Article
Critical Care Medicine
Christina Massoth, Alexander Zarbock, Melanie Meersch
Summary: The incidence of acute kidney injury (AKI) after cardiac surgery is high, with about 3% of patients requiring renal replacement therapy. According to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, AKI is defined as a sudden deterioration of renal function, developing within a period of hours to days.
CRITICAL CARE CLINICS
(2021)
Review
Medicine, General & Internal
Christina Massoth, Alexander Zarbock
Summary: Acute kidney injury after cardiac surgery presents specific patterns of damage and recovery, which are crucial for management and outcomes. The KDIGO classification only partially covers the conceptual framework and is insufficient for a comprehensive diagnosis. This review discusses the strengths and limitations of recent criteria for CSA-AKI and provides an overview of biomarkers. The evolving understanding of CSA-AKI as a time-sensitive condition has led to an increased demand for enhancing diagnostic criteria and implementing biomarkers in clinical practice.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Medicine, General & Internal
Gencheng Liang, Yueyong Li, Sheng Li, Zhaohe Huang
Summary: Cardiac surgery with cardiopulmonary bypass can lead to reversible postischemic cardiac dysfunction and is associated with reperfusion injury and myocardial cell death. Therefore, measures to reduce oxygen consumption and provide myocardial protection are essential. This study aims to evaluate the effect of dexmedetomidine administration on myocardial ischemia/reperfusion injury in patients undergoing cardiac surgery with cardiopulmonary bypass through a systematic review and meta-analysis.
Article
Anesthesiology
Yi Shun Wang, Dong Xu Chen, Min Yan, Zhong Wu, Ying Qiang Guo, Qian Li, Lei Du
Summary: This study developed and validated a model to predict the severity of acute kidney injury (AKI) after on-pump cardiac surgery using 10 predictors. The model showed good accuracy in predicting AKI severity and may be useful in clinical practice.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Pharmacology & Pharmacy
G-R Zhang, C-M Peng, Z-Z Liu, Y-F Leng
Summary: The study found that dexmedetomidine administration in patients undergoing cardiac surgery with cardiopulmonary bypass can reduce CK-MB and cTn-I concentrations, as well as shorten the length of ICU stays. It provides myocardial protection from ischemia reperfusion injury.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
(2021)
Review
Biochemistry & Molecular Biology
Giuseppe Filiberto Serraino, Federica Jiritano, Davide Costa, Nicola Ielapi, Domenica Battaglia, Umberto Marcello Bracale, Pasquale Mastroroberto, Michele Andreucci, Raffaele Serra
Summary: This systematic review aims to explore the role of matrix metalloproteinases (MMPs) in routine cardiac operations, especially cardiopulmonary bypass (CPB). The results show that MMP levels are significantly correlated with CPB and the gelatinases MMP-2 and MMP-9 are highly released during cardiac surgery with CPB. Increased MMP levels are associated with adverse post-operative outcomes. Future large-scale prospective multicenter randomized clinical trials are needed to investigate the impact of mechanical and pharmacological strategies on the inflammatory response and postoperative outcomes in cardiac surgery and CPB.
Article
Critical Care Medicine
Amanda C. Becker, Connor W. Lantz, Joseph M. Forbess, Conrad L. Epting, Edward B. Thorp
Summary: In this study, soluble MER concentrations were found to significantly increase post cardiac bypass in 17 out of 24 pediatric patients (71%). This suggests that soluble MER concentrations rise with cardiopulmonary bypass-induced inflammation and myocardial ischemia and reperfusion injury in pediatric populations. Further investigation is needed to determine the utility of soluble MER as a clinical biomarker for identifying pediatric patients at risk for exacerbated postoperative outcomes after bypass-induced myocardial ischemia and reperfusion injury.
PEDIATRIC CRITICAL CARE MEDICINE
(2021)
Review
Anesthesiology
Yu-qin Long, Xiao-mei Feng, Xi-sheng Shan, Qing-cal Chen, Zhengyuan Xia, Fu-hai Ji, Hong Liu, Ke Peng
Summary: This meta-analysis demonstrates that RIPC reduces the incidence of AKI after cardiac surgery. This renoprotective effect of RIPC is mainly evident during volatile only anesthesia, in non-high-risk patients, and when AKIN or KDIGO criteria used for AKI diagnosis.
ANESTHESIA AND ANALGESIA
(2022)
Article
Multidisciplinary Sciences
Yichuan Wang, Xuliang Huang, Shanshan Xia, Qingqing Huang, Jue Wang, Maochao Ding, Yunchang Mo, Jianping Yang
Summary: There is no gender gap in AKI frequency for cardiac surgery patients below and above 60 years old. However, women exhibit increased AKI severity and extended intubation duration.
Article
Immunology
Maxime Nguyen, Laure Stiel, Adrien Guilloteau, Pierre-Alain Bahr, David Masson, Charles Thomas, Mathieu Blot, Julien Guy, Cecile Fontaine, Bastien Durand, Belaid Bouhemad, Pierre-Gregoire Guinot
Summary: Cardiac surgery with cardiopulmonary bypass activates sterile inflammation, leading to post-operative morbidity. This study explores the use of cell population data from automated flow cytometry devices to monitor immune cell activation in these patients, providing a potential tool for predicting outcomes.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Urology & Nephrology
Sidharth Kumar Sethi, Rajesh Sharma, Aditi Gupta, Abhishek Tibrewal, Romel Akole, Rohan Dhir, Kritika Soni, Shyam Bihari Bansal, Pranaw Kumar Jha, Anil Bhan, Vijay Kher, Rupesh Raina
Summary: This study aimed to establish long-term renal outcomes for pediatric patients after cardiac surgery, focusing on urinary biomarker abnormalities that persist years after surgery and may contribute to a low glomerular filtration rate during follow-up. The presence of AKI, AKI stage, and younger age were not associated with low GFR at follow-up, while children with a higher surgical complexity score tended to have lower GFR.
KIDNEY INTERNATIONAL REPORTS
(2021)
Review
Health Care Sciences & Services
Luan Oliveira Ferreira, Victoria Winkler Vasconcelos, Janielle de Sousa Lima, Jaime Rodrigues Vieira Neto, Giovana Escribano da Costa, Jordana de Castro Esteves, Sallatiel Cabral de Sousa, Jonathan Almeida Moura, Felipe Ruda Silva Santos, Joao Monteiro Leitao Filho, Matheus Ramos Protasio, Pollyana Sousa Araujo, Claudio Jose da Silva Lemos, Karina Dias Resende, Dielly Catrina Favacho Lopes
Summary: Patients undergoing coronary revascularization with extracorporeal circulation or cardiopulmonary bypass may develop systemic inflammatory response due to biochemical changes in the microcirculation. Inflammatory signaling pathways can be activated by surgical incision, reperfusion injury, and blood contact with non-endothelial membranes, leading to the production and activation of inflammatory cells, cytokine production, and oxidative stress. Addressing new perspectives for intraoperative treatment and management may reduce this inflammatory storm, improve prognosis, and potentially lower mortality rates in these patients.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Yun-Wen Peng, Terry Major, Kristopher B. Deatrick, Azmath Mohammed, Mark Jeakle, John R. Charpie
Summary: Nicorandil demonstrates myocardial protection by attenuating IR-induced LV dysfunction associated with oxidative stress, inflammation, apoptosis, and organ injury. It should be further explored as a potential therapeutic strategy for limiting global IR injury during open-heart surgery in humans.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2022)
Article
Immunology
Yuanyuan Wu, Zinah D. Zwaini, Nigel J. Brunskill, Xinyue Zhang, Hui Wang, Ravinder Chana, Cordula M. Stover, Bin Yang
Summary: The study showed that mice lacking Properdin exhibited more severe renal injury during the repair phase post IR, with Properdin playing a crucial role in optimizing damaged cells and regulating phagocytic ability to effectively clear apoptotic cells and reduce inflammation.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Medicine, Research & Experimental
Yungang Shan, Deqing Chen, Bo Hu, Guangtao Xu, Wanlu Li, Ye Jin, Xiuhui Jin, Xin Jin, Limin Jin
Summary: The study demonstrated that allicin exerts a protective effect against renal ischemia/reperfusion injury in rats by regulating apoptosis, oxidative stress, and inflammatory response.
BIOMEDICINE & PHARMACOTHERAPY
(2021)
Article
Anesthesiology
Dongwoo Chae, Hyun-Chang Kim, Young Song, Young Seo Choi, Dong Woo Han
Summary: This study evaluated the efficacy and safety of i.v. bolus remimazolam during induction of anesthesia. The results showed that remimazolam could cause loss of consciousness and respiratory depression, but no serious adverse events occurred within the tested dose range.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Article
Anesthesiology
Jayyoung Bae, Jun Sung Lee, Jooyoung Oh, Dong Woo Han, Heejae Jung, Seok-Mo Kim, Young Song
Summary: This study aimed to evaluate the association between preoperative frontal alpha asymmetry and quality of recovery (QoR) after thyroidectomy in female patients. The study found that preoperative left-sided frontal alpha asymmetry was independently associated with a lower postoperative QoR-15 score.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Medicine, Research & Experimental
Sung Yeon Ham, Ji Hae Jun, Hye-Bin Kim, Jae-Kwang Shim, Gisong Lee, Young-Lan Kwak
Summary: This study investigated the activities of key regulators affecting erythropoiesis in a rat model of iron deficiency anemia with inflammation. The results showed that IV iron therapy exacerbated inflammation and oxidative stress and did not resolve anemia.
Article
Medicine, General & Internal
Seo Hee Ko, Jong-Wook Song, Jae-Kwang Shim, Sarah Soh, Young-Lan Kwak
Summary: This study found a relationship between perioperative rScO(2) and AKI after OPCAB. Mean rScO(2) during surgery was an independent predictor of AKI and could serve as an early marker of renal injury.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Hyun-Chang Kim, Jinyoung Park, Jinyoung Oh, Minjae Kim, Eun Jung Park, Seung Hyuk Baik, Young Song
Summary: This study evaluated the analgesic efficacy of a four-quadrant transversus abdominis plane (4QTAP) block and a combination of 4QTAP block with needle electrical twitch and intramuscular electrical stimulation (NETOIMS) in patients undergoing cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). The results showed that the combination of 4QTAP block with NETOIMS provided better pain control and improved functional restoration and quality of recovery in patients.
INTERNATIONAL JOURNAL OF SURGERY
(2023)
Article
Medicine, General & Internal
Myung Il Bae, Sang-Wook Kang, Jong Seok Lee, Na Young Kim, Bahn Lee, Gilseong Moon, Young Chul Yoo, Kee-Hyun Nam
Summary: This study examined the effects of deep neuromuscular block during robot-assisted transaxillary thyroidectomy on postoperative pain and sensory changes. The results showed that deep neuromuscular block can reduce postoperative pain, but does not reduce sensory abnormalities after surgery.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Immunology
Myung Il Bae, Jae-Kwang Shim, Jong Wook Song, Seo Hee Ko, Young Seo Choi, Young -Lan Kwak
Summary: The study analyzed the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and delta-NLR in cardiac patients undergoing off-pump coronary artery bypass (OPCAB) surgery. The results showed that preoperative NLR and delta-NLR were significantly associated with days alive and out of hospital (DAOH), and delta-NLR was an independent risk factor for long-term mortality. These findings highlight the importance of NLR and delta-NLR in risk assessment and perioperative management.
JOURNAL OF INFLAMMATION RESEARCH
(2023)
Article
Medicine, General & Internal
Youngwon Kim, Young Chul Yoo, Na Young Kim, Hye Jung Shin, Ki Hong Kweon, Jiae Moon, Sang-Wook Kang
Summary: This study investigated the effects of intraoperative dexmedetomidine administration on hemodynamic stability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma. The results showed that intraoperative maximum blood pressures were significantly lower in the dexmedetomidine group, as well as the heart rate. Other parameters of hemodynamic instability were comparable between the two groups.
FRONTIERS IN MEDICINE
(2023)
Article
Health Care Sciences & Services
Hyun-Joung No, Young Chul Yoo, Young Jun Oh, Hye Sun Lee, Soyoung Jeon, Ki Hong Kweon, Na Young Kim
Summary: This study retrospectively analyzed the effects of sugammadex compared with neostigmine on postoperative recovery in patients with myasthenia gravis who underwent video-assisted thoracoscopic surgery. The study found that patients who received sugammadex had a significantly shorter postoperative hospital stay compared to those who received neostigmine.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Anesthesiology
Jae-Kwang Shim, Kwang-Sub Kim, Pierre Couture, Andre Denault, Young-Lan Kwak, Kyung-Jong Yoo, Young-Nam Youn
Summary: Off-pump coronary surgery requires careful management of cardiac displacement and hemodynamics to avoid complications and poor outcomes. Objective hemodynamic targets, such as maintaining mean arterial pressure and venous oxygen saturation within specific ranges, must be considered before the surgery. Transesophageal echocardiography should be used to assess for any potential complications and ensure that the patient can tolerate the procedure. Careful inspection of the ascending aorta is also necessary to prevent embolism.
KOREAN JOURNAL OF ANESTHESIOLOGY
(2023)
Article
Anesthesiology
Kyuho Lee, Kwang-Sub Kim, Jong-Kwang Park, Jun Hyug Choi, Young -Lan Kwak, Jae-Kwang Shim
Summary: This study aimed to investigate the association between transient hemodynamic deterioration during left circumflex artery grafting and the occurrence of composite of morbidity endpoints in off-pump coronary artery bypass surgery (OPCAB). The study found that mixed venous oxygen saturation (SvO2) < 60% during LCX grafting was significantly associated with the composite of morbidity endpoints. Pre-operative anemia was identified as a predictor of SvO2 < 60% during LCX grafting. This highlights the prognostic importance of this transient deterioration in oxygen supply-demand balance.
KOREAN JOURNAL OF ANESTHESIOLOGY
(2023)
Article
Medicine, General & Internal
Jin Ha Park, So Yeon Kim, Jin Sun Cho, Dongkwan Shin, Sung Yeon Ham, Hyesu Kim, Young -Lan Kwak
Summary: This study aimed to investigate the incidence of eGFR6m <60 and identify the risk factors for its occurrence in living kidney donors. The results showed that older age, history of hypertension, lower preoperative eGFR, and greater ACr2_pre were associated with the occurrence of eGFR6m <60. The combination of preoperative eGFR and ACr2_pre had the highest predictive power for eGFR6m <60.
YONSEI MEDICAL JOURNAL
(2023)