preoperative serum biomarkers, and traditional cardiopulmonary exercise testing (CPET)-derived parameters of functional capacity on postoperative outcomes after major colorectal cancer surgery.

First-principles analysis of the optical properties of lead halide perovskite solution precursors.

Lead halide perovskites (LHPs) are promising materials for opto-electronics and photovoltaics, thanks to favorable characteristics and low manufacturing costs enabled by solution processing. In light of this, it is crucial to assess the impact of solvent-solute interactions on the electronic and optical properties of LHPs and of their solution precursors. In a first-principles work based on time-dependent density-functional theory coupled with the polarizable continuum model, we investigate the electronic and optical properties of a set of charge-neutral compounds with chemical formula, PbX(Sol), where X = Cl, Br, and I, and Sol are the six common solvents.

Impaired vascular endothelial function as a perioperative risk predictor - a prospective observational trial.

Background: In the recent years, an increasing number of patients with multiple comorbidities (e.g. coronary artery disease, diabetes, hypertension) presents to the operating room.

Optical Fingerprints of Polynuclear Complexes in Lead Halide Perovskite Precursor Solutions.

Solvent-solute interactions in precursor solutions of lead halide perovskites (LHPs) critically impact the quality of solution-processed materials, as they lead to the formation of a variety of poly-iodoplumbates that act as building blocks for LHPs. The formation of [PbI] complexes is often expected in diluted solutions, while coordination occurring at high concentrations is not yet well understood. In a combined and experimental work, we demonstrate that the optical spectra of the quasi-one-dimensional iodoplumbate complexes PbI(DMSO), PbI(DMSO), and PbI(DMSO) formed in dimethyl sulfoxide solutions are compatible with the spectral fingerprints measured at high lead iodide concentrations.

Video-assisted cardiopulmonary resuscitation via smartphone improves quality of resuscitation: A randomised controlled simulation trial.

Background: Despite intensive research, cardiac arrest remains a leading cause of death. It is of paramount importance to undertake every possible effort to increase the overall quality of cardiopulmonary resuscitation (CPR) and improve patient outcome. CPR initiated by a bystander is one of the key factors in survival of such an incident.

Postoperative complications after bimaxillary orthognathic surgery: A retrospective study with focus on postoperative ventilation strategies and posterior airway space (PAS).

Purpose: The aim of this study was to evaluate the impact of extubation time on postoperative complications in patients undergoing bimaxillary orthognathic surgery. We therefore retrospectively compared the effect of early extubating (EE) in the operating room versus delayed extubating (LE) on the intensive care unit (ICU) regarding postoperative complications and length of ICU/hospital stay (LOICUS/LOHS). Furthermore, we analyzed the influence of the PAS change on postoperative complications.

Impact of Acute Aerobic Exercise on Genome-Wide DNA-Methylation in Natural Killer Cells-A Pilot Study.

Natural Killer (NK-) cells reveal a keen reaction to acute bouts of exercise, including changes of epigenetic modifications. So far, exercise-induced alterations in NK-cell DNA-methylation were shown for single genes only. Studies analyzing genome-wide DNA-methylation have used conglomerates like peripheral blood mononuclear cells (PBMCs) rather than specific subsets of immune cells.

Interrater Reliability of the Braden and Braden Q by Skin Champion Nurses.

The interrater reliability of the Braden Q skin risk assessment scale has never been reported. The purpose of the study was to assess the interrater reliability among pediatric Skin Champion (SC) nurses with the use of the Braden and Braden Q scales. The pilot study included 16 paired SC nurses.

Acute Exercise Increases the Expression of KIR2DS4 by Promoter Demethylation in NK Cells.

Positive effects of exercise on cancer prevention and progression have been proposed to be mediated by stimulating natural killer (NK) cells. Because NK cell receptors are regulated by epigenetic modifications, we investigated whether acute aerobic exercise and training change promoter DNA methylation and gene expression of the activating and the inhibiting gene. Sixteen healthy women (50-60 years) performed a graded exercise test (GXT) and were randomized into either a passive control group or an intervention group performing a four-week endurance exercise intervention.

End-Tidal CO2 Predicts Reduction in Mitral Regurgitation in Patients Undergoing Percutaneous Mitral Valve Edge-to-Edge Repair.

Objectives: We evaluated end-tidal CO2 (etCO2), which has been proposed to assess acute hemodynamic changes, to guide percutaneous edge-to-edge mitral valve repair (PMVR) with the MitraClip system.

Methods: Thirty-nine patients (aged 78 ± 14 years) undergoing PMVR for moderate-to-severe mitral regurgitation (MR) of primary and secondary etiology were included. General anesthesia was maintained with sevoflurane and constant ventilation parameters to ensure stable etCO2 tension.

Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial.

Background: High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR.

Transcutaneous PTCCO measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients.

Hyper or hypoventilation may have serious clinical consequences in critically ill patients and should be generally avoided, especially in neurosurgical patients. Therefore, monitoring of carbon dioxide partial pressure by intermittent arterial blood gas analysis (PaCO) has become standard in intensive care units (ICUs). However, several additional methods are available to determine PCO including end-tidal (PETCO) and transcutaneous (PTCCO) measurements.

Novel Navigated Ultrasound Compared With Conventional Ultrasound for Vascular Access—a Prospective Study in a Gel Phantom Model.

Objectives: The authors hypothesized that, compared with conventional ultrasound (CUS), the use of a novel navigated ultrasound (NUS) technology would increase success rates and decrease performance times of vascular access procedures in a gel phantom model.

Design: A prospective, randomized, crossover study.

Setting: A university Hospital.