Purpose: Ventilator-associated pneumonia (VAP) is the main infectious complication in cardiac surgery patients and is associated with an important increase in morbidity and mortality. The aim of our study was to analyze the impact of VAP on mortality excluding other comorbidities and to study its etiology and the risk factors for its development. Materials and Methods: This prospective cohort study included 1610 postoperative cardiac surgery patients' status post cardiopulmonary bypass (CPB)
Purpose: Ventilator-associated pneumonia (VAP) is the main infectious complication in cardiac surgery patients and is associated with an important increase in morbidity and mortality. The aim of our study was to analyze the impact of VAP on mortality excluding other comorbidities and to study its etiology and the risk factors for its development. Materials and Methods: This prospective cohort study included 1610 postoperative cardiac surgery patients' status post cardiopulmonary bypass (CPB)
Background and Objectives: Ambulatory surgery is much favored in children, as they are usually healthy with no major comorbidities. Obvious benefits are minimization of health costs, optimal utilization of resources, decreased exposure to infections, and psychological and emotional advantages of avoiding admission of the patient, especially for the family. Parental satisfaction is a challenge in pediatric surgery processes. The objective of this study was to compare satisfaction in parents whose children underwent surgery without overnight stays with parents whose children were operated on in an autonomous major ambulatory surgery unit (hospital isolated). Methods: This was a prospective observational study of 200 children who received surgery on an outpatient basis (133 were included in an outpatient unit and 67 in a hospital setting). Different variables were collected, including sex, age, type of surgery, and length of stay in the hospital and location, and a telephone perception survey was conducted (questionnaire of satisfaction of 14 questions with possible answers from 1 to 4 on a Likert scale and a 15th question on global satisfaction, with an answer from 0 to 10). Results: Overall satisfaction during the hospital stay was higher in the group operated on in the autonomous major surgery unit (3.54 ± 0.57 vs 3.28 ± 0.64, P = .004). Whether parents respond as being very satisfied with the hospital stay is influenced by several factors, among which are: being treated at major ambulatory surgery units (odds ratio [OR] = 2.16), good or very good information received prior to surgery (OR = 2.03), and good or very good information received at discharge (OR = 2.48). Conclusions: Parents of children who received surgery on an outpatient basis were more satisfied if the procedure was performed in an autonomous major ambulatory surgery unit compared with hospitalization, even if it was not overnight. The information received during the care process influenced the parents' satisfaction. These findings suggest that efforts should be devoted to the creation of autonomous units for ambulatory surgery and to the improvement of perioperative information.
Mitochondrial dysfunction comprehends a wide range of genetic disorders. These patients’ precarious metabolic balance makes its management difficult. Furthermore, the same systems affected by mitochondrial disease can be altered by many of the frequently used anesthetic agents. Each patient has to be evaluated individually according to their comorbidities and anesthetic requirements.
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