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Intensive Care

November 12, 2017
This randomized trial evaluated restricted (threshold of Hgb <7.5  at induction of anesthesia ) versus liberal (Hgb <9.5 at induction of anesthesia or <8.5 on arrival in ICU) for patients undergoing cardiac surgery who had a EuroSCORE of 6 or more.  The composite outcome was death, MI, stroke, or new onset renal failure.  Transfusion occurre
October 18, 2017
The authors report the non-intuitive finding that blood from female donors who had ever been pregnant was associated with increased mortality among male recipients (HR 1.13).   If validated by other studies, might this substantially complicate matching donated blood with appropriate recipients?  Clearly the underlying mechanism will be interesting to
September 26, 2017
While it is being increasingly understood that frailty in the older adult patient undergoing cardiac surgery is associated with an increased rate of postoperative mortality, it is still unclear if the addition of frailty measures to existing risk-assessment tools contributes to an improved prediction of long-term disabilty.
September 26, 2017
Within the field of Enhanced Recovery after Thoracic and Cardiac Surgery (ERATS and ERACS, respectively), appropriate  fluid administration that avoids the detrimental effects of tissue edema on organ function and wound healing is a potentially important modifier of postoperative outcomes.
July 28, 2017
Patient Care The first total aortic replacement in Malaysia was performed for a patient with a thoracoabdominal aneurysm at the National Heart Institute (IJN) in Kuala Lumpur.
July 12, 2017
Preoperative Inspiratory Muscle Training (IMT) with the Powerbreathe device was assessed with regard to whether A-a gradients and inspiratory muscle power would be improved after CABG.  A group of 40 male patients were randomized to receiving (20) or not receiving (20) preop IMT.
May 23, 2017
The authors conducted a retrospective cohort study of 88 patients that received methylene blue (MB) for refractory vasoplegia following cardiopulmonary bypass.  Administration of MB was associated with an 8 mmHg increase in mean arterial pressure, with the peak response occurring at 2 hours after completion of dose.  
April 17, 2017
Cardiac surgery patients with ICU stays of more than 7 days were evaluated for the incidence of healthcare-associated infections (HAI) over a 3-year period.  15% of over 2,500 pts had ICU stays of more than 7 days, of whom more than 48% had at least 1 HAI.  Mortality in those with HAI was more than twice as high as for those without (29% vs13%).
January 31, 2017
The authors of this review article offer an approach to the utilization of a contempory mechanical circulatory support devices.  They further provide insights of the key role that well-functioning interdisciplinary teams contribute to the success of a MCS program and future directions to consider as this field continues to rapidly evolve.

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