Being perfusionist during the war – cardiac surgery under missile strikes

Maruniak, Stepan; Druzhyna, O.M.; Loskutov, Oleh; Borys, Todurov; Swol, Justyna

doi:10.1177/02676591221118689

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…In addition, a signi cant number of nurses were recruited and also had to be partially replaced. Initially, we expected a decrease in the number of open-heart procedures, such as the one that occurred in Ukraine or at the beginning of the 2020 pandemic (1). Nevertheless, while in the exact same period in 2021 and 2022, respectively, 127 and 109 open-heart cases were carried out, in 2023, during the rst two months of the war, 145 open-heart cases were conducted at our center.…”

Section: Discussionmentioning

confidence: 98%

Cardiac Surgery During Wartime in Israel

Keizman,

Jamal,

Sarantsev

et al. 2024

Preprint

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Background A war in Israel started on 7 October 2023 and has affected all major tertiary centers in Israel. In the largest cardiac surgery department in Israel, there has been a surprising increase in the number of open-heart procedures, while approximately 50% of surgeons were recruited to military service. The purpose of this study is to characterize this increase in the number of procedures during wartime and to assess whether the crisis has affected the results. Methods Patients who underwent cardiac surgery in the first two months of the war were compared to the same period of the year before, namely from 7 October 2023 to 7 December 2022 and 2023. Results 120 patients (43.6%) were operated on in 2022, and 155 (56.4%) during wartime in 2023. This signifies a 33.0% increase in open-heart procedures (109 in 2022 vs. 145 in 2023, p-value 0.26). There were no differences in baseline characteristics of patients in the two years and no differences in intraoperative characteristics, including also the type of surgery. However, compared to 2022, there was a 233% increase in the number of transplantations (p-value 0.24). The results during wartime were similar to those of 2022, including postoperative complications, length of stay, and mortality. Conclusions Patients who underwent cardiac surgery during wartime presented similar results to those of last year and, despite the significant increase in workload, had comparable outcomes. There was a notable increase in the number of transplants this year, attributed to the unfortunate increase in organ donors.

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Section: Discussionmentioning

confidence: 98%

Cardiac Surgery During Wartime in Israel

Keizman,

Jamal,

Sarantsev

et al. 2024

Preprint

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“…War is an undesired state that impacts every system of a nation, in particular the healthcare system. With the ongoing war in Ukraine, few testimonies have reported that in many centers in Ukraine only urgent cardiac surgeries were performed at the beginning of the war [ 1 , 2 ]. As the war began in Israel there was massive military recruitment of healthcare professionals, including surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a number of nurses were recruited for army service. Initially, we expected a decrease in the number of open-heart procedures, such as the one that occurred in Ukraine and at the beginning of the 2020 pandemic [ 1 ]. Nevertheless, 145 open-heart cases were performed in 2023 during the first two months of the war at our center compared to 127 and 109 open-heart cases that were carried out from October 7th – December 7th in 2021 and 2022, respectively.…”

Section: Discussionmentioning

confidence: 99%

Cardiac surgery during wartime in Israel

Keizman,

Jamal,

Sarantsev

et al. 2024

J Cardiothorac Surg

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Background The war that began on October 7th, 2023, has impacted all major tertiary medical centers in Israel. In the largest cardiac surgery department in Israel there has been a surprising increase in the number of open-heart procedures, despite having approximately 50% of surgeons recruited to military service. The purpose of this study is to characterize this increase in the number of operations performed during wartime and assess whether the national crisis has affected patient outcomes. Methods The study was based on a prospectively collected registry of 275 patients who underwent cardiac surgery or extracorporeal membrane oxygenation (ECMO) during the first two months of war, October 7th 2023 – December 7th 2023, as well as patients that underwent cardiac surgery during the same period of time in 2022 (October 7th, 2022 – December 7th, 2022). Results 120 patients (43.6%) were operated on in 2022, and 155 (56.4%) during wartime in 2023. This signifies a 33.0% increase in open-heart procedures (109 in 2022 vs. 145 in 2023, p-value 0.26). There were no significant differences in the baseline characteristics of patients when comparing the 2022 patients to those in 2023. No significant differences between the two groups were found with regards to intraoperative characteristics or the type of surgery. However, compared to 2022, there was a 233% increase in the number of transplantations in the 2023 cohort (p-value 0.24). Patient outcomes during wartime were similar to those of 2022, including postoperative complications, length of stay, and mortality. Conclusions Patients who underwent cardiac surgery during wartime presented with comparable outcomes when compared to those of last year despite the increase in cardiac surgery workload. There was an increase in the number of transplants this year, attributed to the unfortunate increase in organ donors.

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Section: Discussionmentioning

confidence: 99%

“…Since the beginning of the Russian war against Ukraine, the work of the hospitals, not only those providing ECLS, is significantly affected, and the safe access and health care provision irreversibly changed as medical facilities became a target for the attacks and medical resources were required for injured soldiers and civilians. 81 Conclusions GENERATE survey provides a systematic, detailed, and standardized description of contemporary ECLS provision in EuroELSO affiliated countries. The map of spatial distribution of ECLS centers and their accessibility contributes to better understanding of the allocation of ECLS resources.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

et al. 2023

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Introduction A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within 1 hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0–14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

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Being perfusionist during the war – cardiac surgery under missile strikes

Cited by 3 publications

References 4 publications

Cardiac Surgery During Wartime in Israel

Cardiac Surgery During Wartime in Israel

Cardiac surgery during wartime in Israel

GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe (GENERATE)

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