Yearly Archives: 2023

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A transfusion risk stratification score to facilitate quality management in cardiopulmonary bypass

Abstract Background Our previous showed that a blood management program in the cardiopulmonary bypass (CPB) department, reduced red blood cell (RBC) transfusion and complications, but assessing transfusion practice solely based..

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An International Survey of Extracorporeal Membrane Oxygenation Education and Credentialing Practices

Abstract Background: The use of extracorporeal membrane oxygenation (ECMO) has grown rapidly over the past decades because of evolving indications, advances in circuit technology, and encouraging results from modern trials. Because..

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Simple Tool for Bleeding Control During Minimally Invasive and Robotic Cardiac Surgery

Abstract Achievement of complete hemostasis is a key element to success in cardiac surgery. Bleeding control is of utmost importance in minimally invasive and robotic cardiac surgery to avoid conversion,..

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Establishment of a national quality improvement process on oxygen delivery index during cardiopulmonary bypass

Abstract Targeted oxygen delivery during cardiopulmonary bypass (CPB) has received significant attention due to its influence on patient outcomes, especially in mitigating acute kidney injury. While it has gained popularity..

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Influence of Fibrinogen Concentrate on Neonatal Clot Structure When Administered Ex Vivo After Cardiopulmonary Bypass

Abstract BACKGROUND: Bleeding is a serious complication of cardiopulmonary bypass (CPB) in neonates. Blood product transfusions are often needed to adequately restore hemostasis, but are associated with significant risks. Thus,..

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A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass

Abstract Purpose: Intensive care unit-acquired weakness (ICUAW) affects patient prognosis after cardiopulmonary bypass (CPB) surgery, but its risk factors remain unclear. We investigated these risk factors and developed a nomogram..

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Development of the Extracorporeal Life Support Organization International Adult Extracorporeal Membrane Oxygenation Curriculum: Creation of Initial Learning Objectives via a…

Abstract OBJECTIVES Previous studies indicated higher long-term mortality after the transfusion of allogeneic red blood cells (RBC); newer recommendations emphasize lower transfusion rates. The consequences of the transfusion of RBCs..

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Utilization of Impella as a Weaning Platform from ECMO is Associated with Increased Survival in Cardiogenic Shock Patients

Abstract Background: Although extracorporeal membrane oxygenation (ECMO) is an integral part of a robust cardiogenic shock program, it is associated with high mortality. The optimal strategy for weaning from ECMO is..

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Acquired blood stream infections during extracorporeal membrane oxygenation in adults: risk factors and outcomes.

Abstract Infection is one of the most frequent complications in the management of ECMO patients. Although there are several studies demonstrating the role of ECMO in patients with pre-existing sepsis,..

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Takotsubo Syndrome and Severe Cardiogenic Shock secondary to Plastic Surgery treated with VA-ECMO. Case Series

Abstract Beside the tremendous developments in cardiac surgical procedures, the use of cardiopulmonary bypass (CPB) remains the gold standard to perform cardiac surgery but is associated with detrimental effects (e.g...

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Algorithmic Approach to Early Extubation in V-V ECMO Patients

Abstract Background: Extubation while receiving V-V ECMO is being considered earlier for patients with respiratory failure. This can facilitate early mobilization, participation in physical therapy, and reduce the potential consequences of..

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Venting the Left Ventricle from the Atrium: A Case Series of transeptal LA Vent VA-ECMO

Abstract Introduction: In cardiogenic shock, peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide hemodynamic support, however this results in adverse left ventricular afterload. Left ventricle (LV) venting (unloading) has favorable effects..

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Application of ultrasound microbubble contrast to evaluate the effect of sitaxentan on renal microvascular perfusion in beagles undergoing cardiopulmonary bypass

Abstract BACKGROUND & OBJECTIVE: We aimed to evaluate the effect of sitaxentan on renal microvascular perfusion via application of ultrasound microbubble contrast. METHODS: Male beagles were randomly divided into: Sham,..

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Red Blood Cell Conservation and Use in the Cardiovascular Operating Rooms at Ben Taub General Hospital

Abstract Objectives A conservative hemoglobin transfusion threshold is noninferior to a liberal threshold in cardiac surgery. However, red blood cell (RBC) transfusion remains common during cardiac surgery. The authors’ single-center,..

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Prehospital high‑dose methylprednisolone in resuscitated out‑of‑hospital cardiac arrest patients (STEROHCA): a randomized clinical trial

Abstract Purpose: Patients who are successfully resuscitated following out‑of‑hospital cardiac arrest (OHCA) are still at a highrisk of neurological damage and death. Inflammation and brain injury are components of the..

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Mortality on extracorporeal membrane oxygenation: Evaluation of independent risk factors and causes of death during venoarterial and venovenous support

Abstract Introduction Most patients on extracorporeal membrane oxygenation (ECMO) decease during therapy on the system. However, the actual causes of death have not been studied sufficiently. This study analyses the..

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The Cost of Being a Woman in Academic Cardiothoracic Surgery: Joint Collaboration of The Society of Thoracic Surgeons Workforces on…

Abstract Background Gender disparity in the cardiothoracic surgery workforce is challenging to enumerate and quantify. The purpose of our work is to use the most current data to quantify the..

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Using Digital Biomarkers for Objective Assessment of Perfusionists’ Workload and Acute Stress During Cardiac Surgery

Abstract The cardiac operating room (OR) is a high-risk, high-stakes environment inserted into a complex socio-technical healthcare system. During cardiopulmonary bypass (CPB), the most critical phase of cardiac surgery, the..

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Intraoperative neurological pupil index and postoperative delirium and neurologic adverse events after cardiac surgery: an observational study

Abstract Neurological pupil index (NPi) calculated by automated pupillometry predicts clinical outcomes in critically ill patients. However, there are few data on intraoperative NPi and postoperative outcome after cardiac surgery...

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Re-Dosing del Nido cardioplegia in adult cardiac surgery: Perfusion characteristics and outcomes--Is there an optimal redosing strategy?

Abstract Objectives del Nido cardioplegia is utilized for myocardial protection in adult patients undergoing cardiac surgery; however, no standardized re-dosing protocol exists. We describe perfusion characteristics and clinical outcomes in..

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Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy

Abstract Background Patients with simultaneous relevant internal carotid artery stenosis and coronary artery heart or valve disease represent a high-risk collective with respect to cerebral or cardiovascular severe events when..

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Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials

Abstract Congenital heart disease (CHD) represents one of the most common congenital malformations, affecting greater than 40,000 births annually in the United States, many of which require surgery during the..

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Subfatin, Asprosin, Alamandine and Maresin-1 Inflammation Molecules in Cardiopulmonary Bypass

Abstract Purpose: Cardiopulmonary bypass (CPB) is a nonphysiological procedure in which inflammatory reactions and oxidative stress are induced, hormones and hemodynamic parameters are affected, and circulation is maintained outside the body...

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A Deep Dive Into Retroesophageal Major Aortopulmonary Collateral Arteries

Abstract Background: The anatomy of major aortopulmonary collateral arteries (MAPCAs) can be highly variable with regard to number, anatomic origin, course, and relationship to the native pulmonary arteries. Some MAPCAs travel..

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Continuous Ultrafiltration Enhances Recovery After Adult Cardiac Surgery With Cardiopulmonary Bypass: A Systematic Review and Meta-analysis

Abstract Background Cardiac surgery with cardiopulmonary bypass is associated with systemic inflammation. Ultrafiltration used throughout the cardiopulmonary bypass time, continuously, is hypothesized to be an immunomodulatory therapy. Methods A systematic..

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Reduced Invasiveness of Cardiopulmonary Bypass: The Mini-Circuit and the Micro-Cardioplegia

Abstract The aim of cardiopulmonary bypass is the maintenance of a sufficient whole body perfusion and gas exchange during open or closed heart surgery procedure (coronary artery bypass grafting, valve..

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Heparin-induced thrombocytopenia: An illustrated review

Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated  from unfractionated or low-molecular-weight heparin that results in thrombocytopenia and potentially catastrophic thrombosis. HIT occurs due to the development of platelet-activating antibodies against multimolecular..

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Maintenance of pig brain function under extracorporeal pulsatile circulatory control (EPCC)

Abstract Selective vascular access to the brain is desirable in metabolic tracer, pharmacological and other studies aimed to characterize neural properties in isolation from somatic influences from chest, abdomen or..

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Perioperative Red Blood Cell Transfusion Is Associated With Adverse Cardiovascular Outcomes in Heart Valve Surgery

Abstract BACKGROUND:  We examined the relationship between blood transfusion and long-term adverse events to evaluate the clinical impact of red blood cell (RBC) transfusion on patients undergoing cardiac valve surgery...

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Five years since defining global cardiac surgery: from afterthought to tipping point

Abstract BACKGROUND Six billion people lack access to safe, timely and affordable cardiac surgical care [1, 2]. In low- and middle-income countries (LMICs), access to cardiac surgery has been poor due..

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