Journal and News Scan

The authors aimed to explore the applicability of the benefits of early mobility and ambulation for patients receiving extracorporeal membrane oxygenation (ECMO). This single-center preintervention, post-intervention review, performed at a high-volume center found that 13 out of 46 (28 percent) patients who met safety criteria ambulated from January through March 2021, compared to 14 out of 147 (10 percent) in historical controls. The authors note important considerations for devising similar protocols given the limited evidence available to date. Strategies employed by the interprofessional team included mobility discussions during rounds, the development of an ambulation safety checklist, clear expectations for providers during ambulation, and documentation to evaluate tolerance. Through standardized assessment and protocol intervention, progressive ambulation can be safely offered to some patients receiving ECMO. 

This prospective randomized trial assessed whether noninvasive ventilation (NIV) before and after cardiac surgery reduces the incidence of acute pulmonary and cardiac failure in high-risk patients. A total of 216 adult patients at risk of postoperative complications were assigned to either NIV for five days pre- and post-surgery or to standard care alone. The primary outcome was the occurrence of cardio-respiratory failure within one month post-surgery. Results showed that 55.1 percent of the NIV group experienced cardiopulmonary failure, compared to 79.8 percent in the standard care group, with NIV significantly reducing the risk (RR 0.69, p<0.001). The benefit persisted at three months; however, there was no difference in intubation rates or ICU stay duration between the two groups. The use of NIV before and after cardiac surgery could effectively lower the rate of cardiopulmonary failure in high-risk patients. 

This randomized crossover trial evaluated whether combining needle aspiration and forceps biopsy improves diagnostic yield compared to using a single device alone during electromagnetic navigation bronchoscopy (ENB) for peripheral pulmonary lesions. A total of 142 participants underwent both biopsy methods sequentially under moderate sedation. The primary outcome was the diagnostic yield, defined as the percentage of patients whose biopsy provided a specific diagnosis. 
 
Results showed that the combined approach yielded a diagnostic success rate of 66.9 percent, which was significantly higher than either forceps biopsy (44.4 percent) or needle aspiration (51.4 percent) alone (p<0.001 for both comparisons). The combination also increased the sensitivity for malignancy to 71.7 percent, versus 58.3 percent for needle aspiration and 47.5 percent for forceps biopsy (p<0.001). The procedure had a favorable safety profile, with a low incidence of pneumothorax (3.5 percent) and only 1.4 percent of patients requiring drainage.  
 
These findings support the use of a multimodal biopsy approach in ENB for peripheral pulmonary lesions. 

This study aimed to compare the clinical and echocardiographic long-term results of edge-to-edge (E-to-E) repair and neochordal repair, both associated with ring annuloplasty, for isolated anterior mitral leaflet lesions using propensity match analysis. A retrospective review of an institutional database from 2000 to 2021 was conducted using the Kaplan–Meier method and cumulative incidence function. Cox regression was used to identify risk factors for mortality during follow-up. The estimated freedom from reoperative mitral valve surgery at 20 years was 78 percent in the E-to-E group and 64 percent in the neochordal group. Additionally, longitudinal analysis of the mitral regurgitation recurrence rate showed a higher rate of recurrence in the neochordal group at 5, 10, and 15 years.