Yearly Archives: 2025

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Implementing lean six sigma to optimize emergency extracorporeal cardiopulmonary resuscitation process management

Abstract Objective The aim of this study is to evaluate the effectiveness of lean six sigma management in optimizing the emergency extracorporeal cardiopulmonary resuscitation (ECPR) rescue process. Methods The existing..

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Innovations in Risk Assessment, Monitoring, and Management in Cardiothoracic and Vascular Anesthesia

Abstract As the perioperative care in cardiothoracic and vascular anesthesia continues to evolve, more emphasis is being placed on developing innovative methods for risk assessment and early detection of operative..

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Cell-free hemoglobin is associated with microcirculatory perfusion disturbances and acute kidney injury in rats on extracorporeal membrane oxygenation

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment, but carries a high risk of complications such as acute kidney injury (AKI). A contributor to AKI is hemolysis, which..

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Optimising cardiac surgery outcomes in people with diabetes: the OCTOPuS pilot feasibility study

Abstract Background Surgical outcomes are worse in people with diabetes, in part, because of the effects of hyperglycaemia, obesity and other comorbidities. Two important uncertainties in the management of people..

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Optimizing Tranexamic Acid Use in Adult Cardiac Surgery: From Rationale to Clinical Practice

Abstract  (TXA) has emerged as a cornerstone in blood conservation strategies for cardiac surgery. This comprehensive review synthesizes current evidence on TXA's efficacy, safety, and optimal use in various cardiac..

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How I Do It: Donation After Circulatory Death With Normothermic Regional Perfusion in Small Babies

Abstract Background: The gold standard for treatment of patients with end-stage heart failure remains . Time spent on the active waiting list, notably for  patients, contributes to alarmingly high mortality. Donation after..

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Liberal or restrictive transfusion for veno-arterial extracorporeal membrane oxygenation patients: a target trial emulation using the OBLEX study data

Abstract Background The optimal transfusion threshold for patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) remains uncertain. Methods We used data from OBLEX (ClinicalTrials.gov: NCT03714048), an international, prospective, observational study conducted..

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Assessment of Renal Vein Flow Index by Transesophageal Echocardiography: Precision, Variability, and Association with Cardiac Index During Cardiac Surgery

Abstract Objectives Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent and important complication often attributed to decreased kidney blood flow. Ultrasound measurement of renal  has been associated with adverse cardiac..

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Sarcoplasmic reticulum-mitochondria microdomains: hugging and kissing in the heart

Abstract Endoplasmic reticulum (ER)-mitochondrial (ER-Mito) interface, termed mitochondrial-ER contacts (MERCs), plays significant roles in the maintenance of bioenergetics and basal cell functions via the exchange of lipids, Ca2+, and reactive..

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Description and Management of Cardiac Arrests in Congenital Cardiac Patients Undergoing Cardiac Surgery, Cardiac Catheterization, and Cardiac Imaging

Abstract Objective To describe cardiac arrest during anesthesia care provided by a pediatric cardiac anesthesiologist in patients with congenital heart disease and identify predictors of outcome. Design Retrospective chart review...

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Extracorporeal CPR Performance Metrics in Adult In-Hospital Cardiac Arrest: A Stepwise and Evidence-Based Appraisal of the VA-ECMO Implementation Process

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an established intervention for select patients experiencing refractory cardiac arrest. Among modifiable predictors of survival and neurologic recovery during ECPR implementation, timely restoration of..

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Anticoagulation Monitoring During Extracorporeal Membrane Oxygenation: A Narrative Review

Abstract The advancement of  has introduced a new dimension to managing patients who do not respond to conventional treatment of severe .  (ECMO) is a specialized temporary life support that serves as a..

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Early alpha power in the frontal lobe area can predict delirium after cardiac surgery

Abstract Background Delirium is a common postoperative complication in patients undergoing cardiac surgery and is associated with prolonged hospitalization and persistent cognitive impairment. This study aimed to assess the predictive..

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Analysis of Risk Factors for Heparin Resistance During Cardiac Surgery: Does Antithrombin Deficiency Cause Heparin Resistance?

Abstract Objectives To determine whether heparin resistance (HR) occurring during  (CPB) is associated with  (antithrombin III) activity. Design Retrospective review of data collected prospectively in a single center. Setting A tertiary referral..

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Unsupervised machine learning to explore inflammation following cardiopulmonary bypass

Abstract Introduction Cardiac surgery with cardiopulmonary bypass (CPB) often induces systemic inflammatory reaction syndrome (SIRS), affecting postoperative outcome. We aimed to explore adaptive/maladaptive inflammation using unsupervised machine learning. Methods We..

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Survival After Amniotic Fluid Embolism and Extracorporeal Membrane Oxygenation Support

Abstract Background Amniotic fluid embolism is a rare potential complication in the peripartum period. Case Summary A 27-year-old nulliparous woman presented for elective induction at 41 weeks' gestation. Due to..

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The dynamic interplay between endothelial reactivity, temperature, and vascular resistance in cardiopulmonary bypass

Abstract Cardiopulmonary bypass serves as a cornerstone in cardiac surgery, enabling life-sustaining circulatory and respiratory support during complex procedures that necessitate the temporary cessation of cardiac activity. This intricate process..

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“When I walk away and wonder, did I make the best decision?”: A decisional needs assessment among providers involved in…

Abstract Purpose Extracorporeal cardiopulmonary resuscitation (ECPR) is an advanced resuscitation therapy for cardiopulmonary arrest refractory to standard CPR. ECPR treatment recommendations are not supported by strong evidence, and institutional criteria..

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The Effects of Preoperative Resting Blood Pressure and Nighttime Blood Pressure on the Associations between Perioperative Blood Pressures and Postoperative…

Abstract Objectives To describe the associations between perioperative blood pressures and clinical postoperative outcomes, and to investigate if these associations depend on the preoperative resting and nadir nighttime blood pressures...

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Prone positioning and bleeding risk during extracorporeal membrane oxygenation in severe ARDS patients

Abstract Purpose To assess whether prone positioning (PP) increases bleeding risk compared to supine positioning in ARDS patients undergoing veno venous Extracorporeal Membrane Oxygenation (VV ECMO). Materials and Methods A..

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The role of acute normovolemic hemodilution and retrograde autologous priming in reducing intraoperative packed red blood cell transfusion needs in…

Abstract Background Acute normovolemic hemodilution (ANH) and retrograde autologous priming (RAP) are blood conservation techniques designed to reduce transfusion requirements. Purpose This study evaluated the impact of combining ANH and..

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Removal of EpCAM-positive tumor cells during intraoperative blood salvage– A pivotal multicenter clinical study (REMOVE)

Abstract Background Intraoperative blood salvage can reduce the need for allogeneic blood transfusions, minimizing immunological risks and infection by reusing the patient's own blood. However, in cancer surgery, a key..

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Hyperoxia and acute brain injury

Abstract We read the interesting work of Romero‑Garcia and colleagues on the association between partial pressure of O2 in arterial blood (PaO2) and neurological outcomes in a context of acute brain..

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Incidence, Risk Factors, and Outcomes of Seizures in Extracorporeal Cardiopulmonary Resuscitation Patients: An Analysis of the Extracorporeal Life Support Organization…

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest is increasing in usage, but risk factors for seizures are largely unknown. We included adult ECPR patients in the Extracorporeal Life..

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Inflammatory Markers During Extracorporeal Membrane Oxygenation in Neonates With Congenital Diaphragmatic Hernia

Abstract This study aimed to assess whether the proinflammatory markers procalcitonin (PCT), C-reactive protein (CRP), or interleukin 6 (IL-6) are associated with mortality in neonates with congenital diaphragmatic hernia (CDH)..

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Investigating optimal drainage cannula for venovenous extracorporeal membrane oxygenation: impact of side holes on blood oxygenation – an in vitro…

Abstract Venovenous extracorporeal membrane oxygenation (VV ECMO) relies on effective blood drainage, and cannula design plays a crucial role in optimizing blood oxygenation. Recirculation, where oxygenated blood returns to the..

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A Miniaturized Centrifugal Pump ECMO System Enhances Hemocompatibility in Small Animal Models

Abstract Extracorporeal membrane oxygenation (ECMO) is a fundamental treatment for cardiovascular and severe pulmonary diseases, with small animal models providing critical insights into organ protection during cardiopulmonary bypass and ECMO..

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The impact of antithrombin III supplementation on prognosis during extracorporeal membrane oxygenation: a systematic review and meta-analysis

Abstract Extracorporeal membrane oxygenation (ECMO) is a mechanical circulatory and respiratory support system that facilitates gas exchange and hemodynamic stabilization through an external circuit. ECMO has been increasingly utilized for..

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Extracorporeal Membrane Oxygenation in Pregnancy: An Analysis of the Extracorporeal Life Support Organization Registry

Abstract Objectives:  We examined data from the International Registry of the Extracorporeal Life Support Organization to identify risk factors for mortality in pregnant and peripartum patients receiving extracorporeal membrane oxygenation...

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An intraoperative nightmare: sudden bilateral lower limb malperfusion during type A acute aortic dissection surgery

Abstract Lower limb malperfusion for type A acute aortic dissection (ATAAD) is a challenging complication, particularly when it occurs suddenly during the operation. We report a 76‐year‐old female with ATAAD..

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