Echocardiographic Probability of Pulmonary Hypertension in Cardiac Surgery Patients-Occurrence and Association with Respiratory Adverse Events-An Observational Prospective Single-Center Study.

BACKGROUND: Pulmonary hypertension (PH) is an independent risk factor of increased morbidity and mortality in cardiac surgery patients (CS). The most common cause underlying PH is left ventricular (LV) diastolic dysfunction. This study aimed to evaluate the echocardiographic probability of PH in patients undergoing CS and its correlation with postoperative respiratory adverse events (RAE). METHODS: The echocardiographic probability of PH and its correlation with LV diastolic dysfunction was assessed in 56 consecutive adult patients who were qualified for coronary artery bypass grafting (CABG). Later, the postoperative RAE (such as pneumonia, pulmonary congestion, or hypoxemia), the length of intensive care unit (ICU) treatment and mortality in groups with moderate or high (PH-m/h) and low (PH-l) probability of pulmonary hypertension were examined. RESULTS: PH-m/h was observed in 29 patients, of whom 65.5 % had LV diastolic dysfunction stage II or III. A significantly higher occurrence of RAE was observed in the PH-m/h group as compared to the PH-l group. There were no differences between the PH-m/h and PH-l patient groups regarding the in-hospital length of stay or mortality. CONCLUSIONS: High or intermediate probability of PH is common in cardiac surgical patients with left ventricular diastolic dysfunction and correlates with respiratory adverse events.

Efficacy of AutoPulse for Mechanical Chest Compression in Patients with Shock-Resistant Ventricular Fibrillation.

INTRODUCTION: Sudden cardiac arrest is one of the most common causes of death. In cases of shock-resistant ventricular fibrillation, immediate transport of patients to the hospital is essential and made possible with use of devices for mechanical chest compression. OBJECTIVES: The efficacy of AutoPulse in patients with shock-resistant ventricular fibrillation was studied. METHODS: This is a multicentre observational study on a population of 480,000, with 192 reported cases of out-of-hospital cardiac arrest. The study included patients with shock-resistant ventricular fibrillation defined as cardiac arrest secondary to ventricular fibrillation requiring ≥3 consecutive shocks. Eventually, 18 patients met the study criteria. RESULTS: The mean duration of resuscitation was 48.4±43 min, 55% of patients were handed over to the laboratory while still in cardiac arrest, 83.3% of them underwent angiography and, in 93.3% of them, infarction was confirmed. Coronary intervention was continued during mechanical resuscitation in 50.0% of patients, 60% of patients survived the procedure, and 27.8% of the patients survived. CONCLUSIONS: Resistant ventricular fibrillation suggests high likelihood of a coronary component to the cardiac arrest. AutoPulse is helpful in conducting resuscitation, allowing the time to arrival at hospital to be reduced.

Cytogenetic aspects of buprenorphine maintenance treatment program--preliminary report.

The study was aimed at a preliminary evaluation of the effect of buprenorphine, a synthetic opioid used as a substitute in the therapy of dependence on psychoactive substances, on the structure of the genetic material of patients receiving such treatment. The material for the study were lymphocyte cultures from peripheral blood, analysed by a cytogenetic micronuclear test. The obtained results were compared with the literature data on the mutagenic action of methadone.