Posts by Luc Puis
Extracorporeal Membrane Oxygenation Versus Mechanical Ventilation Alone in Adults with Severe Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
This study showed that the ECMO group exhibited a significantly lower mortality rate compared with the MV alone group at 90, 30 and 60 days for severe ARDS patients.
Read MoreSuccessful Antithrombin Administration in Andexanet Alfa-Associated Heparin Resistance
During routine CPB, high-dose unfractionated heparin (UFH) prevents consumptive coagulopathy and the formation of thrombi within the CPB circuit and the patient’s circulation. Prior treatment with andexanet alfa can pose difficulties in achieving adequate anticoagulation during CPB with UFH. The administration of antithrombin, in combination with UFH, may overcome these difficulties.
Read MoreMinimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass
MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% in patients undergoing CABG during normothermic CPB.
Read MoreThromboelastometry, Thromboelastography, and Conventional Tests to Assess Anticoagulation During Extracorporeal Support: A Prospective Observational Study
The aim of the study was to evaluate ROTEM as a tool for assessing hemostasis during ECMO, by comparing it to TEG and conventional coagulation assays.
Read MoreThe Hemovent Oxygenator: A New Low-Resistance, High-Performance Oxygenator
The aim of the current animal study was to evaluate the pressure gradient across the oxygenator and the gas exchange performance within a blood flow rate (BFR) range of 1–4 L/min, typically used in clinical practice for ECMO and ECCO2R.
Read MoreInsight Into ECMO, Mortality and ARDS: A Nationwide Analysis of 45,647 ECMO Runs
ARDS is a severe disease with a high mortality rate despite ECLS therapy. Although endpoints and timing of the evaluations differed from those of the CESAR and EOLIA studies and the Extracorporeal Life Support Organization (ELSO) Registry, the reported mortality in these studies was lower than in the present analysis. Further prospective analyses are necessary to evaluate outcomes in ECMO therapy at the centre volume level.
Read MoreRationale for the Role of Heparin and Related GAG Antithrombotics in COVID-19 Infection
The SARS-CoV-2 pandemic has focused attention on prevention, restriction and treatment methods that are acceptable worldwide. This means that they should be simple and inexpensive. This review examines the possible role of glycosaminoglycan (GAG) antithrombotics in the treatment of COVID-19. The pathophysiology of this disease reveals a complex interplay between the hemostatic and immune systems that can be readily disrupted by SARS-CoV-2.
Read MorePsychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association
Based on current study data, the following statements can be made: There are good data showing clear associations between psychological health and CVD and risk; there is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD; the preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health; simple screening measures can be used by health care providers for patients with or at risk for CVD to assess psychological health status; and consideration of psychological health is advisable in the evaluation and management of patients with or at risk for CVD.
Read MoreModified Ultrafiltration Reduces Postoperative Blood Loss and Transfusions in Adult Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials
MUF is a safe and feasible option in adult cardiac patients, with significant benefits including improved postoperative haematocrit, as well as reduced postoperative chest tube bleeding, transfusion requirements and duration of ICU stay.
Read MoreOxygen Delivery Monitoring under Cardiopulmonary Bypass: What Implication on Postoperative Morbidity and Mortality?
DO2 is a monitoring tool that has proven its advantages for monitoring under CPB.
Read MoreFree Hemoglobin Ratio as a Novel Biomarker of Acute Kidney Injury After On-Pump Cardiac Surgery: Secondary Analysis of a Randomized Controlled Trial
Results from this exploratory, hypothesis-generating retrospective, observational study shows that fHb ratio at the end of CPB might be used as a novel, widely applicable biomarker for AKI. The use of fHb ratio might help for an early detection of AKI, compared with prediction based only on urinary biomarkers.
Read MoreEffect of Different Types of Cerebral Perfusion for Acute Type A Aortic Dissection Undergoing Aortic Arch Procedure, Unilateral Versus Bilateral
In our study, it was observed that b-ACP procedure exhibited shorter CPB time, milder hypothermia, shorter ventilation time, lower incidence of postoperative hypoxia, and neurological dysfunction compared to u-ACP. Meanwhile, the incidence of ND was independently associated with three factors: preoperative neurological dysfunction, CPB time, and type of cerebral perfusion.
Read MoreTidal Flow Perfusion for the Artificial Placenta: A Paradigm Shift
Parameters of the tidal flow group were comparable with those of DLC. Single lumen jugular cannulation using tidal flow is a promising vascular access strategy for AP support. Successful miniaturization holds great potential for clinical translation to support extremely premature infants.
Read MoreNitric Oxide Attenuates the Inflammatory Effects of Air During Extracorporeal Circulation
The NO gas was blended into the ventilation/sweep site of the membrane lung. The platelets and leucocytes were activated by air alone. Addition of NO to the sweep gas attenuated the inflammatory response created by the air/blood interface in this model.
Read MoreImpact of Prothrombin Complex Concentrate and Fresh Frozen Plasma on Correction of Haemostatic Abnormalities in Bleeding Patients Undergoing Cardiac Surgery (PROPHESY Trial Results)
Our results show that 1000 IU and 1500 IU for PCC are comparable with 4 units and 5 units of FFP, respectively, in correcting coagulation abnormalities in bleeding patients undergoing cardiac surgery, and large trials are now needed to evaluate the clinical benefits and risks of both.
Read MoreEnhanced Recovery After Cardiac Surgery and Its Impact on Outcomes: A Systematic Review
ERAS in cardiac surgery has shown to be potentially safe and effective in improving certain postoperative outcomes. However, the evidence is limited by the lack of high-quality RCTs.
Read MoreGender-Based Microaggressions in Surgery: A Scoping Review of the Global Literature
While recent advancements have opened the field of surgery to women, there is still a lack of female representation, and persistent microaggressions may perpetuate this gender disparity. Addressing microaggressions against female surgeons is essential to achieving gender equity in surgical practice.
Read MoreHemadsorption
An evidence-based and personalized approach to EBPTs in sepsis is strongly advocated, in order to solve controversies in this field and optimise the management of critically ill septic patients.
Read MoreExtubation during Extracorporeal Membrane Oxygenation in Adults: An International Qualitative Study on Experts’ Opinions
Highlights In all, 14 adult-ECMO experts participated in four focus groups and two interviews Seven themes were identified in this qualitative multidisciplinary global study. Extubation during ECMO based on patient selection is recommended. Extubation using an ECPG or team decision-making is recommended.
Read MoreEsmolol in Cardiac Surgery: A Randomized Controlled Trial
In the present trial, esmolol as a cardioplegia adjuvant enhanced postoperative cardiac performance but did not reduce a composite endpoint of prolonged intensive care unit stay and/or mortality.
Read MoreChanging of Haemostatic System in A Pig Model During Different Types of Hypothermic Circulatory Arrest
Moderate hypothermic circulatory arrest is more suitable for patients with coagulation dysfunction. We believe the application of deep hypothermic circulatory arrest should pay more attention to changes in coagulation rather than the anticoagulation pathway. Extrinsic coagulation factor supplementation is more effective after deep hypothermic circulatory arrest.
Read MoreThe Dynamics of Heparin-Binding Protein in Cardiothoracic Surgery—A Pilot Study
The usefulness of HBP for predicting postoperative infections in cardiothoracic surgery should be investigated in future studies.
Read MoreEffect of Prolonged Hypothermic Cardiopulmonary Bypass, Heparin, and Protamine on Platelet: A Small-Group Study
Our findings demonstrate that protamine given after CPB plays a central role in PD and count decrease.
Read MoreFeeding Intolerance and Risk of Poor Outcome in Patients Undergoing Cardiopulmonary Bypass Surgery
Thus, the incidence of FI within seven days of EN after CPB was high, which was associated with a poor prognosis.
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