Outbreak of Sepsis Following Surgery: Utilizing 16S RNA Sequencing To Detect the Source of Infection.

Background Nosocomial infections are a significant health concern. Following surgery, infections are most commonly associated with the surgical site, yet there are other potential sources for infections after surgical interventions. Identification of the source of infections can be very challenging.

[DIFFUSE ALVEOLAR BLEEDING IN A PATIENT AFTER GENERAL ANESTHESIA FOR KNEE SURGERY].

A 35-year old male, generally healthy, underwent knee arthroscopy with general anesthesia with a laryngeal mask. Postoperatively, he developed decreased oxygenation and hemoptysis. A chest x-ray and a chest CT presented bilateral diffuse ground glass infiltrates.

Pulse pressure and long-term survival after coronary artery bypass graft surgery.

Background: Data from longitudinal studies reveal that widened pulse pressure (PP) is a major predictor of coronary heart disease and mortality, but it is unknown whether PP similarly decreases survival after coronary artery bypass graft (CABG) surgery for coronary heart disease. We therefore assessed long-term survival in patients with increased PP at the time of presentation for CABG surgery.

Methods: In this retrospective observational study of patients undergoing CABG surgery between January 1993 and July 2004, 973 subjects were included for assessment of long-term survival.

Unusual cause of superior vena cava syndrome diagnosed with transesophageal echocardiography.

Purpose: An unusual case of superior vena cava (SVC) syndrome caused by an infected right atrial-SVC junction thrombus may be diagnosed using transesophageal echocardiography.

Clinical Features: A 59-yr-old male with end-stage renal disease requiring hemodialysis presented with fungemia and later developed facial and bilateral upper extremity edema. Transesophageal echocardiography revealed subtotal occlusion of the SVC at its junction with the right atrium.

Intraoperative hyperglycemia and cognitive decline after CABG.

Background: Neurocognitive dysfunction (NCD) continues to occur in a significant number of patients after cardiac procedures. The factors influencing its incidence and severity are not completely known. We hypothesized that hyperglycemia, which is known to exacerbate other forms of cerebral injury, may exacerbate NCD after cardiac operations.

Cytokine secretion after cardiac surgery and its relationship to postoperative fever.

A relationship between the inflammatory response to cardiopulmonary bypass (CPB) and fever after coronary artery bypass graft surgery (CABG) is assumed, but has not been studied. Therefore, we sought to assess the temporal pattern of cytokines' elevation and its association with post-CABG fever. In 355 primary elective CABG patients, serum cytokines (TNF-alpha, IL-1ra, IL-1beta, IL-6, and IL-8) were measured before surgery, at cessation of CPB and 2.

Preoperative low molecular weight heparin reduces heparin responsiveness during cardiac surgery.

Purpose: Cardiac surgery with cardiopulmonary bypass requires systemic anticoagulation, defined by an activated clotting time (ACT) of 400-480 sec. Patients with altered heparin responsiveness require disproportionately higher doses of heparin to achieve this target ACT. A common risk factor for heparin resistance is preoperative heparin therapy.

Continuous cardiac output monitoring with pulse contour analysis: a comparison with lithium indicator dilution cardiac output measurement.

Objective: Pulse contour analysis can be used to provide beat-to-beat cardiac output (CO) measurement. The current study sought to evaluate this technique by comparing its results with lithium dilution CO (LiCO) measurements.

Design: Prospective, observational study.

Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass surgery.

Objective: Hyperthermia is common in the first 24 hours following coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). An inflammatory response to CPB is often implicated in the pathophysiology of this fever. Unlike CABG with CPB, the temperature pattern after off-pump CABG (OPCAB), where CPB is avoided, has not yet been described.

Aortic atheroma burden and cognitive dysfunction after coronary artery bypass graft surgery.

Background: Neurocognitive dysfunction (NCD) after coronary artery bypass graft (CABG) surgery is a common problem. Atherosclerotic disease of the aorta is a known risk factor for stroke after cardiac surgery, but its relationship to NCD is unclear. This study investigates the relationship between aortic atherosclerotic disease and NCD after CABG.

Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.

Cerebral hyperthermia is common during the rewarming phase of cardiopulmonary bypass (CPB) and is implicated in CPB-associated neurocognitive dysfunction. Limiting rewarming may prevent cerebral hyperthermia but risks postoperative hypothermia. In a prospective, controlled study, we tested whether using a surface-warming device could allow limited rewarming from hypothermic CPB while avoiding prolonged postoperative hypothermia (core body temperature <36 degrees C).

Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures.

Unlabelled: Postoperative immunosuppression is partly ascribed to anesthesia and has been suggested to compromise patients' resistance to infection and tumor metastasis. We compared the effects of various anesthetics on natural killer (NK) cell activity and on resistance to experimental metastasis, and studied mediating mechanisms and prophylactic measures. Fischer 344 rats served as controls or were anesthetized for 1 h with ketamine, thiopental, halothane, or propofol.