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Introduction: Preventing acid-base and electrolyte disturbance is crucial in coronary artery bypass graft (CABG) surgery, since any of these conditions can affect outcome. The type of crystalloid solution used during and after the surgery can affect these disturbances. Methods: In this study, 90 patients who candidates for CABG surgery were randomly allocated to either ringer's lactate (RL) or ringer's group. In order to provide essential blood volume before and after the start of CPB fluid administration with either ringer's or RL solution was started during operation and continued for 18 hours after the patient was transferred to ICU. ABG, serum electrolytes and Lactate level were measured before and at the end of CPB, upon arrival to the ICU, and 6, 12 and 18 hours after ICU admission and compared between the two groups. Results: Blood PH level was significantly different between the two groups upon arrival to ICU, 6 and 18 hours after ICU admission (P < 0.05) which was clinically closer to the normal range in the RL group. Serum bicarbonate level showed a significantly difference between the two groups (P < 0.05). There were no significantly differences between the two groups in terms of lactate level, serum electrolytes, blood loss, intake and output of fluids and blood products transfusion. Conclusion: In this study, ringer's lactate solution creates a more favorable acid-base balance without a significant increase in blood lactate level which is attributed to the buffering effect of existing lactate, and can be used as an appropriate alternative to ringer's solution during and after CABG. [ABSTRACT FROM AUTHOR]

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Introduction: Sleep quality is the main concern of patients after cardiac surgery. We compared the effect of two routinely used sedatives on the sleep quality of patients admitted to the intensive care unit (ICU) after cardiovascular surgery. Methods: It is a prospective, controlled, randomized clinical trial. A total of 120 patients, after cardiac surgery were enrolled. During extubating, patients were randomized into two groups: 60 patients received an infusion of dexmedetomidine (precede; 0.5 μg/kg/h), and 60 patients received 50 μg/kg/min propofol for 6 hours. Baseline characteristics were compared between the groups. The patients completed the St. Mary's Hospital Sleep Questionnaire, and the scores were compared between the groups. Results: The groups were not different in terms of demographics, underlying diseases, smoking/drug abuse/alcohol, number of vessels involved, history of non-cardiac surgery, and mean levels of serum parameters (P >0.05). Most of the medications used were similar between the groups (P >0.05), except calcium channel blockers (more frequently used in the propofol group [ P =0.027). The details of surgery were not statistically significant different (P >0.05); but, the mean volume of platelet received after the surgery was higher in propofol group (P =0.03). The propofol group had less problems with last night's sleep (0 vs 0.1±0.66), felt more clear-headed (4.9±0.6 vs 4.68±0.58, were more satisfied with their last night's sleep (52.1% vs 47.9%), but spent more time getting into sleep (0.38±1.67 vs 0) (P <0.5).> Conclusion: The sleep quality of patients under the influence of propofol seemed to be better than dexmedetomidine after cardiac surgery. [ABSTRACT FROM AUTHOR]

The article presents a case study of a three-year-old male patient with congenital Frank ter Haar syndrome (FTHS). Topics discussed include the clinical characteristics of FTHS which range from cardiac to dental abnormalities, the medical history of the patient and results of the preoperative evaluations performed, and the patient outcomes observed following cardiac surgery and admission to the pediatric cardiac intensive care unit.

Tracheostomy is a common procedure performed on patients who require long-term airway maintenance and ventilation support. It is preferred over endotracheal intubation due to its reduced airway resistance, lower risk of displacement compared with the endotracheal tube, increased patient comfort, improved weaning from mechanical ventilation, and enhanced suction capabilities. According to the literature, patients needing airway support for fewer than 12 days can undergo translaryngeal intubation, while tracheostomy is indicated for patients requiring ventilatory support for more than 20 days. Although tracheostomy is frequently performed in ICUs and operating rooms, several complications can arise following the procedure. These complications include leakage, obstruction of the tracheal tube, minor or major bleeding or oozing, barotrauma, infections, tracheoesophageal fistula, stenosis, and injury to surrounding peripheral tissues such as arteries, veins, and nerves. While herniation of the endotracheal cuff is a more common cause of airway obstruction and hypoxia, tracheostomy tube cuff herniation is a rare complication of this procedure. In this report, we present a rare case of cardiopulmonary arrest following the implantation of a tracheostomy tube cuff in a female patient and its management. [ABSTRACT FROM AUTHOR]

Objectives: Traditional guidelines for preoperative fasting (POF) time lead to several complications in surgery patients. However, not enough attention has been paid to the issue. This aimed of this study was to investigate the management of fasting times in Guilan academic hospitals. Materials and Methods: In this descriptive cross-sectional study, individuals from five academic referral centers enrolled the survey and questionnaires including demographic characteristics, fasting hours for liquids and solids, POF recommenders, and patient's knowledge regarding the definition of clear liquids were completed. Results: A total of 390 individuals candidate for elective surgeries enrolled in the study, the mean age of our cases were 46.61 years. The average POF time for solids and liquids was 11.43 and 9.70 hours, respectively. 95.38% of the participants did not know a correct definition of clear liquids, which was not related to their level of education (P = 0.314). A positive association was observed between age and POF times for liquids and American Society of Anesthesiologists Classification for both solids (P = 0.010) and liquids (P = 0.0001). Conclusions: It was found that the real POF time in our hospitals was significantly longer than the modern guidelines, and needs to be corrected. [ABSTRACT FROM AUTHOR]

Objectives: Day of surgery (DOS) cancellation is an unfortunate situation that affects both patients and hospitals. Cancellation of elective surgeries as a strong indicator for evaluating the management efficacy and quality of care offered by hospital services is associated with several unfavorable consequences. The present study aimed at investigating the rate and causes of elective surgery cancellation in an academic referral hospital. Materials and Methods: This descriptive study was performed at Al-Zahra hospital, an academic center in the North of Iran, during 2018-2019. All scheduled cases for elective surgeries were prospectively enrolled in this study. Then, complete data were collected and recorded from DOS canceled cases, including the type of surgery, age, ASA class, and the reason for cancellation. Results: In general, 82 elective surgeries were canceled (3.3%) during the mentioned period. Among them, hysterectomy was the most canceled one (51.2%) and the lack of intensive care unit (ICU) beds (22%) and the patient's clinical status changes (20.7%) significantly above 60 (P=0.011) and ASA class III (P=0.001) were the main causes in this regard. Conclusions: To improve operating room (OR) efficiency, great attempts should be made to eliminate the number of DOS cancellations through short intervals between preoperative visits and DOS, and to expand the ICU ward. [ABSTRACT FROM AUTHOR]