Perioperative care in infective endocarditis

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Abstract

Patients undergoing surgery for acute infective endocarditis are among those with the highest risk. Their preoperative condition has significant impact on outcomes. There are specific issues related with the preoperative situation, intraoperative findings, and postoperative management. In this narrative review, focus is placed on the most critical aspects in the perioperative period including the management and weaning from mechanical ventilation, the management of vasoplegia, the management of the chest open, antithrombotic therapy, transfusion, coagulopathy, management of atrial fibrillation, the duration of antibiotic therapy, and pacemaker implantation.

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OUP accepted manuscript

(2020)

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The international sepsis forum consensus conference on definitions of infection in the intensive care unit.

Thierry Calandra, Jonathan B Cohen (2005)

To develop definitions of infection that can be used in clinical trials in patients with sepsis. Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a set of valid definitions that can be easily implemented as part of a clinical trial protocol would facilitate patient selection, help classify patients into prospectively defined infection categories, and therefore greatly reduce variability between treatment groups. Experts in infectious diseases, clinical microbiology, and critical care medicine were recruited and allocated specific infection sites. They carried out a systematic literature review and used this, and their own experience, to prepare a draft definition. At a subsequent consensus conference, rapporteurs presented the draft definitions, and these were then refined and improved during discussion. Modifications were circulated electronically and subsequently agreed upon as part of an iterative process until consensus was reached. Consensus definitions of infection were developed for the six most frequent causes of infections in septic patients: pneumonia, bloodstream infections (including infective endocarditis), intravascular catheter-related sepsis, intra-abdominal infections, urosepsis, and surgical wound infections. We have described standardized definitions of the common sites of infection associated with sepsis in critically ill patients. Use of these definitions in clinical trials should help improve the quality of clinical research in this field.

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Infective endocarditis.

Thomas J. Cahill, Bernard Prendergast (2016)

Infective endocarditis occurs worldwide, and is defined by infection of a native or prosthetic heart valve, the endocardial surface, or an indwelling cardiac device. The causes and epidemiology of the disease have evolved in recent decades with a doubling of the average patient age and an increased prevalence in patients with indwelling cardiac devices. The microbiology of the disease has also changed, and staphylococci, most often associated with health-care contact and invasive procedures, have overtaken streptococci as the most common cause of the disease. Although novel diagnostic and therapeutic strategies have emerged, 1 year mortality has not improved and remains at 30%, which is worse than for many cancers. Logistical barriers and an absence of randomised trials hinder clinical management, and longstanding controversies such as use of antibiotic prophylaxis remain unresolved. In this Seminar, we discuss clinical practice, controversies, and strategies needed to target this potentially devastating disease.

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Author and article information

Contributors

Eduard Quintana:

ORCID: http://orcid.org/0000-0002-5386-7463

equintan@clinic.cat

Journal

Journal ID (nlm-ta): Indian J Thorac Cardiovasc Surg

Journal ID (iso-abbrev): Indian J Thorac Cardiovasc Surg

Title: Indian Journal of Thoracic and Cardiovascular Surgery

Publisher: Springer Nature Singapore (Singapore )

ISSN (Print): 0970-9134

ISSN (Electronic): 0973-7723

Publication date (Electronic): 14 May 2024

Publication date PMC-release: 14 May 2024

Publication date (Print): May 2024

Volume: 40

Issue: Suppl 1

Pages: 115-125

Affiliations

[1 ]Department of Cardiovascular Surgery, Hospital Clínic, University of Barcelona, ( https://ror.org/021018s57) Villarroel 170, 08036 Barcelona, Spain

[2 ]Cardiac Surgery Department, Hospital Santa Cruz, ( https://ror.org/02r581p42) Carnaxide, Portugal

[3 ]Department of Anesthesiology, Hospital Clinic, University of Barcelona, ( https://ror.org/021018s57) Barcelona, Spain

[4 ]Department of Myocardial Pathology, Transplantation and Mechanical Circulatory Support, Amosov National Institute of Cardiovascular Surgery, ( https://ror.org/0026pjn75) Kiev, Ukraine

[5 ]Department of Cardiothoracic Surgery and The Robert WM Frater Cardiovascular Research Centre, The University of the Free State, ( https://ror.org/009xwd568) Bloemfontein, South Africa

Author information

Eduard Quintana http://orcid.org/0000-0002-5386-7463

Sara Ranchordas http://orcid.org/0000-0003-3586-707X

Cristina Ibáñez http://orcid.org/0000-0002-9774-4836

Polina Danchenko http://orcid.org/0000-0002-2111-7510

Francis Edwin Smit http://orcid.org/0000-0001-6483-5320

Carlos - Alberto Mestres http://orcid.org/0000-0001-8148-9044

Article

Publisher ID: 1740

DOI: 10.1007/s12055-024-01740-7

PMC ID: 11139830

PubMed ID: 38827544

SO-VID: 9fea2912-2d84-4d79-ab17-f67632b70702

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 7 February 2024

Date revision received : 10 April 2024

Date accepted : 12 April 2024

Funding

Funded by: Universitat de Barcelona

Open Access :

Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.

Custom metadata

Keywords: infective endocarditis,diagnostic criteria,cardiac surgery,perioperative care,complications

Data availability:

Keywords: infective endocarditis, diagnostic criteria, cardiac surgery, perioperative care, complications

Perioperative care in infective endocarditis

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Research from Ukraine

Most cited references 91

OUP accepted manuscript

The international sepsis forum consensus conference on definitions of infection in the intensive care unit.

Infective endocarditis.

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