Posts by Luc Puis
Beating Heart – HIV-to-HIV Heart – Partial Heart
By Luc Puis Let’s talk transplantation today. Last Thursday, September 29, was International Heart Day, so let’s take heart. Three remarkable, first in-heart transplantations happened, extending life and expanding the donor pool. On the China Circuit A team in China performed the first ischaemic-free, beating heart transplantation in a human. By combining adapted surgical techniques…
Read MoreLivaNova (TandemLife) Recalls LifeSPARC System for Risk of Unintentional Extended Pump Stop During Controller Critical Failure
By Luc Puis LivaNova (TandemLife) is recalling the LifeSPARC Controller, part of the LifeSPARC System, due to a software malfunction that may trigger the device to enter Critical Failure mode—clearing the controller screen and issuing an alarm that cannot be muted or turned off. While the LifeSPARC Pump should continue to run at the set…
Read MorePostage Stamp Ultrasound and Pressure Measuring Tattoos: Wearables of the Future
By Luc Puis New technology is exciting, especially when it’s something that might be potentially useful in your daily clinical practice. Everything gets smaller and smaller, but the scale of miniaturization on the next two devices is truly mind-bending. Blood Pressure Measuring Tattoo Admit it. You had temporary tattoos when you were a kid. Eating…
Read MorePlaying Cupid, an Arrow Through the Heart
By Luc Puis “How was your day, honey?” “Well, I did something really stupid, and then I was extremely lucky to survive it…” In a nutshell, this happened to a 54-year-old man in Canada when he was preparing his crossbow, used for hunting large animals. Due to reasons not described in detail in this article,…
Read MoreHow to Become a Perfusionist
Perfusionists are a rare breed, and so it’s even more difficult to know how to become one. This article talks about how to become a perfusionist in the USA.
Read More
Perfusion.com Cardiovascular News Roundup:
September 7, 2022
Weekly roundup of interesting reads for the perfusion community, this week including new reviews, COVID trials, transplant news, and interesting findings on blood groups.
Read MoreDeliberate Practices of Speaking Up and Responding Skills: The Speak-PREP E-Learning Module for Healthcare Professionals
The Speak-PREP module targeted deliberate practice in speaking up and responding skills. Future work should examine the application of these strategies in the clinical environment.
Read MoreProthrombin Complex Concentrate vs Plasma for Post-Cardiopulmonary Bypass Coagulopathy and Bleeding: A Randomized Clinical Trial
The results of this study suggest a similar overall safety and efficacy profile for PCCs compared with plasma in this clinical context, with fewer posttreatment intraoperative RBC transfusions, improved PT/INR correction, and higher likelihood of allogeneic transfusion avoidance in patients receiving PCCs.
Read MoreReliability of the Minto Model for Target-Controlled Infusion of Remifentanil during Cardiac Surgery with Cardiopulmonary Bypass
The Minto model accurately predicts plasma remifentanil concentrations during cardiac surgery with CPB.
Read MoreIntraoperative Hypotension-Physiologic Basis and Future Directions
This new technology has the potential to reduce duration or even prevent IOH. In the authors’ opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
Read MoreAwake Extracorporeal Life Support and Physiotherapy in Adult Patients: A Systematic Review of the Literature
Awake ECLS strategy associated with physiotherapy is performed regardless of cannulation approach. Ambulation, as main objective, is achieved in almost half the population examined. Prospective studies are needed to evaluate safety and efficacy of physiotherapy during Awake ECLS, and suitable patient selection. Guidelines are required to identify appropriate assessment/evaluation tools for Awake ECLS patients monitoring.
Read MoreIncidence and Outcome of Anaphylaxis in Cardiac Surgical Patients
As all patients survived, our results provide preliminary support for proceeding with surgery although we cannot speculate on the likely outcomes of patients who were postponed, had their surgery proceeded. Based on our data, the incidence of anaphylaxis in cardiac surgical patients may be 10–20 times higher than in the general surgical population.
Read MoreImpact of Cardiopulmonary Bypass Duration on Efficacy of Fibrinogen Replacement with Cryoprecipitate Compared with Fibrinogen Concentrate: A Post Hoc Analysis of the Fibrinogen Replenishment in Surgery (FIBRES) Randomised Controlled Trial
The haemostatic efficacy of FC was non-inferior to cryoprecipitate irrespective of CPB duration in cardiac surgery.
Read MoreArterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation
In conclusion, in a cohort with granular arterial blood gas (ABG) data and a standardized neuromonitoring protocol, higher pre-cannulation PaCO2 and larger ΔPaCO2 were associated with increased prevalence of ICH.
Read MoreEffect of Hospital Case Volume on Clinical Outcomes of Patients Requiring Extracorporeal Membrane Oxygenation: A Territory-Wide Longitudinal Observational Study
In a territory-wide observational study, we observed that case volumes in extracorporeal membrane oxygenation centers were not associated with hospital mortality. Maintaining standards of care in low-volume centers is important and improves preparedness for surges in demand.
Read MoreImaging the Acute Respiratory Distress Syndrome: Past, Present and Future
This narrative review aims to draw a didactic and comprehensive picture of how modern imaging techniques improved our understanding of the syndrome, and have the potential to help the clinician guide ventilatory treatment and refine patient prognostication.
Read MoreThe Predictive Value of the 4Ts and HEP Score at Recommended Cutoffs in Patients With Mechanical Circulatory Support Devices
The 4Ts and HEP scores have a modest predictive performance for probable HIT in patients requiring MCS devices. A low 4Ts or HEP score does not reliably rule out HIT in patients requiring MCS, and clinical suspicion for HIT should be investigated, utilizing laboratory tests in this population.
Read MoreCannulas and Cannulation Options for Minimally Invasive Surgery
Traditionally, cardiac surgery has been practiced primarily through a median sternotomy; however, as instrumentation and experience continue to advance at exponential rates, the field of minimally invasive cardiac surgery (MICS) is rapidly expanding. When compared with a conventional sternotomy, alternative access offers patients the potential benefits of decreased infection risk, reduced transfusion requirements, decreased length of admission, quicker return to normal activity, and, perhaps most important for patients, improved cosmesis. We hereby discuss our approach to cannulation for MICS operations.
Read MoreMeasuring the Resting Energy Expenditure in Children on Extracorporeal Membrane Oxygenation: A Prospective Pilot Study
REE measurements can be obtained by indirect calorimetry in children receiving ECMO support. ECMO may not provide metabolic rest for all children as a wide variation in REE was observed. For optimal care, individual testing should be considered to match calories provided with the metabolic demand.
Read MoreEffect Of Aortic Cannulation Depth on Air Emboli Transport during Cardiopulmonary Bypass: A Computational Study.
It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.
Read MoreA Prospective Observational Study on the Effect of Emboli Exposure on Cerebral Autoregulation in Cardiac Surgery Requiring Cardiopulmonary Bypass.
Overall, change in mean velocity index before and after cross-clamp removal did not differ between groups. However, most emboli entered the right cerebral hemisphere where this change was significantly greater in the open-chamber group, suggesting a possible association between embolic exposure and dysautoregulation.
Read MoreTrends, Advantages and Disadvantages in Combined Extracorporeal Lung and Kidney Support From a Technical Point of View
We conducted a review to provide technical background on existing techniques for extracorporeal lung and kidney support and give insight on important aspects to be addressed in the development of this novel highly integrated artificial lung device.
Read MoreEffect of Nitric Oxide via Cardiopulmonary Bypass on Ventilator-Free Days in Young Children Undergoing Congenital Heart Disease SurgeryThe NITRIC Randomized Clinical Trial
In children younger than 2 years undergoing cardiopulmonary bypass surgery for congenital heart disease, the use of nitric oxide via cardiopulmonary bypass did not significantly affect the number of ventilator-free days. These findings do not support the use of nitric oxide delivered into the cardiopulmonary bypass oxygenator during heart surgery.
Read MoreTen Overlooked Mistakes During Early Mobilisation in the Intensive Care Unit
Here are ten overlooked mistakes during early mobilisation in the ICU.
Read More