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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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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…

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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.

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ECMO Implantation Training: Needle Penetration in 3D Printable Materials and Porcine Aorta

Shore A 10 and 20 polymers have similar needle penetration properties compared to the porcine tissue. Significantly more force is needed to pierce through the material fully. The most similar tested material to porcine aorta for needle penetration and piercing in ECMO-implantation is the silicon Shore A 10 polymer. This silicon could be a 3D-printable material in surgical training for ECMO-implantation.

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Relationship Between the Degree of Carotid Stenosis and the Risk of Stroke in Patients Undergoing Cardiac Surgery

CS is an independent risk factor of post-operative stroke and/or TIA. This study suggests for the first time that the risk of stroke increases with the degree of severity of CS, with the greatest risk being for CS between 80-99%. The strength of this relationship and potential causality effect should be further explored in a prospective study focusing on this most at risk population.

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Malignant Hyperthermia During Cardiac Surgery Successfully Treated by Deep Hypothermia Using Cardiopulmonary Bypass: A Case Report

Cardiopulmonary bypass should be considered to treat MH in case dantrolene and conservative therapy are unavailable or insufficient.

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Impact of Partial Pressure of Oxygen Trajectories on the Incidence of Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass

Patients with persistent hyperoxia had a higher incidence of AKI than those with transient hyperoxia. Further studies are required to determine potential underlying mechanisms.

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Ultrafiltration and Cardiopulmonary Bypass Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis

UF in cardiac surgery is not associated with increased AKI incidence and may be safely used even in baseline chronic injury patients.

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To Balloon or Not to Balloon? The Effects of an Intra-Aortic Balloon-Pump on Coronary Artery Flow during Extracorporeal Circulation Simulating Normal and Low Cardiac Output Syndromes

Based on our in vitro study results, combining ECMO and IABP in a heart failure setup further improves coronary blood flow. This effect was more pronounced at a lower heart rate and decreased with heart failure, which might positively impact recovery from cardiac failure.

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Near-Infrared Spectroscopy for Perioperative Assessment and Neonatal Interventions

We identified areas for future research within disease-specific indications and offer a roadmap to aid in developing evidence-based targeted diagnostic and management strategies in neonates.

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Very Low Blood Flow Carbon Dioxide Removal System is Not Effective in A Chronic Obstructive Pulmonary Disease Exacerbation Setting

The present retrospective study describes the first use of PrismaLung in severe COPD patients with acute exacerbation. When compared with a higher blood flow ECCO2R system, our results show that this novel, very low-flow device is not able to remove sufficient CO2, normalize pH or decrease respiratory rate.

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Noninvasive Optical Measurement of Microvascular Cerebral Hemodynamics and Autoregulation in the Neonatal ECMO Patient

Our pilot results suggest that systemic measures alone cannot distinguish impaired CA from intact CA during ECMO. Furthermore, optical neuromonitoring could help determine patient-specific ECMO pump flows for optimal CA integrity, thereby reducing risk of secondary brain injury.