Neuromonitoring during adult cardiac surgery

Introduction The brain has been considered an index organ for global tissue perfusion because of the physiological processes aimed at flow preservation to vital organs of the body.When cerebral perfusion is compromised, other organs are likely inadequately perfused as well. It would therefore be prudent to monitor cerebral perfu- sion based on the proposition that interventions aimed at its preservation will likely result in adequate tissue perfusion of the whole body and reduced complications related to ischemia of various organs.

Changes in Inpatient Hospital Utilization at the Community Level

This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital services with the highest utilization rates. Reductions in inpatient care have also affected services with lower utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, between January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those with low severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Fewer inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.

Risk factors for pressure ulcers in adult patients of cardiac surgery with cardiopulmonary bypass

Pressure ulcers(PUs)are a common complication of surgery.Despite PUs causing a heavy economic burden and diminishing patients’quality of life,their risk factors have not been thoroughly investigated.We aimed to find risk factors for PUs in adult cardiac surgery patients with cardiopulmonary bypass(CPB).Methods:Demographic,laboratory,and surgical data,the score of pressure ulcer(PU)risk tool-Braden Scale of 2307 adult patients who underwent cardiac surgery with cardiopulmonary bypass(CPB)between January 2019 and September 2019 were obtained.The postoperative PU incidence rates were analyzed using binary logistic regression analysis.Receiver operating characteristic curves(ROC)and the areas under the curves(AUC)were calculated to assess the predictive accuracy of PU risk.Results:Of the 2307 patients in this study,176 developed PUs after surgery,PU incidence rate was 7.6%.Univariate analysis showed that sex,emergency status,surgery type,surgery classification,and skin problems before surgery were risk factors for postoperative PUs.In multivariate analysis,emergency surgery,hemoglobin,hematocrit,pro-brain natriuretic peptide(pro-BNP),surgery classification,and skin problems before surgery were risk factors for postoperative PUs.Conclusions:Our findings suggest that emergency surgery,hemoglobin,hematocrit,pro-BNP,surgery classification,and skin problems before surgery are risk factors for PUs in adult cardiac surgery patients with CPB.The widely used Braden Scale is unsuitable for predicting PUs in such patients.