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Bicarb Alternatives: Sodium Acetate & Balanced Crystalloids

Editor’s Note:   Authorization for the contributions below were obtained from each contributor via email.  Please see comments section… THAM A a Buffer Tham Description Tham Solution (tromeThamine injection) is a sterile, non-pyrogenic 0.3 M solution of tromeThamine, adjusted to a pH of approximately 8.6 with glacial acetic acid. It is administered by intravenous injection, by…

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tHE wAITING gAME: O’s to the Toes…

_________________________________________________ – Editor’s Note: – Sometimes you just know… –It was gonna be a long pump run, huge patient, and the CT surgeon is a slow AND meticulous surgeon, an artist of self imposed preciseness that pre-emptively puts down 4.5 LPM as the standard for every bypass run.  No rhyme or reason- his perfect universe ran…

Brothers-and-Sisters

Pediatric Perfusionist Needed for L’Viv Ukraine

________________________________________________ – Editor’s Note: I was finishing up a routine CABG when I received a Messenger text from Dr. Bill Novick, the Director and founder of The Novick Cardiac Alliance, and it read as follows: – – This would obviously be a huge decision for whomever would consider going to a country in the middle…

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We Call them HEROES: An American Heart Team in Ukraine…

“Pensiveness best describes the scene, as we swirl our glasses watching the foam tumble down the side of the glass and picking at a cold piece of pizza. We all know what is coming but none of us know what to expect.” – ___________________________________ – Editor’s Note: – This needs to be written, but it…

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“The Fight is Here; I need Ammunition, NOT a Ride”

Editor’s Note: Typically I do not get involved with politics or international affairs that are not directly related to the field of cardiovascular medicine, or the field of medicine in general. But with the world events of today regarding the Ukrainian crisis, it is impossible to sidestep a position statement that I feel I must…

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Red Sea Rising: Strategies to Improve Surgical Visualization

Editor’s Note: This is a discussion on a very difficult case where anomalous venous return was overwhelming during a multi-valve repair / replacement- Making surgical correction nearly impossible. Well, it was one of those days… Unspoken Silence: When everyone worries…  We Look to get past this morning’s -double-or-triple-valve-something, one step at a time. And they were…

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My Perfusion Job Shadowing Experience: Day 2

(Reprint 2014) Editor’s Note: This is part 2 of what is a 3-part series- these first two posts presented by a young, soon-to-be medical professional who job shadowed for two days with me.   He is soon to graduate from a very prestigious university here in Texas, and has more than established his unwavering commitment to medicine…

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My Perfusion Job Shadowing Experience: Day 1

(Reprint 2014) Editor’s Note: This is part 1 of what is going to be a 3-part series- the first two posts presented by a young, soon-to-be medical professional who job shadowed for two days with me.  The last will be a re-post of something I had written- that reflects the difficulty of the case we…

The-End

Perfusion Art: “Next…?”

Perfusion Art: “NEXT…? ” Photographer: Frank Aprile, CCP, BBA, LP Equipment: I Phone 8+ Editing: Photoshop Narrative: Waiting for the Next ECMO… I write about theses things because it takes it’s toll on everyone- We are outcome driven when it comes to advanced medical care and resuscitation- we truly are the cream of the crop and the Tips…

Beginnings

What Doesn’t Kill You Makes You Stronger…

The take home message on this is that I believe in Miracles– And we could use a few of those- so never give up. – That’s a shout out to: Our Staff: Our Patients: Patient Families: Our Families – – Editor’s Note: – How did I get Here? So I found myself driving South of…

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Thrombosis in Extracorporeal Membrane Oxygenation (ECMO) Circuits

Examination of ECMO circuits after removal is a useful quality improvement tool that can elucidate the cause of circuit problems, indicate patients at increased risk of thrombosis, and suggest areas for possible improvements.

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Cytokine Adsorption Therapy during Extracorporeal Membrane Oxygenation in Adult Patients with COVID-19

This case series aimed to contribute to the body of evidence substantiating CAT utilization in hyperinflammatory patients, namely, COVID-19 patients requiring ECMO rescue.

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The Role of Race on Acute Kidney Injury Following Cardiac Surgery

Despite accounting for differences in risk factors and intra-operative practices, Black patients had a 50% increased odds for developing moderate-severe post-operative AKI compared to White patients. Additional evaluations are warranted to identify potential targets to address racial disparities in AKI outcomes.

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Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension: A STS Database Analysis

Most PEA procedures are performed among a small number of centers, with high-volume hospitals having favorable outcomes. These data suggest a potential role for PEA regionalization.

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Association between Intraoperative Hyperglycemia and Postoperative End-Organ Dysfunctions after Cardiac Surgery: A Retrospective Observational Study

In patients undergoing cardiac surgery with cardiopulmonary bypass, the GE index was an independent predictor of PEOD.

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Central, Peripheral ECMO or CPB? Comparsion between Circulatory Support Methods Used during Lung Transplantation

The use of central extracorporeal membrane oxygenation should be favorized over peripheral cannulation or cardiopulmonary bypass. CPB should be no longer used during LuTx.

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Gelatin and the Risk of Bleeding after Cardiac Surgery

Gelatin was not associated with AKI after cardiac surgery.

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Prolonged Blood Storage and Risk of Posttransfusion Acute Kidney Injury

In a population of patients without severely impaired baseline renal function receiving fewer than 10 erythrocyte units, duration of blood storage had no effect on the incidence of posttransfusion acute kidney injury.

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A Comparative Analysis of Factors Influencing Haemoglobin Content in RBC Units

The marked variation of haemoglobin content in our study revealed that there is a need for standardizing RBC unit. Labelling of units with haemoglobin content and transfusion based on it will result in better patient care.

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Venoarterial Extracorporeal Membrane Oxygenation is A Viable Option as A Bridge to Heart Transplant

Recipients bridged with extracorporeal membrane oxygenation were estimated to survive 16.6 months less than nonmechanical circulatory support recipients. Bridge to heart transplant with extracorporeal membrane oxygenation is a viable option, and these patients should be considered transplant candidates.

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Merry Christmas From ‘Surfers & PDC!!

It’s been a tough Year for all of us. I started the year out in Augusta, GA, then off to Northern Indiana, then 6 months in Ann Arbor, MI, from there to Join a team in KY as well as a week in Hot Springs AR. Every place the same story- Perfusionists doing amazing work…

Perfusion.com

Restrictive Versus Liberal Transfusion in Patients with Diabetes Undergoing Cardiac Surgery: An Open-Label, Randomized, Blinded Outcome Evaluation Trial

The presence of diabetes did not modify the effect of a restrictive transfusion strategy on the primary composite outcome, but improved its efficacy on red cell transfusion. Restrictive transfusion triggers are safe and effective in patients with diabetes undergoing cardiac surgery.

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Carbon Dioxide Elimination After Sodium Bicarbonate Administration as a Novel Method to Assess Cardiac Output: A Pilot Study

This technique may be a way to intermittently assess cardiac output or improve accuracy when used in conjunction with other continuous output monitors.

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Plasma from Patients Undergoing Coronary Artery Bypass Graft Surgery Does Not Activate Endothelial Cells under Shear Stress in Vitro

Patients undergoing CPB surgery showed mild systemic inflammation and kidney injury. However, the plasma components did not stimulate endothelial inflammation and adhesion molecule expression in vitro.

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Research Trends and Hotspots of Extracorporeal Membrane Oxygenation: A 10-Year Bibliometric Study and Visualization Analysis

Inter-regional and inter-institutional cooperation and exchanges should be carried out among ECMO research teams and institutions. The suggested research direction is to further broaden the application scope of ECMO, while determining the ways to reduce the incidence of complications and the cost, cultivate specialized team talents, and promote the application thereof.