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Cerebral oxygen desaturation is associated with neurologic complications and longer intensive care unit stay in high-risk cardiac surgery patients
No full textBACKGROUND
Monitoring cerebral regional oxygen saturation (rSO2) in low-risk coronary surgery patients avoided cerebral
deoxygenation and improved outcome (1). We hypothesized that lower rSO2 values would be associated
with higher incidence of neurologic complications and longer intensive care unit (ICU) stay in high-risk
cardiac surgical patients.
METHODS:
Fifty high-risk patients (EuroScore >5) were monitored during cardiac surgery with cerebral near infrared
spectroscopy (NIRS) to estimate rSO2. Interventions to improve cerebral deoxygenation (defined as a 20%
reduction of rSO2 below baseline) were based on an algorithm for the use of NIRS on optimizing factors that
influence cerebral oxygen supply/demand (e.g., perfusion pressure and cardiac output, arterial oxygen
content, haemoglobin, and the cerebral metabolic rate of O2).
RESULTS:
Patients who exhibited major neurologic complications were 28%. They needed longer duration of
mechanical ventilation (MV) (58±69 vs 20±52 hours, p = 0.041) and ICU stay (8.3±8.4vs 2.6±2.7 days, p =
0.001) than patients without a neurologic complication. Baseline rSO2 values were significantly lower in
patients facing major neurologic complications (Dx 60.1±1.9 vs 64.7±1.2 %, p = 0.04; Sx 61.6±1.6 vs
66.6±1.2 %, p = 0.03) who also exhibited more episodes of cerebral desaturation during surgery (3.0 vs 1.5,
p = 0.004). There was a significant inverse correlation between intraoperative rSO2 and duration of MV (r = -
0.68) and length of ICU stay (r = -0.62).
CONCLUSION:
Preoperative rSO2 values are associated with an increased risk of neurologic dysfunction. Cerebral oxygen
desaturation during cardiac surgery is associated with prolonged MV needs and ICU stay.
REFERENCES:
Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery:
a randomized, prospective study. Anesth Analg. 2007 Jan;104(1):51-8
Myocarditis requiring extracorporeal membrane oxygenation support following Influenza B infection: a case report and literature review
No full textSeasonal influenza A (IA) and B (IB) viruses co-circulate every year, causing respiratory tract infections in individuals of all ages. Recently, the association between laboratory-confirmed influenza infection and acute myocardial infarction has been clearly demonstrated. However, most of the reported cases of fulmi-nant myocarditis had been associated with influenza virus type A infection. Here we report the case of a 44 y/o man who experienced myocarditis with cardiogenic shock [requiring percutaneous extracorporeal membrane oxygenation (ECMO) support], following influenza B virus infection, which circulated widely in Italy in 2017-18
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Infective endocarditis due to Staphylococcus aureus involving three cardiac valves. A case study.
No full textPMID: 1456425
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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