Search Results

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Human Factors in ECLS – A Keystone for Safety and Quality – A Narrative Review for ECLS Providers

Expertise from other industries is extrapolated to improve patient safety through the application of simulation training to reduce error propagation and improve outcomes.

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Recovery of Platelet-Rich Red Blood Cells and Acquisition of Convalescent Plasma With A Novel Gravity-Driven Blood Separation Device

The novel blood filter studied effectively separates whole blood into diluted plasma and platelet-rich RBCs. Moreover, the device effectively washed diluted whole blood, driving over 80% of proteins to the liquid component.

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Retrograde Autologous Priming Method Reduces Plasma Free Hemoglobin Level in Aortic Surgery

In this study, in patients undergoing aortic surgery, a reduction in the increase of fHb was observed with the rRAP method which is a simple procedure that does not require high cost or advanced technology.

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Pregnant/Peripartum Women with COVID-19 High Survival with ECMO: An ELSO Registry Analysis

We investigated the survival and complications of pregnant/peripartum women with COVID19 supported with V-V ECMO reported to the Extracorporeal Life Support Organization (ELSO) Registry.

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Extracorporeal Membrane Oxygenation in the Forensic Setting: A Series of 19 Forensic Cases

As ECMO therapy has become increasingly available, it is of importance for medical examiners and death investigators to be familiar with the procedure as well as its limitations. Familiarity with ECMO and its sequelae allows for the proper documentation of postmortem findings and fosters an informed determination of the cause and manner of death.

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Paving the Road for the Adoption of Normothermic Regional Perfusion in Canada

Here, we propose a research agenda that will allow this technology to be introduced within current Canadian organ donation frameworks.

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Low Mean Arterial Pressure During Cardiopulmonary Bypass and the Risk of Acute Kidney Injury: A Propensity Score Matched Observational Study

Low MAP periods during CPB are associated with an increased occurrence of post-operative AKI, leading to 1) higher creatinine levels; 2) decreased GFR and 3) longer ICU and ward lengths of stay. Both consecutive and cumulative periods of low MAP are associated with an increased risk of AKI. MAP appears to be an important contributor to post-operative AKI and should be carefully managed during CPB. Further studies must address if MAP variations lead to definitive and long-term consequences.

Mass Image Compressor Compressed this image. https://sourceforge.net/projects/icompress/ with Quality:75

Artificial Intelligence for Augmenting Perioperative Surgical Decision-Making—Are We There Yet?

These questions for translating AI into surgical care remain. However, this proof-of-concept study will undoubtedly stimulate surgeons, innovators, and data scientists to continue investigating the role of machine-learning methods to improve care.

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Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is used to support patients with refractory cardiopulmonary failure. Given ECMO’s increased use in adults and the fact that many ECMO patients are cared for by anesthesiologists, the Society of Cardiovascular Anesthesiologists ECMO working group created an expert consensus statement that is intended to help anesthesiologists manage adult ECMO patients who are cared for in the operating room. In the first part of this 2-part series, technical aspects of ECMO are discussed, and related expert consensus statements are provided.

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Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists— Part II, Intraoperative Management and Troubleshooting

In the first stage of creating the expert consensus statement, topics related to intraoperative ECMO management were proposed by group members. A literature review for each topic was performed using MEDLINE, and articles published after 1980 were included at the discretion of group members. The specific search terms that were queried varied for each topic area.

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Real-Time Ventricular Volume Measured Using the Intracardiac Electromyogram

The DA of the iEMG proved to be a significant, independent predictor of EDV. The proposed LV volume sensor is simple to integrate into the inflow cannula of an LVAD and thus has the potential to inform the clinician about the state of LV volume in real time and to automatically control the LVAD.

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Limb Amputation Following Extracorporeal Membrane Oxygenation Therapy Among Survivors: A Nationwide Cohort Study from South Korea

In South Korea, 1.6% of ECMO survivors underwent limb amputation within 365 days after initiating ECMO therapy; however, it was not significantly associated with the 3-year all-cause mortality. Our findings warrant future studies on the impact on the quality of life and morbidity-related implications among patients who undergo limb amputation due to ECMO therapy.

Artwork - Hot ECMO

Mobile Devices and Wearable Technology for Measuring Patient Outcomes after Surgery: A Systematic Review

Despite the potential of DHI to improve postoperative patient care, current progress is severely restricted by limitations in methodological reporting. There is an urgent need to improve reporting for DHI following surgery to identify patient benefit, promote reproducibility and encoura

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The Effect of Low Tidal Volume Ventilation on Inflammatory Cytokines During Cardiopulmonary Bypass

Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.

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Early Experience with Donation after Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion in The United States

DCD heart transplantation outcomes have been excellent. Our DCD protocol is adoptable for more widespread use and will increase donor heart availability in the United States.

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Adrenaline Improves Regional Cerebral Blood Flow, Cerebral Oxygenation and Cerebral Metabolism During CPR in A Porcine Cardiac Arrest Model Using Low-Flow Extracorporeal Support

This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.

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Neuroprotective Effects of Dynamic Bubble Trap Use in Patients Undergoing Pulmonary Endarterectomy: A Two-Arm Randomized Controlled Trial

DBT positively influences memory function after PEA. This effect is most likely caused by the reduction of gaseous microemboli.

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Outcomes and their State-Level Variation in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection in the USA: A Prospective Multicenter Study

Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.

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The Use of Cerebral NIRS Monitoring to Identify Acute Brain Injury in Patients With VA-ECMO

Our results support that cerebral NIRS is a useful, real-time bedside neuromonitoring tool to detect ABI in VA-ECMO patients. A >25% drop from the baseline was sensitive in predicting ABI occurrence. Further research is needed to assess how to implement this knowledge to utilize NIRS in developing appropriate intervention strategy in VA-ECMO patients.

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The 10 Commandments of ERAS for Cardiac Surgery

These guidelines recommend 22 evidence-based care bundles for cardiac surgery. In addition to implementation of these bundles, the creation of a cardiac ERAS program involves pivoting the culture of care to a standardized, patient-centered philosophy with rigorous auditing and benchmarking. Adherence to several guiding principles described below is essential to build a successful cardiac ERAS program and improve outcomes.

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Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: the RESTORE Randomized Clinical Trial

Among patients with symptomatic mild to moderate radiographic knee OA, intra-articular injection of PRP, compared with injection of saline placebo, did not result in a significant difference in symptoms or joint structure at 12 months. These findings do not support use of PRP for the management of knee OA.

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The Challenge of Estimating Treatment Effects in Cardiac Surgery

For several decades the cardiac surgery community has relied on observational comparative studies, often due to the perception than randomized trials are too challenging and complex. We have described how only less than 10% of the available evidence on the 10 most commonly performed surgical procedures comes from randomized trials and how the number of published cardiac surgery trials has decreased significantly over the course of the last 20 years.

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Data-Driven Individualized Surgical Decision-making: Beyond “Better on Average” Clinical Trial Results

Commonly used surgical risk models do not provide the probability of outcome resulting from a counterfactual scenario of not undergoing surgery, providing only half of the information needed to make informed treatment decisions. Risk models developed from RCT data could inform comparative risks and potential benefits of undergoing alternative treatment options.

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Left Heart Decompression on Veno-Arterial Extracorporeal Membrane Oxygenation in Children With Dilated Cardiomyopathy and Myocarditis: An Extracorporeal Life Support Organization Registry Review

Retrospective review of the Extracorporeal Life Support Organization registry revealed an association between left heart decompression and greater odds of survival in children with myocarditis and dilated cardiomyopathy on extracorporeal membrane oxygenation. When comparing patients with dilated cardiomyopathy against those with myocarditis, we could not exclude a three-fold greater odds of survival associated with the use of left heart decompression. This finding warrants further prospective evaluation.