Postoperative Care of the Cardiac Surgical Patient

Dimarco, Ross F.

doi:10.1007/978-0-387-77893-8_47

Cited by 9 publications

(4 citation statements)

References 221 publications

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“…Some of the pulmonary capillary vessels will be collapsed and some completely closed during CPB because of hypothermia, nonpulsatile blood flow, thromboxane A2 release, endothelin-1 secretion, complement and neutrophil activation, nuclear factorkappa B pathway, etc. (Huang et al, 1993;Komai et al, 1993;Ross and DiMarco, 2010;Yang et al, 2015;Karmouty-Quintana et al, 2018). Some of these impacts will last for a couple of days after the surgery but some may recover shortly after CPB [e.g., pulmonary vascular resistance will be increased by hypothermia and/or non-pulsatile blood flow and will quickly recover by rewarming and/or resuming pulsatile blood flow (Halsøy et al, 2016;Taylor et al, 1979].…”

Section: Literature Reviewmentioning

confidence: 99%

Pulmonary Congestion Due to Right and Left Heart Output Mismatching: A Case Report and Literature Review

Yuan

Sun

2021

Front. Physiol.

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We report a new pulmonary circulation model during cardiopulmonary bypass that is able to cause pulmonary congestion but without left heart failure. This kind of congestion is characterized by right and left heart output mismatching. The pathophysiological mechanism, clinical manifestations, diagnosis, differential diagnosis, and treatment of this pulmonary congestion are reviewed and discussed in the following article.

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Section: Literature Reviewmentioning

confidence: 99%

Pulmonary Congestion Due to Right and Left Heart Output Mismatching: A Case Report and Literature Review

Yuan

Sun

2021

Front. Physiol.

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“…In patients with heart failure 12 – 14 , chronic obstructive pulmonary disease 15 , 16 , pulmonary arterial hypertension 17 , and lung cancer 18 , the distance walked during the 6mWT is significantly associated with all-cause mortality. Early after cardiac surgery the estimated physical functional capacity of patients can be affected by perioperative factors, including prolonged bed rest, pain, anaemia, and restrictive respiratory patterns 19 . Currently it is not known whether the distance walked during the 6mWT early after cardiac surgery is associated with all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery

Shawon,

Hsu,

Chard

et al. 2024

Sci Rep

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We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P < 0.001). Those in the top tertile for predicted 6mWT performance had a 49% reduced risk of mortality (HR: 0.51, 95% CI 0.33–0.79) compared to those in the bottom tertile. Patients who met or exceeded the minimum normal 6mWT distance had 36% lower mortality risk (HR: 0.64, 95% CI 0.45–0.92) compared to those who did not meet this benchmark. Subgroup analysis showed that combined CABG and valve surgery patients walked less in the 6mWT compared to those undergoing isolated CABG or valve surgeries, with a significant association between 6mWT and mortality observed in the isolated procedure groups only. In conclusion, the longer the distance covered in the 6mWT before leaving the hospital, the lower the risk of mortality.

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“…After heart surgeries, cardiac monitoring is a frequent practice for assessing postoperative health concerns and observing heart functioning. It is essential to monitor the heart in the hours right after surgery to sustain well-being, ward off any issues, and spot any postoperative difficulties right away. − Unfortunately, current monitoring strategies depend on intricate devices or hard-set implants. , Consequently, a follow-up surgery must be conducted to take out the installed device, which could possibly bring about negative health effects. − …”

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confidence: 99%

Biodegradable, Biocompatible, and Implantable Multifunctional Sensing Platform for Cardiac Monitoring

Omar,

Saliba,

Khatib

et al. 2024

ACS Sens.

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Cardiac monitoring after heart surgeries is crucial for health maintenance and detecting postoperative complications early. However, current methods like rigid implants have limitations, as they require performing second complex surgeries for removal, increasing infection and inflammation risks, thus prompting research for improved sensing monitoring technologies. Herein, we introduce a nanosensor platform that is biodegradable, biocompatible, and integrated with multifunctions, suitable for use as implants for cardiac monitoring. The device has two electrochemical biosensors for sensing lactic acid and pH as well as a pressure sensor and a chemiresistor array for detecting volatile organic compounds. Its biocompatibility with myocytes has been tested in vitro, and its biodegradability and sensing function have been proven with ex vivo experiments using a three-dimensional (3D)-printed heart model and 3D-printed cardiac tissue patches. Moreover, an artificial intelligence-based predictive model was designed to fuse sensor data for more precise health assessment, making it a suitable candidate for clinical use. This sensing platform promises impactful applications in the realm of cardiac patient care, laying the foundation for advanced life-saving developments.

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Postoperative Care of the Cardiac Surgical Patient

Cited by 9 publications

References 221 publications

Pulmonary Congestion Due to Right and Left Heart Output Mismatching: A Case Report and Literature Review

Pulmonary Congestion Due to Right and Left Heart Output Mismatching: A Case Report and Literature Review

Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery

Biodegradable, Biocompatible, and Implantable Multifunctional Sensing Platform for Cardiac Monitoring

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