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Yan Y, Zhao C, Niu J, Yan P, Li J, Wang D, Li G. Rationale and Design of the IMPROVE Trial: A Multicenter, Randomized, Controlled, Open-label, Blinded-endpoint Trial Assessing the Efficacy of Remote Ischemic Conditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting. Adv Ther 2024; 41:3003-3012. [PMID: 38616242 DOI: 10.1007/s12325-024-02836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/07/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Despite the appearance of off-pump coronary artery bypass grafting (CABG), ischemia-reperfusion injury (IRI) in the perioperative period still arouses concerns of clinicians. Remote ischemic conditioning (RIC) is the process of repeated ischemia and reperfusion in the peripheral vessels, which is proven to reduce IRI in vital organs. However, the effect of RIC in patients undergoing off-pump CABG is still unclear. METHODS This IMPROVE trial is a national, multicenter, randomized, controlled, open-label, blinded-endpoint clinical trial designed to assess whether RIC intervention can improve short-term prognosis of patients undergoing off-pump CABG. It plans to enroll 648 patients who will be randomly assigned into a RIC group or control group. Patients in the RIC group will receive four cycles of 5 min of pressurization (about 200 mmHg) and 5 min of rest in the 3 days before and 7 days after the surgery. PLANNED OUTCOMES The primary outcome is the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) within the 3-month follow-up. MACCE is defined as all-cause death, myocardial infarction, stroke, and coronary revascularization surgery. CLINICAL TRIAL REGISTRATION NCT06141525 (ClinicalTrials.gov).
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Affiliation(s)
- Yang Yan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Changying Zhao
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jialan Niu
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Pengyun Yan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jing Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Cardiovascular Surgery, People's Hospital of Qinghai Province, Xining, China
| | - Duolao Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
- Department of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guoliang Li
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Yuan H, Wang F, He S, Xiang Z, Zhang X, Jiang L. SUVmean ratios of liver/muscle and lung/muscle from 13N-NH 3 PET perfusion outperformed traditional myocardial viability parameters in predicting survival after CABG. Jpn J Radiol 2024:10.1007/s11604-024-01611-6. [PMID: 38856879 DOI: 10.1007/s11604-024-01611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Myocardial viability evaluation in predicting survival after coronary artery bypass graft (CABG) remains debatable. Thus, this study aimed to investigate the role of 13N-NH3/18F-FDG PET myocardial viability scan in predicting treatment outcomes and survival. METHODS 90 patients with CABG and pre-surgical PET-based myocardial viability scan were retrospectively reviewed. Perfusion-metabolism features, myocardium motion parameters, and patient characteristics were recorded. Additionally, the SUVmean of blood pool, lung, liver, spleen, and muscle were measured and the SUVmean ratios were calculated. Factors associated with treatment outcomes and survival were analyzed by Logistic and Cox regressions. Nomogram models were subsequently established to predict ejection fraction (EF) improvement and survival outcomes. RESULTS The mean EF of these 90 patients was 38.1 ± 9.5% and 46.0 ± 9.2% before and after CABG surgery, and 35 patients (38.9%) achieved EF improvement ≥ 10%. EF measurements by PET and echocardiogram showed a reasonable linear correlation (R = 0.752). Sex, pre-surgical EF, mismatch of the left ventricle, total perfusion deficit (TPD), and peak ejection rate (PER) were independent predictive factors of EF improvements. Surgery waiting time, valve damage, and SUVmean ratio of Liver/Muscle were independently predictive of event-free survival (EFS), while valve damage, together with SUVmean ratio of either Liver/Muscle or Lung/Muscle, were independently predictive of overall survival (OS). CONCLUSION Although traditional cardiac parameters from PET-based myocardial viability can effectively predict EF improvements after CABG, SUVmean ratios of liver/muscle and lung/muscle from 13N-NH3 PET perfusion outperformed these parameters in predicting survival.
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Affiliation(s)
- Hui Yuan
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Fanghu Wang
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Shanzhen He
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Zeyin Xiang
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Xiaochun Zhang
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China.
| | - Lei Jiang
- PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China.
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China.
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Koçan S, Kulakaç N, Aktuğ C, Demirel S. The Effect of Video-Based Simulation Training on Nursing Students' Motivation and Academic Achievement: A Mixed Study. Comput Inform Nurs 2024; 42:440-447. [PMID: 38453452 DOI: 10.1097/cin.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This study was conducted to determine the effect of video-based simulation education on nursing students' motivation and academic achievement. The research was designed in a mixed model. A quasi-experimental method with a pretest-posttest control group was used for the quantitative part, and the descriptive phenomenology approach was used as the qualitative research method. The sample of the study consisted of second-year nursing students in two state universities in eastern Turkey. The data were collected with the Student Information Form, the Academic Achievement Test, and the Motivation Resources and Problems Scale using Google Forms Web application. Qualitative data were collected through online semistructured interview forms and focus group interviews. According to the results, the posttest academic achievement and Motivation Resources and Problems Scale mean scores of the students in the intervention group were significantly higher than those of the control group ( P < .05). In the analysis of the qualitative, three main themes emerged: We felt fortunate that it increased information retention," "We felt like we were in real practice environment," and "It made us feel that we were nurses." The results showed the use of video-based simulation can be suggested as a strategy to promote classroom teaching and engage students.
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Affiliation(s)
- Sema Koçan
- Author Affiliations: Faculty of Health Sciences, Recep Tayyip Erdogan University, Rize (Ms Koçan); Faculty of Health Sciences Gumushane University, Gumushane (Ms Kulakaç and Ms Aktuğ); and Clinical Simulation Training Center, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize (Ms Demirel), Turkey
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Lannon CM, Nuchovich N, Louis C, Henson J, Connett J, Nina RH, Marath A. Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions. World J Pediatr Congenit Heart Surg 2024; 15:325-331. [PMID: 38629174 PMCID: PMC11100267 DOI: 10.1177/21501351241239316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/06/2024] [Indexed: 05/18/2024]
Abstract
Background: Humanitarian medical missions attempt to lessen the burden of limited access to cardiac surgery in low- and middle-income countries. While organizations express difficulties obtaining follow-up information, there is currently little evidence to support the various assumptions for lack of data. This study examines the factors influencing long-term patient follow-ups on repeated short-term cardiac surgery missions across nine countries. Methods: A retrospective analysis of CardioStart International's database (RedCap) was conducted to investigate demographic, socioeconomic, and surgical factors associated with follow-ups. Results: A total of 550 pediatric (50%) and adult (50%) cardiac surgery patients displayed a follow-up rate of 14.7%, with no significant difference between populations (P = 1). Mean follow-up time was 1.5 years postoperative. Countries were highly variable, with Dominican Republic and Vietnam showing follow-up rates of 30.4% and 43.2%, respectively, while Brazil, Nepal, and Tanzania had no follow-ups (P < 0.0001). The 11 surrogate factors for socioeconomic status, including home amenities and technology access, were predominantly insignificant, with the exception of phone access showing an unexpectedly decreased follow-up rate (11.6%, P = 0.006). Surgical intervention was a significant factor (P = 0.009). No adult cardiac surgery trends were noted; however, congenital cases demonstrated increased follow-ups in patients with higher Risk Adjusted Congenital Heart Surgery scores, with ventricular septal defects (32.5%) exceeding atrial septal defects (7.3%). Conclusions: Follow-ups correlate with mission factors, including location and types of intervention, more so than previously assumed socioeconomic and technological factors. Thus, certain missions may require more allocation of resources and adapted organizational policies to overcome site-specific barriers to follow-up.
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Affiliation(s)
- Christine M. Lannon
- Texas A&M School of Engineering Medicine, Houston, TX, USA
- CardioStart International Inc., St. Petersburg, FL, USA
| | | | - Clauden Louis
- CardioStart International Inc., St. Petersburg, FL, USA
- Brigham and Women's Hospital Harvard University, Boston, MA, USA
| | - Janine Henson
- CardioStart International Inc., St. Petersburg, FL, USA
| | - John Connett
- CardioStart International Inc., St. Petersburg, FL, USA
| | - Rachel Haickel Nina
- CardioStart International Inc., St. Petersburg, FL, USA
- Federal University of Maranhao, Sao Luis, Brazil
| | - Aubyn Marath
- CardioStart International Inc., St. Petersburg, FL, USA
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Karahan E, Demirtaş H, Çelik S, Dolu İ. Relationships between sleep, quality of life and anxiety in patients undergoing cardiac surgeries. Rev Lat Am Enfermagem 2024; 32:e4122. [PMID: 38655934 DOI: 10.1590/1518-8345.6964.4122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE the objective of this study is to examine the relationships between sleep, quality of life and anxiety in patients undergoing cardiac surgeries during the preoperative period, at discharge, two weeks after discharge and three months after discharge. METHOD this study had a prospective, descriptive and correlational design and was conducted in a single center. The sample consisted of 68 patients who had undergone cardiac surgeries. The data were collected using an Information Form, the State-Trait Anxiety Inventory, the Richard-Campbell Sleep Questionnaire and the Nottingham Health Profile. RESULTS the patients' sleep quality increased from moderate to good at each measurement moment after the surgeries, when compared to sleep quality measured at their first hospitalization. While the state anxiety scores decreased at discharge and 2 weeks after the initial hospitalization, they increased to a moderate level 3 months after discharge. There was no significant relationship between anxiety levels and sleep quality at any measurement moment. Additionally, the patients' quality of life was significantly improved 2 weeks and 3 months after discharge. CONCLUSION The results of this study showed that the sleep quality of patients who had undergone cardiac surgeries was improved during the postoperative period, and that this improvement exerted a positive effect on their quality of life.
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Affiliation(s)
- Elif Karahan
- Bartın University, Faculty of Health, Department of Nursing, Bartın, Türkiye
| | - Hüseyin Demirtaş
- Gazi University, Faculty of Medicine, Department of Cardiovascular Surgery, Ankara, Türkiye
| | - Sevim Çelik
- Bartın University, Faculty of Health, Department of Nursing, Bartın, Türkiye
| | - İknur Dolu
- Bartın University, Faculty of Health, Department of Nursing, Bartın, Türkiye
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Mary A, Mzayek F, Lefler LL, Jiang YJ, Meadows Taylor M. Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery. Prof Case Manag 2024:01269241-990000000-00015. [PMID: 38421737 DOI: 10.1097/ncm.0000000000000718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE OF STUDY Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery. PRIMARY PRACTICE SETTINGS The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital. METHODOLOGY AND SAMPLE A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery. RESULTS The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001). IMPLICATIONS FOR CASE MANAGEMENT PRACTICE Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.
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Affiliation(s)
- Annapoorna Mary
- Annapoorna Mary, PhD, MSc(N), RN, CNE, practices in Critical Care & Emergency Room & MRT. Her research interests are critical care, medical surgical nursing, cardiac nursing, and nursing education (critical thinking and clinical reasoning & EBP)
- Fawaz Mzayek, PhD, MD, MPH, is an Associate Professor of Epidemiology. He has extensive experience in the epidemiology of cardiovascular disease. He has been working with large datasets from longitudinal studies such as the Bogalusa Heart Study, a longitudinal, community-based study of the natural evolution of cardiovascular disease
- Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA, FAAN, is an Associate Dean for Research/William A. and Ruth F. Loewenberg Chair of Excellence in Nursing. Dr. Lefler has developed innovative models of care and education and conducted a program of research that informs treatment of older adults with cardiovascular disease
- Yu (Joyce) Jiang, PhD, is an Assistant Professor in the Division of Epidemiology, Biostatistics, and Environmental Health. Her general research interests include Bayesian data analysis, clinical trial studies, cancer epidemiology, and genomics. As a biostatistician, she has broad interests in biological science, medicine, public health, and all other related fields
- Meghan-Meadows Taylor, PhD, MPH, is an accomplished researcher with a diverse background in academia and health care. Her research primarily focuses on multidisciplinary management of chronic diseases in community-based health care systems, with the ultimate goal of optimizing diagnosis and treatment approaches
| | - Fawaz Mzayek
- Annapoorna Mary, PhD, MSc(N), RN, CNE, practices in Critical Care & Emergency Room & MRT. Her research interests are critical care, medical surgical nursing, cardiac nursing, and nursing education (critical thinking and clinical reasoning & EBP)
- Fawaz Mzayek, PhD, MD, MPH, is an Associate Professor of Epidemiology. He has extensive experience in the epidemiology of cardiovascular disease. He has been working with large datasets from longitudinal studies such as the Bogalusa Heart Study, a longitudinal, community-based study of the natural evolution of cardiovascular disease
- Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA, FAAN, is an Associate Dean for Research/William A. and Ruth F. Loewenberg Chair of Excellence in Nursing. Dr. Lefler has developed innovative models of care and education and conducted a program of research that informs treatment of older adults with cardiovascular disease
- Yu (Joyce) Jiang, PhD, is an Assistant Professor in the Division of Epidemiology, Biostatistics, and Environmental Health. Her general research interests include Bayesian data analysis, clinical trial studies, cancer epidemiology, and genomics. As a biostatistician, she has broad interests in biological science, medicine, public health, and all other related fields
- Meghan-Meadows Taylor, PhD, MPH, is an accomplished researcher with a diverse background in academia and health care. Her research primarily focuses on multidisciplinary management of chronic diseases in community-based health care systems, with the ultimate goal of optimizing diagnosis and treatment approaches
| | - Leanne L Lefler
- Annapoorna Mary, PhD, MSc(N), RN, CNE, practices in Critical Care & Emergency Room & MRT. Her research interests are critical care, medical surgical nursing, cardiac nursing, and nursing education (critical thinking and clinical reasoning & EBP)
- Fawaz Mzayek, PhD, MD, MPH, is an Associate Professor of Epidemiology. He has extensive experience in the epidemiology of cardiovascular disease. He has been working with large datasets from longitudinal studies such as the Bogalusa Heart Study, a longitudinal, community-based study of the natural evolution of cardiovascular disease
- Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA, FAAN, is an Associate Dean for Research/William A. and Ruth F. Loewenberg Chair of Excellence in Nursing. Dr. Lefler has developed innovative models of care and education and conducted a program of research that informs treatment of older adults with cardiovascular disease
- Yu (Joyce) Jiang, PhD, is an Assistant Professor in the Division of Epidemiology, Biostatistics, and Environmental Health. Her general research interests include Bayesian data analysis, clinical trial studies, cancer epidemiology, and genomics. As a biostatistician, she has broad interests in biological science, medicine, public health, and all other related fields
- Meghan-Meadows Taylor, PhD, MPH, is an accomplished researcher with a diverse background in academia and health care. Her research primarily focuses on multidisciplinary management of chronic diseases in community-based health care systems, with the ultimate goal of optimizing diagnosis and treatment approaches
| | - Yu Joyce Jiang
- Annapoorna Mary, PhD, MSc(N), RN, CNE, practices in Critical Care & Emergency Room & MRT. Her research interests are critical care, medical surgical nursing, cardiac nursing, and nursing education (critical thinking and clinical reasoning & EBP)
- Fawaz Mzayek, PhD, MD, MPH, is an Associate Professor of Epidemiology. He has extensive experience in the epidemiology of cardiovascular disease. He has been working with large datasets from longitudinal studies such as the Bogalusa Heart Study, a longitudinal, community-based study of the natural evolution of cardiovascular disease
- Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA, FAAN, is an Associate Dean for Research/William A. and Ruth F. Loewenberg Chair of Excellence in Nursing. Dr. Lefler has developed innovative models of care and education and conducted a program of research that informs treatment of older adults with cardiovascular disease
- Yu (Joyce) Jiang, PhD, is an Assistant Professor in the Division of Epidemiology, Biostatistics, and Environmental Health. Her general research interests include Bayesian data analysis, clinical trial studies, cancer epidemiology, and genomics. As a biostatistician, she has broad interests in biological science, medicine, public health, and all other related fields
- Meghan-Meadows Taylor, PhD, MPH, is an accomplished researcher with a diverse background in academia and health care. Her research primarily focuses on multidisciplinary management of chronic diseases in community-based health care systems, with the ultimate goal of optimizing diagnosis and treatment approaches
| | - Meghan Meadows Taylor
- Annapoorna Mary, PhD, MSc(N), RN, CNE, practices in Critical Care & Emergency Room & MRT. Her research interests are critical care, medical surgical nursing, cardiac nursing, and nursing education (critical thinking and clinical reasoning & EBP)
- Fawaz Mzayek, PhD, MD, MPH, is an Associate Professor of Epidemiology. He has extensive experience in the epidemiology of cardiovascular disease. He has been working with large datasets from longitudinal studies such as the Bogalusa Heart Study, a longitudinal, community-based study of the natural evolution of cardiovascular disease
- Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA, FAAN, is an Associate Dean for Research/William A. and Ruth F. Loewenberg Chair of Excellence in Nursing. Dr. Lefler has developed innovative models of care and education and conducted a program of research that informs treatment of older adults with cardiovascular disease
- Yu (Joyce) Jiang, PhD, is an Assistant Professor in the Division of Epidemiology, Biostatistics, and Environmental Health. Her general research interests include Bayesian data analysis, clinical trial studies, cancer epidemiology, and genomics. As a biostatistician, she has broad interests in biological science, medicine, public health, and all other related fields
- Meghan-Meadows Taylor, PhD, MPH, is an accomplished researcher with a diverse background in academia and health care. Her research primarily focuses on multidisciplinary management of chronic diseases in community-based health care systems, with the ultimate goal of optimizing diagnosis and treatment approaches
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Chan MJ, Hsieh CY, Su YJ, Huang CC, Huang WH, Weng CH, Yen TH, Hsu CW. Giant Pancreatic Pseudocyst after Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report. Clin Pract 2023; 13:1236-1243. [PMID: 37887087 PMCID: PMC10605616 DOI: 10.3390/clinpract13050111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
End-stage renal disease (ESRD) patients have a high prevalence of coronary artery disease, and coronary artery bypass graft (CABG) is one of the essential treatments. ESRD patients undergoing CABG surgery have an increased risk of postoperative complications, including acute pancreatitis. Here, we present the unique case of an exceptionally large pancreatic pseudocyst caused by pancreatitis in an ESRD patient after CABG surgery. A 45-year-old male with ESRD under maintenance hemodialysis received CABG surgery for significant coronary artery disease. Two weeks later, he experienced worsening abdominal pain and a palpable mass was noticed in the epigastric region. Computer tomography revealed an unusually large pseudocyst measuring 21 × 17 cm in the retroperitoneum due to necrotizing pancreatitis. The patient underwent percutaneous cystic drainage, and the symptoms were significantly improved without surgical intervention. Factors such as prolonged cardiopulmonary bypass time, postoperative hypotension, and intradialytic hypotension appeared to have contributed to the development of severe pancreatitis in this case. This report highlights the rarity of a giant pancreatic pseudocyst in an ESRD patient after CABG surgery and emphasizes the importance of vigilant postoperative care.
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Affiliation(s)
- Ming-Jen Chan
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
| | - Chun-Yih Hsieh
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
| | - Yi-Jiun Su
- Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan City 333423, Taiwan;
| | - Chien-Chang Huang
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
| | - Wen-Hung Huang
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
| | - Cheng-Hao Weng
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
| | - Ching-Wei Hsu
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333423, Taiwan; (M.-J.C.); (C.-Y.H.); (C.-C.H.); (W.-H.H.); (C.-H.W.); (T.-H.Y.)
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
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Zare Karizak S, Kashef M, Gaeini AA, Nejatian M. Impact of high intensity interval and moderate continuous training on plasma ratios of ProBNP 1-108/BNP 1-32 and NT-pro-BNP 1-76/BNP 1-32 after coronary artery bypass grafting surgery. Front Physiol 2023; 14:1114813. [PMID: 36960152 PMCID: PMC10030057 DOI: 10.3389/fphys.2023.1114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Background: ProBNP1-108/BNP1-32, and NT-pro-BNP1-76/BNP1-32 ratios are significant indices for predicting complications after coronary artery bypass grafting (CABG) surgery. However, the effect of aerobic training types on these biomarkers has not been fully understood. So, the current study aimed to determine the impact of aerobic interval and continuous training programs on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery. Method: 36 patients were selected purposive (27 men and 9 women with mean of age 60.32 ± 5.81 years, height 164.64 ± 9.25 cm, weight 73.86 ± 14.23 kg, fat 32.30 ± 4.28, SBP 142.67 ± 6.49, DBP 84.5 ± 5.16 mmHg in seated position at rest situation and functional capacity of 7.08 ± 2.49 METs) and then divided randomly into three groups: control (C) group (without training program) moderate continuous training (MCT) and high intensity interval training (HIIT) (exercise training program was performed 3 days/week for 8 weeks) with intensities 65%-80% and 80%-95% of reserve heart rate in order. Blood samples were taken 48 h before the first session and 48 h after the last training session to measure the plasma levels of ProBNP1-108, corin enzyme, BNP1-32, and NT-pro-BNP1-76 using the enzyme-linked immunosorbent assay (ELISA) technique. Wilcoxin and kruskal wallis tests were used for analyzing data. Results: The plasma corin enzyme was increased, and the ratios of proBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 were reduced in both training groups in compared with control group (p = 0.004, p = 0000, p = 0.016, p = 0.003, p = 0.009, and p = 0.016) when there was no significant difference was found between training groups (p = 0.074, p = 450, and p = 0.295). Conclusion: Both high intensity interval training and moderate continuous training in compared with inactivity have positive effects on ratios of ProBNP1-108/BNP1-32, NT-pro-BNP1-76/BNP1-32 and could be effective to promote the health of coronary arteries and prevention of HF in post-CABG patients.
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Affiliation(s)
- Sara Zare Karizak
- Sport Science Department, Faculty of Literature and Humanities, Persian Gulf University, Boushehr, Iran
- *Correspondence: Sara Zare Karizak,
| | - Majid Kashef
- Exercise Physiology Department, Sport Science Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Abbas Ali Gaeini
- Exercise Physiology Department, Sport Science Faculty, Tehran University, Tehran, Iran
| | - Mostafa Nejatian
- Cardiac Rehabilitation Specialist and Head of Rehabilitation Clinic of Tehran Heart Center Hospital, Tehran, Iran
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Oravec N, King MAM, Spencer T, Eikelboom R, Kent D, Reynolds K, El-Gabalawy R, Chudyk AM, Metge C, Cornick A, Sanjanwala RM, Lee E, Hiebert B, Nugent K, Dave MG, Duhamel TA, Arora RC. Barriers to Successful Discharge After Cardiac Surgery: A Focus Group Study and Cross-Sectional Survey. Semin Thorac Cardiovasc Surg 2022; 35:675-684. [PMID: 35842203 DOI: 10.1053/j.semtcvs.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/11/2022]
Abstract
At present, there is a lack of information on patient and caregiver values, and perceived priorities and barriers, to guide successful post-discharge recovery. This was a single center, multiple methods study that investigated patient, caregiver, and health care provider perceptions of the discharge process after cardiac surgery. Themes emerging from focus group discussions with patients and caregivers were used to develop surveys relating to values, barriers, and challenges relating to the discharge process. Thirty-two patients (n = 16) and caregivers (n = 16) participated in four separate focus groups. Four themes emerged from these discussions: (1) a lack of understanding about what the discharge process entails and when discharge is appropriate, (2) issues relating to the information provided to patients at the time of discharge, (3) participant experiences with the health care system, and (4) the experiences of caregivers. Seventy-eight patients, 34 caregivers, 53 nurses and/or other allied health professionals, and 8 surgeons completed the cross-sectional surveys. The most important component of the discharge process for patients and caregivers was "knowing what to do in an emergency." Health care providers less accurately identified what caregivers perceived as the most important aspects of the discharge process.Statements relating to informational barriers to discharge were the most discordant among patient and caregiver respondents. After discharge, patients and caregivers identified the need for longer-term follow up with the surgeon and more support in the community. Incorporation of patient and caregiver values to guide the post-cardiac surgery discharge process is essential to promote successful recovery.
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Affiliation(s)
- Nebojša Oravec
- Asper Clinical Research Institute, St. Boniface Hospital, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada.
| | - Mackenzie A M King
- Asper Clinical Research Institute, St. Boniface Hospital, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
| | - Tyler Spencer
- Asper Clinical Research Institute, St. Boniface Hospital, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
| | - Rachel Eikelboom
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada
| | - David Kent
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada; Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Winnipeg, MB, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Anna M Chudyk
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Colleen Metge
- Department of Community Health Sciences, Max Rady College of Medicine University of Manitoba, Winnipeg, MB, Canada
| | - Alexandra Cornick
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada
| | - Rohan M Sanjanwala
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada
| | - Erika Lee
- Asper Clinical Research Institute, St. Boniface Hospital, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
| | - Brett Hiebert
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada
| | - Kristina Nugent
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada
| | - Mudra G Dave
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada; Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Todd A Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada; Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
| | - Rakesh C Arora
- Cardiac Sciences Program, St. Boniface General Hospital, Winnipeg, MB, Canada; Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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10
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Jeffries JJ. Reflecting on my experience after coronary artery bypass grafting. CMAJ 2021; 193:E1432. [PMID: 34518346 PMCID: PMC8443276 DOI: 10.1503/cmaj.79961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- J Joel Jeffries
- Retired psychiatrist, formerly Centre for Addiction and Mental Health, Toronto, Ont
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