Background: Evidence on the effectiveness of pulmonary artery catheters (PACs) in cardiac surgery is scarce.
Research Question: Does perioperative PAC use decrease 1-year all-cause mortality in patients undergoing cardiac surgery?.
Study Design And Methods: This nationwide, population-based cohort study included all adult patients who underwent cardiac surgery in Korea between January 2011 and December 2020, using a Korean health insurance claim database.
Study Objective: There is scarce evidence on the hemodynamic stability of remimazolam during anesthetic induction in patients with significant coronary artery disease. This study aims to compare the effects of remimazolam and propofol on post-induction hypotension in patients undergoing coronary artery bypass grafting (CABG).
Design: Randomized controlled trial.
Background: This study evaluated the effect of head rotation on the first-attempt success rate of i-gel insertion, aiming to alleviate the effect of gravity on the tongue and reduce resistance between the device and the tongue.
Methods: Adult surgical patients were randomized to standard and head rotation technique groups. In the head rotation technique group, patients' heads were maximally rotated to the left before i-gel insertion.
Objectives: This study was designed to compare individualized and conventional hyperglycemic thresholds for the risk of acute kidney injury (AKI) after cardiac surgery.
Design: This was an observational study.
Setting: The study took place in a single-center tertiary teaching hospital.
Background: Many studies have suggested that volatile anesthetic use may improve postoperative outcomes after cardiac surgery compared to total intravenous anesthesia (TIVA) owing to its potential cardioprotective effect. However, the results were inconclusive, and few studies have included patients undergoing heart valve surgery.
Methods: This nationwide population-based study included all adult patients who underwent heart valve surgery between 2010 and 2019 in Korea based on data from a health insurance claim database.
The optimal anesthetic agent for radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) and its impact on the recovery profiles remain uncertain. We compared the recovery and hemodynamic parameters between the remimazolam-flumazenil and propofol groups during RFCA. Patients were randomized into the remimazolam-flumazenil and propofol groups.
View Article and Find Full Text PDFLaryngoscope Investig Otolaryngol
June 2024
Background: Sigmoid sinus diverticulum/dehiscence (SSD) is one of the treatable causes of venous pulsatile tinnitus. It can be diagnosed using temporal bone computed tomography (CT) or magnetic resonance angiography/venography (MRA). In cases where patients find their symptoms intolerable, surgical treatment is typically preferred.
View Article and Find Full Text PDFBackground: This study evaluated the difference in brain metabolite profiles between normothermia and hypothermia reaching 25°C in humans in vivo.
Methods: Thirteen patients who underwent thoracic aorta surgery under moderate hypothermia were prospectively enrolled. Plasma samples were collected simultaneously from the arteries and veins to estimate metabolite uptake or release.
Background: Remimazolam, a short acting benzodiazepine, is being used for general anaesthesia. The results of studies comparing recovery after propofol with that of remimazolam are inconsistent. Given that flumazenil reverses the sedative effects of remimazolam, we hypothesised that it would speed up recovery from remimazolam general anaesthesia.
View Article and Find Full Text PDFPredicting in-hospital cardiac arrest in patients admitted to an intensive care unit (ICU) allows prompt interventions to improve patient outcomes. We developed and validated a machine learning-based real-time model for in-hospital cardiac arrest predictions using electrocardiogram (ECG)-based heart rate variability (HRV) measures. The HRV measures, including time/frequency domains and nonlinear measures, were calculated from 5 min epochs of ECG signals from ICU patients.
View Article and Find Full Text PDFIntroduction: Existing risk-scoring systems for cardiac surgery include only standard preoperative factors without considering nutritional and inflammatory status or intraoperative factors. The objective of this study was to develop a comprehensive prediction model for mortality incorporating nutritional, inflammatory, and perioperative factors in patients undergoing valvular heart surgery.
Materials And Methods: In this retrospective review of 2046 patients who underwent valvular heart surgery, Cox and LASSO regression analyses were performed to identify independent prognostic factors for 1-year postoperative mortality among various perioperative factors known to affect prognosis, including objective nutritional and inflammatory indices.
Neurological pupil index (NPi) calculated by automated pupillometry predicts clinical outcomes in critically ill patients. However, there are few data on intraoperative NPi and postoperative outcome after cardiac surgery. We evaluated the relationships between intraoperative NPi and clinical outcomes, such as delirium, in cardiac surgery patients.
View Article and Find Full Text PDFBackground: Oxygen therapy is used in various clinical situation, but its clinical outcomes are inconsistent. The relationship between the fraction of inspired oxygen (FIO2) during transcatheter aortic valve implantation (TAVI) and clinical outcomes has not been well studied. We investigated the association of FIO2 (low vs.
View Article and Find Full Text PDFBackground: To maintain adequate oxygenation is of utmost importance in intraoperative care. However, clinical evidence supporting specific oxygen levels in distinct surgical settings is lacking. This study aimed to compare the effects of 30% and 80% oxygen in off-pump coronary artery bypass grafting (OPCAB).
View Article and Find Full Text PDFStudy Objective: The effect of perioperative body temperature derangement on postoperative delirium remains unclear. This study aimed to evaluate the association between intraoperative body temperature and postoperative delirium in patients having noncardiac surgery.
Design: Single-center retrospective observational study.
The effect of intraoperative tidal volume (VT) on clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) has not been studied. The aim of this study was to assess the relationship between intraoperative tidal volume (VT) and acute kidney injury (AKI ) after OPCAB. A total of 1049 patients who underwent OPCAB between January 2009 and December 2018 were analyzed.
View Article and Find Full Text PDFBackground: The effect of hyperoxia due to supplemental oxygen administration on postoperative outcomes in patients undergoing cardiac surgery remains unclear. This retrospective study aimed to evaluate the relationship between intraoperative oxygen tension and mortality after off-pump coronary artery bypass grafting (OPCAB).
Methods: The study included adult patients who underwent isolated OPCAB between July 2010 and June 2020.
Flap failure after microvascular reconstructive surgery is a rare but devastating complication caused by reperfusion injury and tissue hypoperfusion. Remote ischemic conditioning (RIC) provides protection against ischemia/reperfusion injury and reduces tissue infarction. We hypothesized that RIC would enhance flap oxygenation and exert organ-protective effects during head and neck free flap reconstructive surgery.
View Article and Find Full Text PDFBackground: Acute kidney injury (AKI) is one of the most common complications in patients undergoing open abdominal aortic aneurysm (AAA) repair. Dopamine has been frequently used in these patients to prevent AKI. We aimed to clarify the relationship between intraoperative dopamine infusion and postoperative AKI in patients undergoing open AAA repair.
View Article and Find Full Text PDFBackground: Cardiopulmonary bypass-related myocardial ischemia-reperfusion injury is a major contributor to postoperative morbidity. Although transcutaneous electrical nerve stimulation (TENS) has been found to have cardioprotective effects in animal studies and healthy volunteers, its effects on cardiac surgery under cardiopulmonary bypass patients have not been evaluated. We investigated the effects of TENS on myocardial protection in patients undergoing aortic valve replacement surgery using cardiopulmonary bypass.
View Article and Find Full Text PDFStudy Objective: The age, creatinine, and ejection fraction (ACEF) I and II scores are known to predict operative mortality after cardiac surgery. However, data from few cases of off-pump coronary artery bypass grafting (OPCAB) were considered during the development of these scores. This study aimed to validate and update the ACEF I and II scores for the prediction of in-hospital mortality after OPCAB.
View Article and Find Full Text PDFBackground: Oxygenation via a high-flow nasal cannula (HFNC) can be an alternative to tracheal intubation during short apnoeic procedures. This randomised, non-inferiority study assessed the efficacy of HFNC compared with tracheal intubation in laryngeal microsurgery.
Methods: Patients (≥20 yr old) undergoing laryngeal microsurgery under general anaesthesia and neuromuscular blockade were randomised to either the HFNC or tracheal intubation groups.