Posts by Luc Puis
Evaluating Changes in del Nido Cardioplegia Practices in Adult Cardiac Surgery
In this large multicenter experience, DC use increased over time and was associated with reduced bypass and ischemic time absent any significant differences in adjusted outcomes.
Read MoreThe Effect of Antifibrinolytic Use on Intraoperative Cell Salvage: Results from a National Registry of Surgical Procedures
The use of AF has increased each year over the 4-year period in most of the surgical categories, but several have declined. There may be a beneficial effect of AF with lower ICS volumes available for return in a few groups.
Read MoreEarly Detection, Prevention, and Management of Acute Limb Ischemia in Adults Supported With Venoarterial Extracorporeal Membrane Oxygenation
Opportunities for future research include improving monitoring technology and standardizing the use of the distal perfusion catheter.
Read MoreCold Agglutinin Disease and Hemolytic Crisis After Hypothermic Circulatory Arrest in a Patient With Beta-Thalassemia Minor
Case Description of Cold Agglutinin Disease and Hemolytic Crisis After Hypothermic Circulatory Arrest in a Patient With Beta-Thalassemia Minor.
Read MoreCan We Rely on the Activated Clotting Time to Measure Heparin Anticoagulation? A Clinical Evaluation of Two ACT Monitors
ACT monitors demonstrate unacceptable bias differences, combined with wide limits of agreement. The ACT response correlated with hematocrit, but not with the actual heparin concentration.
Read MorePerfusion Recruitment Strategies Using Choice-Based Conjoint Analysis
Based on the respondents who completed this survey, the impact ECMO has on the perfusionist was the most significant job attribute. Offering large sign-on bonuses and relocation packages to entice new employees is not indicated as a viable way to satisfy perfusionists. Appropriate management of hours worked, days on call, and how ECMO impacts the perfusionists will be most impactful in recruitment of new employees.
Read MoreExtracorporeal Membrane Oxygenation Support In COVID-19: An International Cohort Study of The Extracorporeal Life Support Organization Registry
In patients with COVID-19 who received ECMO, both estimated mortality 90 days after ECMO and mortality in those with a final disposition of death or discharge were less than 40%. These data from 213 hospitals worldwide provide a generalisable estimate of ECMO mortality in the setting of COVID-19.
Read MoreA Randomized Controlled Trial of Antithrombin Supplementation During Extracorporeal Membrane Oxygenation
Antithrombin supplementation may not decrease heparin requirement nor diminish the incidence of bleeding and/or thrombosis in adult patients on venovenous extracorporeal membrane oxygenation.
Read MoreClinical Controversies in Anticoagulation Monitoring and Antithrombin Supplementation for ECMO
In this clinically focused review, the authors discuss the complexities of anticoagulation monitoring and therapeutic intervention for patients on ECMO and examine the challenges surrounding AT supplementation given both the historical and current perspectives summarized in the literature on these topics.
Read MoreArtificial Intelligence in Cardiothoracic Surgery
In this review, we discuss the current initiatives that are using AI in cardiothoracic surgery and surgical care in general.
Read MorePericardial fluids or Cardiopulmonary Bypass-Is There a Major Culprit for Changes in Coagulation and Inflammation?
Direct recirculation of pericardial fluids rather than conventional CPB itself causes major intraoperative changes of some coagulation markers. Pericardial blood loss with direct recirculation should be kept to a minimum to avoid unnecessary activation of coagulation.
Read MoreVenovenous Bypass During Liver Transplantation: A New Look at an Old Technique
Advances in extracorporeal technologies offer new opportunities for VVB in managing critically ill patients in LT. Here, we review these new developments in VVB.
Read MoreThe Need for Clinical Judgement in The Application of Evidence-Based Medicine
In some instances, when there is a lack of evidence, or faulty interpretation of the evidence, clinical judgement should inform the application of EBM.
Read MoreEstablishment of An Extracorporeal Cardio-Pulmonary Resuscitation Program in Berlin – Outcomes Of 254 Patients with Refractory Circulatory Arrest
An eCPR program can be life-saving for a subset of individuals with refractory circulatory arrest, with time to initiation of eCPR being a main determinant of survival.
Read MoreClotting Functional Stability of Withdrawing Blood in Storage for Acute Normovolemic Hemodilution: A Pilot Study
Even though the MCE significantly decreased in a time-dependent manner, MCF of FIBTEM and EXTEM was normal up to 24 h storage. The blood of ANH can use for the purpose of hemostasis at least 8 h stored at room temperature after blood withdrawal.
Read MoreMulti-Modal Cardiopulmonary Bypass Skills Assessment within a High-Fidelity Simulation Environment
Multimodal assessment using cognitive, technical, and motion analysis of basic CPB tasks using a high-fidelity simulation environment is a valid system to measure performance and discriminate experts from trainees.
Read MoreThe Care and Keeping of Clinicians in Quality Improvement
Our findings highlight areas that organizations and professional development programs should focus on to promote clinician development and engagement in quality improvement. Barriers related to training, time, mentorship, organizational support and implementation must be concurrently addressed to augment the effectiveness of other approaches.
Read MoreSlow Versus Fast Rewarming After Hypothermic Circulatory Arrest: Effects on Neuroinflammation And Cerebral Oedema
The present experimental study demonstrated reduction in the inflammatory response, reduction of inflammatory cell activation in the brain, enhancement of cerebral blood flow and reduction of cerebral oedema when slow rewarming was applied.
Read MorePosition Paper on Global Extracorporeal Membrane Oxygenation Education and Educational Agenda for the Future: A Statement From the Extracorporeal Life Support Organization ECMOed Taskforce
Significant variability and limitations in global extracorporeal membrane oxygenation education exist. In this position paper, we outline a road map for standardizing international extracorporeal membrane oxygenation education and practitioner certification.
Read MoreSurvey of the Routine Practice Limits for Physiologic and Technical Parameters Managed by Clinical Perfusionists during Adult Cardiopulmonary Bypass
We conducted a national survey of clinical practice with the purpose of producing a benchmark of the typical variability of specific technical parameters that are commonly managed during adult CPB procedures.
Read MoreDevelopment and Accuracy Evaluation of a Degree of Occlusion Visualization System for Roller Pumps Used in Cardiopulmonary Bypass
Our experiments indicated that for areas with a small tube gap, this system can construct highly accurate three-dimensional shapes and obtain quantitative indicators assessing the degree of occlusion.
Read MoreECMO in India, SWAAC ELSO: Challenges and Solutions
We elucidated the establishment of a commanding center, Extracorporeal Life Support Organization (ELSO) in the USA, ECMO society of India in the sub-continent and the birth of South and West Asia Chapter (SWAC) of ELSO initially, which became South and West Asia, Africa chapter (SWAAC) ELSO later after amalgamation of Africa to this sub-chapter of ELSO.
Read MoreOxy-RVAD Support for Lung Transplant in The Absence of Inferior Vena Cava
In this report, we describe a patient with congenital absence of the inferior vena cava undergoing lung transplantation who required perioperative cardiopulmonary support.
Read MoreIntraoperative Management of a Hybrid Extracorporeal Membrane Oxygenation Circuit for Lung Transplantation
Our novel technique for intraoperative management of this circuit during lung transplantation is described.
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