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Beyond one-size-fits-all in cardiogenic shock: impella, extracorporeal membrane oxygenation or tailored use of mechanical circulatory support?

Abstract Purpose of review  This article offers an overview of recent randomized controlled trials (RCTs) testing the efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) and microaxial flow pump (mAFP)..

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Preoperative endothelial dysfunction for the prediction of acute kidney injury after cardiac surgery using cardiopulmonary bypass: a pilot study based…

Abstract Background Up to 42% of patients develop acute kidney injury (AKI) after cardiac surgery. The aim of this study was to describe the relationship between preoperative microcirculatory function and..

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Association Between Past and Present Operative Mortality in Congenital Heart Surgery: An Analysis of The Society of Thoracic Surgeons Congenital…

Abstract Background Mortality after congenital heart surgery is an important metric across benchmarking, quality, and reporting initiatives. All rely on estimates from prior years, and how well these reflect current..

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Protocol for the Use of Hemoperfusion in Cardiac Surgery

Abstract Hemoperfusion is a therapeutic method in which a large volume of the patient's blood is passed over an adsorbent material to remove toxins from the blood. Adsorption is a..

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Potential Predictors for Deterioration of Renal Function After Transfusion

Abstract BACKGROUND:  Transfusion of packed red blood cells (pRBCs) is still associated with risks. This study aims to determine whether renal function deterioration in the context of individual transfusions in..

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Cardiac Surgery-Associated Acute Kidney Injury in Neonates Undergoing the Norwood Operation: Retrospective Analysis of the Multicenter Neonatal and Pediatric Heart…

Abstract OBJECTIVES:  Cardiac surgery-associated acute kidney injury (CS-AKI) is associated with adverse outcomes. Single-center studies suggest that the prevalence of CS-AKI is high after the Norwood procedure, or stage 1..

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Severe coagulopathy and inflammation occurred after resection of giant right ventricular intimal sarcoma with cardiopulmonary bypass: a case report

Abstract Background Primary malignant cardiac tumors are rare in clinic, and surgical resection under cardiopulmonary bypass (CPB) remains the main treatment. The non-physiological perfusion process of CPB leads to contact activation,..

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Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention

Abstract Cardiopulmonary bypass (CPB) is a common technique in cardiac surgery but is associated with acute kidney injury (AKI), which carries considerable morbidity and mortality. In this review, we explore..

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Increased platelet to red blood cell transfusion ratio associated with acute kidney injury in children with life-threatening bleeding

Abstract Introduction Transfusion may increase the risk of organ failure through immunomodulatory effects. The primary objective of this study was to assess for patient or transfusion-related factors that are independently..

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Volatile sedation practices in patients with severe acute respiratory distress syndrome under VV-ECMO support

Abstract Veno‐venous extracorporeal membrane oxygenation (VV-ECMO) in severe acute respiratory distress syndrome (ARDS) can be lifesaving. In these cases, the complex brain-lung crosstalk might lead to a form of acute..

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Perioperative acetaminophen is associated with reduced acute kidney injury after cardiac surgery

Abstract Background Cardiac surgery–associated  (AKI) is associated with increased postoperative morbidity and mortality. Evidence suggests an association between perioperative  administration and decreased incidence of postoperative AKI in  cardiac surgery patients; however, an effect..

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Clinical decision making for VA ECMO weaning in patients with cardiogenic shock A formative qualitative study

Abstract Weaning and liberation from VA ECMO in cardiogenic shock patients comprises a complex process requiring a continuous trade off between multiple clinical parameters. In the absence of dedicated international..

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Evolution of distal limb perfusion management in adult peripheral venoarterial extracorporeal membrane oxygenation with femoral artery cannulation

Abstract Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in..

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Adaptive strategies used by surgical teams under pressure: an interview study among senior healthcare professionals in four major hospitals in…

Abstract Background Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians..

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Assessment of a goal-directed perfusion strategy through an oxygen delivery audit

Abstract Introduction Evidence supports the role of oxygen delivery (DO2) in ameliorating acute kidney injury (AKI). While instrumentation for continuous DO2 measurement exists, a simplified method has been reported for targeting..

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Can ChatGPT transform cardiac surgery and heart transplantation?

Abstract Artificial intelligence (AI) is a transformative technology with many benefits, but also risks when applied to healthcare and cardiac surgery in particular. Surgeons must be aware of AI and..

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What Are the Real Issues in Providing Extracorporeal Membrane Oxygenation (ECMO) Support: A Survey

Abstract Introduction By using a novel survey our study aimed to assess the challenges ECMO and Critical Care (CC) teams face when initiating and managing patient's ECMO support. Methods A..

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The knowledge gap on the ECMO gap: The importance of speaking the same language

Abstract We read with great interest the article by Zhang and colleagues : a single-center experience showing that although 48.8% of all extracorporeal membrane oxygenation (ECMO) patients are successfully decannulated..

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Is ultrafiltration volume a predictor of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass?

Abstract Introduction: Intraoperative ultrafiltration (UF) is a procedure used during cardiopulmonary bypass (CPB) to reduce haemodilution and prevent excessive blood transfusion. However, the effect of UF volume on acute kidney injury..

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Formal Ethics Consultation in Extracorporeal Membrane Oxygenation Patients: A Single-Center Retrospective Cohort of a Quaternary Pediatric Hospital

Abstract OBJECTIVE:  To examine characteristics associated with formal ethics consultation (EC) referral in pediatric extracorporeal membrane oxygenation (ECMO) cases, and document ethical issues presented. DESIGN:  Retrospective cohort study using mixed..

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A Dynamic Time-Series Model of Oxygen Consumption during Paediatric Cardiopulmonary Bypass

Abstract Background During cardiopulmonary bypass (CPB), maintaining adequate oxygen consumption (VO2i) can only be achieved indirectly either by modifying oxygen delivery (DO2i) through its component parts or by modulating metabolic demand..

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Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures

Abstract BACKGROUND:  Preoperative anemia is associated with adverse outcomes in cardiac surgery, yet it remains unclear what proportion of this association is mediated through red blood cell (RBC) transfusions. METHODS: ..

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Association between lactic acidosis and multiple organ dysfunction syndrome after cardiopulmonary bypass

Abstract Background The relationship between hyperlactatemia and prognosis after cardiopulmonary bypass (CPB) is controversial, and some studies ignore the presence of lactic acidosis in patients with severe hyperlactacemia. This study..

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Use of intraoperative haemoadsorption in patients undergoing heart transplantation: a proof-of-concept randomized trial

Abstract Aims The aim of this trial was to compare the clinical effects of intraoperative haemoadsorption versus standard care in patients undergoing orthotopic heart transplantation (OHT). Methods and results In..

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Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center

Abstract Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an emerging approach to cardiac arrest. We present two contrasting cases from a high-volume extracorporeal membrane oxygenation (ECMO) center (defined as greater than 30..

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Effect of Glutamine Administration After Cardiac Surgery on Kidney Damage in Patients at High Risk for Acute Kidney Injury: A…

Abstract BACKGROUND: Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with increased morbidity and mortality. However, no specific treatment options are available, emphasizing the..

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Creatinine Reduction Ratio Is a Prognostic Factor for Acute Kidney Injury following Cardiac Surgery with Cardiopulmonary Bypass: A Single-Center Retrospective…

Abstract Acute kidney injury (AKI) after cardiac surgery is a common complication that can lead to death. We previously reported that the creatinine reduction ratio (CRR) serves as a useful..

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European practices on antithrombotic management during percutaneous mechanical circulatory support in adults: A survey of the Association for Acute CardioVascular…

Abstract Background Bleeding and thrombotic complications compromise outcomes in patients undergoing percutaneous mechanical circulatory support (pMCS) with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and/or microaxial flow pumps like the Impella™...

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Randomized controlled trial of remote ischemic preconditioning in children having cardiac surgery

Abstract Background Children undergoing cardiac surgery are at risk for acute kidney injury (AKI) and cardiac dysfunction. Opportunity exists in protecting end organ function with remote ischemic preconditioning. We hypothesize..

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Venovenous Extracorporeal Membrane Oxygenation Candidacy Decision-Making

Abstract Background Use of venovenous extracorporeal membrane oxygenation (ECMO) is increasing, but candidacy selection processes are variable and subject to bias. Research Question What are the reasons behind venovenous ECMO..

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