Description

One of the most pressing concerns regarding the future of our profession is the loss of surgeon-scientists from academic surgery. Basic science research is an essential component of the academic surgical mission. In cardiothoracic surgery, where the development of cardiopulmonary bypass, cardioplegic arrest, systemic hypothermia, anatomic lung resection, and heart and lung transplantation all began with extensive laboratory experimentation, the decline of the surgeon-scientist is especially concerning. In the not-too-distant future, studies of cardiac regeneration, cancer biology, aneurysm biology, transplant immunology, and the development of transcatheter devices may lead to the next revolution in CT surgery and make a difference in the lives of millions of people worldwide. Our team recently found that only 7.4% of CT surgery faculty at US training institutions had published a BSR paper as the first or last author between 2017 and 2018. These results show that only a small number of academic CT surgeons are actively leading BSR projects, and they also raise the possibility that there are not enough CT surgeon-scientists willing to serve as mentors for the next generation.

De-implementation strategies

However, it is still unknown whether these effects have resulted in trainees in CT surgery having less experience with BSR. Understanding the trends in trainee research conducted by the next generation of academic surgeons is essential to comprehending the decline of BSR in academic surgery. The practice of sustainably incorporating evidence-based interventions into routine clinical practice is known as dissemination and implementation science. In cardiothoracic surgery, D&I techniques are underutilized because they are a relatively new field. An overview of D&I science from the perspective of the cardiothoracic surgeon is provided in this review. We begin by providing a general overview of D&I science and the fundamental terminology utilized in the field. Second, we discuss a national implementation of lung protective management strategies for lung donor optimization as a real-world example of D&I techniques. Finally, we give a few examples of evidence-based interventions that have not been effectively implemented in surgical practice and discuss obstacles to successful implementation that are unique to cardiothoracic surgery. De-implementation strategies and other examples of successful D&I interventions from other surgical subspecialties are also provided. When incorporating evidence-based interventions into routine practice, cardiothoracic surgeons may find that this review provides additional resources to explore. Heparin and CPB increase HBP levels in the plasma, while protamine decreases them. Postoperative HBP was only marginally affected by the pro-inflammatory effects of cardiothoracic surgery with CPB, according to the findings of this study.

In this study, HBP concentrations were lower than a previously established threshold for predicting organ injury in patients with infection, regardless of surgical complexity, by the first postoperative day. More than 80% of general surgery trainees plan to pursue fellowship after completing their residency, according to recent trends. Nowadays, applicants are more likely to conduct an internet search for fellowship programs in their desired field when applying for one; consequently, a program's website is frequently their first impression. According to previous research, applicants frequently express dissatisfaction with the quality of websites viewed when deciding whether to apply to or schedule an interview with a program. The majority of existing websites are severely lacking in content areas deemed relevant or important to prospective applicants, despite the fact that programs' websites are an essential resource for trainees during the application process, according to numerous studies assessing the importance, accessibility, and content of residency and fellowship program websites. Additionally, the accessibility of the website is hampered by the fact that applicants frequently use society web pages to find information about available training programs.

Transformative Endeavor

Access to comprehensive, accurate online information may enable applicants to make informed decisions about whether they would be a good fit for a program prior to applying or interviewing, making knowledge of the adequacy of residency and fellowship websites essential. Attending multiple interviews to select the best program may also have beneficial effects on resident finances and training time missed. Utilizing DrugSorb-ATR during the surgical procedure, demonstrate a decrease in blood levels of ticagrelor. Determine whether the intended patient group is safe when DrugSorb-ATR is used intraoperatively. Exposure to ceftriaxone was linked to an increased chance of contracting vanA vancomycin-resistant Enterococcus faecium. During the outbreak, ceftriaxone was frequently used as a surgical antibiotic prophylaxis. There was no correlation found between the risk of VRE and specific surgical procedures, vancomycin exposure, or admission to the ICU. The coronavirus disease 2019 pandemic has a negative impact on cardiothoracic surgical care, leading to operations being postponed to make room for patients with COVID-19 to be cared for. As a result of the pandemic, changes in clinical, academic, and personal responsibilities may disproportionately affect female academic surgeons, highlighting existing sex disparities in academia.

The pandemic's exacerbated household, caregiver, and clinical responsibilities may be hindering female academic productivity, particularly for early-career surgeons. Diverse medical subspecialties and COVID-19 research publications have described a sex-specific effect of the current pandemic on female authorship. However, it is still unknown how the COVID-19 pandemic will affect authorship in CT surgery. Cardiothoracic Surgery at the University of Alabama at Birmingham is a transformative endeavor whose roots lie in local practice and education in a Southern state with a difficult past. It was transformed by the visions of a few to become a dominant force in the history of cardiothoracic surgery at the regional, national, and international levels. Numerous individuals have contributed to important innovations, education, and a recurring theme of surgical excellence throughout its history.