Background: This study aimed to compare the short-term outcomes of surgical treatment for acute type A aortic dissection between patients undergoing cardiopulmonary arrest at the time of entry into the operating room and patients who received successful preoperative cardiopulmonary resuscitation before entering the operating room or patients who had cardiopulmonary arrest on the operating room table after entering the operating room without cardiopulmonary arrest. In the present study, we focused on the circulatory status at the time of entering the operating room because it is economically and emotionally difficult to cease intervention once the patient has entered the operating room, where surgeons, anesthesiologists, nurses, and perfusionists are already present, all necessary materials are packed off and cardiopulmonary bypass have already been primed.
Methods: Twenty (5.5%) of 362 patients who underwent surgical treatment for acute type A aortic dissection between January 2016 and March 2022 had preoperative cardiopulmonary arrest. To compare the early operative outcomes, the patients were divided into the spontaneous circulation group ( = 14, 70.0%) and the non-spontaneous circulation group ( = 6, 30.0%) based on the presence or absence of spontaneous circulation upon entering the operating room. The primary endpoint was postoperative 30-day mortality. The secondary endpoints included in-hospital complications and persistent neurological disorders.
Results: Thirty-day mortality was 65% ( = 13/20) in the entire cohort; 50% ( = 7/14) in the spontaneous circulation group and 100% ( = 6/6) in the non-spontaneous circulation group. The major cardiopulmonary arrest causes were aortic rupture and cardiac tamponade ( = 16; 80.0%), followed by coronary malperfusion ( = 4; 20.0%). Seven patients (50.0%) survived in the spontaneous circulation group, and none survived in the non-spontaneous circulation group (= .044). Five survivors walked unaided and were discharged home; the remaining two were comatose and paraplegic.
Conclusions: The outcomes were extremely poor in patients with acute type A aortic dissection who had preoperative cardiopulmonary arrest and received ongoing cardiopulmonary resuscitation at entry into the operating room. Therefore, surgical treatment might be contraindicated in such patients.
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http://dx.doi.org/10.3389/fsurg.2024.1404825 | DOI Listing |
Am J Transl Res
December 2024
Department of Anesthesiology, Huai'an First People's Hospital Huai'an, Jiangsu, China.
Objective: To evaluate the clinical effect of a subspecialty standardized temperature management process in a hybrid surgery for treating acute aortic dissection.
Methods: From January 2020 to June 2021, 102 patients who underwent hybrid surgery for acute aortic dissection in the Department of Cardiovascular Surgery at the Huai'an First People's Hospital were selected as the control group, receiving routine temperature maintenance measures. From August 2021 to November 2022, 105 similar patients from the same hospital were enrolled in the experimental group, where a subspecialty standardized temperature management process was implemented.
Am J Transl Res
December 2024
Ophthalmic Operating Room, Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an 710004, Shaanxi, China.
Objective: To explore the application value of Internet Family Engagement Continuum of Care in strabismus ambulatory surgery and evaluate its impact on postoperative complications, children's quality of life, and parental satisfaction.
Methods: A retrospective analysis was conducted on the clinical data of 257 children who underwent strabismus ambulatory surgery in our hospital from February 2022 to December 2023. The children were divided into a control group (n=149), which received routine nursing services and telephone follow-up, and an observation group (n=108), which received Internet Family Engagement Continuum of Care through a mobile medical platform.
ATS Sch
December 2024
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: There is significant variability in airway management training among pulmonary and critical care medicine (PCCM) fellows.
Objective: To assess the airway management training of PCCM fellows, specifically evaluating the role of the institutional approach to intubations (anesthesia-predominant primary operators vs. PCCM-predominant) to the overall fellows' educational experience.
ChemSusChem
January 2025
Brandenburgische Technische Universitat Cottbus-Senftenberg, Angewandte Physik und Halbleiterspektroskopie, Konrad-Zuse-Str. 1, 03046, Cottbus, GERMANY.
Ultrathin atomic layer deposited ceria films (< 20 nm) are capable of H2 heterolytic activation at room temperature, undergoing a significant reduction regardless of the absolute pressure, as measured under in-situ conditions by near ambient pressure X-ray photoelectron spectroscopy. ALD-ceria can gradually reduce as a function of H2 concentration under H2/O2 environments, especially for diluted mixtures below 10%. At room temperature, this reduction is limited to the surface region, where the hydroxylation of the ceria surface induces a charge transfer towards the ceria matrix, reducing Ce4+ cations to Ce3+.
View Article and Find Full Text PDFMol Cell Biochem
January 2025
Department of Nursing, Operating Room, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Anoikis, a form of programmed cell death triggered by detachment from the extracellular matrix (ECM), maintains tissue homeostasis by removing mislocalized or detached cells. Cancer cells, however, have evolved multiple mechanisms to evade anoikis under conditions of ECM detachment, enabling survival and distant metastasis. Studies have identified differentially expressed proteins between suspended and adherent cancer cells, revealing that key metabolic and signaling pathways undergo significant alterations during the acquisition of anoikis resistance.
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