Benoy Shah’s Post

Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial https://lnkd.in/gEMHcgQr Title: Cognitive Training for Reducing Delirium in Cardiac Surgery Patients Delirium is a serious issue for patients undergoing cardiac surgery, leading to longer hospital stays and increased risk of complications, including higher mortality rates. Cognitive training involves exercises and activities to improve cognitive function. While its effectiveness in reducing delirium in cardiac surgery patients was not well understood, a recent study in JAMA found promising results. The study involved 377 patients aged 60 years or older scheduled for elective cardiac surgery. The cognitive training program consisted of 10 sessions targeting memory, attention, and executive function, with education on delirium and prevention strategies. Results showed a 47% reduction in delirium risk in the cognitive training group, along with shorter duration of delirium and hospital stay compared to the control group. Cognitive training may improve cognitive reserve and brain plasticity, helping the brain withstand the stress of surgery and recover from its effects. This intervention could be easily incorporated into preoperative care, potentially reducing the risk of delirium and improving patient outcomes. However, further research is needed to understand its long-term effects and cognitive function. In conclusion, cognitive training shows promise in reducing delirium risk in cardiac surgery patients and could become a routine part of clinical practice. #ClinicalTrials #AIinHealthcare #MedicalAI #HealthTech #DigitalHealth #PatientCareAI #AIResearch #MedicalInnovation #BioTech #AIforGood #HealthcareData #AIinMedicine #PharmaAI #ClinicalData #HealthAI #AIHealthSolutions #PrecisionMedicine #AIandHealth #ClinicalAnalytics #AIDiagnostics

The final PDF it's now available

UH patients undergoing surgery for esophageal resection and lung resection have among the lowest mortality and complication rates in the nation, according to data from the Society of Thoracic Surgery (STS). The STS collects data from more than 100 of the largest academic and non-academic hospitals in the nation. Its database is considered the most detailed and advanced surgical database in the country. It reveals that that UH’s results place our program among the top 5% in the country for fewest deaths and fewest complications. UH Cleveland Medical Center’s Division of Thoracic and Esophageal Surgery has outstanding results for esophageal resection, and the program has ranked in the top tier of the nation’s largest and most advanced programs since data was first collected. UH’s rate of major complications and mortality is just two-thirds that of most other major academic medical centers. ”UH Cleveland Medical Center’s results are a testament to the exceptional surgical skills of the entire department, including thoracic surgeons Dr. Christopher Towe, Dr. Leo Tapias, Dr. Jillian Sinopoli and Dr. Bo Jiang,” says Philip Linden, MD, Chief, Division of Thoracic and Esophageal Surgery at UH Cleveland Medical Center. “It also reflects outstanding patient care delivered by nurses and physician extenders, such as Jason Brown, PA, Lucie Engelskirker, NP, Noreen Vick, NP, Madeline Meyers, PA, and Jackie McCluskey, PA.” Read more at https://lnkd.in/gjEnKTZR #thoracicsurgery #thoracicsurgeryquality #healthcarequality #patientsfirst

🔬 Intraoperative Oxygen Treatment and Organ Injury: Insights from a Randomized Clinical Trial 🔬 A recent study, led by Marcos G. Lopez, Matthew Shotwell, Cassandra Hennessy, Mias Pretorius, David R. McIlroy, Melissa J. Kimlinger, Eric H. Mace, Tarek Absi, Ashish S. Shah, Nancy J. Brown, and Frederic T. Billings, investigated the effects of intraoperative oxygen treatment on oxidative stress and organ injury following cardiac surgery. Key Findings: ➡️ Increased Oxidative Stress: The study found that patients receiving high concentrations of oxygen (hyperoxia) during surgery exhibited higher levels of oxidative stress compared to those who were maintained on normal oxygen levels (normoxia). ➡️ No Significant Impact on Organ Injury: Despite the increase in oxidative stress, hyperoxia did not lead to a higher incidence of kidney injury or other postoperative organ dysfunctions, including delirium and myocardial injury. ➡️ Clinical Implications: These findings suggest that strategies to either maximize or minimize oxygenation during cardiac surgery may not have a significant impact on postoperative organ outcomes. This research challenges existing perioperative practices, providing new insights into the management of oxygen levels during cardiac surgery. https://lnkd.in/drtB_ar2 #CardiacSurgery #OxidativeStress #OrganInjury #SurgicalResearch #MedicalResearch #JAMASurgery #PhysicianInsights #DoctorsUpdate

The advance copies of 'Key Questions in Cardiac Surgery', 2nd edition, have arrived hot off the press from the printer!   This is the second edition of 'Key Questions in Cardiac Surgery', which has become the must-read book for all cardiac surgical practitioners and is part of the revolutionary ‘Key Questions’ series of cardiothoracic surgical textbooks. The first edition was an international bestseller, for many years being the most popular cardiac surgical book.   'Key Questions in Cardiac Surgery' provides a systematic overview of the important topics in contemporary adult cardiac surgical practice. The text is evidence-based, incorporating current literature and has been updated from the first edition with the most recent American Heart Association and European Society of Cardiology guidelines. The main chapters have also been refreshed describing contemporary surgical techniques and management philosophies, with additional chapters on statistics and pulmonary embolism.   This illustrated concise text is a practical and clinically focused book that covers all the key questions in cardiac surgery. Whilst being an ideal reference for cardiac surgical trainees and residents, especially when undertaking their cardiothoracic surgery board examinations, this book is also of great value to other specialties involved in the care of cardiac surgical patients, including cardiologists, cardiothoracic intensivists, nurses and physiotherapists.   #cardiacsurgery #cardiacsurgeons #cardiothoracicsurgery #cardiacsurgicaltrainees #cardiacsurgicalresidents #cardiologists #cardiothoracicintensivists #cardiothoracicnurses #physiotherapists

The methodology of this study “Electroencephalography-Guided Anesthesia and Delirium in Older Adults After Cardiac Surgery The ENGAGES-Canada Randomized Clinical Trial” published in JAMA seems questionable. The median MAC reported in two centers in the study were 0.45 and 0.52 (around 0.4 without age adjustment). Given the use of such low MAC volatile anesthesia, there are no surprises that burst suppression were comparable. Supplement 4 eTable 10 in the study provides the data: Kingston & Toronto centers had median MAC of 0.45 and 0.40, they were running the anesthetic near MAC awake. Searching for burst suppression with light anesthesia is a curious strategy! In the EEG-guided group, clinicians were “encouraged” to decrease volatile anesthetic administration to minimize EEG suppression. Encouraged is a vague term and not an actual algorithm or protocol. Monitoring the site of action of anesthesia - the brain - is just good practice. This study should be interpreted with caution. https://lnkd.in/dbNiXScM #eeg #anesthesia #delirium #cardiac #surgery

https://lnkd.in/gDYN8hEt Article title: Postoperative Atrial Fibrillation and its association with the Atrial Substrate and the electrophysiological properties of the Atrial Myocardium Author(s): Osmar Antonio Centurión*; Fabiola Rodríguez; Karina Scavenius; Luis Miño; Orlando Sequeira Journal: Journal of Cardiovascular Medicine and Cardiology Journal ISSN: 2455-2976 Editorial: Postoperative atrial fibrillation (AF) has a high prevalence, affecting up to 45% of coronary artery bypass graft surgery patients within the first week of the operation [1-4]. Interestingly, asymptomatic AF was reported more likely to occur after the first 4 days following the cardiac surgery. Postoperative AF is associated with increased morbidity and several types of complications. #CoronaryArteryDiseases #ValvularHeartDisease #Electrophysiology #CardiacElectrophysiology #Echocardiography #InterventionalCardiology #ClinicalCardiology #NuclearCardiology #AcuteCoronarySyndromes #ArrhythmiaEP #CVImaging #CVDPrevention #CardiacArrhythmias #Peertechz #PeertechzPublications #OpenAccess #ScientificJournals #PeerReviewedJournals #OpenAccessPublishers #CardiacPhysiology #CardiacRegeneration #CardiacRehabilitation #Cardiomyopathies #CardiovascularDrugs #CardiovascularTherapy #CardiovascularAnatomy #CongenitalHeartDefects 

Blood Pressure Fragmentation as a New Measure of Blood Pressure Variability: Association with Predictors of Cardiac Surgery Outcomes ### Summary This study introduces a novel measure for assessing beat-to-beat blood pressure variability (BPV) called blood pressure fragmentation (BPF). #BloodPressureFragmentation #BloodPressureVariability #CardiacSurgery #ICULengthofStay

Advanced Life Support After Cardiac Surgery ‼️🫀 When it comes to the emergent resuscitation in non-cardiac surgery patients, the Basic Life Support (BLS) or the Advanced Cardiac Life Support (ACLS) models are to be followed utilizing external CPR and high doses of vasopressor or anti-arrhythmic medications. However, when caring for the post-cardiac surgery patient it is important for the medical provider to know that a different process should be followed! 😵 This process is called Cardiac Surgery Advanced Life Support (CALS) 🫀 and it is specifically designed for patients who are less than 10 days postoperative from a cardiac surgery that required a sternotomy (an incision down the middle of the chest). Unlike ACLS or BLS, in CALS CPR is not initiated right away upon arrest. This is due to the damage CPR can impose on the fresh sternotomy wires and fresh bypass grafts. Instead, numerous avenues can be taken, depending on what the suspected cause of the arrest is. This can include shocking the patient out of the deadly rhythm they are in or to electrically pace the heart. If these interventions are unsuccessful or if it is suspected the cause of the arrest is cardiac tamponade (a build up of blood or fluid around the heart) then the medical team is to be begin preparing to re-open the chest at the bedside (resternotomy). At this point, if it has been one minute since cardiac arrest, CPR can be initiated while the chest is being prepared for resternotomy. Once the chest is open, this gives the medical team the opportunity to convert to cardiac massage while the cause of the arrest is investigated and (hopefully 🤞) resolved! Also it is important to note that high doses of epinephrine are not to be given as this can impose danger to the fresh bypass grafts due to the severe vasoconstriction it causes. Instead, small doses in ~100 mcg increments are given to supplement blood pressure. 🤓 #cardiacsurgery #legalnurseconsultant

Cardiac Surgery Myths vs. Facts: Unveiling the Truth with Dr. Jaivik Vaghela | Shalby Hospitals Cardiac surgery, once feared by many, has evolved into a life-saving procedure with minimal risk, thanks to advanced technology and refined surgical techniques. In this insightful video, Dr. Jaivik Vaghela, a leading cardiac surgeon, demystifies common myths surrounding cardiac surgery and reveals the facts that every heart patient should know. Cardiac surgery has long been viewed as inherently risky, but with the advent of advanced medical technologies and highly skilled surgeons like Dr. Jaivik Vaghela, the risks have significantly diminished. Modern surgical techniques and cutting-edge innovations have transformed cardiac surgery into a remarkably safe procedure. Patients can now approach surgery with confidence, knowing that these advancements have made the process more precise, effective, and life-enhancing. Contrary to popular belief, cardiac surgery is not exclusive to older patients. Dr. Vaghela emphasizes that heart health is a universal concern, and surgical interventions are determined by the condition of the heart rather than the patient’s age. Additionally, thanks to minimally invasive procedures such as keyhole surgery, recovery times have been drastically reduced, allowing patients to regain their strength within a week. Early diagnosis and timely intervention ensure quicker recoveries and prevent complications. In addition to debunking these myths, Dr. Jaivik Vaghela encourages heart patients to adopt healthy habits, such as daily walking and avoiding oily foods, to maintain optimal heart health. Don’t let myths hold you back—learn the facts about cardiac surgery and take control of your heart health today. For the best Consultation, Diagnosis & Heart Treatment or related issues, book your Appointment at: https://lnkd.in/dWm7y9Jy For more details, call- 079-71238889 #cardiacpatients #heart #heartpatients #surgery #cardiacsurgery #heartsurgery #advancedtechnology #minimallyinvasiveprocedure #health #cardiachealth #hearthealth #cardiology #surgeon #cardiacsurgeon #healthtips #healthylifestyle #medical #treatment #doctortalks #ahmedabad #shalbyhospitals