Posts by Luc Puis
Extracorporeal Membrane Oxygenation: Indications, Technique and Contemporary Outcomes
Extracorporeal membrane oxygenation (ECMO) is an advanced form of temporary life support, to aid respiratory and/or cardiac function. It has been used since the early 1970s and is based on cardiopulmonary bypass technology and diverts venous blood through an extracorporeal circuit and returns it to the body after gas exchange through a semi-permeable membrane.
Read MoreAssociation Between Anemia and Blood Transfusion With Long-term Mortality After Cardiac Surgery
The aim of this study was to investigate the interactions between preoperative anemia and RBC transfusion and their effect on the long-term survival of patients undergoing cardiac surgery.
Read MoreNeurologic Outcomes in Patients Who Undergo Extracorporeal Cardiopulmonary Resuscitation
This study aimed to develop a risk prediction model for neurologic outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR).
Read MoreUse of Quality of Life in Cardiovascular Surgery in Coronary Artery Bypass Grafting: Validation, Reproducibility, and Quality of Life in One Year of Follow-Up
The objectives of this study are to validate the Quality of Life in Cardiovascular Surgery (QLCS) questionnaire and to observe the evolution of quality of life in the first year of postoperative follow-up of patients who underwent coronary artery bypass grafting (CABG).
Read MoreA Century of Heparin
The year 2018 was the centennial of the naming of heparin by Emmett Holt and William Howell and the 102nd anniversary of Jay McLean’s discovery of an anticoagulant heparphosphatide at Johns Hopkins Hospital in Baltimore.
Read MoreBloodSurf 2017: News From the Blood-biomaterial Frontier
From stents and large-diameter vascular grafts, to mechanical heart valves and blood pumps, blood-contacting devices are enjoying significant clinical success owing to the application of systemic antiplatelet and anticoagulation therapies.
Read MoreNitric Oxide Attenuates the Inflammatory Effects of Air During Extracorporeal Circulation
Cardiopulmonary bypass causes a systemic inflammatory response reaction that may contribute to postoperative complications. One cause relates to the air/blood interface from the extracorporeal circuit. The modulatory effects of blending nitric oxide (NO) gas into the ventilation/sweep gas of the membrane lung was studied in a porcine model of air-induced inflammation in which NO gas was added and compared with controls with or without an air/blood interface.
Read MoreLeft Ventricular Decompression on Veno-arterial Extracorporeal Membrane Oxygenation With Intra-aortic Balloon Counterpulsation
There has been growing recognition of the favorable and unfavorable hemodynamic effects of this therapy and recent interest in the use of other percutaneous circulatory support devices to offset some of the potentially harmful hemodynamic effects.
Read MoreStructured Review of Post-cardiotomy Extracorporeal Membrane Oxygenation: Part 2 – Pediatric Patients
Veno-arterial extracorporeal membrane oxygenation (ECMO) is established therapy for short-term circulatory support for children with life-treating cardiorespiratory dysfunction.
Read MoreThe Effect of Various Blood Management Strategies on Intraoperative Red Blood Cell Transfusion in First-time Coronary Artery Bypass Graft Patients
The present study evaluated the distribution of intraoperative interventions in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass.
Read MoreDuration of Critically Low Oxygen Delivery is Associated With Acute Kidney Injury After Cardiac Surgery
The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL. min−1.m−2), during cardiopulmonary bypass on kidney function.
Read MoreHigher Flow on Cardiopulmonary Bypass in Pediatrics is Associated With A Lower Incidence of Acute Kidney Injury
This study examines two different perfusion strategies and their impact on various outcome measures including acute kidney injury (AKI), urine output on CPB, ICU length of stay, time to extubation, and mortality.
Read MoreStudy Protocol: Nitric Oxide During Cardiopulmonary Bypass to Improve Recovery in Infants With Congenital Heart Defects (NITRIC Trial): A Randomised Controlled Trial
Congenital heart disease (CHD) is a major cause of infant mortality. Many infants with CHD require corrective surgery with most operations requiring cardiopulmonary bypass (CPB). CPB triggers a systemic inflammatory response which is associated with low cardiac output syndrome (LCOS), postoperative morbidity and mortality. Delivery of nitric oxide (NO) into CPB circuits can provide myocardial protection and reduce bypass-induced inflammation, leading to less LCOS and improved recovery.
Read MoreAutologous Platelet-Rich Plasmapheresis in Cardiovascular Surgery: A Narrative Review
Perioperative coagulopathy and bleeding are common complications in cardiovascular surgery with cardiopulmonary bypass and result in an increased rate of allogeneic blood transfusion. Both bleeding and transfusion can increase postoperative mortality and morbidity.
Read MoreDevelopment and Validation of a Score to Identify Cardiac Surgery Patients at High Risk of Prolonged Mechanical Ventilation
To develop and validate a score for the early identification of cardiac surgery patients at high risk of prolonged mechanical ventilation (MV) who may be suitable targets for interventional trials.
Read MoreValidation Study of the Transfusion Risk and Clinical Knowledge (TRACK) Tool in Cardiac Surgery Patients: A Retrospective Analysis
The Transfusion Risk and Clinical Knowledge (TRACK) scoring system has been developed for predicting perioperative blood transfusions. However, the TRACK score needs to be validated externally in the US population. The primary objective of this study is to validate TRACK at the authors’ institution.
Read MoreThe Database Dilemma: An Imperfect but Critical Tool to Improve Quality and Benchmark Outcomes (Ed.)
The Society of Thoracic Surgeons (STS) database was created in 1989 as a patient safety initiative for adults undergoing cardiothoracic surgery. In 2005, pediatric and congenital cardiac patient data began being collected by a registry operated by the Congenital Cardiac Anesthesia Society.
Read MoreDiscriminatory Power of Scoring Systems for Outcome Prediction in Patients With Extracorporeal Membrane Oxygenation Following Cardiovascular Surgery
Although extracorporeal membrane oxygenation (ECMO) represents a rapidly evolving treatment option in patients with refractory heart or lung failure, survival remains poor and appropriate risk stratification challenging because established risk prediction models have not been validated for this specific population.
Read MoreRed Blood Cell Dysfunction: a New Player in Cardiovascular Disease
The primary role of red blood cells (RBCs) is to transport oxygen to the tissues and carbon dioxide to the lungs. However, emerging evidence suggests an important role of the RBC beyond being just a passive carrier of the respiratory gases.
Read MoreQuality of Life After Coronary Bypass: a Multicentre Study of Routinely Collected Health Data in the Netherlands
In this study, our aim was to explore how coronary artery bypass grafting affects quality of life, and how this varies with age, particularly with patients at risk of deterioration.
Read MoreCardiopulmonary Bypass and Dual Antiplatelet Therapy: a Strategy to Minimise Transfusions and Blood Loss
Patients with preoperative dual antiplatelet therapy prior to coronary artery bypass surgery are at risk of bleeding and blood component transfusion. We hypothesise that an optimised cardiopulmonary bypass strategy reduces postoperative blood loss and transfusions.
Read MoreIn-vitro Performance of a Low Flow Extracorporeal Carbon Dioxide Removal Circuit
Extracorporeal gas exchange requires the passage of oxygen and carbon dioxide (CO2) across an artificial membrane. Current European Union regulations do not require the transfer to be assessed in models using clinically relevant haemoglobin, making it difficult for clinicians to understand the CO2 clearance of a membrane, and how it changes in relation to sweep gas flow through the membrane.
Read MorePostoperative Pain Management in Pediatric Patients Undergoing Cardiac Surgery: Where Are We Heading?
Adequate postoperative pain management is crucial in pediatric patients undergoing cardiac surgery because pain can lead to devastating short- and long-term consequences. This review discusses the limitations of current postoperative pain assessment and management in children after cardiac surgery, the obstacles to providing optimal treatment, and concepts to consider that may overcome these barriers.
Read MoreDexmedetomidine Extraction by the Extracorporeal Membrane Oxygenation Circuit: Results From an in Vitro Study
Dexmedetomidine is a sedative administered to minimize distress and decrease the risk of life threatening complications in children supported with extracorporeal membrane oxygenation. The extracorporeal membrane oxygenation circuit can extract drug and decrease drug exposure, placing the patient at risk of therapeutic failure.
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