What is the relationship between pre-operative dental prophylaxis and cardiac surgery outcomes?
Best insight from top research papers
Preoperative dental prophylaxis plays a crucial role in cardiac surgery outcomes. Studies have shown that implementing oral hygiene protocols before cardiac surgery can potentially reduce postoperative infections . Additionally, preoperative oral health status, including factors like the number of remaining teeth and periodontal status, significantly impacts postoperative complications and functional recovery in cardiovascular surgery patients . Evaluating different preoperative dental screening approaches, such as focused and comprehensive, revealed no significant difference in 90-day mortality post valve surgery, emphasizing the importance of dental clearance before cardiac procedures . Furthermore, dental treatment before advanced cardiac interventions does not increase the risk of adverse events, highlighting the safety and importance of addressing oral health before such procedures .
Answers from top 5 papers
More filters
| Papers (5) | Insight |
|---|---|
4 Citations | Preoperative dental screening (PDS) approaches (FocA and CompA) showed no significant difference in 90-day mortality post cardiac valve surgery, but CompA had lower reoperation rates due to infection. |
| Pre-operative dental treatment before advanced cardiac surgeries in end-stage heart failure patients does not increase medical adverse events or mortality, indicating no negative impact on cardiac surgery outcomes. | |
01 Mar 2021 2 Citations | Not addressed in the paper. |
10 Jul 2019 | Preoperative periodontal treatment improves oral health status in cardiac valve surgery patients, potentially reducing postoperative infection risk and complications, as indicated by the study. |
| The study found that a standardized oral hygiene protocol before cardiac surgery did not significantly reduce postoperative infections compared to usual practices, highlighting the need for further research in this area. |
Related Questions
What are the effects of dental pericarditis?5 answersDental pericarditis can have severe consequences, including cardiac tamponade and pericardial effusion, as seen in cases where dental infections spread to the mediastinum. While a direct causative relationship between dental disease and cardiovascular disease, like pericarditis, is debated due to shared risk factors and medication effects, it is crucial to manage oral health and cardiovascular risk factors to mitigate potential complications. In some instances, pericarditis can be a result of conditions like constrictive pericarditis due to previous tuberculosis infection, leading to symptoms like peripheral edema and breathlessness. Acute pericarditis, although uncommon, can also be linked to bacterial endocarditis, particularly associated with staphylococcal aureus infection, with a high mortality rate even with treatment. Thyrotoxicosis can also lead to pericarditis, emphasizing the diverse etiologies and implications of this condition.
What are the risks and complications of cardiac surgery?4 answersCardiac surgery carries the risk of various complications. These include myocardial depression, systemic inflammatory response, and catecholamine release, which can lead to end-organ damage. Close monitoring of patients' hemodynamics, chest tube output, electrolytes, acid-base balance, and coagulation status is crucial for early detection of life-threatening conditions such as cardiac tamponade, malignant arrhythmia, and acute myocardial ischemia. Neurological complications are also common after cardiac surgery, ranging from stroke to delirium and neurocognitive decline. Early neurological examination is important for detecting deficits and initiating appropriate intervention. Other potential complications include pulmonary dysfunction, deep sternal wound infection, acute kidney injury, and ileus. Additionally, cardiac surgery can be associated with peripheral nerve injury, retinal damage, seizures, and long-term neuropsychological impairment. It is crucial to recognize and promptly manage these complications to optimize patient outcomes.
Does preoperative radiation for rectal-cancer increase surgical complication?4 answersPreoperative radiation for rectal cancer does not increase surgical complications. There was no difference in severe postoperative complications or any complications between patients who received total neoadjuvant therapy and those who received neoadjuvant chemoradiation. However, total neoadjuvant therapy patients had longer operations and greater estimated blood loss, which may be due to increased operative difficulty from the radiation-to-surgery interval and/or the effects of chemotherapy. In another study, different radiotherapy plans, including 3D conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT), were compared in patients with locally advanced rectal cancer. VMAT had better homogeneity and greater tumor control probability (TCP), while 3DCRT improved conformity and decreased radiation sparing in organs at risk. Overall, preoperative radiation therapy for rectal cancer does not appear to significantly increase surgical complications, but it may have some impact on operative difficulty and blood loss.
Postoperative Cardiac Arrest in Cardiac Surgery–How to Improve the Outcome?5 answersPostoperative cardiac arrest in cardiac surgery can be influenced by various factors. Factors such as myocardial stunning, vasoplegic syndrome, systemic inflammatory response syndrome (SIRS), electrolyte disturbances, operative trauma, and myocardial edema can contribute to cardiac arrest. The use of a universal structured approach and familiarization with resuscitation protocols can improve outcomes. A protocolized approach to management is feasible and desirable in these cases. Mild therapeutic hypothermia has been established as the gold standard in post-arrest care, but the timing, patient selection, and cooling methods remain unclear. Evidence-based resuscitation guidelines, including correcting reversible causes, defibrillation/pacing before external compressions, and resternotomy within 5 minutes if electrical therapies fail, have been shown to improve survival rates. Implementing these guidelines can lead to improved outcomes and reduced resternotomy rates. Hemodynamic monitoring, witnessed-type of cardiac arrest, non-interrupted cardiac massage, and early recognition of cardiac tamponade are factors associated with higher rates of survival.
What are the mechanisms by which lactates affect cardiac surgery outcomes?5 answersElevated lactate levels during cardiac surgery have been associated with poor outcomes. High lactate levels can indicate tissue hypoperfusion and anaerobic metabolism, leading to increased lactate production. Hyperlactatemia can occur due to inadequate tissue perfusion, hypoxia, impaired buffering systems, or metabolic disorders. Measuring lactate levels is a simple and noninvasive method to assess tissue perfusion and predict clinical deterioration in postoperative patients. Intraoperative lactate levels, independent of baseline values, can serve as a dynamic parameter for morbidity and mortality prediction. Patients with a significant increase in intraoperative lactate levels have higher mortality rates, longer ICU stays, and increased incidence of postoperative renal failure. Monitoring lactate levels during cardiac surgery can help identify patients at risk and guide interventions to improve outcomes.
Are nicotine patches safe to use pre-operatively for patients undergoing cardiac surgery?5 answersNicotine patches have been studied for pre-operative use in patients undergoing surgery, including cardiac surgery. One study found that offering free nicotine patches to smokers awaiting non-urgent surgery stimulated interest in quitting, but the protocol had limited effectiveness in achieving smoking abstinence. Another study explored the feasibility of using electronic nicotine delivery systems (ENDS) to help patients reduce or eliminate cigarette consumption around the time of surgery. The study found that ENDS use was associated with a reduction in perioperative cigarette consumption. A narrative review of the literature concluded that nicotine replacement therapy (NRT), including nicotine patches, enhances the efficacy of tobacco use interventions and does not increase the risk of healing-related or cardiovascular complications in surgical patients. While there is limited clinical data on the specific use of nicotine patches in patients undergoing cardiac surgery, the available evidence suggests that NRT, including nicotine patches, can be a useful tool in helping patients quit smoking pre-operatively.