Luc Puis, Author at Perfusion.com

In this randomized controlled trial, intraoperative normoxia did not reduce postoperative cognitive dysfunction when compared to intraoperative hyperoxia in older patients having cardiac surgery. Although the optimal intraoperative oxygenation strategy remains uncertain, the results indicate that intraoperative hyperoxia does not worsen postoperative cognition after cardiac surgery.

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We have developed a finite element computational fluid dynamics model incorporating fluid-structure interaction (FSI) that incorporates atrial deformation during atrial filling and emptying, with fluid flow solved using large eddy simulation. With this model, we have evaluated an extensive number of factors that could influence recirculation during two-site VV ECMO, and characterized their impact on recirculation, including cannula construction, insertion depth and orientation, VV ECMO configuration, circuit blood flow, and changes in volume, venous return, heart rate, and blood viscosity.

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Central cannulation for VA-ECMO provides antegrade flow without Harlequin’s syndrome, changes of arterial cannula site, and better 30 day survival. Complication rates regarding need for reexploration and transfusion requirements were similar.

The presented mock circulation was reliable and gave values with high accuracy both at baseline and during mechanical assistance. This system allows evaluation of the mesenteric flow during IABP, under different clinical/hemodynamic conditions. Nonetheless, its translational potential needs to be further evaluated

The mortality rate in our ECMO center was considerably higher than that in the international registry report. Improved team education, rigid patient selection criteria, and a reimbursement protocol should lead to ameliorated outcomes.

Careful considerations are required before selecting an additional support to ECLS.

The use of a bloodless protocol for Jehovah’s Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

This review presents the fundamental mechanisms of conditioning strategies and provides an overview of the most recent and relevant findings on different concepts achieving cardioprotection in the experimental setting, specifically emphasizing pharmacological approaches in the perioperative context.

After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

In conclusion, both the experience in managing patients and the availability of neonatal/pediatric ECMO in the centers the responders are working
seemed to increase physicians’ preparedness.

Our results indicate a strong correlation between fibrinogen activation and serum fibrinogen concentration. The maximum amplitude of activator f can estimate low fibrinogen concentration faster than traditional methods; this method quickly provides important information for anesthesia and hemostatic management in cardiac surgery.

This study will compare the efficacy of prophylactic corticosteroids for adults and children undergoing cardiac surgery with CPB. Due to the nature of the disease and intervention methods, randomized controlled trials may be inadequate, and we will carefully consider inclusion in high-quality, non-randomized controlled trials, but this may result in high heterogeneity and affect the reliability of the results.

Anesthesiologists should take a lead role in studying this specialty and should be involved in development and maintenance of surgical specialty databases and quality improvement initiatives. The reliability of the data is at stake.

In cardiopulmonary bypass surgery, low-dose tranexamic acid seems to be an appropriate regimen for reducing bleeding outcomes. This meta-analysis has to be interpreted with caution because the results are observational and dependent on the lack of bias of the predicted tranexamic acid exposures and the quality of the included studies.

CS were found to have a favorable impact on postoperative fluid balance and may be associated with shortening the duration of mechanical ventilation. While CS had no impact on mortality, they may be beneficial, particularly in neonates and those undergoing high complexity surgery.

RIPC did not alter platelet activation and reactivity during CPB in patients undergoing cardiac surgery.

Recent progress in artificial lung technologies includes continued advances in both engineering and biology. The final goal is to achieve a truly implantable and durable artificial lung that is applicable to destination therapy.

To our knowledge, this is the first description in the literature of using an automated proning system with an ECMO circuit in place. This report describes the technique we used to safely perform axial rotations for two days with fewer providers required than manual proning.

The pathophysiology of AKI in ECMO is multifactorial, and includes ischaemia, RBCs breakdown, comorbidity, conversion of zymogen form of pro‐inflammatory mediators, structural alteration of the kidney, coadministration of nephrotoxic drugs, coagulation abnormality, and oxidative stress.

Our data in patients undergoing isolated CABG indicate no significant effect on CS risk by use of CPB when TXA doses of up to ∼2 g are given. However, caution regarding TXA administration is necessary in patients with renal impairment.

The Standards and Guidelines for Pediatric and Congenital Perfusion Practice is an essential tool for pediatric perfusionists and serves as the backbone for institutionally based protocols, promotes improved decision-making, and identifies opportunities for future research and collaboration with other disciplines.

Given the biological effects of oxygen molecules, although the optimal target levels remain controversial, unnecessary oxygen administration should be avoided, and exposure to hyperoxemia should be minimized in critically ill patients.

We plan to extract study data, format our comparisons in data tables and prepare a ‘Summary of findings’ table before writing the results and conclusions of our review.

Herein the authors report a case of a patient with APS undergoing PTE that highlights several limitations of the available coagulation monitoring strategies. The patient provided written consent for publication of the details of the case.