This is a provocative study questioning the current practice of using blood pressure targets perioperatively to ensure adequate perfusion. Plasma levels of a brain-specific injury biomarker (GFAP) were measured in 121 patients undergoing cardiac surgery.
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Hypotension After Cardiac Operations Based on Autoregulation Monitoring Leads to Brain Cellular Injury
July 6, 2015
Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients
April 8, 2015
This thought provoking article by Drew et al., utilized state-of-the art monitoring technology to document the problem of "alarm fatigue" by recording an astounding number of alarm events; 2,558,760 unique alarms were triggered for 461 patients over a 31-day period.
April 8, 2015
The authors describe a simplified method of providing regional citrate anticoagulation for Continuous Renal Replacement Therapy (CRRT) to patients.
April 4, 2015
This multicenter randomized trial examined restrictive versus liberal threshold in red-cell transfusion in patients after cardiac surgery. The results were provocative, with more deaths in the restrictiv group compared to the liberal transfusion group. Posoperative complications were also slightly higher in the restrictive group.
Treatment of severe metabolic alkalosis with continuous renal replacement therapy: bicarbonate kinetic equations of clinical value.
March 30, 2015
The authors describe a kinetic modeling tool to safely regulate the osmotic changes that can occur when treating severe metabolic alkalosis and concurent hypernatremia. The authors discuss disequilibrium syndrome and brain edema, a potential occurence when intermittant dialisis is used versus a longer, slower, and potentially more easily regulable t
March 17, 2015
The authors sought to validate the definition of the systemic inflammatory response syndrome (SIRS), which requires the presence of 2 or more clinical criteria, and determined whether meeting the definition was associated with an increased risk of death. Over 109,000 ICU patients in Australia and New Zealand who had infection and organ failure were
March 2, 2015
The frequency of blood draws after cardiac surgery is rarely tracked. This study tracked such activity for a 6-month period at the Cleveland Clinic. In over 1,800 pts, the average number of tests requiring blood was 115. Total average blood volume removed was 454 ml. The average for complex procedures was 653 ml. This system is ripe for process
Extracorporeal life support in cardiogenic shock: impact of acute versus chronic etiology on outcome
March 2, 2015
The authors retrospectively analyze outcomes for patients placed on ECMO for cardiogenic shock, and separately analyze the patients depending on whether the ECMO support was for isolated acute cardiogenic shock or for acute-upon-chronic cardiogenic shock.
January 21, 2015
In this comprehensive article the author describes the potential harmful effects of peri-operative allogeneic transfusions during cardaic surgery employing the CPB circuit. The author also describes potenital risks of low hematocrits during CPB as would be seen when employing Acute Normovolemic Hemodilution technique for blood conservation.
January 11, 2015
The CCF group conducted a study of their phlebotomy practices during a 6-month period in 2012. Phlebotomy volumes on each patient were estimated and calculated. Surprisingly, the group found that, on average, cardiac surgery patients lose ~10% of their blood volume due to postoperative phlebotomy alone.