Beneficial Effect of Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Our study highlights that prone positioning during venovenous extracorporeal membrane oxygenation support for refractory coronavirus disease 2019-related acute respiratory distress syndrome is associated with reduced mortality. Given the observational nature of the study, a randomized controlled trial of prone positioning on venovenous extracorporeal membrane oxygenation is needed to confirm these findings.
Tranexamic Acid after Cardiopulmonary Bypass Does Not Increase Risk of Postoperative Seizures: A Retrospective Study
Administering TXA after bypass may reduce requirements for blood products without increasing risk of seizures following cardiac surgery.
Cardiac Surgery under Cardiopulmonary Bypass in Pregnancy: Report of Four Cases
Heart disease during pregnancy should be treated actively and proactively when the patient has obvious symptoms. Heart valve replacement under CPB will be the first choice, and this may become the primary surgical treatment for symptomatic heart disease during pregnancy.
Brain and Muscle Oxygen Saturation Combined with Kidney Injury Biomarkers Predict Cardiac Surgery Related Acute Kidney Injury
Brain and muscle oxygen saturation 20 min after CPB could be considered early parameters possibly related to CS-AKI risk, especially in patients with increased cystatin C and NGAL levels.
Thrombocytosis and Neutrophilia Associated with Oxygenator Failure and Protamine Reaction after Cardiopulmonary Bypass: A Case Report and Literature Review
The patient subsequently suffered a severe protamine reaction that was successfully managed. A review of the literature of similar patients and the relevant cellular and biochemical mechanisms in this setting are presented, with potential therapeutic approaches to prevent such complications noted.
Impact of Cardiopulmonary Bypass on Neurogenesis and Cortical Maturation
Our results provide novel insights into cellular mechanisms contributing to CHD-induced neurological impairments. Further refinement of CPB hardware and techniques is necessary to improve long-term frontal cortical dysmaturation observed in children with CHD.
Clinical Monitoring of Activated Clotting Time during Cardiothoracic Surgery: Comparing the Hemochron® Response and Hemochron® Signature Elite
The Elite was more reliable, but the variation was higher for the Elite than the Response. The observed positive bias in the Response compared to the Elite could affect heparin administration during surgery making the two systems not interchangeable.
The Importance of Autologous Blood Transfusion in Lung Transplantation and Cardiovascular Surgeries
Autologous blood transfusion may prevent the development of transfusion-related complications by reducing the amount of allogenic transfusion in major surgical procedures. In our study, the autologous blood transfusion was used in critical patients with major bleeding and, therefore, the total amount of transfused blood/blood product was higher in these patients. Nevertheless, lower complication rates in this patient group emphasize the importance of autologous blood transfusion.
Implementation of an Electronic Identification System in the Setting of Perioperative Autologous Cell Salvage Transfusion: Experience at A University Hospital.
Our observations suggest that a bar code-based EIS can be successfully applied to PACS transfusion, as well as allogeneic blood transfusion in operating rooms.
Reduced Systemic Nitric Oxide Bioavailability Parallels Microvascular Endothelial Dysfunction during Cardiopulmonary Bypass
The impairment of microvascular endothelial function during CPB in cardiac surgery for the correction of congenital heart defects appears to be related to a reduced systemic bioavailability of NO, resulting from the inflammatory and pro-oxidative response typical of this surgical procedure.
Early Biochemical Markers in the Assessment of Acute Kidney Injury in Children after Cardiac Surgery
We showed that plasma CysC and urinary NGAL could reliably predict the development of acute kidney injury. Measurement of early biochemical markers in plasma and urine, individually and combination, may predict the development of cardiac surgery-associated acute kidney injury in children.
Early Outcomes of Cardiac Surgical Patients Who Developed COVID-19 in the Peri-Operative Period-Results from An Online Survey
The development of peri-operative COVID in cardiac surgery was associated with very high mortality. We believe that it is time for us as a fraternity to introspect and adapt to the changing practice environment, furthered by research and revision of guidelines.
Effects of Rewarming with Extracorporeal Membrane Oxygenation to Restore Oxygen Transport and Organ Blood Flow after Hypothermic Cardiac Arrest in A Porcine Model
Thus, like continuous CPR, ECMO rewarming plays a crucial role in “the chain of survival” when resuscitating victims of hypothermic cardiac arrest.
Education in Evidence-Based Health Care: Never A Greater Need
The pandemic has highlighted the importance of health science and research that is efficiently produced, evaluated and acted on. Hand in hand with this comes the ability to ask, find, appraise and apply evidence to support effective decisions. These abilities are essential skills—skills that need to be taught. Where there is a need to be taught, there is a need for people to teach. The final article in the series aims to aid EBHC educators in this mission. Through collaboration and consensus, our peers come together to provide aspiring EBHC teachers a resource of their go-to articles in support of effective and inspirational teaching and education.
Extracorporeal Membrane Oxygenation in Jehovah’s Witness Patients: Case Report, Literature Review, and Summary of Recommendations
We describe the use of a bloodless approach to reduce the waste of blood, avoiding anticoagulation, and improving red blood cell production. We then summarize the current literature on the use of ECMO in Jehovah’s Witness patients and, fi
One-Year Functional, Cognitive, and Psychological Outcomes Following the Use of Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019: A Prospective Study
Functional impairment was common a year following the use of extracorporeal membrane oxygenation in coronavirus disease 2019, although the majority achieved independence in daily living and about half returned to work. Long-term anxiety, depression, and post-traumatic stress disorder were common, but cognitive impairment was not.
Renal Safety of Hydroxyethyl starch 130/0.42 After Cardiac Surgery: A Retrospective Cohort Analysis
This study showed no association between HES and the postoperative occurrence of acute kidney injury and thus further closes the evidence gap on HES safety in cardiac surgery patients. Although this was a retrospective cohort study, the results indicated that HES might be safely administered to cardiac surgery patients with regard to renal outcomes, especially if it was administered early and dosed appropriately.
Weaning from Cardiopulmonary Bypass, Decannulation, and Closure
Although thoracotomy or newer, less-invasive options such as peripheral cannulation are being used more frequently for minimally invasive cardiac surgery, surgical access through a median sternotomy and central cannulation remain the cornerstones of cardiac surgery and residency training. It is of utmost importance to wean the patient properly from cardiopulmonary bypass (CPB). This video tutorial discusses weaning the patient from CPB, decannulation, and closure of the sternotomy, and describes the safeguards and pitfalls of weaning from CPB.
Delirium and Long-Term Outcomes among Survivors of Extracorporeal Membrane Oxygenation Therapy: A Nationwide Cohort Study in South Korea
The prevalence of delirium among ECMO survivors during hospitalization was 6.8% in South Korea, and old age, male sex, longer duration of hospital stay, and underlying depression were associated with it. However, there was no significant association between delirium and 1-year all-cause mortality among ECMO survivors.
Regional Lung Metabolic Profile in A Piglet Model of Cardiopulmonary Bypass with Circulatory Arrest
Our results demonstrate significant metabolic disturbances between dorsocaudal and ventral lung regions during supine mechanical ventilation with or without CPB/DHCA. CPB/DHCA also leads to metabolic differences and may have additive effects to the regional disturbances. Most pathways driving this pathology are involved in energy metabolism and the metabolism of amino acids, carbohydrates, and reduction–oxidation pathways.
Argatroban for Anticoagulation in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019
Argatroban, with or without aspirin, is an effective anticoagulation strategy for patients who require venovenous extracorporeal membrane oxygenation support secondary to coronavirus disease 2019. In comparison with heparin, this anticoagulation strategy was not associated with a significant difference in bleeding or thrombotic complications, and was associated with a significantly decreased time to therapeutic anticoagulation goal, likely as a result of high rates of heparin resistance observed in this patient population.
The Association of Prothrombin Complex Concentrates with Postoperative Outcomes in Cardiac Surgery: An Observational Substudy of the FIBRES Randomized Controlled Trial
In cardiac surgical patients with post-cardiopulmonary bypass bleeding, PCC use was associated with lower RBC and platelet transfusion than FP use was. Prospective, randomized clinical trials comparing FP with PCC in this setting are warranted.
Calcium Chloride Infusions are Not Associated with Improved Outcomes in Neonates Undergoing Cardiac Operations
Calcium chloride infusions in neonates who underwent cardiac surgery did not decrease exposure to other inotropic and vasoactive agents in the first 24 post-operative hours or improve patient outcomes.
Biomarkers for Adverse Lung Injury Following Pediatric Cardiopulmonary Bypass
Multiple proteomic biomarkers were associated with worse respiratory outcomes. Precardiopulmonary bypass biomarkers might indicate risk factors (e.g., abnormalities of coagulation), whereas those identified at 0 hour and post cardiopulmonary bypass may reflect mechanisms of ongoing pathobiology.