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Implementation of the Kidney Disease Improving Global Outcomes guidelines for the prevention of acute kidney injury after cardiac surgery

Abstract BACKGROUND  Increasing evidence from randomised controlled trials supports the implementation of a six-measure care bundle proposed by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in patients at high..

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Assessing Risk Factors for Prolonged Intensive Care Unit Stay After Surgery for Adult Congenital Heart Disease: A Study From a…

Abstract Background Prolonged post-surgery intensive care unit (ICU) stay for congenital heart disease (CHD) has been explored in the pediatric population. However, there is limited data for adult CHD (ACHD),..

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Large volume acute normovolemic hemodilution in patients undergoing cardiac surgery with intermediate-high risk of transfusion: A randomized controlled trial

Abstract Study Objective: To investigate whether large volume acute normovolemic  (L-ANH), compared with moderate acute normovolemic  (M-ANH), can reduce perioperative allogeneic   with intermediate-high risk of transfusion during cardiac surgery with  (CPB). Design: Prospective . Setting:..

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Is Fasciotomy Associated With Increased Mortality in Extracorporeal Cardiopulmonary Resuscitation?

Abstract Our primary objective was to identify if fasciotomy was associated with increased mortality in patients who developed acute compartment syndrome (ACS) on extracorporeal cardiopulmonary resuscitation (ECPR). Additionally, we sought to identify any additional risk factors..

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Absolute Versus Relative Near-Infrared Spectroscopy in Pediatric Cardiac Patients

Abstract OBJECTIVES:  Near-infrared spectroscopy (NIRS) has been increasingly accepted as a noninvasive marker of regional tissue oxygenation despite concerns of imprecision and wide limits of agreement (LOA) with invasive oximetry. New generation absolute..

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“Beyond waking and walking. Intensive rehabilitation in patients requiring extended durations of advanced mechanical circulatory support: A case series”

Abstract Background: Physical therapy (PT) utilization in patients requiring mechanical circulatory support (MCS) and extracorporeal membrane oxygenation (ECMO) has been reported; however, little is known about intensive rehabilitation and associated..

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Deciding When to Start Renal Replacement Therapy After Cardiac Surgery in Real Life

Abstract Acute kidney injury (AKI) is a frequent complication of cardiac surgery that contributes to postoperative morbidity and mortality. The timing of renal replacement therapy (RRT) remains unclear. The Artificial..

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Perioperative Gelatin Use Is Associated With Increased Complication Rates and Does Not Prevent Postoperative Fluid Overload in Patients Undergoing Elective…

Abstract Objectives The benefit of using gelatin solution in cardiac surgery is still controversial. Previous data suggested adverse interactions of gelatin infusion with  (AKI) or . The purpose of this study was..

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Escalation and Withdrawal of Treatment for Patients on Extracorporeal Membrane Oxygenation

Abstract Objective:  The aim of this study was to describe decisions about the escalation and withdrawal of treatment for patients on extracorporeal membrane oxygenation (ECMO). Summary Background Data:  Interventions premised..

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The comparison of three different acute kidney injury classification systems after congenital heart surgery

Abstract Background We aimed to compare the frequency of acute kidney injury (AKI) and its effects on mortality and morbidity with different classification systems in pediatric patients who had surgery..

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Epidemiology of Neonatal Acute Kidney Injury After Cardiac Surgery Without Cardiopulmonary Bypass

Abstract Background The purpose of this Neonatal and Pediatric Heart and Renal Outcomes Network study was to describe the  and outcomes of cardiac surgery–associated  (CS-AKI) after cardiac surgery without  (non-CPB). Methods We performed..

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Cost-effectiveness of bivalirudin in pediatric ventricular assist devices

Abstract Background Despite recent data suggesting improved outcomes with bivalirudin vs heparin in pediatric Ventricular assist devices (VAD), higher costs remain a barrier. This study quantified trends in bivalirudin use..

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Skin colour affects the accuracy of medical oxygen sensors

Abstract The pulse oximeter is a device that estimates a person’s oxygen saturation level, a measure of the oxygen concentration in their blood, by shining light through their tissue, typically..

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Association of Preoperative Pulse Pressure and Oxygen Delivery Index During Cardiopulmonary Bypass With Postoperative Acute Kidney Injury

Abstract Objective To investigate if oxygen delivery index during  (DO2I) was more strongly associated with  (AKI), the higher the patient's preoperative pulse pressure (PP). Design Retrospective cohort of 1064 patients undergoing cardiac..

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Venovenous extracorporeal membrane oxygenation promotes alveolar epithelial recovery by activating Hippo/YAP signaling after lung injury

Abstract Background The preferred configuration for bridging patients with respiratory failure while awaiting  is venovenous  (VV ECMO). However, the protective effect of VV ECMO on the lung, as well as the underlying..

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Model to reduce waste in healthcare and add value

Introduction The startling revelation that one fifth of health expenditure makes little contribution to good health outcomes is surely a call to action to tackle waste in the delivery of care...

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Physiological adaptations during weaning from veno‑venous extracorporeal membrane oxygenation

Abstract Veno-venous extracorporeal membrane oxygenation (V–V ECMO) has an established evidence base in acute respiratory distress syndrome (ARDS) and has seen exponential growth in its use over the past decades...

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Addressing Patient Safety Hazards Using Critical Incident Reporting in Hospitals: A Systematic Review

Abstract Introduction  Critical incident reporting systems (CIRS) are in use worldwide. They are designed to improve patient care by detecting and analyzing critical and adverse patient events and by taking..

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Building cardiac surgical programs in lower-middle income countries

Abstract Objectives Medical care in low-income countries is often limited by inadequate resources, treatment facilities, and the necessary infrastructure for healthcare delivery. We hypothesized that the development of an independently..

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Diagnosis, pathophysiology and preventive strategies for cardiac surgery-associated acute kidney injury: a narrative review

Abstract Acute kidney injury (AKI) is a common and serious complication of cardiac surgery and is associated with increased mortality and morbidity, accompanied by a substantial economic burden. The pathogenesis..

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Extracorporeal membrane oxygenation in adults receiving haematopoietic cell transplantation: an international expert statement

Abstract Combined advances in haematopoietic cell transplantation (HCT) and intensive care management have improved the survival of patients with haematological malignancies admitted to the intensive care unit. In cases of..

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Physiological adaptations during weaning from veno-venous extracorporeal membrane oxygenation

Abstract Veno-venous extracorporeal membrane oxygenation (V–V ECMO) has an established evidence base in acute respiratory distress syndrome (ARDS) and has seen exponential growth in its use over the past decades...

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Simulators and Simulations for Extracorporeal Membrane Oxygenation: An ECMO Scoping Review

Abstract High-volume extracorporeal membrane oxygenation (ECMO) centers generally have better outcomes than (new) low-volume ECMO centers, most likely achieved by a suitable exposure to ECMO cases. To achieve a higher..

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Simulators and Simulations for Extracorporeal Membrane Oxygenation: An ECMO Scoping Review

Abstract High-volume extracorporeal membrane oxygenation (ECMO) centers generally have better outcomes than (new) low-volume ECMO centers, most likely achieved by a suitable exposure to ECMO cases. To achieve a higher..

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The ProtekDuo in ECMO configuration for ARDS secondary to COVID-19: A systematic review

Abstract Objective: Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19. Methods: Systematic literature search in NHS library,..

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Cardiopulmonary Bypass Emergencies and Intraoperative Issues

Abstract Cardiopulmonary bypass (CPB) is a complex biomechanical engineering undertaking and an essential component of cardiac surgery. However, similar to all complex bioengineering systems, CPB activities are prone to a..

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Perioperative Management of the Patient at High-Risk for Cardiac Surgery-Associated Acute Kidney Injury

Abstract Acute kidney injury (AKI) is one of the most common major complications of cardiac surgery, and is associated with increased morbidity and mortality. Cardiac surgery-associated AKI has a complex,..

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Medical nutrition therapy in patients receiving ECMO: Evidence-based guidance for clinical practice

Abstract Patients receiving extracorporeal membrane oxygenation (ECMO) inherit substantial disease-associated metabolic, endocrinologic, and immunologic modifications. Along with the technical components of ECMO, the aforementioned alterations may affect patients' needs and..

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Role of nebulized heparin in mechanically ventilated critically ill patients

Abstract Background  Mechanical ventilation is a technique for supporting or substituting respiration. Fibrin deposition in the pulmonary microcirculation and alveolar sacs (hyaline membrane generation) is a major inflammatory route of..

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The multifactorial dynamic perfusion index: A predictive tool of cardiac surgery associated acute kidney injury

Abstract Introduction Cardiac surgery associated acute kidney injury (CSA-AKI) has a number of preoperative and intraoperative risk factors. Cardiopulmonary bypass (CPB) factors have not yet been elucidated in a single..

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