Objective To review and analyze the statistics of laboratory critical values in the Department of Cardiovascular Surgery in order to improve the procedures of dealing with these values and provide references for the enhancement of the nursing level. Methods We retrospectively analyzed laboratory critical values of 236 inpatients in the Department of Cardiovascular Surgery from April 2013 to April 2014. General data of the patients including the type of critical values, the critical value, distribution, clinical processing time and complications related to the critical values. Results A total of 208 laboratory critical values of 185 inpatients were analyzed including abnormal blood potassium was involved in 99 (47.60%); abnormal blood glucose was involved in 13 (6.25%); abnormal blood sodium was involved in 11 (5.29%); abnormal blood troponin was involved in 13 (6.25%); and 72 cases had other kinds of critical values (34.62%). A total of 136 critical values were closely related to the Department of Cardiovascular Surgery. Among them, 60 cases had a processing time of 15 minutes or shorter. After re-examination, 16 were confirmed to be fake critical values; and 11 critical values did not need to be treated according to the condition of the patients. There were altogether 27 cases of complications related to critical values, including 23 cases of arrhythmia related to abnormal blood potassium, 2 cases of abnormal muscle strength caused by abnormal blood sodium, and 2 cases of hypoglycemia. After the critical values were handled, related complications disappeared without any recurrence. Conclusions Perfect regulatory regime and process of recording and handling laboratory critical values are important for nurses in our department to carry out more accurate measures in treating these critical values including abnormal blood potassium, blood glucose, blood sodium, and blood troponin, etc. In order to continuously improve medical and nursing quality, nurses should pay more attention to the identification and treatment of laboratory critical values.
In the late-breaking trials session of the American Heart Association’s Scientific Sessions 2021, which took place in November 2021, six clinical trials in cardiac surgery published their primary results. This review will look into three of them including the management of patients with moderate or less-than-moderate tricuspid regurgitation at the time of surgery for degenerative mitral regurgitation, timing of ticagrelor cessation before coronary artery bypass grafting, and long-term outcomes of ticagrelor-based antiplatelet therapy for secondary prevention of coronary artery bypass grafting.
目的 探討四肢動脈損傷的診斷和治療方法。方法 回顧分析我院1996年1月至2006年7月共診治的23例四肢動脈損傷患者的臨床資料。分別采用直接動脈修補、動脈結扎、端端吻合、自體大隱靜脈移植及人工血管吻合。術中取栓6例,合并靜脈損傷修復8例。結果 截肢3例（13.0%）。獲得隨訪12例，隨訪時間3個月~5年，11例多普勒超聲證實損傷血管血流通暢，下肢肌肉攣縮1例； 下肢血供不足1例。結論 早期診斷是提高肢體存活率和避免假性動脈瘤發生的關鍵。手術方式的合理選擇、Fogarty導管常規取栓和早期筋膜切開可提高治愈率。
Artificial intelligence in robot system is mainly divided into two types: endoscopic robot system and intracavitary robot navigation system. The endoscopic robot system can effectively shorten the time of vascular anastomosis and occlusion during vascular bypass surgery, while the intracavitary robot navigation system has good localization and real-time observation function. Moreover, it has significant advantages in complex lesions and special anatomical locations. High cost and complicated equipment debugging are the main factors that limit the wide application of robot systems. Artificial intelligence represented by robot system has obvious advantages and broad prospects in the field of vascular surgery, but more research is needed to improve its shortcomings and to further clarify its standard operation and long-term results.
In 2022, many excellent clinical studies emerged in the field of cardiovascular surgery. Selecting papers published in The New England Journal of Medicine and other top medicine and cardiology journals, this review focused on the research progress on 7 topics in the field of cardiovascular surgery: coronary artery surgery, vascular surgery, valvular surgery, structural heart disease, congenital heart disease, heart transplantation, perioperative management, and special population.