To assess the impact of topical vancomycin (TV) application in decreasing sternal wound infections (SWIs) post cardiac surgery (CS), we lead a meta-analysis. Twenty-three thousand seven hundred and forty five participants had CS at the outset of the investigations, according to a thorough evaluation of the literature done up to November 2022; 8730 of them used TV, while 15 015 were controls. To assess the effectiveness of TV application in lowering SWIs following CS, odds ratios (OR) with 95% confidence intervals (CIs) were computed with dichotomous technique with a fixed- or random-effect model. The TV had significantly lower SWIs post CS (OR, 0.34; 95% CI, 0.20-0.57; P < .001), and deep SWIs post CS (OR, 0.26; 95% CI, 0.11-0.65; P = .004) compared with control as shown in Figures 2 and 3. Yet, there was no significant difference found amongst TV and control in superficial SWIs post CS (OR, 0.30; 95% CI, 0.07-1.30; P = .011). The TV had significantly lower SWIs, and deep SWIs post CS, and no significant difference was found in superficial SWIs post CS compared with control. The low number of included studies in this meta-analysis for superficial SWIs calls for precaution when analysing the outcomes.

OBJECTIVE:This study aimed to explore and analyze the factors affecting the incidence of pneumonia after coronary artery bypass grafting (CABG) to provide reference for the prevention of such situation.METHODS:A total of 500 patients who underwent CABG in a hospital were selected. From March 2019 to March 2022, 410 patients without pneumonia and 90 patients with pneumonia were divided into groups A and B. The influencing factors and pathogen composition of postoperative pneumonia were discussed and analyzed.RESULTS:Univariable analysis results showed that age, cardiac function grade, occurrence of smoking, operation time, tracheal intubation time, suspended red-blood-cell transfusion and hospital stay in group B were higher than those in group A. Multivariable logistic analysis results showed that operation time, smoking history, and tracheal intubation time were risk factors for pneumonia after CABG. Among the 90 patients with postoperative pneumonia, 90 had pathogens, 81 had Gram-negative bacteria, 4 had Gram-positive bacteria, and 5 had fungi.CONCLUSIONS:Patients after CABG were more likely to develop pneumonia. Operation time, smoking history, and tracheal intubation time were the risk factors of pneumonia after CABG. Most of these patients had Gram-negative bacteria. Patient intervention based on the influencing factors can effectively prevent the occurrence of postoperative pneumonia.

目的探讨体外膜肺氧合（ECMO）联合主动脉内球囊反搏（IABP）预防性应用于高危经皮冠状动脉介入治疗（HR-PCI）患者的短期临床疗效。方法选择2018年5–8月10例HRPCI患者,术中应用ECMO联合IABP循环支持。结果 10例患者中男性8例,女性2例,年龄51～84（70.3±11.1）岁,平均左心室射血分数（35.7±10.2）%。10例患者均为严重三支病变,左主干病变7例,其中合并右冠状动脉（RCA）慢性完全闭塞（CTO）病变5例,前降支CTO病变2例;剩余3例中2例为RCA和左前降支（LAD）近/中段CTO病变,1例为RCA CTO病变合并LAD/左回旋支（LCX）严重狭窄。在ECMO联合IABP支持下7例左主干病变中先处理左主干病变6例,1例处理了RAC CTO病变和LAD重度狭窄;剩余3例中2例RCA和LAD近/中段CTO病变均先处理了LAD CTO病变,另1例RCA CTO病变合并LAD/LCX严重病变患者先处理了RCA CTO病变。术中ECMO平均灌注流量（1.80±0.30）L/min,总运转时间（3.4±0.7）h。PCI平均手术时间（2.2±0.5）h。1例PCI术中发生血流动力学崩溃,ECMO灌注流量提高到3.0 L/min维持血流动力学,直到循环正常。术后所有患者ECMO均成功撤机。2例患者IABP穿刺部位血肿,其中1例术后发现假性动脉瘤;1例术后于ICU发生室性心动过速和心室颤动;无ECMO管道机械性问题、下肢缺血和感染并发症发生。结论对不适合行外科血管重建术的HR-PCI术患者,ECMO联合IABP循环支持下行PCI术是可行的。

To explore the function and importance of Extracorporeal membrane oxygenation (ECMO) combined with Intra-aortic balloon pump (IABP) support for high-risk percutaneous coronary intervention (PCI). We analyzed 7 cases undergoing high-risk PCI assisted by ECMO combined with IABP from May 2012 to