The objectives of this project were to see whether heart rate, respiration rate, blood pressure, and vocalization could be used to evaluate stress of castration in pigs. Six groups of pigs 1, 2, 4, 8, 16, and 24 d of age were used in the study, a total of 172 pigs. Half of each group of pigs received lidocaine before castration, injected subcutaneously over the testicle and infiltrated around the cord; the other half were left as controls. Pigs castrated without lidocaine had a higher heart rate (P < .02) and higher frequency of highest energy (HEF) measurements of vocalization (P < .05). Incising the scrotum and severing the spermatic cord elicited the greater heart rate response (P < .05) to castration without anesthetic, whereas HEF was lower during cutting of the cord. Both the heart rate and HEF data suggest that castration without anesthetic is of greater stress for pigs 8 d of age or older. Respiration rate was not a viable measure of stress associated with castration.

Background The use of extracorporeal membrane oxygenation (ECMO) in the postoperative period has expanded to include a variety of noncardiotomy procedures. It is important to investigate outcomes for this uniquely ill subset of patients as currently published data on this subject is limited. Methods All ECMO events at our institution from 2006 to 2017 were retrospectively considered. Patients were grouped into a postoperative noncardiotomy (PNC) cohort (n = 20) and a larger control cohort (n = 220). For additional analysis, the PNC cohort was further split into a liver transplant group (n = 4) and thoracic surgery group (n = 10). Basic demographics, medical history, type of operation performed, indication for support, and survival data were collected on all patients. Appropriate statistical analyses were performed and a P < .05 was considered statistically significant. Results Twenty PNC‐ECMO patients were identified. The indications for support were respiratory failure, cardiac arrest, and cardiogenic shock. PNC patient survival was similar to our control cohort, as well as extracorporeal life support organization (ELSO) published data with 55% weaning off ECMO and 50% surviving to discharge. Twelve‐month predicted survival was 40%. Post thoracic surgical patients were reviewed, and their survival rates were similar to the larger control cohort as well. There were no survivors in the liver transplant group. Conclusions Despite recent noncardiotomy surgery, patients who required ECMO for salvage in the postoperative period showed similar outcomes compared to our larger cohort and to published ELSO data, and reasonable long‐term survival outcomes. This suggests that ECMO may be applied to a variety of postoperative settings with outcomes on par with nationally published results.

No abstract

This is a response to the Letter to Editor received regarding the article "Outcomes of Non-Cardiotomy Patients Requiring Postoperative Extracorporeal Membrane Oxygenation."