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I am a contract perfusionist willing and ready to travel. Excellent current and past references, ABCP certified x forever- and have put patients on bypass at 57 facilities during my career. > Chief Perfusionist at 2 startup heart programs >Adult Perfusion >Adult and Pediatric ECMO >STS Data Coordinator > CV Database Developer >Long term Contracts…
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…
Thrombin: A Pivotal Player in Hemostasis and Beyond
This review provides a description of structure and mechanisms of action of thrombin both in physiological and pathological processes. Furthermore, it summarizes laboratory tests that measure in vivo or ex vivo thrombin generation, and presents knowledge on the value of these biomarkers in bleeding disorders, cardiopulmonary bypass surgery, and thromboembolic risk assessment in different patient populations. Finally, this review outlines further perspectives on using thrombin generation biomarkers for research purposes and in clinical practice.
Procalcitonin and Early Postoperative Infection After Pediatric Cardiopulmonary Bypass Surgery
In light of this preliminary result, the clinical relevance and predictive accuracy of PCT are promising in patients with increasing values of PCT but need to be confirmed in a larger sample.
Epidemiology of Acute Kidney Injury After Neonatal Cardiac Surgery: A Report From the Multicenter Neonatal and Pediatric Heart and Renal Outcomes Network
Cardiac surgery–associated acute kidney injury occurs frequently after neonatal cardiac surgery in both cardiopulmonary bypass and noncardiopulmonary bypass patients. Rates vary significantly across hospitals. Only stage 3 cardiac surgery–associated acute kidney injury is associated with mortality. Cardiac surgery–associated acute kidney injury was not associated with any other outcomes. Kidney Disease Improving Global Outcomes criteria may not precisely define a clinically meaningful renal injury phenotype in this population.
Pro-Con Debate: Fibrinogen Concentrate or Cryoprecipitate for Treatment of Acquired Hypofibrinogenemia in Cardiac Surgical Patients
In this Pro-Con commentary article, we discuss the advantages and disadvantages of using fibrinogen concentrate and cryoprecipitate to treat acquired hypofibrinogenemia in cardiac surgical patients.
Biomarkers of Cerebral Injury for Prediction of Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery
Postoperative serum levels of tau and GFAP were significantly elevated in cardiac surgery patients with POCD at discharge, however, the biomarkers achieved only modest predictive abilities for POCD at discharge. Postoperative levels of NSE were not associated with POCD at discharge.
The Use of Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) in Neonates: A Systematic Review
TEG and ROTEM need to become part of the standard coagulation assessment in clinical settings in which hemostatic abnormalities are involved, as they seem to provide more rapid and accurate information regarding the hemostatic profile of the neonates. Their predictive value for bleeding events in critically ill neonates could lead to a more targeted therapy optimizing utilization of blood products.
Nationwide Utilization of Cardiopulmonary Bypass in Cardiothoracic Trauma: A Retrospective Analysis of the National Trauma Data Bank
The use of CPB in the initial management of select cardiothoracic injuries is associated with a survival benefit. Further investigation is required to delineate which specific injuries would benefit the most from the use of CPB.
Measuring and Improving Emotional Intelligence in Surgery: A Systematic Review
The literature entailing the intersection between EI and surgery is diverse but still limited. Generally, EI has been demonstrated to be beneficial in terms of overall well-being and job satisfaction while also protecting against burnout. EI skills may provide a promising modifiable target to achieve desirable outcomes for both the surgeon and the patient. Future studies may emphasize the relevance of EI in the context of surgical teamwork.
A Nomogram to Predict Acute Respiratory Distress Syndrome After Cardiac Surgery
Our developed model predicted ARDS in patients undergoing cardiac surgery and may serve as a tool for identifying patients at high risk for ARDS after cardiac surgery.
Neonatal Cardiopulmonary Bypass Circuit Blood Prime Quality Analysis
Attention to the prime quality beyond the immediate post-priming period may be beneficial. Should the time period between validation of the prime quality and initiation of bypass be extended, it may be advisable to reevaluate the prime quality.
Myocardial Revascularization Surgery
Coronary artery bypass grafting (CABG) was introduced in the 1960s as the first procedure for direct coronary artery revascularization and rapidly became one of the most common surgical procedures worldwide, with an overall total of more than 20 million operations performed.
Perfusion Art: “Gradients”
Perfusion Art: “Gradients” Photographer: Frank Aprile, CCP, BBA, LP Equipment: I Phone 8+ Editing: Photoshop Narrative: Say hello to your little friend… Every day we see this so often- I think we forget we are looking at it 🙂 Time & Place: 2021: MidWest About The Artist: CCP Commentary: Things we look at every day … _______________________________________ The Original Shot:
The Impact of Team Familiarity on Intra and Postoperative Cardiac Surgical Outcomes
Team familiarity, which was predictive of improved intraoperative efficiency without compromising major postoperative outcomes, may serve as a novel quality improvement target in the setting of cardiac surgery.
Preservation of Renal Endothelial Integrity and Reduction of Renal Edema by Aprotinin Does Not Preserve Renal Perfusion and Function Following Experimental Cardiopulmonary Bypass
Aprotinin did not improve renal perfusion nor reduce renal injury during the first hour following experimental CPB despite preservation of renal endothelial integrity and reduction of renal edema.
Essence of Cardiopulmonary Bypass Circuit and Intra-Aortic Balloon Pump
This chapter outlines the fundamentals of cardiopulmonary bypass, associated physiological derangements and utilisation of intra-aortic balloon pumps in cardiac surgical patients.
The Use of Artificial Neural Networks to Determine In-Hospital Mortality After Coronary Artery Bypass Surgery
The ANN model tended to outperform multiple linear regression models in predicting in-hospital mortality among patients who have undergone coronary artery bypass graft surgery. Physicians can make use of this information as an aid in performing treatments and ensuring that more accurate quality of surgical care is achieved.
Intraoperative Red Blood Cell Transfusion Decision-making: A Systematic Review of Guidelines
This review has identified several clinical practice guidelines providing recommendations for intraoperative transfusion. The existing guidelines were noted to be highly variable in their recommendations and to lack a sufficient evidence base from the intraoperative setting. This represents a major knowledge gap in the literature.
Efficacy And Cost-Effectiveness Of Cell Saver Usage In The Repair Of Thoracic Aortic Aneurysms And Dissections
There was a significant association between the use of cell savers and the decreased need for red blood cell and total blood product transfusions. Considering the cost of the cell saver set, transfusion costs in the two groups were comparable.
Neonatal Respiratory and Cardiac ECMO in Europe
ECMO is a life support with a potential impact on long-term patients’ outcomes. In the next years, advances in knowledge, technology, and expertise may push neonatal ECMO boundaries towards more premature and increasingly complex infants, with the final aim to reduce the burden of ECMO-related complications and improve overall patients’ outcomes.
Pro: Priming the Cardiopulmonary Bypass Circuit With Fresh Frozen Plasma Reduces Bleeding in Complex Cardiac Surgery
Reports in the literature estimate that 50%-to-65% of all patients undergoing surgery with CPB will require a blood transfusion in the perioperative period.
Con: Routine Use of Fresh Frozen Plasma Should Not Be Used to Prime Cardiopulmonary Bypass Circuits During Cardiac Surgery
In this review, the authors examine the use of fresh frozen plasma (FFP) for priming the cardiopulmonary bypass (CPB) circuit and discuss the lack of evidence supporting its routine use in this population.
The Association of Bispectral Index Values and Metrics of Cerebral Perfusion During Cardiopulmonary Bypass
There was an association of BIS and metrics of cerebral perfusion during a period of constant anesthetic administration, but the absolute magnitude of change in BIS as MAP decreased below the LLA was small.
Comparison of Clinical Scoring Tools to Predict Heparin-Induced Thrombocytopenia in Cardiac Surgery
The CPB score is the preferred HIT clinical scoring tool in adult cardiac surgery patients, whereas the 4Ts score performed less effectively. A cut-off of ≥ 3 points on the CPB score could increase specificity while preserving high sensitivity, which should be validated in a prospective evaluation.