Publications by authors named "Tu Guo-Wei"
Objectives: This study aims to evaluate the organ-protective efficacy of postoperative glucocorticoid in patients with type A aortic dissection.
Methods: Postoperative type A aortic dissection patients were randomly allocated to receive either postoperative glucocorticoid or standard-of-care treatment. Intravenous methylprednisolone was administered for 3 days.
Article Synopsis
- The study investigates the effectiveness of the modified furosemide responsiveness index (mFRI) as a biomarker for predicting the progression of acute kidney injury (AKI) and adverse outcomes in patients who experienced mild to moderate AKI after cardiac surgery.
- It compared mFRI with other renal biomarkers and cytokines, finding that mFRI performed equally or better in predicting AKI progression and other serious outcomes like hospital mortality and renal replacement therapy (RRT).
- The research suggests that using a combination of mFRI and urinary injury biomarkers improves the prediction of adverse renal outcomes more effectively than using either biomarker alone.
Article Synopsis
- The study evaluated the effectiveness and safety of remifentanil compared to dexmedetomidine in cardiac surgery patients experiencing moderate-to-severe intolerance to noninvasive ventilation (NIV).
- The results indicated that while both medications had similar mitigation rates for NIV intolerance overall, remifentanil showed a significant advantage at the 15-minute mark and had a higher odds ratio for success after accounting for time.
- Adverse effects were noted in the dexmedetomidine group, including instances of bradycardia and severe hypotension, whereas no adverse effects were reported for the remifentanil group.
Article Synopsis
- - The study explores using pulse oximetry waveforms to identify aortic dissection (AD), which is often misdiagnosed and can lead to severe complications.
- - Researchers recruited patients with chest pain from emergency departments, utilizing a random forest algorithm to analyze waveform data alongside demographic information to create a predictive model.
- - The model showed high accuracy in detecting AD, with an impressive area under the ROC curve of 0.979 in the training set and 0.855 in the external validation set, demonstrating its potential as a diagnostic tool.
Background: No reliable clinical tools exist to predict acute kidney injury (AKI) progression. We aim to explore a scoring system for predicting the composite outcome of progression to severe AKI or death within seven days among early AKI patients after cardiac surgery.
Methods: In this study, we used two independent cohorts, and patients who experienced mild/moderate AKI within 48 h after cardiac surgery were enrolled.
Background: Skin mottling is a common manifestation of peripheral tissue hypoperfusion, and its severity can be described using the skin mottling score (SMS). This study aims to evaluate the value of the SMS in detecting peripheral tissue hypoperfusion in critically ill patients following cardiac surgery.
Methods: Critically ill patients following cardiac surgery with risk factors for tissue hypoperfusion were enrolled (n = 373).
Background: Postoperative patients with Type A aortic dissection (TAAD) often experience severe inflammatory responses caused by multiple factors perioperatively. However, the effect of postoperative glucocorticoid (GC) use, which is a potent anti-inflammatory agent, on complications or all-cause mortality is unclear.
Methods: Patients with TAAD who underwent surgical repair requiring deep hypothermic circulatory arrest between January 2020 and December 2021 were included in the study.
Background: As patients with acute kidney injury (AKI) progress to a higher stage, the risk for poor outcomes dramatically rises. Early identification of patients at high risk for AKI progression remains a major challenge. This study aimed to evaluate the value of furosemide responsiveness (FR) for predicting AKI progression in patients with initial mild and moderate AKI after cardiac surgery.
View Article and Find Full Text PDFBackground: Patients receiving surgical treatment of acute type A Aortic Dissection (aTAAD) are common to suffer organ dysfunction in the intensive care unit due to overwhelming inflammation. Previous studies have revealed that glucocorticoids may reduce complications in certain patient groups, but evidence between postoperative glucocorticoids administration and improvement in organ dysfunction after aTAAD surgery are lacking.
Methods: This study will be an investigator-initiated, prospective, single-blind, randomized, single-center study.
Background: Sepsis is an abnormal immune response after infection, wherein the lung is the most susceptible organ to fail, leading to acute lung injury. To overcome the limitations of current therapeutic strategies and develop more specific treatment, the inflammatory process, in which T cell-derived extracellular vesicles (EVs) play a central role, should be explored deeply.
Methods: Liquid chromatography-tandem mass spectrometry was performed for serum EV protein profiling.
Background: Hypoperfusion, a common manifestation of many critical illnesses, could lead to abnormalities in body surface thermal distribution. However, the interpretation of thermal images is difficult. Our aim was to assess the mortality risk of critically ill patients at risk of hypoperfusion in a prospective cohort by infrared thermography combined with deep learning methods.
View Article and Find Full Text PDFPurpose: This national study aimed to investigate the lung ultrasound (LUS) training and practice of respiratory therapists (RTs) in mainland China.
Methods: A cross-sectional multicenter survey was conducted from May 22, 2021 to August 12, 2021, through online platforms. This survey included RTs in mainland China.
Early postoperative organ dysfunction is highly associated with the mortality risk of patients with type A aortic dissection.
Interact Cardiovasc Thorac Surg
November 2022
Article Synopsis
- This study explored how early postoperative organ dysfunction (EPOD) affects in-hospital mortality in patients undergoing surgery for type A aortic dissection (TAAD).
- Researchers used the Sequential Organ Failure Assessment (SOFA) score to categorize organ dysfunction severity into mild, moderate, and severe, monitoring patients for 3 days after surgery.
- Results showed that the risk of mortality increased significantly with higher SOFA scores, with no deaths in the mild group, while 3% with moderate and 23% with severe EPOD died, demonstrating the SOFA score's effectiveness in predicting patient outcomes.
In this editorial, we comment on the current development and deployment of data science in intensive care units (ICUs). Data in ICUs can be classified into qualitative and quantitative data with different technologies needed to translate and interpret them. Data science, in the form of artificial intelligence (AI), should find the right interaction between physicians, data and algorithm.
View Article and Find Full Text PDFArticle Synopsis
- * During the weaning process, reducing pump flow creates a "flow challenge" that shifts blood dynamics, affecting how the heart manages pressure and volume (preload and afterload).
- * The article suggests using this flow challenge as a method to quantitatively evaluate the heart's ability to function independently, discussing both the hemodynamic details and clinical implications of this test.
Background: Uneven body-surface thermal distribution is a manifestation of hypoperfusion and can be quantified by infrared thermography. Our aim was to investigate whether body-surface thermal inhomogeneity could accurately evaluate the severity of patients at risk of hypoperfusion. Methods: This was a prospective cohort study in which infrared thermography images were taken from unilateral legs of critically ill patients at high risk of hypoperfusion in a cardiac surgical intensive care unit.
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- This study investigates early predictors of noninvasive ventilation (NIV) failure in critically ill patients post-extubation, highlighting the importance of identifying at-risk patients early to improve outcomes.
- Researchers analyzed data from a large cohort and utilized machine learning techniques, specifically the Categorical Boosting (CatBoost) model, to develop an accurate predictive model for NIV failure.
- The final model demonstrated high predictive accuracy in both the internal validation (AUROC: 0.872) and prospective validation (AUROC: 0.846) cohorts, showcasing its potential usefulness in clinical settings.
Article Synopsis
- The study investigates the immediate effects of recombinant human brain natriuretic peptide (rh-BNP) on heart function in patients recovering from heart surgery who are experiencing congestive heart failure (CHF).
- Twenty-four patients received rh-BNP, and various heart function parameters were monitored before and after treatment.
- Results showed reduced levels of cardiac congestion indicators, suggesting that rh-BNP improves venous return without significantly altering overall cardiac output in these post-cardiotomy CHF patients.
Article Synopsis
- The study explored the link between steroid therapy and lung damage measured by quantitative CT (QCT) in 72 severe COVID-19 patients over time.
- Results showed that patients receiving steroids had a significant decrease in compromised lung volume after stage 3 of hospitalization, particularly in those with higher initial lung damage.
- The findings suggest steroids can be beneficial in reducing lung impairment in COVID-19 patients but their effectiveness may depend on the duration of treatment and the severity of lung compromise at the start.