Posts by John Englert

Tranexamic Acid Versus ɛ-Aminocaproic Acid: Efficacy and Safety in Pediatric Cardiac Surgery

OBJECTIVE: Tranexamic acid (TXA) and ɛ-aminocaproic acid (EACA) are used for antifibrinolytic therapy in cardiac surgery, although data directly comparing their blood sparing effect and their side effects, especially in paediatric cardiac surgical patients, are still missing. METHODS: We analysed perioperative data of 234 paediatric patients weighing less than 20 kg undergoing cardiac surgery. In a 5-month period,…

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Comparative Study Between Different Modes of Ventilation During Cardiopulmonary Bypass and its Effect on Postoperative Pulmonary Dysfunction

BACKGROUND: Postoperative pulmonary dysfunction is a prevalent complication after cardiac surgery; it has many contributing considerations due to either the surgery itself, anomalies to gas exchange or maybe as a result of alterations in lung mechanics. The aim of this study was to compare pressure-controlled ventilation versus volume-controlled ventilation in the presence of no ventilation…

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Minimally Invasive Biventricular Mechanical Circulatory Support With Impella Pumps as a Bridge to Heart Transplantation

Abstract Cardiogenic shock from biventricular failure that requires acute mechanical circulatory support carries high 30 day mortality. Acute mechanical circulatory support can serve as bridge to orthotopic heart transplant (OHT) in selected patients. We report a patient with biventricular failure secondary to rapidly progressive cardiac sarcoidosis refractory to medical management who was bridged to OHT…

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Impella Versus IABP in Acute Myocardial Infarction Complicated by Cardiogenic Shock.

OBJECTIVE: We investigated the benefit of Impella, a modern percutaneous mechanical support (pMCS) device, versus former standard intra-aortic balloon pump (IABP) in acute myocardial infarction complicated by cardiogenic shock (AMICS). METHODS: This single-centre, retrospective study included patients with AMICS receiving pMCS with either Impella or IABP. Disease severity at baseline was assessed with the IABP-SHOCK II score. The…

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The Effect of Ultrafiltration on End-Cardiopulmonary Bypass Hematocrit During Cardiac Surgery

OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on…

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Effect of Ultrafiltration on Extravascular Lung Water Assessed by Lung Ultrasound in Children Undergoing Cardiac Surgery: A Randomized Prospective Study

Ultrafiltration has been shown to decrease total body water and postoperative blood loss and improve the alveolar to arterial oxygen gradient and pulmonary compliance. This study investigated whether conventional ultrafiltration during CPB in paediatric heart surgeries influences post-bypass extravascular lung water (EVLW) assessed by lung ultrasound (LUS).

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