Yearly Archives: 2023

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Low postoperative perfused vessel density is associated with increased soluble endothelial cell adhesion molecules during circulatory shock after cardiac surgery.

Abstract Introduction Microcirculatory dysfunction after  is associated with significant morbidity and worse clinical outcomes. Abnormal  can occur from multiple causes, including cytokine-mediated vascular , , and an inadequate balance between  and . In response to ,  produce cellular  (CAMs)..

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Management of priming fluids in cardiopulmonary bypass for adult cardiac surgery: network meta-analysis

Abstract Background Cardiopulmonary bypass (CPB) is frequently employed for cardiac surgery, and selecting a suitable priming fluid is a prerequisite for CPB. Currently, the commonly used priming fluids in clinics..

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De senectute and the art of medicine: how old is too old for ECMO in cardiogenic shock?

Abstract Complexity and a certain level of uncertainty are inherent to the clinical scenarios faced by the treating teams, often inundated with exhaustive details. Disease arises from a multitude of..

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PREPARA PERFUSÃO

Criamos esses 3 dias de evento gratuito para te ajudar a entrar em um centro formador reconhecido pela SBCEC.   Prof. Elio Carvalho é Biomédico, Microbiologista e Perfusionista pela Unicamp,..

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Peripheral Veno-Arterial-Extracorporeal Membrane Oxygenation for Refractory Septic Shock in Children: A Multicenter Review

Abstract Background Extracorporeal membrane oxygenation (ECMO) is utilized as a rescue therapy in the management of pediatric patients with refractory septic shock. Multiple studies support the use of a central..

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Early Changes in Arterial Partial Pressure of Carbon Dioxide and Blood Pressure After Starting Extracorporeal Membrane Oxygenation in Children: Extracorporeal…

Abstract Objective:  Neurologic complications in pediatric patients supported by extracorporeal membrane oxygenation (ECMO) are common and lead to morbidity and mortality; however, few modifiable factors are known. Design:  Retrospective study..

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Outcomes in Obese Are Comparable to Non-Obese Patients: A Propensity Matched Cohort Study

Abstract Introduction: Obesity, defined as a body mass index ≥ 40 kg/m2, was considered a relative contraindication to cannulation for extra-corporeal membrane oxygenation (ECMO) during the coronavirus pandemic. While body habitus can..

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A safe and effective method for percutaneous, awake, bedside decannulation of peripheral VA ECMO using vascular closure devices: a case…

Abstract Decannulation of patients on peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) typically involves femoral arterial cutdown and surgical arteriotomy closure in an operating room under general anesthesia. However, this..

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Levosimendan in extracorporeal membrane oxygenation in refractory cardiac arrest

Abstract Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can re-establish tissue perfusion in refractory cardiac arrest requiring cardiopulmonary resuscitation (CPR). Levosimendan showed potential benefit in VA-ECMO weaning and mortality but was not..

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How I manage differential gas exchange in peripheral venoarterial extracorporeal membrane oxygenation

Abstract Dual circulation is a common but underrecognized physiological occurrence associated with peripheral venoarterial extracorporeal membrane oxygenation (ECMO). Competitive flow will develop between blood ejected from the heart and blood..

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Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Abstract Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia..

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The systemic inflammatory response syndrome and cardiopulmonary bypass

Abstract Cardiac surgery using cardiopulmonary bypass (CPB) provokes a systemic inflammatory response. This is mainly triggered by contact activation of blood by artificial surfaces of the extracorporeal circuit. Although often..

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Radiation Exposure in Extracorporeal Life Support

Abstract Extracorporeal membrane oxygenation (ECMO) exposes patients to multiple radiologic studies. We hypothesized ECMO patients endure radiation exposure in excess of the International Commission of Radiological Protection (ICRP) recommendations of..

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Prevalence of FXII-Deficiency and Its Relevance to Monitoring Anticoagulation in Adults Receiving Extracorporeal Membrane Oxygenation

Abstract During extracorporeal membrane oxygenation (ECMO) blood is exposed to artificial surfaces, resulting in contact activation of the intrinsic coagulation pathway initiated by coagulation factor XII (FXII). Little is known..

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Age and associated outcomes among patients receiving venoarterial extracorporeal membrane oxygenation–analysis of the Extracorporeal Life Support Organization registry

Abstract Purpose Venoarterial extracorporeal membrane oxygenation (V-A ECMO) can be used to support severely ill patients with cardiogenic shock. While age is commonly used in patient selection, little is known..

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Anticoagulation strategies in COVID-19 infected patients receiving ECMO support

Abstract Background: Hospitalized COVID-19 patients with hypoxemic respiratory failure may deteriorate despite invasive mechanical ventilation and thus require extracorporeal membrane oxygenation (ECMO) support. Unfractionated heparin (UFH) is the antithrombotic of..

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Albumin Infusion and Blood Loss After Cardiac Surgery

Abstract Background In the recent ALBICS (ALBumin In Cardiac Surgery) trial, 4% albumin used for  priming and volume replacement increased perioperative bleeding compared with . In the present exploratory study, albumin-related bleeding..

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Understanding lactate and its clearance during extracorporeal membrane oxygenation for supporting refractory cardiogenic shock patients

Abstract The recent study by Scolari et al. [] entitled ‘Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort..

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Acute severe pulmonary hypertension during weaning from cardiopulmonary bypass for aortic valve replacement surgery: A case report

Abstract Pulmonary arterial pressure (PAH) usually increases after cardiopulmonary bypass (CPB), but this normally does not affect weaning off CPB. Here we report a case of severe PAH in a..

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Harlequin syndrome during peripheral cardiopulmonary bypass in a patient with an obstructing tracheal schwannoma: A case report

Abstract Surgical resection of obstructive tracheal tumors can be challenging to cardiothoracic surgeons and anesthesiologists. It is often difficult in these cases to maintain oxygenation by face mask ventilation during..

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Outcomes of Prolonged ICU Stay for Patients Undergoing Cardiac Surgery in Australia and New Zealand

Abstract Objective To determine the effect of intensive care unit (ICU) length of stay (LOS) on hospital mortality and non-home discharge for patients undergoing cardiac surgery over a 16-year period..

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Perfusion Strategy to Prevent Right Ventricular Decompression on Cardiopulmonary Bypass During Extracardiac Fontan for Right Ventricle–Dependent Coronary Circulation

Abstract Early and long-term outcomes in patients with pulmonary atresia-intact ventricular septum undergoing staged univentricular palliations have been known to be adversely affected by the presence of right ventricle–dependent coronary..

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The need for a structured pathway to facilitate perfusionist mobility across borders

Abstract This letter highlights the need for a structured pathway for Perfusionists to work across borders in order to address workforce shortages and provide comparable opportunities to other medical professions...

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Temperature analysis of aortic repair with hypothermic circulatory arrest to quantify the injury by cooling

Abstract OBJECTIVES We analyzed the temperature in proximal aortic repair with moderate hypothermic circulatory arrest (HCA) and evaluated the effect of the cooling status on postoperative outcomes. METHODS A total..

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Integral assessment of gas exchange during veno-arterial ECMO: accuracy and precision of a modified Fick principle in a porcine model

Abstract Assessment of native cardiac output during extracorporeal circulation is challenging. We assessed a modified Fick principle under conditions such as dead space and shunt in 13 anesthetized swine undergoing..

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The next generation of evidence-based medicine

Abstract Recently, advances in wearable technologies, data science and machine learning have begun to transform evidence-based medicine, offering a tantalizing glimpse into a future of next-generation ‘deep’ medicine. Despite stunning..

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Albumin Infusion Reduces Fluid Loading for Postresuscitation Syndrome in a Pig Model of Refractory Cardiac Arrest Resuscitated With Venoarterial Extra…

Abstract Hemodynamic instability in postresuscitation syndrome worsens survival and neurological outcomes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) for refractory cardiac arrest might improve outcomes. Hemodynamical support under VA ECMO relies..

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Perioperative cerebral perfusion in aortic arch surgery: a potential link with neurological outcome

Abstract OBJECTIVES The aim of this study was to examine whether perioperative changes in cerebral blood flow (CBF) relate to postoperative neurological deficits in patients undergoing aortic arch surgery involving..

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Protamine dose to neutralize heparin at the completion of cardiopulmonary bypass can be reduced significantly without affecting post-operative bleeding

Abstract Background: Systemic anticoagulation with heparin during cardiopulmonary bypass (CPB) should be neutralized by protamine administration to restore normal hemostasis. Our previous study showed the protamine-to-heparin ratio (P-to-H) of 1:1..

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