Conectar
Perioperative myocardial injury (PMI) is a common complication following non-cardiac, particularly thoracic, surgery and is associated with increased cardiovascular risk. Although guidelines recommend cardiac biomarker monitoring to detect PMI, its implementation in routine clinical practice remains limited.
To evaluate the combined use of high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting major adverse cardiovascular events (MACE) following elective thoracic surgery, and to determine whether NT-proBNP provides incremental prognostic value beyond hs-cTnI alone.
Multicentre observational cohort study.
Conducted between February 2021 and November 2023 in three Spanish tertiary hospitals.
Patients aged ≥45 years scheduled for elective thoracic surgery involving lung resection (pneumonectomy, lobectomy, bilobectomy or segmentectomy) under general anaesthesia. Exclusion criteria included urgent or non-thoracic surgery, active infection or sepsis and a history of severe heart failure (ejection fraction
Combined measurement of hs-cTnI and NT-proBNP at baseline (preoperatively) and at 24 and 48 hours postoperatively.
PMI was defined as hs-cTnI ≥45 ng/L at 24 and/or 48 hours or a ≥20% increase from baseline in patients with elevated preoperative concentrations.
Among 475 patients, PMI occurred in 11.8%. PMI had higher rates of prior stroke (12.5% vs 2.9%; p=0.004), smoking history (85.7% vs 64.0%; p=0.001) and severe renal dysfunction (7.1% vs 0.7%; p=0.001), with similar Revised Cardiac Risk Index distribution. Patients with PMI also had greater postoperative elevations of hs-cTnI and NT-proBNP (p
Combined hs-cTnI and NT-proBNP assessment improves perioperative cardiovascular risk stratification beyond ischaemia.
To explore parents’ experiences of parenting adolescents with food allergies.
An interpretive descriptive qualitative study.
Semi-structured interviews were conducted between November 2023 and March 2024 with 11 parents of adolescents with food allergies aged 12–16 years, 8 mothers and 3 fathers. Reflexive thematic analysis was conducted.
Three themes were generated: (1) Impact on everyday life, which concerns having to ‘always be on alert’, restriction as a family and mitigating feelings of difference in their child, (2) ‘handing over the reins,’ which describes parents role in the process of transition, including trusting their child, considering new adolescent socialising behaviours such as alcohol and intimate relationships, and ‘letting go' of some responsibility, and (3) learning, which details common misconceptions that parents still have and lessons learned from experiences of anaphylaxis and from tragedies in the media.
This study adds substantial knowledge about the parental experience in food allergy, specific to parents of adolescents. Parents endure constant worry for their child, heightened at critical times, including the transition period of adolescence. Parents need guidance and support from healthcare professionals in this crucial time of change. Further education is needed as knowledge gaps remain even at this advanced stage in a parent's food allergy journey. Throughout the narrative, there was an undercurrent of parental anxiety, with periods of heightened anxiety illustrated in each theme.
The topic of transition and parents' role in the process should be introduced by healthcare professionals. Future work should focus on creating learning resources for families which cover the common areas of concern identified. Accessible education is needed for healthcare professionals without a background in allergy, particularly concerning anaphylaxis management.
The Reflexive Thematic Analysis Reporting Guidelines were used to guide reporting.
No Patient or Public Contribution.
FreshRSS 