Yearly Archives: 2021

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NGAL expression during cardiopulmonary bypass does not predict severity of postoperative acute kidney injury

Abstract Background Renal injury is a serious complication after cardiac surgery and therefore, early detection and much more prediction of postoperative kidney injury is desirable. Neutrophil gelatinase-associated lipocalin (NGAL) is..

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Myocardial energy metabolism and ultrastructure with polarizing and depolarizing cardioplegia in a porcine model.

Abstract OBJECTIVES:  This study investigated whether the novel St. Thomas’ Hospital polarizing cardioplegic solution (STH-POL) with esmolol/adenosine/magnesium offers improved myocardial protection by reducing demands for high-energy phosphates during cardiac arrest..

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External validation of predictive models for acute kidney injury following cardiac surgery

Abstract BACKGROUND  Four predictive models for acute kidney injury associated with cardiac surgery were developed by Demirjian in the United States in 2012. However, the usefulness of these models in..

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Recirculation in Extracorporeal Membrane Oxygenation: The Warning Comes From the Cannula

We are writing to point out a simple clinical sign in a pedagogic way, about recirculation in venovenous extracorporeal membrane oxygenation (ECMO). These last years, ECMO has emerged as a..

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Enhanced Hemocompatibility and In Vivo Analytical Accuracy of Intravascular Potentiometric Carbon Dioxide Sensors via Nitric Oxide Release

Abstract In this letter, the innate ability of nitric oxide (NO) to inhibit platelet activation/adhesion/thrombus formation is employed to improve the hemocompatibility and in vivo accuracy of an intravascular (IV) potentiometric PCO2 (partial pressure..

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Air embolism: diagnosis and management

Abstract Air embolism is an uncommon, but potentially life-threatening event for which prompt diagnosis and management can result in significantly improved patient outcomes. Most air emboli are iatrogenic. Arterial air..

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Do we have enough evidence for minimally-invasive cardiac surgery? A critical review of scientific and non-scientific information

Abstract Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits..

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In Vitro Evaluation of Pediatric Hollow‐Fiber Membrane Oxygenators on Hemodynamic Performance and Gaseous Microemboli Handling: An International Multicenter/Multidisciplinary Approach

Abstract The objective of this study was to compare the hemodynamic performances and gaseous microemboli (GME) handling ability of two pediatric oxygenators in a simulated pediatric cardiopulmonary bypass (CPB) model..

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Accuracy of predicted haemoglobin concentration on cardiopulmonary bypass in paediatric cardiac surgery: effect of different formulae for estimating patient blood…

Abstract Introduction: When applying a blood-conserving approach in paediatric cardiac surgery with the aim of reducing the transfusion of homologous blood products, the decision to use blood or blood-free priming..

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Postoperative Bleeding After Change in Heparin Supplier: A Cardiothoracic Center Experience

Abstract Objective Unfractionated heparin is a mixture of  with different pharmacologic and  properties. The literature suggests that blood loss after cardiac surgery is related to both elevated postoperative heparin concentrations and the..

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Development of a high fidelity pressurized porcine beating heart simulator for cardiac surgery training

Abstract Background: Development of a high-fidelity cardiac surgery simulator (CSS) requires integration of a heart model with a mock cardiopulmonary bypass (CPB) circuit that can provide feedback to mimic the..

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Mycobacterium chimaera left ventricular assist device infections

Abstract A global outbreak of invasive Mycobacterium chimaera infections after cardiac surgery has recently been linked to bioaerosols from contaminated heater‐cooler units. The majority of cases have occurred after valvular surgery or..

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Thromboelastography during coronary artery bypass grafting surgery of severe hemophilia A patient – the effect of heparin and protamine on…

Abstract Coronary artery bypass grafting surgery (CABG) in hemophilia patients is challenging. Thromboelastography (TEG) is useful to assess hemostasis perioperatively. A patient with severe hemophilia A underwent CABG with TEG studies...

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Anticoagulation and Transfusions Management in Veno-Venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: Assessment of Factors Associated With Transfusion…

Abstract Purpose: We describe an approach for anticoagulation and transfusions in veno-venous–extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. Methods: Observational study..

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Utility of Sonoclot in Prediction of Postoperative Bleeding in Pediatric Patients Undergoing Cardiac Surgery for Congenital Cyanotic Heart Disease: A…

Abstract Objectives To assess the utility of Sonoclot in prediction of  in pediatric patients undergoing cardiac surgery with  for . Design Prospective, . Setting Single university hospital. Participants Eighty-seven pediatric patients undergoing cardiac surgery..

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Colloids in Cardiac Surgery—Friend or Foe?

Abstract Objective The right choice of fluid replacement still is a matter of debate. Recently, two large-scale studies on the use of  (HES) in the intensive care setting have been published,..

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Pushing the boundaries of ECLS: Outcomes in < 34 week EGA neonates

Abstract Purpose  (ECLS) is usually reserved for infants ≥ 34 weeks estimated  (EGA) owing to concerns about increased mortality and incidence of  (ICH). We sought to characterize survival, rates of ICH, and complications in..

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Hospital-level variation in inpatient cost among children receiving extracorporeal membrane oxygenation

Abstract Objective: Pediatric extracorporeal membrane oxygenation (ECMO) varies in the way care is provided from hospital to hospital. This variability in hospital ECMO care can be represented by the variation..

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Extracorporeal membrane oxygenation for Kawasaki disease: two case reports and the Extracorporeal Life Support Organization experience 1999–2015

Abstract Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We..

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Ninety-two days of extracorporeal membrane oxygenation support following congenital heart surgery

Abstract We report on a case involving a 10-month-old infant who received prolonged ECMO therapy following cardiac surgery for multiple ventricular septal defects (VSD). The patient was successfully weaned from..

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Minimally Circulatory‐Assisted On‐Pump Beating Coronary Artery Bypass Grafting for Patients With Complex Conditions for Off‐Pump Surgery

Abstract Off‐pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed..

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Correction of dilutional anemia induces renal dysfunction in diabetic patients undergoing coronary artery bypass grafting: a consequence of microcirculatory alterations?

Abstract Background In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue..

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Association between delay to coronary reperfusion and outcome in patients with acute coronary syndrome undergoing extracorporeal cardiopulmonary resuscitation☆

Abstract Aim The prognostic effect of early  therapy with  cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to  (ACS) has yet to be clarified. We investigated the relationship between time interval from..

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Pilot validation of an individualised pharmacokinetic algorithm for protamine dosing after systemic heparinisation for cardiopulmonary bypass

Abstract Introduction: This manuscript represents a pilot study assessing the feasibility of a single-compartment, individualised, pharmacokinetic algorithm for protamine dosing after cardiopulmonary bypass. Methods: A pilot cohort study in a..

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Citrate pathophysiology and metabolism

Abstract By chelating ionized  allows  circuit  without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of  and platelets. Citrate clearance by  (Krebs cycle) is not modified by renal..

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Perioperative Near-Infrared Spectroscopy Monitoring in Neonates With Congenital Heart Disease: Relationship of Cerebral Tissue Oxygenation Index Variability With Neurodevelopmental Outcome

Abstract Objectives:  To evaluate the value of perioperative cerebral near-infrared spectroscopy monitoring using variability analysis in the prediction of neurodevelopmental outcomes in neonates undergoing surgery for congenital heart disease. Design: ..

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Central Venous to Arterial Co2 Difference After Cardiac Surgery in Infants and Neonates

Abstract Objectives:  Venous to arterial Co2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial Co2 difference..

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Long-Term Survival and Causes of Late Death in Children Treated With Extracorporeal Membrane Oxygenation*

Abstract Objective:  Extracorporeal membrane oxygenation has been used in patients with severe circulatory or respiratory failure since the 1970s, but the knowledge on long-term survival in this group is scarce...

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Oncotic pressure and paediatric cardiopulmonary bypass: establishing baseline data for complex congenital cardiac surgery and its relation to risk stratification.

Abstract Objectives: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very..

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