Table1_The importance of liver function assessment before cardiac surgery: A narrative review.docx

The demand for cardiac surgery procedures is increasing globally. Thanks to an improvement in survival driven by medical advances, patients with liver disease undergo cardiac surgery more often. Liver disease is associated with the development of heart failure, especially in patients with advanced cirrhosis. Cardiovascular risk factors can also contribute to the development of both cardiomyopathy and liver disease and heart failure itself can worsen liver function. Despite the risk that liver disease and cirrhosis represent for the perioperative management of patients who undergo cardiac surgery, liver function is often not included in common risk scores for preoperative evaluation. These patients have worse short and long-term survival when compared with other cardiac surgery populations. Preoperative evaluation of liver function, postoperative management and close postoperative follow-up are crucial for avoiding complications and improving results. In the present narrative review, we discuss the pathophysiological components related with postoperative complications and mortality in patients with liver disease who undergo cardiac surgery and provide recommendations for the perioperative management.</p

Could CPAP Devices Be Used to Ventilate Cardiac Arrest Patients? A Bench Study

To investigate the potential efficacy of a commercial continuous positive airway pressure (CPAP) ventilator to provide effective respiratory support in a simulated scenario of out-of-hospital cardiac arrest (OHCA). The study was conducted on a high-fidelity manikin (SimMan 3 GTM, Laerdal, NOR) connected to the ASL 5000TM Lung Simulator (IngMar Medical, USA). To simulate OHCA, we set no spontaneous respiratory acts and physiological respiratory system resistance (13 cmH2O/L.sec) and compliance (50 mL/cmH2O). The Respironics BiPAP A40 ventilatorI (Philips, NL) was used to provide ventilatory support while operating in CPAP mode. Tests were performed at different values of positive pressure of the CPAP ventilator (PCPAP: 5, 7.5, 10, 12.5 and 15 cmH2O) and the intrapulmonary volume (tidal volume, Vt) measured via the simulator software computer interface. A trained physician performed the tests. Our primary outcome was a VT of ≈500-600 mL with an intermittent maneuver simulating cardiopulmonary resuscitation (CPR)-like ventilatory support practice according to international guideline-based target (1-sec ventilation followed by 1-sec pause). In intermittent ventilatory support tests, PCPAP levels of 12.5, and 15 cmH2O resulted in a VT equal to 508 ± 13 mL, and 557 ± 44 mL respectively (p = 0.04), thus approaching the VT target. We provide preliminary evidence of the potential efficacy of CPAP ventilators designed for home use to provide effective respiratory support to a simulated respiratory arrest patient.</p

Additional file 2 of Propofol and survival: an updated meta-analysis of randomized clinical trials

Additional file 2. Complete reference list of included studies

Additional file 1 of Propofol and survival: an updated meta-analysis of randomized clinical trials

Additional file 1. Search strategy, supplemental Tables, and supplemental Figures

Additional file 1: of Effect sizes in ongoing randomized controlled critical care trials

Survey.pdf (final version of survey). (PDF 113 kb

Additional file 2: of Effect sizes in ongoing randomized controlled critical care trials

Online data supplement. (DOCX 473 kb

Additional file 1: of Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials

Supplementary material. (PDF 2.18 mb

Funnel plot.

<p>Funnel plot.</p

Examined studies.

<p>Examined studies.</p

Furosemide prevention VS treatment subgroup.

<p>Furosemide prevention VS treatment subgroup.</p