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Critical Care

March 14, 2015
This is a very provocative British study that examined whether a more liberal (Hgb < 9 g/dL) versus a more restrictive (Hgb < 7.5 g/dL) transfusion threshold after cardiac surgery is associated with higher morbidity and costs.
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
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.
January 8, 2015
Read this amusing article that documents a series of names of genuine doctors on the  UK  GMC registar such as psychiatrists called Dr Bhatti, Dr Moodie, a Genitourinary doctor called Dr Hussey and general surgeons called Mr Gore and Mr butcher !  Got any of your own ? Post them now in the comments section     
December 3, 2014
This single institution study evaluated the effects of 24-hr in hospital congenital cardiac surgery coverage on outcomes for perioperative congenital heart surgery ECMO.  Institution of 24-hr coverage reduced hospital mortality from 68% to 43% as well as rates of cardiac arrhythmias and pneumonia.  24-hr coverage was independently associated with a r
December 1, 2014
This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS).  The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy.
November 25, 2014
In a retrospective review of 45 cases where patients were placed on VV ECMO, investigators from Seoul performed a multivariate analysis of pre-ECMO risk factors  that might be predictive of  an unsuccessful ECMO wean.  Notably, successful weaning from ECMO was only 46%, and overall survival was only 18%.

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