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Severe Impairment of Microcirculatory Perfused Vessel Density Is Associated With Postoperative Lactate and Acute Organ Injury After Cardiac Surgery
In patients undergoing cardiac surgery, there was a significant decrease in postoperative microcirculatory convective blood flow and diffusive capacity during early postoperative resuscitation.
Hyperlactatemia of Dialysis-Dependent Patients After Cardiac Surgery Impacts on In-Hospital Mortality: A Two-Center Retrospective Study
In dialysis-dependent patients after cardiac surgery, the early-onset of a maximum arterial lactate concentration of > 4.5 mmol/L was significantly associated with in-hospital mortality.
Toll-like Receptor 9 and the Inflammatory Response to Surgical Trauma and Cardiopulmonary Bypass
CPB, surgical trauma and ischemic perfusion injury trigger the release of circulating mtDNA that activates TLR-9, in turn stimulating a release of IL-6. Therefore, TLR-9 antagonists may attenuate this response and may provide a future therapeutic target whereby the systemic inflammatory response to cardiac surgery may be manipulated to improve clinical outcomes.
Effect of Pulsatile Cardiopulmonary Bypass in Adult Heart Surgery
Findings of this study do not support the superiority of pulsatile flow pattern during CPB, in terms of cerebral oxygen saturation or postoperative mortality/morbidity.
Preoperative Vitamin D Level is Associated with Postoperative Delirium After Cardiac Surgery in Patients Over 65 Years of Age
Vitamin D deficiency exacerbates delirium after coronary artery bypass surgery with cardiopulmonary bypass.
Normoxic Re-Oxygenation Ameliorates End-Organ Injury After Cardiopulmonary Bypass
Normoxic reperfusion ameliorates cardiac, renal and neural injury compared with hyperoxic reperfusion in an in vivo animal model of CPB and cardioplegic arrest. This protective effect of normoxic reperfusion may be due to a reduction in signaling pathways for OS, inflammation, and apoptosis.
Anticoagulation Management During Pulmonary Endarterectomy With Cardiopulmonary Bypass and Deep Hypothermic Circulatory Arrest
This study shows a wide variation in individual heparin sensitivity in patients undergoing pulmonary endarterectomy with deep hypothermic circulatory arrest.
Minimally Invasive Extracorporeal Circulation Is a Cost-Effective Alternative to Conventional Extracorporeal Circulation for Coronary Artery Bypass Grafting: Propensity Matched Analysis
Minimally invasive extracorporeal circulation for coronary artery bypass grafting is associated with a reduced requirement for blood transfusion, reduced incidence of acute kidney injury and a significant cost saving. Minimally invasive extracorporeal circulation should be considered as an adjunct for all patients undergoing coronary artery bypass grafting.
Feasibility Study of a Novel Method of Concentrating Fresh Frozen Plasma by Hemoconcentrating Filter Outside Cardiopulmonary Bypass
We invented a novel method of concentrating FFP by applying a hemoconcentrating filter directly to FFP to both minimize volume and avoid affecting platelet function.
Acute Kidney Injury, Stroke and Death After Cardiopulmonary Bypass Surgery: The Role of Perfusion Flow and Pressure
Neither low perfusion pressure nor low perfusion flow during cardiopulmonary bypass were predictive of postoperative acute kidney injury, stroke or death.
Will High-Dose Heparin Affect Blood Loss and Inflammatory Response in Patients Undergoing Cardiopulmonary Bypass?
This small study showed a small increase of post-operative bleeding associated with higher heparin dosage in conjunction with cardiopulmonary bypass but did not demonstrate an effect of heparin on the inflammatory response to cardiopulmonary bypass.
Effect of High-Dose Ulinastatin on the Cardiopulmonary Bypass-Induced Inflammatory Response in Patients Undergoing Open-Heart Surgery
Therefore, different routes of UTI administration may restrict its effects. Further studies are needed to evaluate the most effective route of administering the total dose of UTI used in this study.
Using a Quality Improvement Initiative to Reduce Acute Kidney Injury During On-Pump Coronary Artery Bypass Grafting
This initiative confirms previous assertions that DO2 is a critical intraoperative parameter and should direct perfusion intervention accordingly.
Non-Pulsatile Blood Flow is Associated with Enhanced Cerebrovascular Carbon Dioxide Reactivity and an Attenuated Relationship Between Cerebral Blood Flow and Regional Brain Oxygenation
Non-pulsatile perfusion is associated with enhanced cerebrovascular CVR resulting in greater relative decreases of cerebral blood flow during hypocapnia.
Antifactor Xa Monitoring and Hematologic Complications of Pediatric Extracorporeal Membrane Oxygenation
Management of anticoagulation based on anti-Xa levels appears to be as effective as management based on ACT results.
Pressure and Flow Properties of Dual-Lumen Cannulae for Extracorporeal Membrane Oxygenation
Non-standardized testing of pressure–flow properties of extracorporeal membrane oxygenation dual-lumen cannulae prevents an adequate prediction of pressure–flow results when these cannulae are used in patients. Properties of dual-lumen cannulae may vary between sizes within same cannula family, in particular concerning the drainage flow.
A Single Preoperative Dose of Tranexamic Acid Reduces Perioperative Blood Loss
Preoperative intravenous TXA reduced perioperative blood loss and transfusion requirements in a variety of surgical disciplines without increasing the risk of thromboembolic events. Therefore, it should be considered for prophylactic use in surgery to reduce operative bleeding.
Spinal Cord Collateral Flow During Antegrade Cerebral Perfusion for Aortic Arch Surgery
Cooling is a more important means of protection for the lower spinal cord during lower body circulatory arrest than is antegrade cerebral perfusion.
Does the Prognostic Nutritional Index have a Predictive Role in the Outcomes of Adult Cardiac Surgery?
The prognostic nutritional index may be a useful preoperative nutrition screening tool for predicting the early clinical outcomes of adult patients after cardiac surgery using cardiopulmonary bypass.
Watershed Phenomena during Extracorporeal Life Support and their Clinical Impact: a Systematic In Vitro Investigation
Using an in vitro mock circulation loop, we systematically investigated the impact of heart failure, extracorporeal support, and cannulation routes on the formation of flow phenomena and flow distribution in the arterial tree.
Bivalirudin
Bivalirudin is an inhibitor of thrombin, an essential factor within the coagulation cascade crucial to thrombus formation.
Development and Application of ‘Systems Thinking’ Principles for Quality Improvement
Application of the adapted principles underpins, and is characteristic of, a holistic systems approach and may aid care team and organisational system understanding and improvement.
Neurological Pupil index for Early Prognostication After Venoarterial Extracorporeal Membrane Oxygenation
Quantitative NPi alone had excellent ability to predict a poor outcome from day 1 after VA-ECMO insertion, with no false positives. Combining NPi and 12-h PREDICT-VA ECMO score increased the sensitivity of outcome prediction, while maintaining 100% specificity.
