Recommended Manuscripts Library

As part of the Society’s increasing focus on quality, the Task Force on Quality Initiatives has created the Recommended Manuscripts Library— a resource for STS members that provides summaries of pertinent articles relevant to cardiothoracic surgery. The articles included in the library are not intended to provide an exhaustive treatment of each subject matter selected; they will initially focus on quality webinar topics, as well as other quality-related areas.

Mediastinal Staging

A patient with a diagnosis or potential diagnosis of non-small cell lung cancer (NSCLC) must be evaluated for extent of disease. The stage of NSCLC directs the management and prognosis. If a patient is determined to have disease limited to the chest, mediastinal staging is critical to identifying the appropriate therapy.

The following manuscripts briefly describe non-invasive (imaging) and invasive techniques to stage the mediastinum. The articles demonstrate the evolution, secondary to technologic advances, of noninvasive and invasive modalities over the last 15 years.

Glycemic Control

The following manuscripts describe the role and rationale of glycemic control in cardiac surgery. Recent clinical studies suggest that normoglycemia is not desirable during surgery, but that blood glucose should always be less than 180 – 200 mg/dL. Studies also suggest that normoglycemia in the ICU is the optimal target and has the greatest influence on mortality and overall morbidity.

Some issues not addressed by these articles include:

1. Basic science elucidation of the biochemical basis for BG < 200 mg/dL during surgery and normoglycemia in the ICU.
2. Whether or not hyperglycemia is a cause or symptom among non-survivors.
3. Whether an optimal duration for normoglycemia should be defined or if simple average blood glucose levels are sufficient to improve outcomes.

The STS Task Force on Quality Initiatives hopes STS membership finds the library useful. Please use this form to provide comments and suggestions.