Postoperative acute respiratory failure in cardiac surgery

Еременко, А А; Zyulyaeva, T.P.

doi:10.17116/hirurgia20190815

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…Extracorporeal membrane oxygenation (ECMO) in adults who have undergone these procedures has been shown to be associated with better outcomes than conventional treatment. [1][2][3][4][5][6] However, these patients are likely to receive prolonged mechanical ventilation. Prolonged ventilatory support can leave patients without the ability to protect their airway.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous dilatation tracheotomy in patients on extracorporeal membrane oxygenation after cardiac surgery

Xin

Wang

et al. 2022

Perfusion

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Background Current practices regarding percutaneous dilatational tracheostomy in adult patients treated with extracorporeal membrane oxygenation (ECMO) after cardiac surgery is not completely defined. This study aimed to evaluate the safety of the percutaneous dilatational tracheostomy in patients with ECMO after cardiac surgery. Methods Between July 2017 and May 2021, 371 ECMO procedures were performed in more than 35,000 adult patients who underwent cardiac surgery in our hospital. Sixty-two patients underwent percutaneous dilatational tracheostomy (PDT) during or after ECMO. A retrospective analysis was performed comparing the incidence of complications and clinical outcomes of the two groups. Results Of the 371 patients treated with ECMO after adult cardiac surgery during the enrollment period, 22 (7.1%) and 40 (12.8%) underwent PDT during or after ECMO, respectively. The platelet count (PLT) of the day was significantly lower in the PDT during ECMO group (54 (34, 68) vs. 108 (69, 162) (thousands), p < 0.001)). The prothrombin time (PT) and activated partial thromboplastin time (APTT) of the day were longer in the PDT during ECMO group (15.8 (14.6, 19.9) vs. 13.8 (13.2, 15.2) seconds, p = 0.001, 43.8 (38.0, 49.4) vs. 35.2 (28.2, 40.9) seconds, p < 0.001, respectively). There was no significant difference in tracheotomy-related complications between the two groups. Significantly decreased ventilator time was observed in the PDT during ECMO group. Conclusions Despite poor coagulation of the day, PDT during ECMO is safe and can appropriately reduce the duration of mechanical ventilation compared with PDT after ECMO weaning in adult patients who have undergone cardiac surgery.

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Section: Introductionmentioning

confidence: 99%

Percutaneous dilatation tracheotomy in patients on extracorporeal membrane oxygenation after cardiac surgery

Xin

Wang

et al. 2022

Perfusion

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“…With the development of CPB technologies and surgical techniques, its safety has been greatly improved, and the incidence of mortality and complications has been gradually reduced. However, acute lung injury (ALI) after CPB is still an important complication, which is closely related to the success rate of cardiac surgery and postoperative mortality [ 1 ]. The clinical treatment of acute lung injury after CPB mainly includes controlled fluid therapy, protective ventilation strategies, and extracorporeal membrane oxygenation (ECMO).…”

Section: Introductionmentioning

confidence: 99%

XueFu ZhuYu Decoction Alleviates Cardiopulmonary Bypass-Induced NLRP3 Inflammasome-Dependent Pyroptosis by Inhibiting IkB-α/NF-κB Pathway in Acute Lung Injury Rats

Zhang

Lou

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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XueFu ZhuYu Decoction (XFZYD) is an effective prescription that is widely used to improve blood circulation by removing blood stasis. This study aimed to investigate the effects and the underlying molecular mechanisms of XFZYD on lung pyroptosis in cardiopulmonary bypass- (CPB-) induced acute lung injury (ALI) rats. A rat model of ALI was induced by CPB treatment after XFZYD, Ac-YVAD-CMK, and Bay-11-7082 administration. The respiratory index (RI) and oxygenation index (OI) were determined at each time point. The levels of interleukin (IL)-1β, IL-6, IL-18, and TNF-α in serum and lung were measured by enzyme-linked immunosorbent assays (ELISA). Moreover, the protein levels, neutrophil counts, and total cell of bronchoalveolar lavage fluid (BALF) were detected. Additionally, Myeloperoxidase (MPO) expression was detected by immunohistochemical assay. Lung injury was evaluated with the wet/dry (W/D) ratio and pathologic changes, respectively. Besides, the expression of NLRP3 inflammasome and IkB-α/NF-κB pathway proteins was estimated by immunofluorescence, quantitative real-time PCR (qRT-PCR), and Western blotting assays, respectively. XFZYD pretreatment significantly ameliorated pulmonary ventilation function and reduced the CPB-induced lung histopathological injury, inflammatory cell infiltration in BALF and lung, and the apoptosis of lung cells. Interestingly, XFZYD decreased the CPB-induced NLRP3, ASC, Caspase-1 p20, Pro-GSDMD, GSDMD p30, IL-18, IL-1β p-P65, and p-IKBα mRNA or protein levels in lung tissues in ALI model rats. In summary, these findings suggest that XFZYD effectively mitigates NLRP3 inflammasome-dependent pyroptosis in CPB-induced ALI model rats, possibly by inhibiting the IkB-α/NF-κB pathway in the lung.

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“…Complications during the postoperative period are commonly described among patients undergoing cardiac surgery, for example, complications such as delirium (18.4%; Li et al, 2015), atrial fibrillation (AF; 5% to 40%) (Montrief, Koyfman, & Long, 2018), pulmonary complications (32%), renal failure (10%), neurological complications (7%), acute respiratory failure (3.5%; Eremenko & Zyulyaeva, 2019), and multiorgan failure (2%; Ariyaratnam et al, 2019).…”

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confidence: 99%

Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery

Carmo

Santana

Lopes

et al. 2021

J of Nursing Scholarship

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Purpose The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery. Design A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018. Methods At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan‐Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time‐dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status. Results A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery. Conclusions Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery. Clinical Relevance Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient.

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Postoperative acute respiratory failure in cardiac surgery

Cited by 6 publications

References 20 publications

Percutaneous dilatation tracheotomy in patients on extracorporeal membrane oxygenation after cardiac surgery

Percutaneous dilatation tracheotomy in patients on extracorporeal membrane oxygenation after cardiac surgery

XueFu ZhuYu Decoction Alleviates Cardiopulmonary Bypass-Induced NLRP3 Inflammasome-Dependent Pyroptosis by Inhibiting IkB-α/NF-κB Pathway in Acute Lung Injury Rats

Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery

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