Patients undergoing coronary artery bypass grafting (CABG) routinely stop low-dose aspirin therapy 7 to 10 days before the operation to restore normal platelet hemostatic function, but a new study suggests that it may be more beneficial to continue taking aspirin until the surgery. Israeli researchers studied 32 patients with coronary artery disease about to have CABG. Fourteen patients received aspirin until the day of the operation, and 18 patients stopped receiving aspirin at least one week beforehand. The results show that the patients who stopped aspirin one day before the operation had significantly improved oxygen levels with only a slight increase in bleeding. This group had a significantly shorter ventilation period following the surgery, an average of 3.8 hours compared to 6.9 hours, as well as a significantly shorter stay in the ICU. They also had significantly lower thromboxane A2 levels, 117 pg/mL compared with 1,306 pg/mL (which can usually cause lung injury after this surgery), and were significantly better in their oxygenation capability. While these patients' operations were 24 minutes longer than the other patients, and the patients experienced slightly increased bleeding, none of the patients in the study required more transfusions, nor were there any deaths in either group. The study appears in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Perceptions of Death and Dying in the ICU: Doctors, Nurses, Residents, and Family

Following the deaths of 68 patients in the ICU, researchers from Nashville, TN, administered the 31-item Quality of Dying and Death (QODD) instrument to each of the patient's attending physician, nurse, resident, and, one month following the death, to one of the patient's family members to capture their views on the quality of the dying process. Signific
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Contact: Arielle Green
agreen@chestnet.org
847-498-8387
American College of Chest Physicians
9-May-2005