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Related Concept Videos

Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches

Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
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Factors Affecting Protein-Drug Binding: Drug-Related Factors01:18

Factors Affecting Protein-Drug Binding: Drug-Related Factors

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Related Experiment Video

Updated: May 13, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Risk factor analysis for fast track protocol failure.

Arndt H Kiessling1, Patrick Huneke, Christian Reyher

  • 1Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany. cardiac.surgeon@dr-kiessling.com

Journal of Cardiothoracic Surgery
|March 19, 2013
PubMed
Summary
This summary is machine-generated.

Fast-track cardiac surgery protocols aim to reduce intensive care unit (ICU) stays. However, failure to transfer or readmission to the ICU indicates poor patient outcomes, with specific predictors identified.

Related Experiment Videos

Last Updated: May 13, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Area of Science:

  • Cardiac Surgery
  • Intensive Care Medicine
  • Patient Management Protocols

Background:

  • Fast-track protocols in cardiac surgery aim to shorten intensive care unit (ICU) hospitalization.
  • Readmission to the ICU is a critical indicator of negative patient outcomes and protocol effectiveness.

Purpose of the Study:

  • To statistically analyze risk factors and predictors for ICU readmission following fast-track cardiac surgery.
  • To identify independent predictors for the failure of fast-track patient management programs.

Main Methods:

  • Retrospective analysis of 229 cardiac surgery patients undergoing a preoperative fast-track protocol.
  • Uni- and multivariate analyses were employed to identify predictors for ICU readmission.
  • Data collected included patient demographics, operation details, and postoperative outcomes.

Main Results:

  • 36% of patients failed to transfer to an intermediate care unit (IMC) on the day of surgery, and 4% required ICU readmission.
  • Failure of the fast-track procedure was predicted by a preoperative American Society of Anesthesiologists (ASA) class >3, New York Heart Association (NYHA) class >III, and operation time >267 minutes.
  • Significant risk factors for major postoperative events included a poor ejection fraction (EF) and ICU readmission.

Conclusions:

  • Failure to transfer to IMC or ICU readmission is associated with significantly worse patient outcomes.
  • Preoperative ASA class >3, NYHA class >III, and prolonged operation times (>267 minutes) are independent predictors of fast-track protocol failure.
  • Identifying these predictors is crucial for optimizing patient selection and management within fast-track programs.