Journal articles: 'OPCAT'

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Fletcher, Adam. "Australia and the OPCAT." Alternative Law Journal 37, no. 4 (December 2012): 233–37. http://dx.doi.org/10.1177/1037969x1203700404.

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Grenfell, Laura. "Aged care, detention and OPCAT." Australian Journal of Human Rights 25, no. 2 (May 4, 2019): 248–62. http://dx.doi.org/10.1080/1323238x.2019.1642998.

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van Kalmthout, A. M. "CPT, OPCAT and the Dutch Caribbean." Netherlands Quarterly of Human Rights 32, no. 2 (June 2014): 127–29. http://dx.doi.org/10.1177/016934411403200202.

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Herbert, Tania. "An Overview of Torture Prevention Systems in Russia, Lithuania, Sweden and Norway." Torture Journal 30, no. 2 (November 9, 2020): 129–30. http://dx.doi.org/10.7146/torture.v30i2.122539.

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The very nature of detention means that those subjected to it are dependent on detaining authorities to provide protection and to refrain from human rights abuses, including torture and ill treatment. Recognising this, the Optional Protocol to the UN Convention against Torture (OPCAT) obliges signatories to establish detention monitoring bodies through National Preventative Mechanisms (NPMs). Whilst some regions have received considerable attention in terms of CAT and OPCAT compliance, this has not generally been so for the region incorporating Russia, Nordic and Baltic countries.

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Hardwick, Nick, and Rachel Murray. "Regularity of OPCAT visits by NPMs in Europe." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 66–90. http://dx.doi.org/10.1080/1323238x.2019.1588054.

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Gleeson, Madeline. "Monitoring places of immigration detention in Australia under OPCAT." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 150–69. http://dx.doi.org/10.1080/1323238x.2019.1588059.

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Naylor, Bronwyn, and Stan Winford. "Implementing OPCAT through prison monitoring: the relevance of rehabilitation." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 113–29. http://dx.doi.org/10.1080/1323238x.2019.1588060.

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Ploton, V. "The OPCAT Special Fund: A New Resource for Torture Prevention?" Journal of Human Rights Practice 7, no. 1 (February 1, 2015): 153–65. http://dx.doi.org/10.1093/jhuman/huv002.

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Weller, Penelope. "OPCAT monitoring and the Convention on the Rights of Persons with Disabilities." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 130–49. http://dx.doi.org/10.1080/1323238x.2019.1588056.

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McGregor, Judy. "The challenges and limitations of OPCAT national preventive mechanisms: lessons from New Zealand." Australian Journal of Human Rights 23, no. 3 (September 2, 2017): 351–67. http://dx.doi.org/10.1080/1323238x.2017.1392477.

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Buckland, Ben, and Audrey Olivier-Muralt. "OPCAT in federal states: towards a better understanding of NPM models and challenges." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 23–43. http://dx.doi.org/10.1080/1323238x.2019.1588061.

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Harding, Richard. "Australia’s circuitous path towards the ratification of OPCAT, 2002–2017: the challenges of implementation." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 4–22. http://dx.doi.org/10.1080/1323238x.2019.1588062.

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de Wolf, Antenor Hallo, and James Watson. "Navigating the Boundaries of Prevention: The Role of Opcat in Deportations with Diplomatic Assurances." Netherlands Quarterly of Human Rights 27, no. 4 (December 2009): 525–66. http://dx.doi.org/10.1177/016934410902700404.

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Lea, Meredith, Fleur Beaupert, Ngila Bevan, Danielle Celermajer, Piers Gooding, Rebecca Minty, Emma Phillips, et al. "A disability aware approach to torture prevention? Australian OPCAT ratification and improved protections for people with disability." Australian Journal of Human Rights 24, no. 1 (January 2, 2018): 70–96. http://dx.doi.org/10.1080/1323238x.2018.1441611.

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15

Pegram, Tom. "Regulatory Stewardship and Intermediation." ANNALS of the American Academy of Political and Social Science 670, no. 1 (March 2017): 225–44. http://dx.doi.org/10.1177/0002716217693986.

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The regulator-intermediary-target (RIT) framework exposes the potential for intermediaries to provide alternative channels for capture. In this article, I argue that the risk of capture can be mitigated through what I call regulatory stewardship—a novel conception of regulatory management that involves the intermediaries themselves monitoring the performance of one another. I explore regulatory stewardship by examining a new generation of human rights treaty innovation: the Optional Protocol to the Convention against Torture (OPCAT) and the Convention on the Rights of Persons with Disabilities (CRPD). These instruments differentially formalize relations between intermediaries. I use their contrasting experiences to identify three factors central to effective regulatory stewardship: (1) the nature of the task environment, (2) the quality of rule frameworks, and (3) the approaches adopted by potential stewards in practice. This study argues for the importance of regulatory stewardship within RIT arrangements, particularly where targets are strongly motivated to resist implementation.

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Ledwidge, Frank. "The Optional Protocol to the Convention Against Torture (OPCAT): A major step forward in the global prevention of torture." Helsinki Monitor 17, no. 1 (2006): 69–82. http://dx.doi.org/10.1163/157181406776564011.

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White, Michael. "The role and scope of OPCAT in protecting those deprived of liberty: a critical analysis of the New Zealand experience." Australian Journal of Human Rights 25, no. 1 (January 2, 2019): 44–65. http://dx.doi.org/10.1080/1323238x.2019.1588055.

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Sveaass, Nora, and Victor Madrigal-Borloz. "The preventive approach: OPCAT and the prevention of violence and abuse of persons with mental disabilities by monitoring places of detention." International Journal of Law and Psychiatry 53 (July 2017): 15–26. http://dx.doi.org/10.1016/j.ijlp.2017.06.001.

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de Beco, Gauthier. "The Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (the OPCAT) in Europe: Duplication or Reinforcement?" Maastricht Journal of European and Comparative Law 18, no. 3 (September 2011): 257–74. http://dx.doi.org/10.1177/1023263x1101800303.

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Muntingh, Lukas M. "Africa, Prisons and COVID-19." Journal of Human Rights Practice 12, no. 2 (July 2020): 284–92. http://dx.doi.org/10.1093/jhuman/huaa031.

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Abstract Africa’s prisons are a long-standing concern for rights defenders given the prevalence of rights abuses, overcrowding, poor conditions of detention and the extent to which the criminal justice system is used to target the poor. The paper surveys 24 southern and east African countries within the context of COVID-19. Between 5 March and 15 April 2020 COVID-19 had spread to 23 southern and east African countries, except Lesotho. The overwhelming majority of these countries imposed general restrictions on their populations from March 2020 and nearly all restricted visits to prisons to prevent the spread of the coronavirus. The pandemic and government responses demonstrated the importance of reliable and up to date data on the prison population, and any confined population, as it became evident that such information is sorely lacking. The World Health Organization recommended the release of prisoners to ease congestion, a step supported by the UN Subcommittee on Prevention of Torture. However, the lack of data and the particular African context pose some questions about the desirability of such a move. The curtailment of prison visits by external persons also did away with independent oversight even in states parties to the Optional Protocol to the Convention against Torture (OPCAT). In the case of South Africa, prison monitors were not listed in the ensuing legislation as part of essential services and thus were excluded from access to prisons. In the case of Mozambique, it was funding being placed on hold by the donor community that prevented the Human Rights Commission from visiting prisons. The COVID-19 pandemic has highlighted long-standing systemic problems in Africa’s prisons. Yet African states have remained remarkably reluctant to engage in prison reform, despite the fact that poorly managed prisons pose a significant threat to general public health care.

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21

Koster, A. "OPCAB." European Journal of Anaesthesiology 24, Supplement 40 (June 2007): 77–82. http://dx.doi.org/10.1097/00003643-200706002-00007.

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Lassere, J. M. "Optat (Saint)." Encyclopédie berbère, no. 35 (June 1, 2013): 5787. http://dx.doi.org/10.4000/encyclopedieberbere.2818.

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23

Cremer, J. "OPCAB-Revaskularisation." Zeitschrift für Herz-,Thorax- und Gefäßchirurgie 25, no. 1 (January 27, 2011): 13–14. http://dx.doi.org/10.1007/s00398-010-0822-x.

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24

Morris, Cullen D., John D. Puskas, Sorin V. Pusca, Omar M. Lattouf, William A. Cooper, Thomas A. Vassiliades, Edward P. Chen, Vinod H. Thourani, Patrick D. Kilgo, and Robert A. Guyton. "Outcomes after Off-Pump Reoperative Coronary Artery Bypass Grafting." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 2, no. 1 (January 2007): 29–32. http://dx.doi.org/10.1097/01.imi.0000250499.99341.97.

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Objective Application of off-pump techniques to reoperative coronary artery bypass (redo CABG) has been limited by technical difficulty and potential for embolism of atheromatous debris from diseased grafts, resulting in myocardial infarction and rapid hemodynamic deterioration. We compared outcomes after off-pump (OPCAB) and on-pump (ONCAB) in redo CABG. Methods A retrospective chart review was performed for patients who underwent redo CABG at a single academic institution between January 1997 and December 2004. Outcomes were compared between groups based on intention to treat. Propensity scores were calculated for each patient using 23 preoperative risk factors. Logistic regression was applied for each end point as a function of group and propensity score. Results A total of 771 consecutive patients had redo CABG (639 ONCAB and 132 OPCAB); 22 patients (16.7%) were converted from OPCAB to ONCAB for hemodynamic in stability, severe adhesions, or graft injury; 7 patients (1.1%) were converted from ONCAB to OPCAB for severe aortic calcification. Propensity-matched comparison of outcomes after OPCAB versus ONCAB for redo CABG showed that OPCAB was associated with a reduction in postoperative complications, transfusion, atrial fibrillation, and length of stay. OPCAB patients received fewer grafts with similar use of left internal mammary artery conduit; conversion from OPCAB to ONCAB did not reduce the benefit of OPCAB. Conclusions OPCAB can be safely and effectively applied to reoperative CABG in selected cases.

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Fan, Guangpu, Xuan Wang, Chen Chen, Jing Liu, and Yu Chen. "Surgeons’ Preference for Off-Pump or On-Pump Coronary Artery Bypass Grafting Surgery." Heart Surgery Forum 24, no. 3 (May 11, 2021): E422—E426. http://dx.doi.org/10.1532/hsf.3747.

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Background: Surgeon’s preference is an important factor in clinical strategy for off-pump (OPCAB) or on-pump (ONCAB) coronary artery bypass graft (CABG) surgery. This study analyzed surgeons’ understanding of and propensity for both techniques. Methods: A survey was performed by self-reported questionnaire. Two sections were included: Q1 questionnaire investigated each surgeon’s opinion on the indications of OPCAB and ONCAB; and Q2 questionnaire investigated each surgeon’s choice of OPCAB or ONCAB in different clinical situations. Results: The questionnaires were sent to 169 surgeons. In Q1, 71.2% of surgeons indicated that the degree of overlap between the indications of OPCAB and ONCAB is >70%; 55.1% believed that OPCAB had a wider scope of indications than ONCAB, and 35.3% believed that ONCAB had a wider scope of indications than OPCAB. In Q2, >70% of surgeons who responded chose OPCAB for patients with the following characteristics: high risk of stroke, renal dysfunction, pulmonary dysfunction, malignancy, clotting and coagulation disorders, or age ≥80 years. More than 57.5% of surgeons chose ONCAB for patients with poor target vessels or ventricular enlargement and dysfunction. For novice surgeons, 87.5% of surgeons chose ONCAB. Conclusion: Most surgeons surveyed agreed that OPCAB and ONCAB are suitable for most patients; however, surgeons’ preference for ONCAB or OPCAB varied. Surgeons are more willing to choose ONCAB in the presence of complicated heart conditions and OPCAB in the presence of serious concomitant diseases.

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Rabindranauth, Prem, Jacob G. Burns, Todd T. Vessey, Michelle A. Mathiason, Kara J. Kallies, and Venki Paramesh. "Minimally Invasive Coronary Artery Bypass Grafting is Associated with Improved Clinical Outcomes." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 9, no. 6 (November 2014): 421–26. http://dx.doi.org/10.1177/155698451400900605.

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Objective Minimally invasive coronary artery bypass grafting (MICS CABG) via left minithoracotomy is an alternative to off-pump coronary artery bypass (OPCAB) via sternotomy. Our objective was to evaluate the clinical outcomes after MICS CABG versus OPCAB. Methods The medical records of patients who underwent MICS CABG from December 2009 to December 2011 and OPCAB from January 2005 to April 2011 were reviewed. Patients who underwent OPCAB were matched 2:1 to patients who underwent MICS CABG by age, sex, preoperative ejection fraction, creatinine concentration, as well as history of diabetes and myocardial infarction. Results A total of 130 MICS CABG patients were matched with 260 OPCAB patients. Mean bypasses in the MICS CABG and OPCAB groups were 2.1 and 3.2, respectively ( P = 0.001). Extubation in the operating room (OR) occurred in 70.0% and 12.7% of patients in the MICS CABG and OPCAB groups, respectively ( P = 0.001). Mean postoperative length of stay was 4 days for the MICS CABG patients versus 5 days for the OPCAB patients ( P = 0.002) and 3.8 days versus 4.6 days for the MICS CABG patients extubated in the OR compared with those who remained intubated ( P = 0.007). There were no 30-day mortalities in the MICS CABG group and 1 in the OPCAB group (P= 0.999). Thirty-day readmissions were similar, with 5.4% and 7.4% in the MICS CABG and OPCAB groups, respectively ( P = 0.527). Conclusions Minimally invasive coronary artery bypass grafting is safe, and early clinical outcomes are comparable, if not superior in some respects, to OPCAB. Extubation in the OR is feasible, well tolerated, and associated with earlier discharge. Shorter hospital stays may decrease resource use and promote earlier return to activities; however, further research is needed.

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Sarin, Eric L., Michael O. Kayatta, Patrick Kilgo, Ameesh Dara, John D. Puskas, Omar M. Lattouf, Edward P. Chen, Michael E. Halkos, Robert A. Guyton, and Vinod H. Thourani. "Short- and Long-Term Outcomes in Octogenarian Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Compared with On-Pump Coronary Artery Bypass Grafting." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 6, no. 2 (March 2011): 110–15. http://dx.doi.org/10.1097/imi.0b013e31821692b1.

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Objective Coronary artery bypass grafting (CAB) on elderly patients presenting with multivessel coronary artery disease has become routine in modern day operating rooms. The aim of our study was to compare short- and long-term outcomes in octogenarian patients undergoing off-pump CAB (OPCAB) versus on-pump CAB (ONCAB). Methods A propensity-adjusted, retrospective review of patients older than 80 years who underwent primary CAB from January 1996 to September 2008 at our institution's hospitals was performed. Nine hundred thirty-seven patients were divided into two groups: OPCAB (n = 540) or ONCAB (n = 397). A propensity score was calculated based on 29 preoperative risk factors to adjust for selection bias when comparing the groups for differences in death, stroke, myocardial infarction incidence, and their composite (major adverse cardiac events). Long-term survival status was determined by cross-referencing patient records with the Social Security Death Index. Logistic regression analysis and Cox proportional hazards analysis were used to determine group differences in short- and long-term survival, respectively, adjusted for the propensity score. Kaplan-Meier curves were fit to estimate 10-year survival. Results The mean age (OPCAB: 82.9 ± 2.8 years vs ONCAB: 82.3 ± 2.4, P = 0.003) and male sex (OPCAB: 292/540, 54.1% vs ONCAB: 220/397, 55.4%, P = 0.68) were clinically similar between groups. Although the ejection fraction (OPCAB: 52.1 ± 12.5% vs ONCAB: 50.6 ± 13.1, P = 0.10) were similar between groups, the mean number of distal anastomoses [OPCAB: 2.7 ± 1.0 (median 3) vs ONCAB: 3.4 ± 0.9 (median 3), P < 0.001] were less in the OPCAB group. The median postoperative length of stay was 7 days for OPCAB group and 6 for the ONCAB group (P = 0.31). The Society of Thoracic Surgery predicted risk of in-hospital mortality was similar for OPCAB (5.4%) and ONCAB (5.3%) patients (P = 0.81). However, observed in-hospital mortality was improved for patients in the OPCAB group (OPCAB: 15/540, 2.8% vs ONCAB: 37/397, 9.3%, P = 0.007). Ten-year survival was similar between groups (OPCAB: 28.8% vs ONCAB: 26.3%, P = 0.22). Conclusions In this series, OPCAB reduced the incidence of in-hospital mortality compared with ONCAB. Long-term mortality was similar between groups.

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Westin, Andreas, Elin Strøm, and Lars Slørdal. "Opiat eller opioid?" Tidsskrift for Den norske legeforening 131, no. 13-14 (2011): 1320–21. http://dx.doi.org/10.4045/tidsskr.11.0465.

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Ward, Herbert B., and Rosemary F. Kelly. "OPCAB vs CABG." Chest 125, no. 3 (March 2004): 815–16. http://dx.doi.org/10.1378/chest.125.3.815.

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Vuylsteke, Alain, and Caroline Gerrard. "OPCAB: heparin reversal?" Journal of Cardiothoracic and Vascular Anesthesia 18, no. 3 (June 2004): 394–95. http://dx.doi.org/10.1053/j.jvca.2004.03.025.

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31

Wait, Michael A. "OPCAB selection bias." Annals of Thoracic Surgery 71, no. 5 (May 2001): 1751. http://dx.doi.org/10.1016/s0003-4975(01)02483-3.

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Zenz, M. "Peridurale Opiat-Analgesie." DMW - Deutsche Medizinische Wochenschrift 106, no. 16 (March 26, 2008): 483–85. http://dx.doi.org/10.1055/s-2008-1070341.

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Mizuno, Tomohiro, and Hirokuni Arai. "Surgical technique and the devices for off-pump coronary artery bypass grafting." Journal of the Japanese Coronary Association 19, no. 3 (2013): 296–300. http://dx.doi.org/10.7793/jcoron.19.031.

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Puskas, John, Davy Cheng, John Knight, Gianni Angelini, Didier DeCannier, Anno Diegeler, Mercedes Dullum, et al. "Off-Pump versus Conventional Coronary Artery Bypass Grafting: A Meta-Analysis and Consensus Statement from the 2004 ISMICS Consensus Conference." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 1, no. 1 (September 2005): 3–27. http://dx.doi.org/10.1097/01243895-200500110-00002.

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Background The purpose of this evidence-based consensus statement is to systematically review and meta-analyze the randomized and nonrandomized evidence comparing off-pump (OPCAB) to conventional coronary artery bypass (CCAB) surgery and to provide consensus on the role of OPCAB in low- and high-risk surgical patients. Methods and Results This consensus conference was conducted according to the American College of Cardiology (ACC)/American Heart Association (AHA) standards for development of clinical practice guidelines. The Steering Committee collated all published studies of OPCAB versus CCAB through May 2004 and developed six questions central to controversies surrounding OPCAB surgery in mortality, morbidity, and resource utilization. For mixed-risk patient populations, meta-analysis of 37 randomized clinical trials (3,369 patients, Level A) reported across a total of 53 papers, and two meta-analyses of nonrandomized trials (Level B) comparing OPCAB versus CCAB were identified. For high-risk patient populations, we performed a meta-analysis of 3 randomized and 42 nonrandomized trials (26,349 patients, Level B). Conclusion Meta-analysis of Level A and B evidence provided the basis for the following consensus statements in patients undergoing surgical myocardial revascularization: (1) OPCAB should be considered a safe alternative to CCAB with respect to risk of mortality [Class I, Level A]; (2) With appropriate use of modern stabilizers, heart positioning devices, and adequate surgeon experience, similar completeness of revascularization and graft patency can be achieved [Class IIa, Level A]; (3) OPCAB is recommended to reduce perioperative morbidity [Class I, Level A]; (4) OPCAB may be recommended to minimize midterm cognitive dysfunction [Class IIa, Level A]; (5) OPCAB should be considered as an equivalent alternative to CCAB in regard to quality of life [Class I, Level A]; (6) OPCAB is recommended to reduce the duration of ventilation, ICU and hospital stay, and resource utilization [Class I, Level A]; (7) OPCAB should be considered in high-risk patients to reduce perioperative mortality, morbidity, and resource utilization [Class IIa, Level B].

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Saha, Kamales Kumar, Mandar Deval, Lukash Jagdale, and Preetam Sahani. "Off-Pump Coronary Artery Bypass Grafting in a Low-Volume Center." Heart Surgery Forum 14, no. 6 (December 13, 2011): 349. http://dx.doi.org/10.1532/hsf98.20111048.

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Background: The advantages of off-pump coronary artery bypass grafting (OPCAB) are well documented; however, the conversion of OPCAB to cardiopulmonary bypass (CPB) is associated with higher morbidity and mortality. This issue is of particular concern in low-volume centers or centers that are beginning to use OPCAB. We present an OPCAB methodology that uses a maximum number of arterial grafts.Methods: We routinely use OPCAB in every patient unless there is another associated condition. We used the following methods to improve the safety of OPCAB: (1) maintaining normothermia, (2) routine use of a pulmonary artery catheter, (3) routine use of a femoral arterial line, (4) routine use of a cell saver, and (5) complete revascularization.Results: We included 173 consecutive patients in the study. All patients underwent OPCAB without any conversion to CPB. Hemodynamic compromise in 5 patients (2.89%) required insertion of an intra-aortic balloon pump (IABP). OPCAB was completed in all 5 patients after IABP insertion. Blood transfusions (BTs) were avoided in 55 patients (31.8%), and 68 patients (39.3%) required ?2 units of blood.Conclusion: The OPCAB technique is still evolving. Low-volume centers have higher rates of conversion to CPB. Hypotension due to an impaired left ventricular function can be successfully treated by using an IABP. Although blood loss can be managed with BTs, use of a cell saver helps to reduce the number of BTs. We conclude that our technique of total arterial OPCAB using a cell saver can be safely performed in a low-volume center.

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ter Woorst, J. F., A. H. T. Hoff, M. C. Haanschoten, S. Houterman, A. H. M. van Straten, and M. A. Soliman-Hamad. "Do women benefit more than men from off-pump coronary artery bypass grafting?" Netherlands Heart Journal 27, no. 12 (September 20, 2019): 629–35. http://dx.doi.org/10.1007/s12471-019-01333-9.

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Abstract Objectives Outcomes after coronary artery bypass grafting (CABG) are worse in women than in men. This study aims to investigate whether off-pump coronary artery bypass (OPCAB) surgery improves the outcomes in women by comparing different outcome measures in both genders. Methods Patients who underwent isolated CABG, either on-pump (ONCAB) or OPCAB, between January 1998 and June 2017 were included. Primary endpoints were 30-day and 120-day mortality. Logistic regression models were constructed to evaluate the effect of the CABG technique on important outcomes such as mortality and the need for blood transfusion. Results The data of 17,052 patients were analysed, 3,684 of whom were women (414 OPCAB) and 13,368 men (1,483 OPCAB). The mean number of grafts was lower in the OPCAB group of both genders (p < 0.001). Postoperatively, both men and women undergoing OPCAB surgery received fewer red blood cell transfusions (p < 0.001) and had higher postoperative haemoglobin levels (p < 0.001) than those undergoing ONCAB. Early mortality occurred less frequently after OPCAB surgery in both genders, although the difference was not significant. However, 120-day mortality was significantly lower after OPCAB surgery in women, even after correction for preoperative risk factors [odds ratio (OR) = 0.356, 95% confidence interval (CI) 0.144–0.882, p = 0.026]. The difference in 120-day mortality was not significant in men (OR = 0.787, 95% CI 0.498–1.246, p = 0.307). Conclusions Women undergoing CABG benefit more from OPCAB surgery than from ONCAB surgery in terms of 120-day mortality. This difference was not found in men in our patient population.

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Agnihotri, Gaurav, Alan E. Gross, Minji Seok, Cheng Yu Yen, Farah Khan, Laura M. Ebbitt, Susan C. Bleasdale, Monica K. Sikka, and Andrew B. Trotter. "600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S362—S363. http://dx.doi.org/10.1093/ofid/ofaa439.794.

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Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

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Gorki, Hagen, Nirav C. Patel, Georgia Panagopoulos, Joan Jennings, Lognathen Balacumaraswami, Konstadinos Plestis, and Valavanur A. Subramanian. "Off-pump Coronary Bypass Surgery in Patients with Low Ejection Fraction." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 5, no. 1 (January 2010): 33–41. http://dx.doi.org/10.1097/imi.0b013e3181cf8228.

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Objective Long-term survival after off-pump surgery in patients with low ejection fraction was investigated. Methods Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery. Results The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients. Conclusions OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.

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Swartwood, Michael J., Claire E. Farel, Nikolaos Mavrogiorgos, Renae A. Boerneke, Ashley Marx, Emily J. Ciccone, Asher J. Schranz, and Alan C. Kinlaw. "607. Identifying Intervention Opportunities to Prevent Readmissions during OPAT." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S365. http://dx.doi.org/10.1093/ofid/ofaa439.801.

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Abstract Background Patients receiving outpatient parenteral antimicrobial therapy (OPAT) experience high rates of unplanned readmissions. To inform interventions that may reduce risk of unplanned readmissions during OPAT, we examined the frequency and reasons for readmission in a large cohort of OPAT patients. Methods We analyzed data on all patients enrolled in UNC’s OPAT program from February 2015-February 2020. Patients were evaluated by an infectious diseases (ID) physician prior to OPAT enrollment, discharged with >14 remaining days of prescribed therapy, and received care coordination and systematic monitoring by an ID pharmacist. We abstracted EHR data into a REDCap database to ascertain information on each patient’s OPAT course and readmission details: length of stay, primary ICD-9-CM/ICD-10-CM diagnosis code associated with readmission, and reason for readmission from clinical notes. Diagnosis codes and notes were adjudicated and summarized by a multidisciplinary team. Results Among 1,165 OPAT courses, 19% resulted in at least one readmission during therapy, lasting for a median length of stay of 5 days. Among those patients who were readmitted during OPAT, the median time from OPAT start to readmission was 17 days (interquartile range, IQR: 8-29 days). 66% of readmissions preceded the scheduled follow-up appointment during OPAT (median time to scheduled follow-up was 27 days, IQR: 15-35 days). 55% of readmissions were unrelated to OPAT diagnosis. Based on ICD-9-CM/ICD-10-CM code classifications, the most common infectious diseases-related reasons for readmission were worsening OPAT infection (18%), OPAT-related adverse drug reaction (12%), and new infection (11%). Conclusion One-fifth of OPAT courses resulted in readmission during therapy. Half of readmissions were associated with OPAT or other infection, and half were for other reasons. Earlier post-discharge follow-up by a multidisciplinary team (including primary care providers, case management, and OPAT) might prevent infection-related readmissions for OPAT patients. Future work should also address the need for enhanced care coordination with non-infectious disease providers to manage OPAT patients. Disclosures All Authors: No reported disclosures

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Neumann, Anneke, Luise Vöhringer, Julia Fischer, Migdat Mustafi, Wilke Schneider, Tobias Krüger, and Christian Schlensak. "Off-Pump Coronary Artery Bypass Grafting in Acute Coronary Syndrome: Focus on Safety and Completeness of Revascularization." Thoracic and Cardiovascular Surgeon 68, no. 08 (February 6, 2019): 679–86. http://dx.doi.org/10.1055/s-0039-1677834.

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Abstract Background Emergency coronary artery bypass grafting (CABG) in the setting of acute coronary syndrome (ACS) has been associated with increased morbidity and mortality. Avoiding cardiopulmonary bypass might be advantageous, but the role of off-pump CABG (OPCAB) remains controversial, as it has been associated with incomplete revascularization in several studies. The objective of this study was to evaluate the feasibility, efficacy, and outcome of OPCAB surgery in ACS patients. Methods We performed a retrospective review of ACS patients who underwent on-pump CABG (ONCAB) or OPCAB, either emergently or delayed, at our institution. Results Between January 2015 and December 2016, a total of 205 consecutive ACS patients underwent either ONCAB (109 patients, 53.2%) or OPCAB surgery (96 patients, 46.8%). EuroSCORE II levels (5.6 ± 7.2 vs 4.9 ± 6.5, p = 0.226) and demography were comparable between groups.A trend towards lower postoperative mortality was observed in OPCAB patients (2.1 vs 5.5%). The incidence of postoperative stroke and low cardiac output syndrome, as well as the duration of inotropic support and the need for re-sternotomy, was significantly lower in the OPCAB group (p < 0.05).CABG performed instantly in an emergency situation was not associated with increased mortality or morbidity when compared with delayed procedures, and OPCAB surgery in emergency patients was associated with lower postoperative morbidity and shorter stays in the intensive care unit (p < 0.05).There were no differences in completeness of revascularization between groups (median 1 [1–1.33;0.33–1.67] OPCAB versus median 1 (1–1.33;0.67–2) ONCAB, p = 0.617), even in the emergency setting. Conclusion OPCAB surgery is safe and effective in ACS and may be considered in hemodynamically stable patients in the emergency setting.

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Ganguly, Anisha, Larry Brown, Deepak Agrawal, and Kavita Bhavan. "Emergency Department Utilization During Self-Administered Outpatient Parenteral Antimicrobial Therapy." Open Forum Infectious Diseases 4, suppl_1 (2017): S332. http://dx.doi.org/10.1093/ofid/ofx163.786.

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Abstract Background Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) has been established as a clinically safe and effective alternative to inpatient or outpatient extended-course intravenous antibiotics while reducing healthcare resource utilization. However, previous research has not confirmed that transferring patients from the hospital to home for treatment does not cause a compensatory increase in emergency department (ED) visits. We sought to validate S-OPAT clinical safety and healthcare costs associated with S-OPAT by confirming that S-OPAT does not increase ED utilization during treatment. Methods We conducted a before-after study of ED utilization among S-OPAT patients. We compared ED visits, hospital admissions resulting from ED visits, hospital admissions due to OPAT-related causes, and hospital charges associated with all ED visits 60 days before and after initiation of S-OPAT. A 60-day time frame was selected to effectively encompass the maximum treatment duration (8 weeks) for S-OPAT. Paired t-tests were used to compare the change in ED utilization before and after initiation of S-OPAT. Results Among our cohort of 944 S-OPAT patients, 430 patients visited the ED 60 days before or after starting treatment. Of the patients with ED visits, 69 were admitted to the hospital for OPAT-related causes and 228 incurred hospital charges from their visit. Initiation of S-OPAT was associated with a statistically significant reduction in total ED visits, all-cause hospital admission, OPAT-related hospital admission, and hospital charges (see Table 1). Conclusion Our review of ED utilization among S-OPAT patients demonstrates a reduction in multiple parameters of ED utilization with the initiation of S-OPAT treatment. Our findings confirm that S-OPAT does not yield an increase, but rather a decrease, in ED visits with the transfer of patients from hospital to home. Disclosures All authors: No reported disclosures.

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Zarro, Debra L., David A. Palanzo, and Ralph M. Montesano. "A comparison of several variables of off-pump coronary artery bypass procedures versus myocardial revascularization utilizing cardiopulmonary bypass." Perfusion 17, no. 1 (January 2002): 9–14. http://dx.doi.org/10.1191/0267659102pf527oa.

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An investigation was conducted to compare several variables of off-pump coronary artery bypass (OPCAB) procedures with those using cardiopulmonary bypass (CPB) for myocardial revascularization by two surgeons. The patients were divided into four groups: group 1 patients received CPB for their myocardial revascularization performed by surgeon A; group 2 patients received the OPCAB procedure performed by surgeon A; group 3 patients received CPB for their myocardial revascularization performed by surgeon B; and group 4 received the OPCAB procedure performed by surgeon B. The same anesthesia technique and postoperative management were employed for all patients in this study. The CPB procedures received the same perfusion circuit and conduct. Postoperative laboratory values, including hemoglobin, hematocrit and platelet counts for the OPCAB groups, were higher than the CPB groups. Chest tube drainage was similar for both the OPCAB and CPB groups, but postoperative urine outputs were significantly higher in the CPB groups for both surgeons. Positive fluid balance was statistically greater in the CPB groups compared to the OPCAB groups for both surgeons. Ventilator times, length of stay in the intensive care unit (ICU) and length of hospital stay were not statistically significant for the groups in this study. Postoperative weight gain for both surgeons was higher in the CPB groups. Intraoperative packed red blood cell (PRBC) usage for surgeon B was similar for both the OPCAB and CPB groups, but the OPCAB group for surgeon A had greater intraoperative PRBC usage than the CPB group.

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Berrevoets, Marvin A. H., Jaap ten Oever, Anke J. M. Oerlemans, Bart Jan Kullberg, Marlies E. Hulscher, and Jeroen A. Schouten. "Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure." Clinical Infectious Diseases 70, no. 6 (May 6, 2019): 1075–82. http://dx.doi.org/10.1093/cid/ciz362.

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Abstract Background Our aim in this study was to develop quality indicators (QIs) for outpatient parenteral antimicrobial therapy (OPAT) care that can be used as metrics for quality assessment and improvement. Methods A RAND-modified Delphi procedure was used to develop a set of QIs. Recommendations on appropriate OPAT care in adults were retrieved from the literature using a systematic review and translated into potential QIs. These QIs were appraised and prioritized by a multidisciplinary panel of international OPAT experts in 2 questionnaire rounds combined with a meeting between rounds. Results The procedure resulted in 33 OPAT-specific recommendations. The following QIs that describe recommended OPAT care were prioritized by the expert panel: the presence of a structured OPAT program, a formal OPAT care team, a policy on patient selection criteria, and a treatment and monitoring plan; assessment for OPAT should be performed by the OPAT team; patients and family should be informed about OPAT; there should be a mechanism in place for urgent discussion and review of emergent clinical problems, and a system in place for rapid communication; laboratory results should be delivered to physicians within 24 hours; and the OPAT team should document clinical response to antimicrobial management, document adverse events, and monitor QIs for OPAT care and make these data available. Conclusions We systematically developed a set of 33 QIs for optimal OPAT care, of which 12 were prioritized by the expert panel. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

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Bianchini, Monica L., Rachel Kenney, Robyn Lentz, Marcus Zervos, Manu Malhotra, and Susan L. Davis. "772. Access Denied: Impact of Insurance Denials for High-Cost Outpatient Parenteral Antimicrobial Therapy." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S343. http://dx.doi.org/10.1093/ofid/ofz360.840.

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Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) allows patients to receive prolonged antimicrobial therapy while reducing the length of hospitalization and healthcare costs. In the United States, most public and private insurance companies require prior authorization (PA) for OPAT. The impact of OPAT PA delays is not known. This study aimed to characterize discharge barriers and authorization delays associated with high-cost OPAT antibiotics. Methods IRB-approved study of adult patients discharged with high-cost OPAT antibiotics from January to December 2017. Antibiotics were included based on the frequency of OPAT use and average sales price (ASP) greater than $100 per day, including: daptomycin, ceftaroline, ertapenem, and the novel β-lactam β-lactam inhibitor combinations. Patients with an OPAT authorization delay >24 hours were compared with patients without an OPAT authorization delay. Primary endpoint: total direct hospital costs, starting from the start of treatment with the OPAT antibiotic, from the institutional perspective using Healthcare Cost and Utilization Project and Center for Medicare and Medicaid Services 2019 ASP Drug Pricing data. Secondary outcomes: discharge delay and 30-day readmission or mortality. Results Two-hundred patients included: 151 (76%) no OPAT delay vs. 49 (25%) OPAT delay. The use of antibiotics was similar between groups, except ertapenem was more common in the no OPAT delay group: 60 (43%) vs. 15 (25%), P = 0.022. Patients with no OPAT delay were more commonly discharged with home infusion and less commonly to a facility: 75 (53%) vs. 19 (32%), P = 0.007, and 52 (37%) vs. 37 (63%), P = 0.001, respectively. Discharge delays were more common in patients with OPAT delays: 21 (15%) vs. 31 (53%), P < 0.001. The median total direct hospital costs were higher in patients with OPAT delays: $7,770 (3,031–13,974) vs. $19,576 vs. (10,056–37,038), P < 0.001. Table 1 compares the total direct hospital costs of patients with and without an authorization delay. Conclusion OPAT with high-cost antibiotics requires significant care coordination. Authorization delays for these antibiotics are common and may contribute to a delay in discharge. OPAT transitions of care represent an important opportunity for Infectious Diseases providers to improve care and address access barriers. Disclosures All authors: No reported disclosures.

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Muttaqin, Akhmad. "Relapse Opiat di Rumah Sakit Ketergantungan Obat Jakarta, Tahun 2003-2005." Kesmas: National Public Health Journal 1, no. 5 (April 1, 2007): 202. http://dx.doi.org/10.21109/kesmas.v1i5.291.

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Penyalahgunaan ulang opiat merupakan penyakit kronik yang berkali-kali muncul. Angka kambuh (relapse) pecandu Narkotika, Psikotropika dan Zat Adiktif (Napza) secara umum tidak jauh berbeda dengan angka relapse pecandu opiat. Tujuan penelitian ini mengetahui berbagai faktor saja yang berhubungan dengan kejadian relapse opiat di RSKO Jakarta tahun 2003-2005. Penelitian dengan disain kasus control ini dilakukan terhadap data sekunder rekam medik. Variabel yang diteliti meliputi faktor individu (jenis kelamin, tingkat pendidikan, golongan umur, status perkawinan, status pekerjaan, dan status infeksi hepatitis) serta faktor zat (pola penggunaan, lama pakai, cara pakai, frekuensi pakai, dan kadar zat). Sampel studi terdiri dari 72 kasus dan 84 kontrol, Kasus adalah pasien ketergantungan opiat yang berkunjung berturut-turut 6 bulan tanpa menggunakan opiat dan kembali berkunjung dengan keluhan kembali menyalahgunakan opiat. Kontrol adalah pasien ketergantungan opiat yang berkunjung berturut-turut 6 bulan tanpa menggunakaan opiat dan tetap berkunjung tanpa keluhan menyalahgunakan opiat. Penelitian ini menggunakan metoda analisis multivariat logistik regresi ganda. Variabel berhubungan dengan relapse opiat adalah tingkat pendidikan, status perkawinan, status hepatitis, lama pakai, dan cara pakai. Variabel yang paling dominan adalah status hepatitis, penderita hepatitis berisiko relapse lebih besar daripada bukan penderita hepatitis.Kata kunci: Relaps, ketergantungan opiat, regresi logistikAbstractDrug abuse is a chronic condition that can relapse several times. Generally the relapse rates of narcotic, psychotropic and other additive material are not differed from that of opiate. The objective of this study is to know factors related to the occurrence of opiate relapse in Jakarta Drug Abuse Hospital in 2003- 2005. The study design used in this study is case control design using medical record as secondary source of data. The study variables include individual variables (sex, education eve, age, marital status, job, and status of hepatitis), the drug factors including pattern of abuse, duration, method, frequency, and dose. The sample consists of 72 cases and 84 control. The cases are opiate abuse patient who visited the Jakarta Drug Abuse for 6 months without relapse and revisited with opiate relapse. The controls are opiate abuse patient who visited the Jakarta Drug Abuse for 6 months without relapse and still not relapse in the next visit. The analysis method used in this study is multiple logistic regression method. Variables related to opiate relapse include education, marriage status, hepatitis status, method and duration of abuse.Key words: Relapse, opiate abuse, logistic regression

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Heintz, Brett H., Jenana Halilovic, and Cinda L. Christensen. "Impact of a Multidisciplinary Team Review of Potential Outpatient Parenteral Antimicrobial Therapy Prior to Discharge from an Academic Medical Center." Annals of Pharmacotherapy 45, no. 11 (October 11, 2011): 1329–37. http://dx.doi.org/10.1345/aph.1q240.

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Background:: Outpatient parenteral antimicrobial therapy (OPAT) is frequently prescribed at hospital discharge, often without infectious diseases (ID) clinician oversight. We developed a multidisciplinary team, including an ID pharmacist, to review OPAT care plans at hospital discharge to improve safety, clinical efficacy, practicality, and appropriateness of the proposed antimicrobial regimen. Objective: To evaluate the impact of the OPAT team on regimen safety, efficacy, and complexity; calculate the economic benefits of the service by avoiding hospital discharge delay, central venous catheter placement, or need for OPAT; and evaluate the discharge environment among OPAT referrals. Methods: In an observational design, we analyzed the impact of an OPAT team from July 2009 through June 2010 at a large academic tertiary care hospital. All patients with plans for continued parenteral therapy after discharge referred to the OPAT team were included in the analysis. Patients were excluded if OPAT was cancelled prior to processing of the referral. Results: During the 1-year study period. 569 of 644 consecutive referrals to the OPAT team met inclusion criteria, resulting in 494 OPAT courses. Interventions by an ID pharmacist were made for safety (56%), regimen complexity (41%), and efficacy (29%). Lack of formal ID physician consultation resulted in more interventions for safety (64% vs 48%, p < 0.001) and efficacy (36% vs 21%, p < 0.001). Discharge delays were avoided for 35 referrals, resulting in 228 hospital days avoided and approximately $366,000 in hospital bed cost savings. Use of OPAT was avoided in 75 referrals (13.2%), preventing central venous catheter placement in 48 patients (8.4%), resulting in an additional $58,080 in cost savings. Conclusions: The OPAT team optimized safety, efficacy, and convenience of OPAT while providing substantial cost savings. Further studies are needed to confirm the program's cost-effectiveness.

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Puskas, John D., Janet Martin, Davy C. H. Cheng, Stefano Benussi, Johannes O. Bonatti, Anno Diegeler, Francis D. Ferdinand, et al. "ISMICS Consensus Conference and Statements of Randomized Controlled Trials of Off-Pump versus Conventional Coronary Artery Bypass Surgery." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 10, no. 4 (July 2015): 219–29. http://dx.doi.org/10.1097/imi.0000000000000184.

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Objective At this consensus conference, we developed evidence-informed consensus statements and recommendations on the practice of off-pump coronary artery bypass graft (OPCAB) by systematically reviewing and performing meta-analysis of the randomized controlled trials (RCTs) comparing OPCAB and conventional coronary artery bypass (CCAB). Methods All RCTs of OPCAB versus CCAB through April 2013 were screened, and 102 relevant RCTs (19,101 patients) were included in a systematic review and meta-analysis (15 RCTs of 9551 high-risk patients; and 87 RCTs of 9550 low-risk patients) in accordance with the Cochrane Collaboration and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Consensus statements for the risks and benefits of OPCAB surgery in mortality, morbidity, and resource use were developed based on best available evidence. Results Compared to CCAB, it is reasonable to perform OPCAB to reduce risks of stroke [class IIa, level of evidence (LOE) A], renal dysfunction/failure (class IIa, LOE A), blood transfusion (class I, LOE A), respiratory failure (class I, LOE A), atrial fibrillation (class I, LOE A), wound infection (class I, LOE A), ventilation time, and ICU and hospital length of stay (class I, LOE A). However, OPCAB may be associated with a reduced number of grafts performed (class I, LOE A) and with diminished graft patency (class IIa, LOE A, with increased coronary reintervention at 1 year and beyond (class IIa, LOE A), as well as increased mortality at a median follow-up of 5 years (class IIb, LOE A). Conclusions OPCAB compared with CCAB may improve outcomes in the short-term (stroke, renal dysfunction, blood transfusion, respiratory failure, atrial fibrillation, wound infection, ventilation time, and length of stay). However, over the longer-term, OPCAB may be associated with reduced graft patency, and increased risk of cardiac re-intervention and death.

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Dhruba, Avishek Sarker, Md Kamrul Hasan, and Md Azizul Islam Khan. "Effect of Intact Pleura on Early Outcome after Off-Pump Coronary Artery Bypass Grafting." Cardiovascular Journal 13, no. 2 (April 15, 2021): 112–19. http://dx.doi.org/10.3329/cardio.v13i2.52964.

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Background: Among the various options of treatment of ischemic heart disease coronary artery bypass grafting (CABG) remains one of the standard modes of revascularization. Coronary artery bypass grafting can be done with or without using cardiopulmonary bypass (CPB). This study was to compare postoperative early (up to 1 month) outcome of intact versus open pleura after off pump coronary artery bypass grafting (OPCAB). Methods: In this study, sixty patients aged 18-70 years admitted in Department of Cardiac Surgery, NICVD who underwent OPCAB were selected for the study sample and divided into two groups. Groups I (n=30) consist of the patients who underwent OPCAB with pleurotomy and Group II (n=30) consists of patients who underwent OPCAB with intact pleura. Outcome of patients including Forced expiratory volume in first second (FEV1) & Forced vital capacity were evaluated. Results: Patients having OPCAB with intact pleura showed lower incidence of atelectasis and pleural Effusion in 2nd postoperative & 5th postoperative day (p<0.05). Lower amount of chest tube drainage and transfusion requirement were observed in group II patients than Group I (530.00 ± 28.97 vs. 485.96±38.62; p<0.05 and 611.23±99.22 vs. 577.93±135.38, p>0.05, respectively). Moreover, higher duration of ventilation were noted in group I (7.50 ± 2.22 vs. 6.30±2.32, p<0.05). Beside these, total duration of ICU stay & hospital stay were significantly higher in patients OPCAB with open pleura (p<0.05). Conclusion: Keeping the pleura intact during OPCAB is significantly associated with low rate of atelectasis and pleural effusion. Clinically, it decreases postoperative amount of blood loss and significantly lowers ICU stay, mechanical ventilation time and hospital stay. Therefore, it can be concluded that intact pleura during OPCAB improves postoperative pulmonary outcomes. Cardiovasc. j. 2021; 13(2): 112-119

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Kshettry, Vibhu R., Thomas F. Flavin, Robert W. Emery, Demetre M. Nicoloff, and Rebecca J. Petersen. "OPCAB selection bias: Reply." Annals of Thoracic Surgery 71, no. 5 (May 2001): 1751. http://dx.doi.org/10.1016/s0003-4975(01)02484-5.

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Mack, Michael J. "OPCAB selection bias: Reply." Annals of Thoracic Surgery 71, no. 5 (May 2001): 1751–52. http://dx.doi.org/10.1016/s0003-4975(01)02485-7.

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Journal articles on the topic 'OPCAT'

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