Monthly Archives: junio 2026

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The Gut Microbiome in Congenital Heart Disease: Dysbiosis, Intestinal Barrier Injury, and Translational Opportunities Across the Childhood—A Narrative Review

Abstract Congenital heart disease (CHD) is the most common congenital anomaly worldwide and is associated with substantial infant morbidity and mortality. This narrative review synthesizes evidence linking CHD to alterations..

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On-Scene, Residential Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest: Operational and Logistical Considerations

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging rescue strategy for select patients with refractory out-of-hospital cardiac arrest (OHCA). Mobile ECPR programs aim to reduce low-flow time by initiating extracorporeal..

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The hemodynamics of tracheal intubation in critically ill patients: a narrative review

Abstract Background Tracheal intubation is a ubiquitous but high-risk procedure in critically ill patients, often required in the setting of severe hypoxemia, shock, or metabolic acidosis. Despite being a life-saving..

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Next generation spray-dried on-demand plasma: A multicenter, randomized, dose-escalation, first-in-human safety study

Abstract Background Prehospital plasma transfusion for patients at risk of hemorrhagic shock reduces mortality, but cold-chain and logistical constraints limit product availability. This study reports the first-in-human clinical evaluation of..

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Exploring carboxyhemoglobin as a predictive marker of hemolysis-related CSA-AKI

Abstract Background Cardiac surgery–associated acute kidney injury (CSA-AKI) is one of the most frequent complications after cardiopulmonary bypass (CPB), in which hemolysis plays an important pathophysiological role. Carboxyhemoglobin (COHb) plays..

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Oxygenator failures during cardiopulmonary bypass lead to associated injury patterns

Abstract Background Cardiopulmonary bypass (CPB) oxygenators provide essential intra-operative gas exchange. Although rare, CPB oxygenator failures can cause catastrophic morbidity and mortality, and published analyses of CPB-specific oxygenator failures are..

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Fatigue risk management in healthcare: A scoping literature review

Abstract Background Occupational fatigue among healthcare professionals is a complex, multifaceted issue associated with increased likelihood of medical error, compromised patient safety and negative impacts on staff mental and physical..

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Anticoagulation Changes and Biochemical Signals Preceding Hospital-Acquired Infections in Pediatric Extracorporeal Support

Abstract Hospital-acquired infection (HAI) is a major complication in pediatric patients on extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Infection detection is challenging, as traditional inflammatory markers..

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Lighting in intensive care units: A systematic review of patient outcomes and directions for future research

Abstract Objectives Patients admitted to ICUs are frequently exposed to disrupted light–dark cycles due to limited daylight exposure and inappropriate electrical lighting in terms of intensity, duration, timing, and spectral..

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Interactive ECMO Simulation Webinar: Managing Refractory Hypoxemia in Real Time - July 29

Managing refractory 𝐡𝐲𝐩𝐨𝐱𝐞𝐦𝐢𝐚 𝐨𝐧 𝐕𝐕 𝐄𝐂𝐌𝐎 isn't just about protocols— it's about making the right decisions at the right time. Join this live interactive 𝐄𝐂𝐌𝐎 𝐬𝐢𝐦𝐮𝐥𝐚𝐭𝐢𝐨𝐧 𝐰𝐞𝐛𝐢𝐧𝐚𝐫 and gain practical..

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Microcirculatory effects of cardiopulmonary bypass primings in coronary artery bypass graft surgery the prime randomised clinical trial for a physiological…

Abstract Objectives Cardiopulmonary bypass (CPB) impairs endothelial function, causing oedema and disturbed microcirculatory perfusion, that contribute to organ dysfunction following cardiac surgery. We hypothesised that the composition of CPB prime..

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Patient Blood Management: a systematic review of current international guidelines

Abstract Background Patient Blood Management (PBM) is a multidisciplinary strategy to optimise patient outcomes by preserving autologous blood and reducing unnecessary transfusion. Although PBM initiatives exist worldwide, the consistency of..

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Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Cardiac Catheterization Laboratory: Incidence, Risk Scoring, and Outcomes

Abstract Pediatric patients undergoing cardiac catheterization are at risk of major adverse events, including cardiac arrest and the need for extracorporeal membrane oxygenation support. The primary aim of this study..

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Hemodynamic-guided V-A ECMO management for cardiogenic shock: Insight from initial experience from TWEET study (to wean an ECMO trials)

Abstract Background Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used for refractory cardiogenic shock, yet optimal weaning strategies and the role of left ventricular (LV) venting remain unclear. The TWEET-1..

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Perioperative Inflammation and Immune Response in Anesthesia: Implications for Recovery and Postoperative Outcomes

Abstract This review explores the regulatory mechanism of anesthesia on the perioperative immune response and its impact on postoperative recovery and complications in patients. Surgical trauma can activate the body's..

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How To Dose Prothrombin Complex Concentrates in Bleeding Patients After Cardiac Surgery

Abstract Coagulopathy, bleeding, and transfusion of allogeneic blood products remain major concerns in a relevant portion of patients undergoing cardiac surgery, and all of them have been associated with increased..

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Nutrition provision across acute hospitalization in adult patients receiving extracorporeal membrane oxygenation: A prospective multicenter observational, registry-embedded study

Abstract Background Patients receiving extracorporeal membrane oxygenation (ECMO) are considered nutritionally vulnerable, with previous studies focussed on Intensive Care Unit (ICU) admission alone. We aimed to address this gap by..

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Efficacy of universal genome sequencing in infant extracorporeal membrane oxygenation

Abstract Objective To evaluate the feasibility and diagnostic yield of universal genome sequencing (GS) in infants receiving extracorporeal membrane oxygenation (ECMO). Study design Prospective multicenter study across eight Children’s Hospital..

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Optimal metrics for assessing the climatic impact of volatile anaesthetics

Abstract Anthropogenic climate change is evident, and its impacts are being felt around the globe. The World Health Organization (WHO) recently revealed that approximately one in four deaths can be..

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AI-induced never-skilling in medical education

Abstract The integration of artificial intelligence (AI) into medical training is accelerating faster than the educational frameworks designed to govern it. This Perspective identifies a risk that has received insufficient..

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Transfusion of blood products to neonatal and pediatric extracorporeal membrane oxygenation patients: A prospective, observational study

Abstract Study Question To describe the blood product utilization during neonatal and pediatric extracorporeal membrane oxygenation (ECMO) and to determine whether its usage correlates with clinical outcomes of bleeding, thrombosis..

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Antidotes for Anticoagulation Reversal

Abstract The global rise in anticoagulant use has increased the number of major bleeding events that warrant timely and effective pharmacologic reversal. Reversal strategies should be informed by the pharmacodynamic..

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Early Neurodevelopmental Outcomes in Children With Congenital Heart Disease

Abstract Importance  Neurodevelopmental impairments are common in children with congenital heart disease. Objectives  To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes..

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CytoSorb® haemoadsorption in high-risk cardiac surgery: A focused review with proposed tiered patient selection

Abstract Cardiopulmonary bypass (CPB) activates a well-characterised systemic inflammatory response that contributes substantially to postoperative morbidity and mortality, particularly in high-risk patient subgroups. CytoSorb® (CytoSorbents Corporation, Princeton, NJ) is a..

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The Role of Cytokines in Vascular Endothelial Glycocalyx Integrity and Impairment Following Open-Heart Surgery

Abstract Open-heart surgery with cardiopulmonary bypass (CPB) is a high-risk procedure with significant morbidity and mortality. CPB, tissue injury, blood loss, endotoxemia and ischemia–reperfusion injury induce a pronounced systemic inflammatory..

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Adverse events as key risk factors for in-hospital mortality in intensive care units

Abstract Introduction Intensive care units (ICUs) represent high-risk environments for adverse events (AEs). Preventing these events requires a solid understanding of their epidemiology based on standardized and validated methodologies. The..

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Mechanical Ventilation and Extracorporeal Membrane Oxygenation in Acute Respiratory Insufficiency

Abstract Background: Invasive ventilation saves lives but carries major risks, including ventilation-associated lung damage and long-term functional impairment. Data from recent studies compel reassessment of the evidence for every step of..

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Nitric Oxide–Releasing Surfaces Reduce Thrombosis in Venovenous Extracorporeal Life Support: A 5 day Long Ovine Study

Abstract Extracorporeal life support (ECLS) components designed to reduce clot formation have been developed, but thrombosis remains a significant challenge, requiring systemic anticoagulation. To address this, we evaluated a nitric..

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Topical use of tranexamic acid for antifibrinolysis in cardiac surgery with cardiopulmonary bypass: a randomized clinical study

Abstract Objective To assess the non-inferiority of topical intrapericardial tranexamic acid (TXA) versus intravenous TXA for efficacy and safety in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods In..

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The case for washing red blood cells and platelets – A concise review of donors, processes, and products

Abstract Transfusions are one of the most common procedures performed in the hospital setting, but the frequency of adverse events is often not recognized. These transfusion adverse events include transfusion..

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