Browsing by Author "Zvaigzne, Ligita"
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Item Identifying Early Risk Factors for Postoperative Pulmonary Complications in Cardiac Surgery Patients(2024-09) Šetlers, Kaspars; Jurcenko, Anastasija; Arkliņa, Baiba; Zvaigzne, Ligita; Sabeļņikovs, Oļegs; Stradiņš, Pēteris; Strīķe, Eva; Department of Anaesthesiology, Intensive Care and Clinical simulations; Department of SurgeryBackground and Objectives: Postoperative pulmonary complications (PPCs) are common in patients who undergo cardiac surgery and are widely acknowledged as significant contributors to increased morbidity, mortality rates, prolonged hospital stays, and healthcare costs. Clinical manifestations of PPCs can vary from mild to severe symptoms, with different radiological findings and varying incidence. Detecting early signs and identifying influencing factors of PPCs is essential to prevent patients from further complications. Our study aimed to determine the frequency, types, and risk factors significant for each PPC on the first postoperative day. The main goal of this study was to identify the incidence of pleural effusion (right-sided, left-sided, or bilateral), atelectasis, pulmonary edema, and pneumothorax as well as detect specific factors related to its development. Materials and Methods: This study was a retrospective single-center trial. It involved 314 adult patients scheduled for elective open-heart surgery under CPB. Results: Of the 314 patients reviewed, 42% developed PPCs within 12 h post-surgery. Up to 60.6% experienced one PPC, while 35.6% developed two PPCs. Pleural effusion was the most frequently observed complication in 89 patients. Left-sided effusion was the most common, presenting in 45 cases. Regression analysis showed a significant association between left-sided pleural effusion development and moderate hypoalbuminemia. Valve surgery was associated with reduced risk for left-sided effusion. Independent parameters for bilateral effusion include increased urine output and longer ICU stays. Higher BMI was inversely related to the risk of pulmonary edema. Conclusions: At least one PPC developed in almost half of the patients. Left-sided pleural effusion was the most common PPC, with hypoalbuminemia as a risk factor for effusion development. Atelectasis was the second most common. Bilateral effusion was the third most common PPC, significantly related to increased urine output. BMI was an independent risk factor for pulmonary edema development.Item Impact of body mass index on parameters of the left atrium : Cardiac computed tomography study(2022-12-01) Verhovceva, Viktorija; Zvaigzne, Ligita; Jubele, Kristīne; Kalējs, Oskars; Department of Internal DiseasesIncreased Body Mass Index (BMI) is often used as a predictor for cardiovascular diseases, and it is also known to be associated with left atrial enlargement, potentially affecting anatomic structures of the left atrium. The aim of the study was to determine the association between BMI and parameters of the left atrium, including characteristics of the pulmonary veins (PVs), found in cardiac computed tomography (CT) scan. The retrospective study included 140 patients with a mean age of 66.9 years (SD = 7.8). There were statistically significant correlations between BMI and volume changes of the left atrium during the cardiac cycle: Vmax (rs = 0.199, p = 0.023), Vmin (rs = 0.177, p = 0.043), Vmean (rs = 0.190, p = 0.029), which supports previously known data. The study also revealed unique associations regarding the impact of BMI on PV structures. There was a significant correlation between BMI and PV orifice size in the left inferior PV (rs = 0.216, p = 0.032) and the right accessory PV (rs = -0.629, p = 0.012). The right PV angle was positively correlated with BMI (rs = 0.178, p = 0.044), while the angle between left PVs did not show any correlation with BMI (p = 0.436). The results support previously known associations between increased BMI and left atrial enlargement and show a statistically significant effect of increased BMI on the characteristics of pulmonary veins.Item The Impact of Pulmonary Vein Anatomy on P-Wave Appearance during Sinus Rhythm : Cardiac Computed Tomography Study(2023-09) Verhovceva, Viktorija; Zvaigzne, Ligita; Lācis, Romans; Kalējs, Oskars; Department of Internal DiseasesElectrocardigraphy remains a first-line evaluation method for cardiac electrical activity, recorded from the body surface. Since atrial activation is seen on the ECG as a P-wave, several factors are known to impact the appearance of the P-wave, such as the direction of electric impulse, conduction abnormalities, and anatomical characteristics of the atria. This retrospective study aimed to find statistically significant associations between the anatomy of pulmonary veins (PVs) observed in cardiac computed tomography (CT) and P-wave appearance during sinus rhythm on resting ECG. For each patient, a resting 12-lead ECG was recorded, and the field of analysis was P-wave—its duration, morphology, and axis. The evaluation of the CT scan recordings was performed by creating 3D models of the left atrium and analyzing the anatomy of the PVs and left atrial appendages (LAA). Noteworthy correlations were found: anatomy of the left PVs showed an association with LAA volume, LAA morphology, and P-wave notching in lead II. The right PVs demonstrated a relation with the P-wave axis and amplitude. Although these correlations cannot be classified as strong, the results not only expand understanding about discussed variables but also suggest the presence of a subtle and complex relationship, that warrants further exploration.Item Multislice Computed Tomography Imaging of Diverticultis Complication: Colovenous Fistula(2010-01-01) Radzina, Maija; Laganovskis, Andris; Tirane, Mara; Zvaigzne, Ligita; Prieditis, Peteris; Bruns, Voldemars; Lugovska, SvetlanaAcute colon pathology as diverticulitis is a frequent and important gastrointestinal disease, but the clinical diagnosis is often difficult to state. Several radiological studies have been used to assist in the diagnosis of acute diverticulitis (e.g. barium enema, ultrasound, and computed tomography (CT). Colovenous fistula is a rare complication of diverticulitis. We have analyzed MSCT imaging role in evaluation of such complicated form of diverticular disease.Item A Randomized Controlled Trial on the Efficacy of 20% Human Albumin in Reducing Pleural Effusion After Cardiopulmonary Bypass(2024) Šetlers, Kaspars; Aispure, Klaudija; Zolovs, Maksims; Zvaigzne, Ligita; Sabeļņikovs, Oļegs; Stradiņš, Pēteris; Strīķe, Eva; Department of Anaesthesiology, Intensive Care and Clinical simulations; Statistics Unit; Department of Surgery