Statistical analysis
Data were analyzed using IBM SPSS statistics 20.0 software. Independent t‑test was used for comparison of the continuous variable between the two groups.
Variables expressed as mean ± standard deviation then converted to standard errors of the mean. For repeated or continuous measurements, analysis of variance was used.
P < 0.05 was considered as statistically significant.
RESULTS
Of the 49 patients included in our study, 36 patients underwent CABG, while 13 required valve replacement,
12 underwent mitral valve replacement, while one patient with chronic aortic dissection underwent aortic root replacement with re‑implantation of the coronaries.
Twenty‑four patients were diabetic, with 9 having insulin‑dependent diabetes mellitus (DM), and 15, noninsulin‑dependent DM. Seven patients had suffered a myocardial infarction (MI) < 0.05) [Table 1]. About 17 (74%) patients in the
ETT group required extra doses of fentanyl in response to laryngoscopy and after tracheal intubation, while none of the patients in the I‑gel group required additional doses of fentanyl after I‑gel insertion. Following the skin incision, however, only two patients (8%) in the ETT group required extra doses of fentanyl as compared to none in I‑gel group. No patient from any group required extra analgesia
Table 1: Patient characteristics and demographic data (mean±SEM) ratio or number of patients
I‑gel airway group (n=23)
Endotracheal
tube group
(n=26)
Sex (male: female) 17:6 22:4
Age
Diagnosing myocardial infarction in critically ill patients is challenging [1]. Ischaemic chest pain is uncommon due to analgesic use and communication of ischaemic symptoms – when
This was a retrospective, descriptive, and correlational study. Data from the records of patients who had undergone a heart catheterization or PCI over the span of two years was retrieved from the Clinical Automated Office Solutions database. (Dumont, Keeling, Bourguignon,
"In 2006, more than 690,000 open heart surgeries were performed in the United States. These included surgeries to correct and repair defective valves as well as coronary artery bypass surgery. As recently as 70 years ago, these surgeries would have been impossible. The heart lung machine had yet to be invented, allowing surgeons to temporarily stop and start the heart. Prior to its invention, the longest a heart could be stopped was 30 to 40 minutes---not enough time to complete extensive surgery" (Smith, 2009). Since then, a number of minimally invasive surgical procedures have been introduced that permit surgeons to perform a variety of surgeries, making smaller incisions that leave smaller scars, reduce the chance of infection, are less painful to the patient and necessitate shorter hospital stays. These include minimally invasive direct coronary artery bypass, off-pump coronary artery bypass, videoscopic surgery and robotic-assisted heart surgery.
The capacity of this hospital is 1400 beds. These participants were selected from the local residents who could speak and understand the Norwegian language, who were willing to be interviewed for at least an hour, and who were older than 18 years. These participants had to have had a mechanical aortic valve surgery done 6 months to 10 years before the beginning of the study. Out of the 27 selected participants, a total of 20 signed up for the study. There were 12 men and 8 women whose ages ranged from 24 through 74.
Dumont, C.J., Keeling, A.W., Bourguignon, C., Sarembock, I.J., Turner, M. (2006, May/June). Predictors of vascular complications post diagnostic cardiac catheterization and percutaneous coronary interventions. Dimension of Critical Care Nursing, 25(3), 137-142. Retrieved from http://journals.lww.com Jerlock, M., Gaston-Johansson, F., & Danielson, E. (2005). Living with unexplained chest pain.
In addition, the need for intraoperative beta blockers was significantly higher in lidocaine group (16.7%), decreased to 3.3% in magnesium group and in both drugs group, there was no need for intraoperative beta blockers. Also, perioperative aortic balloon pump was significantly higher in lidocaine group (20.0%), followed by 6.7% in magnesium group and none in both drugs group. The percentage of ventricular tachycardia was significantly increased in lidocaine group (16.7%), followed by magnesium group (3.3%) and none in both drugs groups. On the other hand, there was no statistically significant difference between studied groups as regard to number of vessels (it was 1.37±0.49, 1.30±0.46 and 1.27±0.45 in Mg, lidocaine and both drugs groups respectively) or ejection fraction ( it was 41.87±1.87, 40.96±2.35, 40.67±3.42 in the same order of groups). In addition, there was no statistically significant difference between the three groups as regard to ST segment elevation, need for intraoperative inotropic agents, use of defibrillation, the mean number of transfused blood units, duration of
The Leapfrog Group was formed in 2000 in an effort to bridge the gap between of evidence-based medicine (EBM) and practice (Brooke, Dominici, Makary, & Pronovost, 2009). One EBM practice that Leapfrog has promoted is the use of perioperative beta-blockers during AAA repairs (Brooke, Dominici, Makary, & Pronovost, 2009). A random control trial concluded of the hospitals partaking in the study, 26% reported compliance with routine beta-blocker use after surgery, whereas, 74% reported failure to implement the policy. The study showed a decrease in mortality following open AAA repair was among hospitals that adopted the beta-blocker policy, which was significantly lower than the mortality rate
The authors write: “All procedures were performed under general anaesthesia, mostly from a femoral venous approach (73%) with transoesophageal echocardiographic guidance. A Sapien valve was implanted in 17 patients (85%)—most often a 26mm or a 29mm Sapien XT (80%)—and a Melody valve were implanted in
Preoperative assessment and evaluation of patients including those with diabetes undergoing elective surgical procedures provides optimum cardiopulmonary risk assessment and modification. Diabetes is a chronic illness that puts patients at a higher and complex intraoperative and postoperative complications (Fairburn & Elliot ,2014). This writer works in pre-surgical unit where patients undergoing surgical procedures under anesthesia are evaluated. For those patients with diabetes, glycemic control and optimization is part of the process. However, it remains to be an issue often leading to last minute surgery cancelations which can be very costly (Fairburn & Elliot ,2014) and/or not so optimal management of patients leading to untoward complications and increased length of stay.
The Valve Academic Research Consortium (VARC) is an organization that overlooks the TAVR trials and has met twice in San Francisco and Amsterdam and proposed a standardized endpoints for the TAVR clinical trials.58,59 The purpose was to standardize post-operative complications of TAVR such as myocardial infarction, stroke, bleeding complications, acute kidney injury, vascular complications, prosthetic valve performance, other complications related to prosthetic valve, and mortality. Other post-operative complications noted with TAVR are malpositioning, valve migration or embolization, conversion to open surgery and need for pacemaker implantation.60 VARC also proposed some clinical benefit endpoints: exercise performance, assessment of New York Heart Association ( NYHA) functional status, and various quality of life and frailty questionnaires. VARC recommended using CPK-MB as a periprocedural marker for myocardial infarction and required >20% increase with the second sample with elevation of a minimum of 10 times the upper limit of normal.
Hemodynamic parameters measured during intra-operative and postoperative periods did not show any significant differences over that time within each group or between the two groups (p> 0.05). Also there was no significant difference between both groups in the mean postoperative sedation score,
BB have been shown to be effective in treating people with PAD as well as those with undergoing any vascular surgery. For instance, after vascular surgery, the chance for myocardial infarction ranges from 5-24% after the surgery (Mostafaie et al., 2015). The aim of the study is to investigate the role of metoprolol and its effects on cardiac complications after vascular surgery in reducing cardiac mortality, myocardial infarction, and other cardiac problems. This was shown in a study by the Colcharne Collaboration. It is a double blind random control trial with one group (298 people) receiving a placebo, while the other group (301 people) received some type of beta blocker. To measure the results, a meta-analysis was done with an odds ratio (OR) and Confidence Interval (CI) (Mostafie et al., 2015). There was no evidence that perioperative beta-adrenergic blockade reduced all-cause mortality (OR 0.62, 95% CI 0.03 to 15.02), non-fatal myocardial infarction (OR 0.83, 95% CI 0.46 to 1.49; P value = 0.53), heart failure (OR 1.71, 95% CI 0.40 to 7.23), stroke (OR 2.67, 95% CI 0.11 to 67.08), or composite cardiovascular events (OR 0.87, 95% CI 0.55 to 1.39; P value= 0.57). However, there was strong evidence that BB increased the odds of intra-operative bradycardia (OR 4.97, 95% CI 3.22 to 7.65; P value < 0.00001) and intra-operative hypotension (OR 1.84, 95% CI 1.31 to 2.59; P value = 0.0005)
The study was conducted in the Medical and Surgical Intensive Care Units and the Coronary Care Unit at King Fahd Hospital
The patient, who will be referred to as Mr. Doe throughout this paper, is a 58 year old male with coronary artery disease. His medical history includes angina, shortness of breath, diabetes type II, as well as hypercholesterolemia. He was scheduled for a CABG
SPSS is the premier statistical analysis software, and has been the industry benchmark for decades. It is practically impossible to do work in the social sciences without understanding the basic uses and functions of SPSS. As the full name of the software (Statistical Package for the Social Sciences) suggests, the suite is especially designed for use in the social sciences and has become standardized in some fields like psychology (Field, 2005). Researchers can use SPSS to input the raw data from their research designed and the software can compute a practically limitless set of statistics based on those raw figures and inputs. Basic descriptive statistics such as frequency and rates of distribution are obviously available, as are various ratios that can be drawn from the data. Simple correlations can therefore be drawn. However, there are many more robust uses for the software including the ability to run some of the most sophisticated analytic techniques that ensure the reliability and validity of the research. These techniques include an Analysis of Variance (ANOVA), bivariate correlations, t-tests, chi-tests and more. Regression analyses, factor analyses, and two-step cluster analyses are also possible using SPSS (IBM, 2013). It is impossible to imagine computing the data gleaned from research in any other way, although there are competing products on the market. The vast majority of researchers and analysts in the educational, "think tank," and corporate sectors are