1,720,994 research outputs found
Principles and Practice of Cardiothoracic Surgery
Get PDFThe field of cardiothoracic surgery continues to evolve at a rapidly expanding rate. New technologies are under constant development and as patients present with more advanced pathophysiology and complex comorbidities, management becomes more dependent on multi-disciplinary Teams. While there are a variety of innovative and high-profile topics that dominate the literature and the interests of clinicians, sometimes is it the basics both in terms of acute and sometimes unusual problems that often challenge cardiothoracic surgeons on a day to day basis. The goal of Principles and Practice of Cardiothoracic Surgery is to hopefully highlight the current state of the art management of these problems
Evolving Therapies and Technologies in Extracorporeal Membrane Oxygenation
No full textOver the past 20 years, coinciding with the global H1H1 influenza and COVID-19 pandemics, there has been an exponential increase in the application of Extracorporeal Membrane Oxygenation (ECMO) therapies for acute cardiac and/or respiratory failure. Not only has the number of patients supported with ECMO increased substantially but so has the number of centers offering such technologies and the types of clinical problems successfully managed with ECMO. In addition, technological advances and the science of long-term extracorporeal biology have also increased our knowledge and understanding of this complex therapy. This comprehensive review of ECMO highlights several aspects of clinical use, management challenges, and evolving technology
Extracorporeal Membrane Oxygenation
Get PDFExtracorporeal membrane oxygenation (ECMO), despite a long and troubled history, is very rapidly evolving into a therapy that can be safely and effectively applied across the world in patients experiencing acute cardiac and/or pulmonary failure. As experiences grow, there is a better understanding of nuances of the importance of teamwork, therapy guidelines and protocols, patient selection, and understanding the functional aspects of pump-circuit technology as it interfaces with human biology. The challenges in managing these very sick and complex patients cannot be understated. The goal of this text is to provide a framework for the development and successful growth of a program. Authors from Centers of Excellence Worldwide have shared their experiences in the full spectrum in dealing with this evolving field
Advances in Extracorporeal Membrane Oxygenation
No full textExtracorporeal membrane oxygenation is an effective tool for managing patients with severe acute cardiogenic shock and/or respiratory failure. With emphasis on teamwork and adherence to guidelines, protocols, and objective tools to assist in patient selection, management, and weaning, outcomes have improved. Nevertheless, every aspect of supporting patients who require extracorporeal support remains a challenge - with many unanswered questions. The goal of this text, as a supplement to the previous editions on this rapidly evolving topic, is to provide the reader with a more in-depth review of some of the ongoing issues in this field. Topics ranging from administrative aspects to developing a program, nursing issues, ethical concerns, and a variety of clinical topics are discussed at length
Advances in Extra-corporeal Perfusion Therapies
No full textExtracorporeal membrane oxygenation (ECMO) has evolved into an exciting and valuable tool to assist in the management of patients experiencing cardiogenic shock, severe acute respiratory failure, or often a combination of both. While outcomes remain less than ideal, they continue to improve with team experience, better patient selection, and a growing understanding of the nuances of managing patients who require mechanical circulatory support. Patients requiring ECMO are often extremely sick and have complex problems - initiating therapy before the development of end-organ damage is critical. Without doubt, teamwork, guidelines, and protocols are cornerstone concepts for clinical and program success - all topics that are emphasized in this text. The goals of this text are to further outline topics that help address some of the key challenges providers face when considering and applying extracorporeal support therapies to the evolving spectrum of acutely ill patients
Advanced Concepts in Endocarditis
No full textThe concept of endocarditis has evolved significantly over the years. While initially associated with patients with advanced co-morbidities, such as renal failure and chronic immunosuppression, endocarditis now spans many diverse disciplines. As such, the importance of advanced diagnostic imagining tools, a better understanding of the pathophysiology of not only the infectious (and non-infectious) disease process but also of cardiac structural abnormalities, and the growing literature on management cannot be underemphasized. This book broadens our collective understanding of the spectrum of diagnostic and therapeutic challenges that all areas of medicine must appreciate when faced with the challenging clinical problem of endocarditis
Advances in Extracorporeal Membrane Oxygenation
Get PDFExtracorporeal membrane oxygenation is an effective tool for managing patients with severe acute cardiogenic shock and/or respiratory failure. With emphasis on teamwork and adherence to guidelines, protocols, and objective tools to assist in patient selection, management, and weaning, outcomes have improved. Nevertheless, every aspect of supporting patients who require extracorporeal support remains a challenge - with many unanswered questions. The goal of this text, as a supplement to the previous editions on this rapidly evolving topic, is to provide the reader with a more in-depth review of some of the ongoing issues in this field. Topics ranging from administrative aspects to developing a program, nursing issues, ethical concerns, and a variety of clinical topics are discussed at length
Microcirculation
No full textMicrocirculation reflects the vascular bridge which is the conduit of blood flow between the arteries and veins in the body. It plays a critical role in the delivery of oxygen and nutrients to the cells of the body while also serving to wash away and eliminate biological waste products of metabolism. A complex interplay exists between the normal structure and function of the larger vessels of the body and the blood coursing through. This book discusses the evolving science in understanding the role of microcirculation in some of the most common and devastating diseases that plague humanity. By understanding the role of microcirculation in the normal feedback mechanisms that balance bleeding and clotting with the opportunities to manipulate this balance to treat disease, the impact on the individual and social burden of arterial and venous occlusive and thromboembolic disease can be substantial. Understanding disease mechanisms and enhancing our collective tools for diagnosis and treatment are some of the greatest challenges facing our global healthcare systems. The chapters in this book serve as a foundation for further research into the quest to reduce, if not eliminate, one of the most significant causes of major morbidity, mortality, and overall loss of quality of life worldwide. Without a doubt, the impact of the body’s microcirculation, as our understanding continues to evolve and as emphasized in this text, cannot and should not be underappreciated
Advances in Complex Valvular Disease
No full textAs the diagnostic and therapeutic tools for the management of complex cardiac valve disease continue to evolve, the options for patients who previously had few choices continue to expand. Such advances have resulted in a renaissance in how Heart Teams approach problems and have been able to engage patients in shared decision-making conversations towards a common goal. While opportunities exist in the management of physiologically challenging congenital heart disease, the vast explosion of research and development in the area of aortic valve disease has offered new hope to patients for improving their quality and quantity of life. The goal of this text is to hopefully serve as a foundation for those who want to explore such topics in greater detail
Contemporary Topics in Patient Safety
Get PDFAs healthcare systems continue to evolve, it is clear that providing safe, high-quality care to patients is an extremely complex process. Ranging from multi-disciplinary teams to bedside care, virtually every aspect of the patient-care experience provides us with an opportunity for doing things better, from improving efficiency, safety, and overall outcomes to reducing costs and promoting team synergy. This book, the fifth in our patient safety series collection, consists of chapters that help explore key concepts related to both the safety and quality of care. In a departure from the vignette-driven format of our earlier books, this installment gravitates toward discussing frameworks, theoretical considerations, team-centric approaches, and a variety of other concepts that are critical to both our understanding and the implementation of safer and better-performing health systems. We also feel that the knowledge presented herein increasingly applies across the world, especially as global health systems evolve and mature over time. It is our goal to improve the recognition of potential opportunities that will highlight various aspects of the delivery of healthcare and thus contribute to better patient experiences, with safety at the forefront. Topics covered in this volume, as well as the previous volumes, highlight the critical importance of identifying and addressing opportunities for improvement, not as one-time events, but rather as continuous, hardwired institutional processes
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