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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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Outcomes of Venovenous Extracorporeal Membrane Oxygenation in Viral Acute Respiratory Distress Syndrome

Abstract Our study assessed the relationship between the duration of venovenous extracorporeal membrane oxygenation (V-V ECMO) and patient outcomes. We studied patients undergoing V-V ECMO support for acute respiratory distress..

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Pre-operative kidney biomarkers and risks for death, cardiovascular and chronic kidney disease events after cardiac surgery: the TRIBE-AKI study

Abstract Background Soluble tumor necrosis factor receptor (sTNFR)1, sTNFR2, and plasma kidney injury molecule-1 (KIM-1) are associated with kidney events in patients with and without diabetes. However, their associations with..

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Implementing change in the care of the complex cardiac patient

Abstract Purpose of review  Development of advanced and minimally invasive surgical procedures is providing treatment opportunities to older and higher risk patients. This has also led to highly specialized physicians..

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VV-ECMO in severe COVID-19: multidimensional perspectives on the use of a complex treatment

Abstract Accurately selecting patients who are likely to benefit from venovenous extracorporeal membrane oxygenation (VV-ECMO) for severe respiratory failure is crucial given its low availability, substantial invasiveness, associated complications, and..

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Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation

Abstract The concept of “prehabilitation” consists of screening for and identification of pre-existing disorders followed by medical optimization. This is performed for many types of surgery, but may have profound..

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Does Root Cause Analysis Improve Patient Safety? A Systematic Review at the Department of Veterans Affairs

Abstract Background and Objectives:  While root cause analysis (RCA) is used to analyze medical errors with a systems approach, evidence demonstrating its effectiveness in reducing patient harm remains sparse. The..

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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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Medical Nutrition Therapy in ECMO Patients: 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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Recurrent Candidemia Due to Extracorporeal Membrane Oxygenation Circuit Seeding in Acute Respiratory Distress Syndrome From COVID-19

Abstract Nosocomial infections are a leading complication of prolonged extracorporeal membrane oxygenation (ECMO) therapy, and invasive fungal infections are of particular concern. Candida bloodstream infection specifically is associated with poor outcomes in acute..

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Parameters associated with successful weaning of veno‑arterial extracorporeal membrane oxygenation: a systematic review

Abstract Purpose: Veno‑arterial (VA) extracorporeal membrane oxygenation (ECMO) can be used to restore organ perfusionin patients with cardiogenic shock until native heart recovery occurs. It may be challenging, however, to..

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Why identifying adverse events in paediatric emergency care matters

Abstract The emergency department (ED) abounds with hazards that might lead to adverse events (AEs). Clinicians must make frequent, high-consequence decisions with high diagnostic uncertainty as part of ad hoc..

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Positive results presented from the Australian & New Zealand heart preservation study

Abstract Earlier this month, Professor David Kaye of The Alfred in Melbourne, Australia, presented late breaking science at the American Heart Association (AHA) 2022 meeting in Chicago from an ongoing..

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Acute Kidney Injury With a Miniaturized Extracorporeal Circuit for Neonatal Cardiopulmonary Bypass

Abstract Objectives The objectives of this study were to evaluate the incidence and to identify risk factors for acute kidney injury (AKI) in neonates undergoing cardiopulmonary bypass (CPB) with a..

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Unloading the left ventricle in venoarterial extracorporeal life support: The urgent need of speaking the same language!

Abstract We have read the review article entitled “Controversies in ECMO: Immediate versus Watchful Waiting for VA-ECMO Venting” by Cavayas and colleagues, published in the Special Issue of Invited Presentations:..

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Higher Mean Arterial Pressure during Cardiopulmonary Bypass May Not Prevent Acute Kidney Injury in Elderly Patients Undergoing Cardiac Surgery

Abstract We aimed to evaluate the role of higher mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) in preventing development of acute kidney injury (AKI).  Methods. We evaluated a population..

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