Nonsurgical Strategies to Reduce Mortality in Patients Undergoing Cardiac Surgery: An Updated Consensus Process
J Cardiothorac Vasc Anesth
; 32(1): 225-235, 2018.
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1063645
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
OBJECTIVE:
A careful choice of perioperative care strategies is pivotal to improve survival in cardiac surgery. However, there is no general agreement or particular attention to which nonsurgical interventions can reduce mortality in this setting. The authors sought to address this issue with a consensus-based approach.DESIGN:
A systematic review of the literature followed by a consensus-based voting process.SETTING:
A web-based international consensus conference.PARTICIPANTS:
More than 400 physicians from 52 countries participated in this web-based consensus conference.INTERVENTIONS:
The authors identified all studies published in peer-reviewed journals that reported on interventions with a statistically significant effect on mortality in the setting of cardiac surgery through a systematic Medline/PubMed search and contacts with experts. These studies were discussed during a consensus meeting and those considered eligible for inclusion in this study were voted on by clinicians worldwide.MEASUREMENTS AND MAINRESULTS:
Eleven interventions finally were selected 10 were shown to reduce mortality (aspirin, glycemic control, high-volume surgeons, prophylactic intra-aortic balloon pump, levosimendan, leuko-depleted red blood cells transfusion, noninvasive ventilation, tranexamic acid, vacuum-assisted closure, and volatile agents), whereas 1 (aprotinin) increased mortality. A significant difference in the percentages of agreement among different countries and a variable gap between agreement and clinical practice were found for most of the interventions.CONCLUSIONS:
This updated consensus process identified 11 nonsurgical interventions with possible survival implications for patients undergoing cardiac surgery. This list of interventions may help cardiac anesthesiologists and intensivists worldwide in their daily clinical practice and can contribute to direct future research in the field.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Período Perioperatório
Tipo de estudo:
Estudo prognóstico
Idioma:
Inglês
Revista:
J Cardiothorac Vasc Anesth
Ano de publicação:
2018
Tipo de documento:
Artigo
Instituição/País de afiliação:
A.O.U. Citta della Salute e della Scienza/IT
/
Azienda Ospedaliera Dei Colli/IT
/
Beijing Anzhen Hospital/CN
/
Busto Arsizio Hospital/IT
/
Cardiocentro Ticino/CH
/
Dante Pazzanese Institute of Cardiology/BR
/
IRCCS San Raffaele Scientific Institute/IT
/
InCor/BR
/
Institute for Clinical and Experimental Medicine/CZ
/
Medipol Mega University Hospital/TR