HSR proceedings in intensive care & cardiovascular anesthesia最新文献

{"title":"Arterial bypass grafting of the coronary circulation.","authors":"C J Parsa,&nbsp;M A Daneshmand,&nbsp;J G Gaca,&nbsp;J S Rankin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgical coronary bypass has evolved continually, and recent developments favor performing coronary grafts with all-arterial conduits in order to obtain better long-term graft patencies. With bilateral internal mammary artery grafts and both radial arteries, four excellent arterial conduits exist for revascularization of the majority of multivessel disease patients, including those with valve disorders. Using contemporary surgical techniques, it is possible to obtain greater than 95% overall long-term graft patencies that translate into better outcomes, including improved survival, freedom from myocardial infarction, percutaneous coronary intervention , and redo coronary bypass. Two-thirds of patients receive a right internal mammary artery to the left anterior descending , a left internal mammary artery to the circumflex coronary artery system, and a radial artery to the right coronary artery Using newer management techniques, early postoperative complications, including the incidence of sternal infections, are extremely uncommon, and all-arterial grafts currently are used in over 75% of multivessel patients including those with concomitant valve disease. Because patencies and outcomes are so much better than with standard coronary bypass or percutaneous coronary intervention, referring physicians frequently favor all-arterial bypass as the primary therapy for patients with prognostically serious multivessel obstruction. Thus, all-arterial bypass could play an increasingly important role in the future treatment of severe coronary atherosclerosis.</p>","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"227-34"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/18/hsrp-03-227.PMC3563437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECMO and the intensivist.","authors":"F E Ghio,&nbsp;G Falbo,&nbsp;D Cremonesi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/23/hsrp-03-075.PMC3484609.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A is for Abstract.","authors":"M John","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"77-8"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/83/hsrp-03-077.PMC3484600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Too-many-bullets spoil the broth (slightly modified English proverb).","authors":"M John","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"271-2"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/36/hsrp-03-271.PMC3484636.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference.","authors":"G Landoni,&nbsp;J G Augoustides,&nbsp;F Guarracino,&nbsp;F Santini,&nbsp;M Ponschab,&nbsp;D Pasero,&nbsp;R N Rodseth,&nbsp;G Biondi-Zoccai,&nbsp;G Silvay,&nbsp;L Salvi,&nbsp;E Camporesi,&nbsp;M Comis,&nbsp;M Conte,&nbsp;S Bevilacqua,&nbsp;L Cabrini,&nbsp;C Cariello,&nbsp;F Caramelli,&nbsp;V De Santis,&nbsp;P Del Sarto,&nbsp;D Dini,&nbsp;A Forti,&nbsp;N Galdieri,&nbsp;G Giordano,&nbsp;L Gottin,&nbsp;M Greco,&nbsp;E Maglioni,&nbsp;L Mantovani,&nbsp;A Manzato,&nbsp;M Meli,&nbsp;G Paternoster,&nbsp;D Pittarello,&nbsp;N K Rana,&nbsp;L Ruggeri,&nbsp;V Salandin,&nbsp;F Sangalli,&nbsp;M Zambon,&nbsp;M Zucchetti,&nbsp;E Bignami,&nbsp;O Alfieri,&nbsp;A Zangrillo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on which drugs/techniques/strategies can affect mortality in the perioperative period of cardiac surgery. With the aim of identifying these measures, and suggesting measures for prioritized future investigation we performed the first international consensus conference on this topic.</p><p><strong>Methods: </strong>The consensus was a continuous international internet-based process with a final meeting on June 28th 2010 in Milan at the Vita-Salute University. Participants included 340 cardiac anesthesiologists, cardiac surgeons and cardiologists from 65 countries all over the world. A comprehensive literature review was performed to identify topics that subsequently generated position statements for discussion, voting and ranking.</p><p><strong>Results: </strong>Of the 17 major topics with a documented mortality effect, seven were subsequently excluded after further evaluation due to concerns about clinical applicability and/or study methodology. The following topics are documented as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, the use of preoperative intra-aortic balloon counterpulsation and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence and effect on mortality and a position statement was generated.</p><p><strong>Conclusion: </strong>This international consensus conference has identified the non-surgical interventions that merit urgent study to achieve further reductions in mortality after cardiac surgery: insulin, intra-aortic balloon counterpulsation, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, and referral to high-volume centers. The use of aprotinin and aged red blood cells may result in increased mortality.</p>","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"9-19"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/ce/hsrp-03-009.PMC3484607.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31356872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The physician assistant: Shifting the Paradigm of European medical practice?","authors":"F Merkle,&nbsp;T S Ritsema,&nbsp;S Bauer,&nbsp;L Kuilman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Physician Assistants are medical care providers working under supervision and/or in collaboration with a medical doctor. The Physician Assistant profession has its origin in the United States, but in the last decade has also reached other nations to overcome medical staffing issues. With little summarized literature available, the aim of this study is to portray the Physician Assistant movement in Europe.</p><p><strong>Methods: </strong>A literature search was conducted in Academic Search Premier, CINAHL, ERIC and MEDLINE databases. In addition, European PA educational programs, professional associations, and local experts on the PA profession were queried.</p><p><strong>Results: </strong>Currently, in Europe there are three countries in which physician assistants are trained and are working. The educational models of physician assistant training in the United Kingdom, Germany and the Netherlands differ, as do the degrees offered by the training institutions.</p><p><strong>Conclusions: </strong>There is scant literature about physician assistant training and practice in Europe available in the common scientific databases. The paucity of literature makes it difficult for an outsider to observe the developments and to value the impact of a new profession on national health systems. Further high-quality research is needed to adequately characterize physician assistant education and implementation across Europe.</p>","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"255-62"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/63/hsrp-03-255.PMC3484637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of cardiac surgery allied health professionals in Asia.","authors":"Z Liu,&nbsp;W Ye","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>More and more allied health professions are getting involved in clinical health care. One estimate reported allied health personnel makes up 60 percent of the total health workforce. In Asia, in the field of cardiothoracic surgery, allied health personnel includes perfusionists, physician assistants, physiotherapist, intensivists, rehabilitation therapists, nutritionists and social workers. They work in collaboration with surgeons to provide a range of diagnostic, technical, therapeutic, cardiac care and support services to the patients and their families.Some allied health professions are more specialized. They must adhere to national training and education standards and their professional scope of practice. For example, the training of perfusionists consists of at least five years of academic in medical schools and another three-year-long clinical training in the hospital. The cardiac intensivists usually are medical doctors with a background in cardiology. They spend 3-4 years rotating in Internal Medicine, Anesthesiology, Emergency Rooms and Intensive Care Units. There have specialized medical societies to grant certified credentials and to provide continuing education. Other allied health professions require no special training or credentials and are trained for their work by the hospitals through on-the-job training. Many young health care providers are getting involved in the allied health personnel projects. They consider this as a career ladder because of the opportunities for advancement within specific fields.</p>","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"245-7"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/dd/hsrp-03-245.PMC3563439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31265083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-type natriuretic peptide as a predictor of outcome in a general intensive care unit.","authors":"P Grassi,&nbsp;C Calderan,&nbsp;M C Vassallo,&nbsp;D Cageggi,&nbsp;E Stenner,&nbsp;B Biasioli,&nbsp;G Berlot","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>B-type natriuretic peptide is a hormone secreted by the heart in response to ventricular wall stress. Increased B-type natriuretic peptide plasma levels are also found as a consequence of noncardiac conditions including sepsis, surgery-induced systemic inflammatory response syndrome and kidney failure. Since these conditions are common in general intensive care unit patients, we hypothesized that B-type natriuretic peptide could be a helpful marker in predicting outcome in this setting.</p><p><strong>Methods: </strong>We measured plasma B-type natriuretic peptide concentrations in 228 patients at admission to our general intensive care unit. The primary aim of the study was to investigate the relationship between B-type natriuretic peptide and hospital mortality. The secondary aim of the study was to investigate the association between B-type natriuretic peptide and severity of disease, quantified by the Simplified Acute Physiology Score II.</p><p><strong>Results: </strong>Logistic regression revealed a positive association between B-type natriuretic peptide level and in-hospital death (OR= 1.59; 95% CI 1.30 to 1.95; p<0.0001) and a Cox proportional hazards regression model showed that B-type natriuretic peptide was significantly associated with the risk of death (HR=1.27; 95% CI 1.11 to 1.46; p=0.0005). B-type natriuretic peptide was higher in patients who died in the hospital than in those who survived (371.20 pg/ml vs. 127.10 pg/ml; p<0.0001). There was a positive correlation between B-type natriuretic peptide and Simplified Acute Physiology Score II (r=0.50; 95% CI 0.40 to 0.59; p<0.0001).</p><p><strong>Discussion: </strong>B-type natriuretic peptide on admission is an independent prognostic marker of outcome in an unselected cohort of critically ill patients.</p>","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/42/hsrp-03-059.PMC3484602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A loop in the neck.","authors":"V Casati,&nbsp;A Romano,&nbsp;E Stelian,&nbsp;M Scandone,&nbsp;A Jabbour,&nbsp;T Khouri","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"269-70"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/0b/hsrp-03-269.PMC3563442.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalies and Variant Anatomy of the Aorta and the Supra- aortic Vessels","authors":"C. Setacci, P. Sirignano, G. Donato, F. Setacci","doi":"10.1007/978-88-470-1857-0_47","DOIUrl":"https://doi.org/10.1007/978-88-470-1857-0_47","url":null,"abstract":"","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"1 1","pages":"585-593"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51445648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}