Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity.
Please complete the following steps:
Read the article by Cheng et al. entitled “Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials” on page 188 and the accompanying editorial by Floyd and Fleisher entitled “Off-pump coronary artery bypass and the hypothesis from which it grew: Is it yet to be tested? What are the downsides of the lingering questions?” on page 3 of this issue.
Review the questions and other required information for CME program completion (published in both the print and online journal).
When ready, go to the CME Web site: http://www.asahq.org/journal-cme. Submit your answers, form of payment, and other required information by December 31 of the year following publication.
The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA’s Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.
Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives: After reading the articles related to this program, the participants should be familiar with the current state of knowledge concerning the risks and benefits of coronary artery bypass graft surgery with and without the use of cardiopulmonary bypass.
Author – Thomas Floyd, M.D., and Lee A. Fleisher, M.D. Grants or research support: None Consultantships or honoraria: None The article authored by Drs. Floyd and Fleisher was supported solely from institutional and/or departmental sources.
Authors – Davy C. Cheng, M.D., M.Sc., F.R.C.P.C., Daniel Bainbridge, M.D., F.R.C.P.C., Janet E. Martin, Pharm.D., Richard J. Novick, M.D., M.Sc., F.R.C.S.C., and The Evidence-based Perioperative Clinical Outcomes Research Group
Grants or research support: None
Consultantships or honoraria: None
The article authored by Drs. Cheng, Bainbridge, Martin, and Novick and The Evidence-based Perioperative Clinical Outcomes Research Group was supported solely from institutional and/or departmental sources.
Question Writer – Peter Bailey, M.D.Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Based on the article by Cheng et al. entitled “Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=102&issue=1&spage=188&part=fulltextand its accompanying editorial by Floyd and Fleisher entitled “Off-pump coronary artery bypass and the hypothesis from which it grew: Is it yet to be tested? What are the downsides of the lingering questions?”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=102&issue=1&spage=3&part=fulltextin the January issue of Anesthesiology, choose the one correct answer for each question:
1. The increased interest in “off-pump” coronary artery bypass graft (CABG) surgery, without the use of cardiopulmonary bypass (CPB), instead of CABG with CPB, most likely results from concern over
A. the routine costs of cardiac surgery.
B. the incidence of myocardial infarction after CABG with CPB.
C. the incidence of neurological complications following CABG with CPB.
D. the transfusion of blood products.
2. Which statement concerning the quality of life (QOL) for patients after CABG surgery is most likely true?
A. QOL only improves after conventional (with CPB) CABG.
B. QOL only improves after off-pump CABG.
C. QOL improves after conventional (with CPB) or off-pump CABG.
D. QOL does not improve after either conventional (with CPB) or off-pump CABG.
3. Factors contributing to difficulties in determining the benefits related to off-pump CABG compared to CABG include all of the following except
A. undeclared repeat (duplicate) publication of results of some clinical trials.
B. insufficient enrollment in individual randomized controlled trials.
C. insufficient numbers of randomized controlled trials.
D. insufficient consensus as to the performance of high quality meta-analyses.
4. Compared to CABG with CPB, which statement about patients undergoing off-pump CABG is most likely true?
A. The risk of postoperative atrial fibrillation is less.
B. The risk of blood product transfusion is the same.
C. The risk of mortality is greater.
D. The risk of myocardial infarction is greater.
5. To date, which statement about the quality and completeness of revascularization after off-pump CABG versus CABG with CPB is most likely true?
A. There are too few studies on which to base an assessment.
B. The majority of studies reporting early (1-24 months) results indicate equivalent revascularization.
C. There are sufficient studies to allow assessment of long (7-10 years) term results.
D. Long (7-10 years) term results of revascularization are equivalent.