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Perioperative THR-184 and AKI after Cardiac Surgery
AKI after cardiac surgery is associated with mortality, prolonged hospital length of stay, use of dialysis, and subsequent CKD. We evaluated the effects of THR-184, a bone morphogenetic protein-7 agonist, in patients at high risk for AKI after cardiac surgery.
Acute Kidney Injury After Cardiac Surgery: Prevalence, Impact and Management Challenges
In this review, we explore the definition of cardiac surgery-associated acute kidney injury (CSA-AKI) and identify diverse mechanisms and risk factors contributing to the renal insult.
A Pilot Goal-Directed Perfusion Initiative Is Associated With Less Acute Kidney Injury After Cardiac Surgery
We sought to determine whether a pilot goal-directed perfusion initiative could reduce the incidence of acute kidney injury after cardiac surgery.
Optimizing Perioperative Blood and Coagulation Management During Cardiac Surgery
This article reviews the hemostasis disturbances in cardiac surgery with cardiopulmonary bypass and gives an overview of the most important patient blood management strategies.
Enhanced Activity by NKCC1 and Slc26a6 Mediates Acidic pH and Cl- Movement after Cardioplegia-Induced Arrest of db/db Diabetic Heart
Diabetic heart dysfunctions during cardiac surgeries have revealed several clinical problems associated with ion imbalance. However, the mechanism of ion imbalance mediated by cardioplegia and a diabetic heart is largely unclear.
Protamine is an FDA-approved drug for use in neutralizing the effect of unfractionated heparin. It is most commonly used to neutralize heparin-induced anticoagulation after separation from cardiopulmonary bypass. When appropriately dosed, this neutralization reduces the risk of postoperative bleeding. Protamine is also utilized to reverse the anticoagulation effects of unfractionated heparin in the setting of dialysis, invasive…
Short-Term Results of Bilateral Internal Mammary Arterial Grafting for Patients Aged 60–75 Years
Bilateral internal mammary artery (BIMA) grafting has a good long-term survival rate and graft patency rate, but it is only recommended in young patients due to its high technical requirements and high incidence of sternal complications. Previous studies indicated that BIMA grafting has a significant benefit in patients aged 50–59 years, but this benefit does not…
How to Become a Perfusionist in the US for Foreign Students
This is a guide to becoming a perfusionist in the United States for designed for foreign students that are not US citizens.
Acute Kidney Injury after Cardiac Surgery: Risk Factors and Novel Biomarkers
Acute kidney injury (AKI) is a common and severe complication after cardiac surgery. Currently, a series of novel biomarkers have favored the assessment of AKI after cardiac surgery in addition to the conventional indicators.
Blood Utilization in Revision Versus First-Time Cardiac Surgery: An Update in the Era of Patient Blood Management
Relative to first-time (primary) cardiac surgery, revision cardiac surgery is associated with increased transfusion requirements, but studies comparing these cohorts were performed before patient blood management (PBM) and blood conservation measures were commonplace. The current study was performed as an update to determine if this finding is still evident in the PBM era.
Nature of Cardiac Rehabilitation Around the Globe
Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region.
Heart Valve Operations Associated With Reduced Risk Of Death From Mitral Valve Disease But Other Operations Associated With Increased Risk of Death: A National Population-Based Case-Control Study
This study analyzed the death risk from heart valve disease with respect to the frequency of heart valve operation and other operations in patients with mitral valve disease.
Higher 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.
Study 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.
Development 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.
Validation 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.
The 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.
Discriminatory 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.
Red 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.
Quality 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.
Cardiopulmonary 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.
In-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.
Postoperative 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.
Neurological Complications After Cardiac Surgery Anesthetic Considerations Based on Outcome Evidence
Neurological complications after cardiac surgery remain prevalent. This review aims to discuss the modifiable and outcome-relevant risk factors based on an up-to-date literature review, with a focus on interventions that may improve outcomes.