Gastrointestinal Complications After Cardiac Surgery: A Nationwide Population-Based Analysis of Morbidity and Mortality Predictors

Chaudhry, Rabail; Zaki, John; Wegner, Robert; Pednekar, Greesha; Tse, Alex; Sheinbaum, Roy; Williams, George W.

doi:10.1053/j.jvca.2017.04.013

Cited by 52 publications

(68 citation statements)

References 18 publications

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“…As intestinal ischemia is a rare, but highly lethal complication after cardiac surgery, occurring in 0.5% and being fatal in up to a quarter of patients [ 85 , 86 , 87 , 88 , 89 ], the use of PN is often favored in cardiac surgery patients, especially within the first days after operation. However, there is no sufficient evidence available to evaluate the role of postoperative PN and its influence on clinically relevant outcome data, including survival, disease progression and morbidity in cardiac surgery patients.…”

Section: Perioperative Nutrition Support In Cardiac Surgery Patienmentioning

confidence: 99%

Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know?

et al. 2018

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Nutrition support is increasingly recognized as a clinically relevant aspect of the intensive care treatment of cardiac surgery patients. However, evidence from adequate large-scale studies evaluating its clinical significance for patients’ mid- to long-term outcome remains sparse. Considering nutrition support as a key component in the perioperative treatment of these critically ill patients led us to review and discuss our understanding of the metabolic response to the inflammatory burst induced by cardiac surgery. In addition, we discuss how to identify patients who may benefit from nutrition therapy, when to start nutritional interventions, present evidence about the use of enteral and parenteral nutrition and the potential role of pharmaconutrition in cardiac surgery patients. Although the clinical setting of cardiac surgery provides advantages due to its scheduled insult and predictable inflammatory response, researchers and clinicians face lack of evidence and several limitations in the clinical routine, which are critically considered and discussed in this paper.

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Section: Perioperative Nutrition Support In Cardiac Surgery Patienmentioning

confidence: 99%

Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know?

et al. 2018

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“…While cardiac surgery is often used to treat complications of ischemic heart disease, correct congenital heart disease, or treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis, these procedures have several disadvantages [ 2 – 4 ]. Cardiac surgery is suggested to be associated with high risks of cardiovascular complications and other adverse events when performing operations, which are often resulted in increased hospital stay and even mortality [ 5 – 10 ]. Although great improvements in equipment, techniques and medical care have been achieved, and decreased the incidences of major complication rates and mortality [ 11 – 16 ], effective and safe perioperative medication is required to further reduce these negative events [ 8 , 11 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

Wang

Niu

et al. 2018

PLoS ONE

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This study aimed to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients who have undergone cardiac surgery. Electronic databases including PubMed, Embase, and Cochrane Library were systematically searched without limitations of language and publication time. Randomized controlled trials (RCTs) aiming to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients that have undergone cardiac surgery were selected. Endpoints such as hemodynamic indexes and adverse events in eligible studies were extracted by two researchers, independently. The data was analyzed using RevMan 5.3 and Stata 11.0 software. A total of 18 RCTs met the inclusion criteria, involving 1730 patients. Compared to control (any treatment without dexmedetomidine), dexmedetomidine showed a pooled mean difference (MD) of -14.46 [95% confidence interval(CI): -24.69, -4.23; p<0.01] for systolic arterial pressure, a standardized mean difference (SMD) of -1.74 for mean arterial blood pressure (95% CI: -2.80, -0.68; P < 0.01), -2.12 (95%CI: -3.23, -1.00; p<0.01) for heart rate, and combined odds ratio (OR) of 0.22 (95%CI: 0.11, 0.44; p<0.01) for tachycardia, 3.44 (95%CI: 1.95, 5.96; p<0.01) for bradycardia, 0.74 (95%CI: 0.49, 1.12; p>0.05) for atrial fibrillation, and 0.99 (95%CI: 0.51, 1.90; p>0.05) for hypotension. In addition, dexmedetomidine could reduce time of surgery and stay in intensive care units, improve delirium with good safety. Our study shows clinical application of dexmedetomidine in cardiac surgery patients can reduce risks of abnormal hemodynamics with good safety.

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“…The most common GI complications are postoperative ileus and GI hemorrhage, while mesenteric ischemia and intestinal perforation are GI complications with the highest mortality. GI complications increase LOS and mortality [ 3 , 10 , 123 , 124 , 125 ].…”

Section: Influence Of Vitamin C On Organ Systems In Cardiac Surgermentioning

confidence: 99%

Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients—Review and Pragmatic Approach

et al. 2018

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The pleiotropic biochemical and antioxidant functions of vitamin C have sparked recent interest in its application in intensive care. Vitamin C protects important organ systems (cardiovascular, neurologic and renal systems) during inflammation and oxidative stress. It also influences coagulation and inflammation; its application might prevent organ damage. The current evidence of vitamin C’s effect on pathophysiological reactions during various acute stress events (such as sepsis, shock, trauma, burn and ischemia-reperfusion injury) questions whether the application of vitamin C might be especially beneficial for cardiac surgery patients who are routinely exposed to ischemia/reperfusion and subsequent inflammation, systematically affecting different organ systems. This review covers current knowledge about the role of vitamin C in cardiac surgery patients with focus on its influence on organ dysfunctions. The relationships between vitamin C and clinical health outcomes are reviewed with special emphasis on its application in cardiac surgery. Additionally, this review pragmatically discusses evidence on the administration of vitamin C in every day clinical practice, tackling the issues of safety, monitoring, dosage, and appropriate application strategy.

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Gastrointestinal Complications After Cardiac Surgery: A Nationwide Population-Based Analysis of Morbidity and Mortality Predictors

Cited by 52 publications

References 18 publications

Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know?

Current Evidence about Nutrition Support in Cardiac Surgery Patients—What Do We Know?

The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients—Review and Pragmatic Approach

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