AI Article Synopsis
- Delayed sternum closure is an important method for managing hemodynamic instability after heart surgery, particularly effective in patients showing compromised conditions post-surgery.
- The study reviewed data from patients who received delayed closure between 2014 and 2022, showing that this technique was required in 3.6% of cases, mostly due to hemodynamic instability.
- Overall outcomes indicated a survival rate of 92%, with low complications such as deep sternal infections, suggesting that delayed closure is both safe and effective.
Article Abstract
Background: Delayed sternum closure is a crucial strategy in the management of hemodynamic instability after weaning from cardiopulmonary bypass. This study aimed to evaluate our outcomes with this technique in light of the literature.
Methods: We retrospectively reviewed the data of all the patients who developed postcardiotomy hemodynamic compromise and intraaotic balloon pump was inserted between November 2014 to January 2022. Patients were divided into two groups: primary sternal closure group, and delayed sternum closure group. Patients' demographic data, hemodynamic parameters, and postoperative morbidities were recorded.
Results: Delayed sternum closure was performed in 16 patients with an incidence of 3.6%. The most common indication was hemodynamic instability in 14 patients (82%), followed by arrhythmia in 2 patients (12%) and diffuse bleeding in 1 patient (6%). The mean time to sternum closure was 21 (±7) hours. Three patients died (19%), p > 0.999. The median follow-up period was 25 months. Survival analysis revealed that the survival rate was 92%, p = 0.921. Deep sternal infection was observed in one patient with (6%), p > 0.999. multivariate logistic regression analysis revealed that end-diastolic diameter [odds ratio (OR) 4.5, 95% CI (1.19-17), p = 0.027], right ventricle diameter [OR 3.9, 95% CI (1.3-10.7), p = 0.012] and aortic clamp time [OR 1.16, 95% CI (1.02-1.12), p = 0.008] were independent risk factors for delayed sternum closure.
Conclusions: Elective delayed sternal closure is a safe and effective method for treating postcardiotomy hemodynamic instability. It can be performed with a low incidence of mortality and sternal infections.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1532/hsf.5461 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical Outcomes in Delayed Sternal Closure in Lung Transplantation.
Transplant Proc
December 2024
Department of Surgery, University of Washington, Seattle, Washington.
Introduction: Lung transplantation (LTx) is a critical treatment for end-stage pulmonary diseases. Delayed sternal closure (DSC) has been noted in cardiac surgery for several decades and is a viable strategy for patients who are hemodynamically unstable, at high risk for postoperative bleeding, and/or require prolonged cardiopulmonary bypass. However, DSC use and its effects on LTx clinical outcomes are not well-defined.
View Article and Find Full Text PDFMonitoring of lung stiffness for long-COVID patients using magnetic resonance elastography (MRE).
Magn Reson Imaging
January 2025
ACRIM-Polyclinique Saint Côme, Radiology Department, Compiègne, France.
Purpose: Transaxial CT imaging is the main clinical imaging modality for the assessment of COVID-induced lung damage. However, this type of data does not quantify the functional properties of the lung. The objective is to provide non-invasive personalized cartographies of lung stiffness for long-COVID patients using MR elastography (MRE) and follow-up the evolution of this quantitative mapping over time.
View Article and Find Full Text PDFEffectiveness of Delayed First Baths on Transepidermal Water Loss in Late Preterm Infants: A Randomized Controlled Trial.
J Perinat Neonatal Nurs
October 2024
Author Affiliations: Child Health Nursing Department, Burdur Mehmet Akif Ersoy University, Bucak Health School, Burdur, Turkey (Dr Taşdemir); and Child Health Nursing Department, Nursing Faculty, Akdeniz University, Antalya, Turkey (Dr Efe).
Purpose: This study evaluates whether delaying the first bath affects late preterm infants' skin barriers, body temperatures, and comfort.
Background: Late preterm infants' skin is drier and has a limited water retention capacity compared to term infants and adults. It is important to determine timing of care for this population with limited competencies.
IL-4 promotes chondrogenesis of bone marrow mesenchymal stem cells and blockade of IL-4Rα retards the endochondral ossification during rat embryonic bone development.
Basic Clin Pharmacol Toxicol
December 2024
Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai, China.
Article Synopsis
- The study investigates the roles of interleukin-4 (IL-4) and its receptor (IL-4Rα) in bone formation processes like chondrogenic differentiation and ossification during embryonic development.
- Using an anti-IL-4Rα monoclonal antibody, researchers found that IL-4 significantly promotes the differentiation of rat bone marrow mesenchymal stem cells (BMSCs) into cartilage-forming cells (chondrocytes).
- The research revealed that blocking IL-4Rα in pregnant rats led to abnormal fetal bone development, such as incomplete ossification in the sternum and long bones, indicating that IL-4/IL-4Rα signaling is crucial for proper bone development
To Study the Efficacy of Ultrasound Guided Pecto-Intercostal Fascial Plane Block in Patients Undergoing Midline Sternotomy in Open Cardiac Surgery: A Randomized Prospective Comparative Study.
Ann Card Anaesth
October 2024
Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Background: The incidence of acute poststernotomy pain after cardiac surgery is 80%1. Pecto-intercostal fascial plane block (PIFB) adjacent to the sternum anesthetizes the anterior cutaneous branches of the intercostal nerves and may provide effective analgesia after sternotomy.
Methodology: A randomized controlled, double-blinded, prospective comparative trial was conducted at a tertiary care center on patients of midline sternotomy between 18 and 65 years and NYHA Class 2 and 3 for open cardiac surgery with the primary aim to evaluate analgesia on deep breathing after 3 hours of PIFB block bilaterally.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!