Mapping the Science of palliative care: A bibliometric analysis of the top 100 cited articles.

Background: The palliative care evidence base has grown substantially in recent years with the benefits, barriers, and facilitators of care delivery well established across many settings and contexts.

Aim: We aimed to rigorously and systematically delineate the trends, themes, and scope of the top 100 papers aided by bibliometrics to map the field of palliative care science and identify future directions for the field.

Design: We conducted a bibliometric analysis in accordance with the BIBLIO checklist for reporting the bibliometric reviews.

Norepinephrine pharmacolexicology: a chronological review of dose reporting and the implications of salt formulations.

Uncertainties in norepinephrine dose reporting due to variable labeling practices secondary to salt formulation considerations have resulted in significant clinical and research challenges, potentially leading to impaired comparability across studies. The objective of this review was to summarize the chronology of the available literature on the issue of norepinephrine salt formulations and dose reporting. A systematic search of PubMed/MEDLINE, EMBASE, and Google Scholar databases was conducted to identify pertinent studies addressing the variability in norepinephrine salt formulations and labeling practices, the evolution of pharmacological understanding, and recent developments in proposed guidelines.

Robustness of Randomized Controlled Trials Evaluating Acute Normovolemic Hemodilution as a Blood Conservation Strategy in Cardiac Surgery.

Objective: To evaluate the robustness of randomized controlled trials (RCTs) investigating acute normovolemic hemodilution (ANH), a blood conservation strategy designed to reduce transfusion requirements, in cardiac surgery using the Fragility Index (FI). Although recommended in clinical guidelines, high-quality evidence supporting ANH remains limited.

Design: A systematic review of RCTs.

Dosing Reliability of Direct Thrombin Inhibitors in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis.

Empirical evidence suggests direct thrombin inhibitors (DTIs) produce more favorable hemostatic outcomes than heparin in patients supported by extracorporeal membrane oxygenation (ECMO), yet the exact mechanisms responsible are unknown. We systematically searched databases and registers for studies comparing DTIs to heparin in humans receiving ECMO. A total of 28 studies were identified, most of which (n = 25) used bivalirudin, while the rest (n = 3) used argatroban.

A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.

Background: Patients undergoing cardiac surgery often receive red-cell transfusions, along with the associated risks and costs. Early intraoperative normovolemic hemodilution (i.e.

Remimazolam for anesthesia in cardiac and noncardiac surgery. A narrative literature review and synthesis.

Despite decades of advancements in anesthetic techniques, a novel hypnotic agent combining rapid onset and offset, hemodynamic stability, and predictable effects has remained elusive. The recent approval of remimazolam, a short-acting benzodiazepine, represents a potential breakthrough in fulfilling these criteria. Since its first approval, growing evidence highlights its benefits, including superior hemodynamic stability, rapid emergence from anesthesia, and minimal respiratory depression compared to widely used agents such as propofol.

Clevidipine for the management of hypertension in the perioperative cardiac and noncardiac surgical settings: a systematic review.

Introduction: Perioperative hypertension is a common occurrence in anesthetic practice, potentially leading to cardiac complications resulting in unfavorable patient outcomes. Clevidipine emerges in the current drug scenario as an antihypertensive agent with advantageous properties like ultra-short half-life, titratable effect, and ease of use.

Methods: A systematic search of PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Google Scholar databases was performed aided by a specific search string, to provide a synthesis of the available body of literature regarding clevidipine administration for the management of hypertension in the perioperative cardiac and noncardiac surgical settings.

Con: Cardiac Arrest Patients Should Be Included in Cardiogenic Shock Trials.

While often being both triggered by acute myocardial infarction, cardiogenic shock (CS) and cardiac arrest (CA) constitute two distinct clinical entities with different underlying pathophysiologic backgrounds. CS is a syndrome characterized by systemic hypoperfusion and end-organ dysfunction due to a primary impairment of the cardiac pump function. CA arises instead from an abrupt loss of cardiac mechanical function-commonly triggered by arrhythmias, structural heart disease, or ischemic events-which leads to the immediate loss of effective circulation.

Clinical and Preclinical Evidence on a Novel Percutaneous Pulsatile Ventricular Assist Device (PulseCath): Protocol for a Scoping Review.

Background And Aims: Temporary mechanical circulatory support (tMCS) devices play a crucial role in improving survival for patients with hemodynamic instability by providing cardiac assistance, and may serve as either a bridge to recovery or destination therapy. Recently, the PulseCath (iVAC2L and iVAC3L) has been introduced into the broader tMCS landscape. Due to its ease of implantation and low cost, it appears to enhance and complement the spectrum of tMCS devices.

Pro: All Cardiac Arrest Patients Should Be Transferred To a Cardiac Arrest Center.

Out-of-hospital cardiac arrest (OHCA) is characterized by a high prevalence and is burdened by significant mortality and morbidity. While underlying atherosclerotic coronary artery disease accounts for the majority of the cases in the Western world owing to lifestyle and dietary customs, several other conditions and diseases can lead to OHCA. Although patient survival rates have doubled over the past 3 decades, only marginal improvements in terms of overall survival and neurologic outcomes have been observed over the last decade.

Magenta Elevate: The Beginning of a New Era in Protected PCI?

The Magenta Elevate (Magenta Medical Ltd.) pump-a novel transvalvular percutaneous ventricular assist device-was tested in the first-in-human study at the Israeli-Georgian Medical Research Clinic 'Helsicore' in Tbilisi, Georgia. Results on 14 patients undergoing high-risk percutaneous coronary intervention suggested a promising safety and efficacy profile.

How Would We Treat Our Own Left Ventricular Outflow Tract Obstruction in Transcatheter Mitral Valve Replacement?

This article aims to provide a comprehensive review of the current knowledge on the prevention and treatment of left ventricular outflow tract obstruction (LVOTO) associated with transcatheter mitral valve replacement-a novel and evolving treatment alternative for mitral regurgitation-encompassing both surgical and pharmacological interventions. LVOTO is a potentially catastrophic complication of transcatheter mitral valve replacement. Therefore, identifying patients at high risk for LVOTO and implementing a carefully tailored medical and surgical strategy are essential for optimizing perioperative management and improving patient outcomes.

Outcomes of Octogenarians Undergoing Edge-to-Edge Transcatheter Valve Repair for Tricuspid Regurgitation: Inverse Propensity Score-Weighted Analysis.

There is a scarcity of data for perioperative outcomes of octogenarians undergoing tricuspid transcatheter edge-to-edge repair (TEER), despite both the potential procedural effectiveness in treating tricuspid regurgitation and a low incidence of severe complications observed in the nonelderly population. We assessed the characteristics and outcomes of TEER in octogenarians compared to those in patients under 80 years old treated at a referral tertiary teaching hospital. We retrospectively enrolled all adult patients undergoing tricuspid TEER.

Perioperative Mechanical Circulatory Support for Cardiac Assistance in Thoracic Surgery: A Scoping Review.

Background: Patients with pre-existing severe cardiovascular comorbidities are often deemed ineligible for potentially life-saving thoracic surgeries and are referred to other conservative therapies. However, this patient population may theoretically benefit from the timely perioperative implantation of temporary mechanical circulation support (tMCS) to both mitigate the surgical stress and stabilize hemodynamics. We performed a scoping review to summarize the evidence regarding the use of tMCS in thoracic surgery.

The effect of Neurokinin-1 receptor antagonists on postoperative pain: A meta-analysis of randomized controlled trials.

Study Objective: Substance P is a neuropeptide with a pivotal role in pain transmission and modulation. Preclinical studies suggest that targeting substance P and inhibiting its receptor, neurokinin 1 (NK-1), is a potential avenue for pain relief. When translated into clinical settings, these preliminary findings yielded mixed results.

The role of amino acids and protein administration in preventing cardiac surgery-associated acute kidney injury.

Acute kidney injury (AKI) persists as one of the most common complications after cardiac surgery. Beyond being burdened by high morbidity and mortality rates, effective therapeutic options are still lacking. To date, the management of cardiac surgery-associated AKI (CSA-AKI) mainly focuses on preventive strategies, e.

Chronic obstructive pulmonary disease: A narrative synthesis of its hallmarks for palliative care clinicians.

Chronic obstructive pulmonary disease (COPD) is a life-limiting condition and the third leading cause of death worldwide. People with COPD experience physical and psychological symptoms and functional limitations that impair their quality of life. Their caregivers face adverse clinical outcomes due to personal, social, and financial demands.