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Article ; Online: Invited commentary: "Adapting technology and rapid transitions to optimize management outcomes in mechanical circulatory support".

Brozzi, Nicolas

2021 Volume 36, Issue 4, Page(s) 1572–1573

MeSH term(s)	Extracorporeal Membrane Oxygenation ; Humans ; Shock, Cardiogenic ; Technology
Language	English
Publishing date	2021-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.15228
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Article ; Online: Cardiogenic Shock: Searching for a Better Lifeboat.

Baran, David A / Brozzi, Nicolas

Journal of the American Heart Association

2022 Volume 11, Issue 23, Page(s) e028354

MeSH term(s)	Humans ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/therapy
Language	English
Publishing date	2022-11-24
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.028354
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Article ; Online: Understanding the potential value of cardiovascular brain death donors to increase the heart donor pool.

Brozzi, Nicolas A / Baran, David A / Napoli, Federico

Journal of cardiac surgery

2022 Volume 37, Issue 12, Page(s) 4628–4629

MeSH term(s)	Humans ; Brain Death ; Tissue Donors ; Tissue and Organ Procurement ; Heart ; Mediastinum ; Heart Transplantation
Language	English
Publishing date	2022-11-15
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.17153
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Article ; Online: Sepsis in cardiothoracic surgery.

Napoli, Federico / Aleman, Rene / Zadneulitca, Nikita / Navia, Jose / Brozzi, Nicolas A

Surgery

2023 Volume 175, Issue 2, Page(s) 556–558

Abstract: Sepsis is a life-changing condition that can occur in patients undergoing cardiothoracic surgery. It is characterized by a dysregulated inflammatory response to infection, often leading to higher rates of organ dysfunction and mortality. The importance ... ...

Abstract	Sepsis is a life-changing condition that can occur in patients undergoing cardiothoracic surgery. It is characterized by a dysregulated inflammatory response to infection, often leading to higher rates of organ dysfunction and mortality. The importance of early recognition and prompt intervention in managing sepsis-related complications in cardiothoracic surgery is pivotal to adequate surgical practice. Due to the multiple subsections that construct the broad spectrum of cardiothoracic surgery, it is important to address the presence of sepsis in elective cardiothoracic surgery, urgent/emergency cardiothoracic surgery, solid organ transplantation, and both temporary and permanent mechanical circulatory support (ie, left ventricular assist devices, extracorporeal membrane oxygenation, and percutaneous temporary devices [eg, Impella series]). Exploring the incidence, prevalence, and risk factors of said subsections can lead to improvement in postoperative outcomes. The impact of accompanying infections can progress into further operative morbidity and mortality. To this effect, the perioperative management of cardiothoracic surgery transcends surgical techniques and should undergo additional recognition of other occurrences such as wound infections, bloodstream infections, urinary tract infections, and pneumonia. Sepsis remains a concern in cardiothoracic surgery, as it can lead to devastating consequences. Hence, there is an evident need for heightened vigilance, early recognition, and effective management strategies to mitigate the risk of sepsis in this patient population. The purpose of this article is to provide an overview of sepsis in the different cardiothoracic surgery areas.
MeSH term(s)	Humans ; Pneumonia ; Morbidity ; Incidence ; Elective Surgical Procedures ; Sepsis/epidemiology ; Sepsis/etiology ; Sepsis/therapy
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.10.015
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Article ; Online: GoogleTrends as a patient therapeutic education resource on extracorporeal life support: What do patients want to know?

Aleman, Rene / Patel, Sinal / Frieder, Joel S / Navia, Jose / Sheffield, Cedric / Brozzi, Nicolas A

Journal of cardiac surgery

2022 Volume 37, Issue 7, Page(s) 2000–2005

Abstract: Introduction: Extracorporeal membrane oxygenation (ECMO) is implemented as rescue therapy in COVID-19 related acute distress respiratory syndrome (ARDS) and refractory hypoxemia. Google Trends (GT) is an ongoing-developing web kit providing feedback on ... ...

Abstract	Introduction: Extracorporeal membrane oxygenation (ECMO) is implemented as rescue therapy in COVID-19 related acute distress respiratory syndrome (ARDS) and refractory hypoxemia. Google Trends (GT) is an ongoing-developing web kit providing feedback on specific population's interests. This study uses GT to analyze the United States (US) general population interest in ECMO as COVD-19/ARDS salvage therapy. Methods: GT was used to access data searched for the term ECMO and COVID-19. The gathered information included data from March 2020 to July 2021 within US territories. Search frequency, time intervals, sub-regions, frequent topics of interest, and related searches were analyzed. Data were reported as search frequency on means, and a value of 100 represented overall peak popularity. Results: The number of Google searches related to the terms ECMO and COVID-19 has surged and sustained interest over time ever since the initial reports of COVID-19 in the US, from an initial mean of 34% in March 2020 to a 100% interest by April 2020, resulting in an up-to-date overall average of 40% interest. Over time West Virginia, Gainesville, and Houston, lead the frequency of searches in sub-region, metro and city areas, respectively. Top search terms by frequency include: ECMO machine, COVID ECMO, what is ECMO, ECMO treatment and VV ECMO. Parallel to this, the related rising terms are: COVID ECMO, ECMO machine COVID, ECMO for COVID, ECMO machine coronavirus, and ECMO vs ventilator. Seemingly, medical-relevant websites fail to adequately address these for patient therapeutic education (PTE) purposes. Conclusions: GT complements the understanding of interest in ECMO for COVID-19. When properly interpreted, the use of these trends can potentially improve on PTE and therapy awareness via specific medical relevant websites.
MeSH term(s)	COVID-19/therapy ; Extracorporeal Membrane Oxygenation/methods ; Humans ; Respiratory Distress Syndrome/therapy ; Salvage Therapy ; United States/epidemiology
Language	English
Publishing date	2022-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16513
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Article ; Online: Prognostic value of patient-reported outcome measures in adult heart-transplant patients: a systematic review.

Villa, Bernardo Perez / Alotaibi, Sultan / Brozzi, Nicolas / Spindler, Kurt P / Navia, Jose / Hernandez-Montfort, Jaime

Journal of patient-reported outcomes

2022 Volume 6, Issue 1, Page(s) 23

Abstract: Background: The aim of this systematic review was to describe the prognostic value of patient-reported outcome measures (PROMs) in adult heart-transplant (HT) patients.: Methods: A systematic search was performed on Ovid Medline, CINAHL Plus, Web of ... ...

Abstract	Background: The aim of this systematic review was to describe the prognostic value of patient-reported outcome measures (PROMs) in adult heart-transplant (HT) patients. Methods: A systematic search was performed on Ovid Medline, CINAHL Plus, Web of Science, and PubMed. The study protocol was registered on the PROSPERO database (CRD42021225398), and the last search was performed on January 7, 2021. We included studies of adult HT patients where generic and disease-specific PROMs were used as prognostic indicators for survival, readmissions, HT complications, and the onset of new comorbidities. We excluded studies that used clinician-reported and patient-experience outcomes. The Quality in Prognosis Studies tool (QUIPS) was used to measure the risk of bias of the included studies. Results: We included five observational studies between 1987 and 2015, whose populations' mean age ranged from 43 to 56 years and presented a higher proportion of males than females. The Kansas City Cardiomyopathy Questionnaire demonstrated a negative correlation with readmissions (coefficient = - 1.177, p = 0.031), and the EQ-5D showed a negative correlation with the onset of neuromuscular disease after HT (coefficient = - 0.158, p < 0.001). The Millon Behavioral Health Inventory and the Nottingham Health Profile demonstrated a statistically significant association as survival predictors (p = 0.002 and p < 0.05, respectively). A moderate overall risk of bias was reported in three studies, one study resulted in a low risk of bias, and a proportion of more than 75% of males in each of the studies. High heterogeneity between the studies impeded establishing a link between PROMs and prognostic value. Conclusion: There is low evidence supporting PROMs usage as prognostic tools in adult HT patients. Comparing outcomes of PROMS to routine prognostic in wider and systematic settings is warranted. Systematic use of PROMs in clinical settings is warranted.
Language	English
Publishing date	2022-03-16
Publishing country	Germany
Document type	Journal Article ; Review
ISSN	2509-8020
ISSN (online)	2509-8020
DOI	10.1186/s41687-022-00431-4
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Article: Application of total artificial heart in patients with primary malignant cardiac tumors-current treatment strategies.

Xiao, Jiewen / Brozzi, Nicolas / Cifuentes, Renzo / Ghodsizad, Ali / Loebe, Matthias

Annals of cardiothoracic surgery

2020 Volume 9, Issue 2, Page(s) 113–115

Language	English
Publishing date	2020-04-11
Publishing country	China
Document type	Editorial
ZDB-ID	2713627-9
ISSN	2304-1021 ; 2225-319X
ISSN (online)	2304-1021
ISSN	2225-319X
DOI	10.21037/acs.2020.02.12
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Article ; Online: Cardiogenic shock and machine learning: A systematic review on prediction through clinical decision support softwares.

Aleman, Rene / Patel, Sinal / Sleiman, Jose / Navia, Jose / Sheffield, Cedric / Brozzi, Nicolas A

Journal of cardiac surgery

2021 Volume 36, Issue 11, Page(s) 4153–4159

Abstract: Background and aim: Cardiogenic shock (CS) withholds a significantly high mortality rate between 40% and 60% despite advances in diagnosis and medical/surgical intervention. To date, machine learning (ML) is being implemented to integrate numerous data ... ...

Abstract	Background and aim: Cardiogenic shock (CS) withholds a significantly high mortality rate between 40% and 60% despite advances in diagnosis and medical/surgical intervention. To date, machine learning (ML) is being implemented to integrate numerous data to optimize early diagnostic predictions and suggest clinical courses. This systematic review summarizes the area under the curve (AUC) receiver operating characteristics (ROCs) accuracy for the early prediction of CS. Methods: A systematic review was conducted within databases of PubMed, ScienceDirect, Clinical Key/MEDLINE, Embase, GoogleScholar, and Cochrane. Cohort studies that assessed the accuracy of early detection of CS using ML software were included. Data extraction was focused on AUC-ROC values directed towards the early detection of CS. Results: A total of 943 studies were included for systematic review. From the reviewed studies, 2.2% (N = 21) evaluated patient outcomes, of which 14.3% (N = 3) were assessed. The collective patient cohort (N = 698) consisted of 314 (45.0%) females, with an average age and body mass index of 64.1 years and 28.1 kg/m Conclusions: From the present comprehensively gathered data, this study accounts the use of ML software for the early detection of CS in a clinical setting as a valid tool to predict patients at risk of CS. The complexity of ML and its parallel lack of clinical evidence implies that further prospective randomized control trials are needed to draw definitive conclusions before standardizing the use of these technologies. Brief summary: The catastrophic risk of developing CS continues to be a concern in the management of critical cardiac care. The use of ML predictive models have the potential to provide the accurate and necessary feedback for the early detection and proper management of CS. This systematic review summarizes the AUC-ROCs accuracy for the early prediction of CS.
MeSH term(s)	Decision Support Systems, Clinical ; Female ; Humans ; Machine Learning ; Sensitivity and Specificity ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/therapy ; Software
Language	English
Publishing date	2021-08-31
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.15934
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Article ; Online: The pandemic effect: The outlook of lung transplantation.

Aleman, Rene / Napoli, Federico / Frieder, Joel S / Jorge Balzan, N E / Sheffield, Cedric / Navia, Jose / Brozzi, Nicolas A

Respiratory medicine and research

2022 Volume 83, Page(s) 100967

Abstract: Lung transplant (LT) is a life-saving treatment for patients with end-stage lung disease. In the setting of COVID-19-associated acute respiratory distress syndrome (ARDS), LT emerged as a therapeutic option for select cases. It is challenging to ... ...

Abstract	Lung transplant (LT) is a life-saving treatment for patients with end-stage lung disease. In the setting of COVID-19-associated acute respiratory distress syndrome (ARDS), LT emerged as a therapeutic option for select cases. It is challenging to determine the extent of the knowledge and interest the United States (US) general population has on LT as salvage therapy during and following the COVID-19 pandemic. It is the authors' opinion that patient therapeutic education (PTE) can directly influence established practices by creating an open channel of communication based on needs and expectations for healthcare services. This perspective is a cursory reflection of the nuances between healthcare providers, their services, the interests and expectations of the general population, specifically on LT following COVID-19. The main endpoint of this study is to analyze the US general population's interest in LT as COVID-19 salvage therapy via the Google Trends (GT) web-kit tool.
MeSH term(s)	Humans ; United States/epidemiology ; COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; Lung ; Lung Transplantation
Language	English
Publishing date	2022-10-18
Publishing country	France
Document type	Journal Article
ISSN	2590-0412
ISSN (online)	2590-0412
DOI	10.1016/j.resmer.2022.100967
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Article ; Online: Shifting surgical archetypes of ICG fluorescent-angiography for bowel perfusion assessment in cardiogenic shock under ECMO support.

Aleman, Rene / Labkovski, Matthew / Patel, Sinal / Zadneulitca, Nikita / Frieder, Joel S / Rosenthal, Raul J / Sheffield, Cedric / Navia, Jose / Brozzi, Nicolas A

Journal of cardiac surgery

2022 Volume 37, Issue 7, Page(s) 2187–2190

Abstract: Extracorporeal membrane oxygenation (ECMO) has been adopted to support patients with acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. Mesenteric ischemia (MI) can present as a life- ... ...

Abstract	Extracorporeal membrane oxygenation (ECMO) has been adopted to support patients with acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. Mesenteric ischemia (MI) can present as a life-threatening complication in patients receiving veno-arterial echocardiogram (ECHO) support. Due to the nature and acuity of these conditions, determining adequate perfusion upon surgical intervention is challenging for the operating surgeon, especially in cardiogenic shock (CS) patients on ECMO support persenting low arterial pulsatility. Indocyanine green fluorescent angiography (ICG-FA) has proven to be useful for real-time assessment of vascular perfusion, which may help determine the extent of bowel ischemia in patients receiving ECMO support. The case report here-in presented, breaks the paradigm of performing non-cardiac surgical procedures on ECMO support via a pioneering visual aid technique. LEARNING OBJECTIVE: ICG-FA is a promising visual intraoperatory technique providing real-time feedback for the adequate identification and assessment of target tissue/organs. The high morbidity and mortality rates associated to MI and CS-particularly when concomitantly present-hinders salvage surgical therapy. The use of ECMO provides hemodynamic stability This case report highlights the importance of adequate surgical intervention under extracorporeal life support in the presence of both CS and MI. To the authors' knowledge, this is the first report of application of ICG-FA to evaluate mesenteric perfusion in a patient receiving ECMO support.
MeSH term(s)	Angiography/adverse effects ; Extracorporeal Membrane Oxygenation/methods ; Hemodynamics ; Humans ; Perfusion/adverse effects ; Retrospective Studies ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/etiology ; Shock, Cardiogenic/surgery
Language	English
Publishing date	2022-04-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16490
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