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Depth of anesthesia, temperature, and postoperative delirium in children and adolescents undergoing cardiac surgery

Abstract Background After pediatric cardiosurgical interventions, postoperative delirium can occur, which can be associated with undesirable consequences during and after the hospital stay. It is therefore important to avoid any..

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Albumin and Cardioprotection in On-Pump Cardiac Surgery—A Post Hoc Analysis of a Randomized Trial

Abstract Objectives To study the quantitative potency of plasma albumin on cardioprotection in terms of creatinine kinase-myocardial band mass (CK-MBm) in on-pump cardiac surgery. Design Post hoc analysis of a..

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Cardiopulmonary Bypass Surgery-Cold Alert!

Abstract The term “cold agglutinin (CA)” refers to a group of disorders caused by anti-erythrocyte autoantibodies that preferentially bind RBCs at cold temperatures (4°C–18°C). CAs contribute to 10 to 15%..

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Does heparin rebound lead to postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass?

Abstract Background Heparin rebound is a common observed phenomenon after cardiac surgery with CPB and is associated with increased postoperative blood loss. However, the administration of extra protamine may lead..

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Successful Prehospital Extracorporeal Cardiopulmonary Resuscitation: A Comprehensive Case Report and Analysis of the Current Experience and Knowledge

Abstract This case report describes a prehospital extracorporeal cardiopulmonary resuscitation (ECPR) in a female patient who suffered a sudden cardiac arrest while shopping in a supermarket. The success of this..

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Error traps in Pediatric Patient Blood Management in the Perioperative Period

Abstract Patient blood management is a patient-centered evidence-based approach to improve patient outcomes by harnessing the patient's own hematopoietic system to optimize blood health while promoting patient safety and empowerment...

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Plasma Exosome Hemoglobin Released During Surgery Is Associated With Cardiac Injury in Animal Model

Abstract Background Patients with valvular heart disease require  and cardiac arrest. Here, we test the hypothesis that exosomal hemoglobin formed during  mediates acute cardiac injury in humans and in an animal model..

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Narrative Review of Systemic Inflammatory Response Mechanisms in Cardiac Surgery and Immunomodulatory Role of Anesthetic Agents

Abstract Although surgical techniques and perioperative care have made significant advances, perioperative mortality in cardiac surgery remains relatively high. Single- or multiple-organ failure remains the leading cause of postoperative mortality...

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Balloon atrial septostomy versus left atrial cannulation for left heart decompression in children with dilated cardiomyopathy and myocarditis on extracorporeal…

Abstract Introduction In children with myocarditis or dilated cardiomyopathy (DCM) on extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, it is often necessary to decompress the left heart to minimize distension..

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Acute Kidney Injury after Cardiac Surgery: Prediction, Prevention, and Management

Abstract Acute kidney injury (AKI) is a common complication in cardiac surgery patients, with a reported incidence of 20 to 30%. The development of AKI is associated with worse short-..

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Cardiopulmonary bypass management and risk of new-onset atrial fibrillation after cardiac surgery

OBJECTIVES Cardiopulmonary bypass (CPB) management may potentially play a role in the development of new-onset atrial fibrillation (AF) after cardiac surgery. The aim of this study was to explore this..

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State of the art: Monitoring of the respiratory system during veno-venous extracorporeal membrane oxygenation

Abstract Monitoring the patient receiving veno-venous extracorporeal membrane oxygenation (VV ECMO) is challenging due to the complex physiological interplay between native and membrane lung. Understanding these interactions is essential to..

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Cannula-Associated Deep Vein Thrombosis After Venovenous Extracorporeal Membrane Oxygenation in Patients with and Without Systemic Anticoagulation

Abstract Objective To identify and compare the rates of cannula-associated  (CaDVT)  on venovenous  (VV-ECMO) who receive systemic  (AC) and those who do not receive AC. Design Retrospective observational study. Setting Tertiary academic medical center...

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Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience

Abstract Background and Objectives: Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are..

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Association of intraoperative cerebral and somatic tissue oxygen saturation with postoperative acute kidney injury in adult patients undergoing multiple valve…

Abstract Background The association between tissue oxygenation with postoperative acute kidney injury (AKI) in adult patients undergoing multiple valve surgery has not been specifically studied. Methods In this prospective exploratory..

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Long-Term Outcomes of Valve-in-Valve Transcatheter Aortic Valve Implantation Versus Redo Surgical Aortic Valve Replacement: Meta-Analysis of Kaplan–Meier–Derived Data

Abstract Valve-in-valve (ViV)  (ViV-TAVI)  with failed bioprostheses arose as an alternative to redo surgical  (SAVR). To evaluate all-cause mortality in ViV-TAVI versus redo-SAVR, we performed a study-level meta-analysis of reconstructed time-to-event data from..

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Exposure to severe hyperoxemia worsens survival and neurological outcome in patients supported by veno-arterial extracorporeal membrane oxygenation: A meta-analysis

Abstract Background Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) is a rescue treatment in refractory cardiogenic shock (CS) or refractory cardiac arrest (CA). Exposure to hyperoxemia is common during VA-ECMO, and its..

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Extracorporeal membrane oxygenation in diabetic ketoacidosis-related cardiac and respiratory failure

Abstract Introduction: Diabetic ketoacidosis (DKA) is a common clinical problem. When patients develop severe shock and/or respiratory failure, extracorporeal membrane oxygenation (ECMO) may be considered. This case series describes the..

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Red Blood Cell Transfusion Guided by Hemoglobin Only or Integrating Perfusion Markers in Patients Undergoing Cardiac Surgery: A Systematic Review…

Abstract Objective Strategies for red blood cell (RBC) transfusion in patients undergoing cardiac surgery have been traditionally anchored to hemoglobin (Hb) targets. A more physiologic approach would consider markers of..

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Systematic Assessment of Shock Severity in Postoperative Cardiac Surgery Patients

Abstract Background The Society for Cardiovascular  and Interventions (SCAI)  classification has been shown to provide robust mortality  in a variety of cardiovascular patients. Objectives This study sought to evaluate the SCAI  classification in postoperative..

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Characterizing the Racial Discrepancy in Hypoxemia Detection in VV-ECMO: An ELSO Registry Analysis

Abstract Importance: Skin pigmentation influences peripheral oxygen saturation (SpO2) measured by pulse oximetry compared to the arterial saturation of oxygen (SaO2) measured via arterial blood gas analysis. However, data on..

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Is cardioplegia system pressure the optimal measure of coronary perfusion during antegrade cardioplegia delivery? A critical review of pressure measurements…

Abstract Antegrade cardioplegia is routinely given during cardiac surgery. The delivery of antegrade cardioplegia from the cardiopulmonary bypass machine has many variables. Many perfusionists rely exclusively on cardioplegia system pressure..

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Factors determining safety culture in hospitals: a scoping review

Abstract Objective To evaluate and synthesise the factors determining patient safety culture in hospitals. Methods The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were..

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Oxygenation During Venoarterial Extracorporeal Membrane Oxygenation: Physiology, Current Evidence, and a Pragmatic Approach to Oxygen Titration

Abstract OBJECTIVES:  This review aims to: 1) identify the key circuit and patient factors affecting systemic oxygenation, 2) summarize the literature reporting the association between hyperoxia and patient outcomes, and..

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Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin

Abstract Objectives We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO). Methods We performed a retrospective cohort study of..

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Prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis of non-pharmacological interventions

Abstract Background Cardiac surgery-associated acute kidney injury (CSA-AKI) is frequent. While two network meta-analyses assessed the impact of pharmacological interventions to prevent CSA-AKI, none focused on non-pharmacological interventions. We aim..

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Left Ventricular Unloading With Impella Versus IABP in Patients With VA-ECMO: A Systematic Review and Meta-Analysis

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) use for circulatory support in cardiogenic shock results in increased left ventricular (LV) afterload. The use of concomitant Impella or intra-aortic balloon pump (IABP)..

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Central venous-to-arterial CO2 difference as a biomarker of outcome in children who underwent surgery for congenital heart disease

Abstract Background: In congenital heart surgery, low cardiac output syndrome (LCOS) is a major cause of morbidity in the immediate post-operative period. A decrease in cardiac output leads to an increase..

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Renal medullary oxygenation during laparoscopic vs open surgery: the impact of blood pressure management—a pilot randomized controlled trial

Abstract The impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation (PuO2), a validated surrogate of renal medullary PO2, during general surgery, is unclear...

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Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: 10-year experience in a metropolitan cardiac arrest centre in Milan, Italy

Abstract Introduction Growing evidence supports  cardiopulmonary resuscitation (ECPR) for refractory out-of-hospital cardiac arrest (OHCA) patients, especially in experienced centres. We present characteristics, , and outcomes of patients treated with ECPR in a..

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