Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the availability of cardiology services and management of cardiac conditions. Elective surgeries, outpatient appointments and cardiac imaging have been largely cancelled across the world due to the risk of infection transmission and the need for reallocation of resources to deal with the increasing number of COVID-19 patients. The impact on patients with cardiac co-morbidities during these times may be drastic. However, cardiologists and hospitals across the world have implemented measures to ensure on-going monitoring and care of patients remotely. In this review, we discuss the impact of COVID-19 on cardiac services including interventional cardiology services, cardiac imaging and outpatient appointments. In addition, implications for future research and clinical practice are also discussed.

A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaemia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened.

Gastrointestinal complications after cardiac surgery may be uncommon but they carry high mortality rates. Incidences range from 0.5% to 5.5%, while mortality rates of such complications vary from 0.3% to 87%. They range from small gastrointestinal bleeds, ileus, and pancreatitis to life-threatening complications such as liver failure and ischemic bowel. Due to the vague and often absence of specific signs and symptoms, diagnosis of a gastrointestinal complication is often late. This article aims to review and summarize the literature concerning gastrointestinal complications after cardiac surgery. We discuss the causes, risk factors, diagnosis, preventative measures, and management of these complications. In general, risk factor identification, preventive measures, early diagnosis, and swift management are the keys to reducing the occurrence of gastrointestinal complications and their associated morbidity and mortality.

No abstract

Objectives The use of extracorporeal membrane oxygenation (ECMO) in cardiac surgery has been established in cases of postcardiotomy cardiogenic shock, which is refractory to conventional therapy with inotropes and intra‐aortic balloon pulsation support. We sought to examine the literature in a systematic review manner on the outcomes of using ECMO postcardiac surgery. Methods A comprehensive electronic literature search was done to identify all the articles that have discussed the use of ECMO postcardiac surgery. The keywords and medical subject headings terms were used to identify the relevant articles. Studies have been screened according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results The identified studies have been summarized in each relevant section of this study. Cardiogenic shock postcardiac surgery can benefit from ECMO to varying degrees and the survival for this; otherwise, fatal condition has been shown to be improving through the use of ECMO. However, the decision and timing to initiate ECMO therapy remains selective and is dependent on a range of factors such as patient factor, clinician's judgment, meaning there is no consistent and solid ground regarding the timing of ECMO initiation. Conclusion Current evidence suggests that the circulatory support provided by ECMO improves survival rates for postcardiac surgery cardiogenic shock patients who are refractory to inotropic management, without such ECMO support patient mortality rates would be much greater.

Extra Corporeal Membrane Oxygenation (ECMO) is a supportive therapy used to provide cardiac support with or without respiratory support in the event of cardiopulmonary failure. The two main types of ECMO are Veno-arterial ECMO (VA-ECMO) and Veno-venous ECMO (VV-ECMO). The use of ECMO in cardiac surgery has been established in cases of post-cardiotomy cardiogenic shock which is refractory to conventional therapy with inotropes and intra-aortic balloon pulsation support. Survival for this, otherwise, fatal condition has been shown to be improving through the use of ECMO. However, the decision and timing to initiate ECMO therapy remains selective and is dependent on a range of factors such as patient factor, clinician's judgement, meaning there is no consistent and solid ground regarding the timing of ECMO initiation. This article will provide an extensive review of ECMO indications, contraindications, complications and outcomes to analyse the survival benefit of ECMO following cardiac surgery.