A clinical study on the effects of ICU cardiac rehabilitation nursing care on patients with totally thoracoscopic cardiac operation

Background The video-assisted thoracoscopic surgical techniques are widely used in the treatment of patients with congenital heart diseases with good outcomes. However, the feasibility and significance of nurse based early cardiac rehabilitation in cardiac intensive care unit （ICU） for patients with totally thoracoscopic cardi- ac operation has been seldom studied. Methods Thirty-six patients with totally thoracoscopic cardiac operation under the condition of the cardiac ICU in Guangdong General Hospital were random allocated to the intervention group and the control group between January 2012 to December 2014. The control group received standard nursing care, and the intervention group received early cardiac rehabilitation nursingcare in addition to standard care. The outcome measures included the oxygen saturation （SPO2%）, vital capacity, forced expiratory volume in 1 second （FEV1）, and pain in the thoracic wound （visual analogue scale, VAS）, which were measured at the baseline and within 2-day after 4-week nursingcare. For safety reason, we also monitored the rate of perceived exertion （RPE）, heart rate, systemic blood pressure. Results There were non-significant differences between the groups in age, sex, total number of comorbid conditions, total number of medications, surgical time, and anesthetic time （P〉0.05）. Following 4 weeks treatment, the cardiopulmonary functions and VAS scorewere improved （P〈0.05） in all groups. In addition, the improvements were more in the early cardiac rehabilitation nurse care group than in the control group （P〈0.05）. Conclusion The early cardiac rehabilitation nursing care in cardiac ICU is safe, feasible and beneficial for patients with totally thoracoscopic cardiac operation.

Validation of the Chinese system for cardiac operative risk evaluation (SinoSCORE):the experience from Guangdong Cardiovascular Institute

Objective To validate of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in Cantonese surgery patients. Methods Data from Guangdong Cardiovascular Institute in the period January 2004 through December 2008 were analyzed on 2462 Cantonese heart surgery patients. First,compared risk factors of this series and database of SinoSCORE,and then calculated

Cardiac surgical operation after renal transplantation

Several studies reported the impact of cardiac surgical operation on morbidity and mortality in renal transplant recipients as well as on renal graft function and safety and effect of immunosuppressant medication.1-3 However,few data are available about the risk and immunosuppressant medication in patients who undergo cardiac surgical operation after successful renal transplantation,especially in patients who underwent offpump coronary artery bypass grafting （CABG） with previous renal transplantation.This research provides important insights into the immunosuppressive management of a patient requiring valve replacement or CABG after renal transplantation during the perioperative period.

Is the European System for Cardiac Operative Risk Evaluation useful in Chinese patients undergoing heart valve surgery？

Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation （SinoSCORE）. Methods Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve （AUC） was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow （H-L） goodness-of-fit test was used to study the calibration of the predictive models. Results A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% （additive）, 3.19% （logistic） and 3.66% （SinoSCORE）. AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good （H-L： P=-0.250 and P=0.051, respectively）, but the logistic EuroSCORE model had a poor calibration （H-L： P〈0.05）. The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients, However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles. Conclusions The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.