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NEWS (4)

Perfusion.com Cardiovascular News Roundup: September 19, 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.

NEWS (4)

Perfusion.com Cardiovascular News Roundup:
September 15, 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.

NEWS (4)

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.

NEWS (4)

Perfusion.com Cardiovascular News Roundup: September 2, 2022

Weekly roundup of interesting reads for the perfusion community, this week including a re-cap on the continuous search for biocompatible materials, big studies in China, Norway and the Netherlands, along with new technologies and original research.

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Deliberate 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.

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Prothrombin 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.

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Reliability 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.

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Intraoperative 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.

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Awake 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.

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Incidence 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.

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Impact 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.

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Arterial 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.

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Effect 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.

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Imaging 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.

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The 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.

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Cannulas 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.

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Measuring 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.

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Effect 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.

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A 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.

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Trends, 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.

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Effect 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.

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Ten Overlooked Mistakes During Early Mobilisation in the Intensive Care Unit

Here are ten overlooked mistakes during early mobilisation in the ICU.

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Effect of Intraoperative Handovers of Anesthesia Care on Mortality, Readmission, or Postoperative Complications Among AdultsThe HandiCAP Randomized Clinical Trial

Among adults undergoing extended surgical procedures, there was no significant difference between the patients randomized to receive handover of anesthesia care from one clinician to another, compared with the no handover group, in the composite primary outcome of mortality, readmission, or serious postoperative complications within 30 days.

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Key Characteristics Impacting Survival of COVID-19 Extracorporeal Membrane Oxygenation.

Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.