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Debates in cardiac CT: Coronary CT angiography is the best test in asymptomatic patients

Abstract Cardiovascular disease remains a major cause of mortality, accounting for a third of all global deaths annually. Although there have been major improvements in our ability to detect and..

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Paraprotein associated heparin resistance during cardiopulmonary bypass

Abstract Introduction Heparin resistance during cardiopulmonary bypass poses a significant intraoperative dilemma. Antithrombin deficiency related heparin resistance is well described, but less common causes are still poorly understood and inadequately..

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Thrombus formation during ECMO: Insights from a detailed histological analysis of thrombus composition

Abstract Objectives Intra-device thrombosis remains one of the most common complications during extracorporeal membrane oxygenation (ECMO). Despite anticoagulation, approximately 35% of patients develop thrombi in the membrane oxygenator, pump heads,..

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Venoarterial Extracorporeal Membrane Oxygenation in Severe Drug Intoxication: A Retrospective Comparison of Survivors and Nonsurvivors

Abstract Selecting patients most likely to benefit from venoarterial extracorporeal membrane oxygenation (V-A ECMO) to treat refractory drug-induced cardiovascular shock remains a difficult challenge for physicians. This study reported short-term..

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Epidemiology of persistent postoperative opioid use after cardiac surgery: a systematic review and meta-analysis

Abstract Background The epidemiology of persistent postoperative opioid use at least 3 months after cardiac surgery is poorly characterised despite its potential public health importance. Methods We searched MEDLINE, Embase,..

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Titrated versus conventional anticoagulation management for thrombin generation in cardiac surgery: a randomized controlled trial

Abstract Purpose Optimal heparin titration during cardiopulmonary bypass (CPB) may reduce coagulation system activation and preserve hemostatic function post-CPB. Our objective was to assess if the Heparin Management System (HMS)..

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Implementing Root Cause Analysis and Action: Integrating Human Factors to Create Strong Interventions and Reduce Risk of Patient Harm

Abstract Objectives  The goal of this study was to develop a systems approach for root cause analysis and action to achieve strong, sustainable interventions. The team integrated human factors principles into the..

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Venting during venoarterial extracorporeal membrane oxygenation

Abstract Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering..

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Effect of High- vs Low-Dose Tranexamic Acid Infusion on Need for Red Blood Cell Transfusion and Adverse Events in Patients…

Abstract Importance  Tranexamic acid is recommended for reducing blood loss and transfusion in cardiac surgery. However, it remains unknown whether a high dose of tranexamic acid provides better blood-sparing effect than..

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Hemoperfusion in the intensive care unit

Abstract Multiple organ failure following a septic event derives from immune dysregulation. Many of the mediators of this process are humoral factors (cytokines), which could theoretically be cleared by direct..

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The HeartMate 6

Abstract The need for biventricular support poses significant challenges for patients who require a mechanical bridge to transplantation. Recent improvements in ventricular assist device (VAD) technology has made possible the..

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Perioperative Management of Bleeding and Transfusion for Lung Transplantation

Abstract Perioperative allogeneic blood product transfusion is common in lung transplantation and has various implications on the short- and long-term outcomes of lung recipients. This review summarizes the effect of..

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Management of perioperative bleeding risk in patients on antithrombotic medications undergoing cardiac surgery—a systematic review

Abstract Background: Antithrombotic drugs increase the risk of bleeding, especially in patients who need urgent surgery without an adequate wash-out period. This review aims to evaluate perioperative bleeding complications in..

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Survival and Factors Associated with Survival with Extracorporeal Life Support During Cardiac Arrest: A Systematic Review and Meta-Analysis

Abstract The survival rate after cardiac arrest (CA) remains low. The utilization of extracorporeal life support is proposed to improve management. However, this resource-intensive tool is associated with complications and..

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EVALUATING INTERFACILITY ECMO TRANSFER OUTCOMES BY CANNULATION LOCATION AND MODE OF TRANSPORT

Abstract A study published in March 2022 evaluated complications and in-hospital mortality in patients treated with Venovenous (VV) ECMO based on cannula locations and transport mode. The manuscript, written by..

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Impact of cardiopulmonary bypass duration on efficacy of fibrinogen replacement with cryoprecipitate compared with fibrinogen concentrate: a post hoc analysis…

Abstract Background Coagulopathy in cardiac surgery is frequently associated with acquired hypofibrinogenaemia, which can be treated with either purified fibrinogen concentrate (FC) or cryoprecipitate. Because the latter is not purified..

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Recent advancements in pediatric cardiopulmonary bypass technology for better outcomes of pediatric cardiac surgery

Abstract Background Pediatric cardiac surgery is in itself very enigmatic and individualized. Presently, there has been a slew of new developments aimed primarily toward pediatric cardiopulmonary bypass for safer, patient-centered..

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Incidence and outcome of anaphylaxis in cardiac surgical patients

Abstract Introduction:  Anaphylaxis is a rare but serious and potentially fatal complication of anesthesia. Little is known about the incidence and outcome of anaphylaxis in cardiac surgical patients, which we..

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Awake extracorporeal life support and physiotherapy in adult patients: A systematic review of the literature

Abstract Objective The Awake Extracorporeal Life Support (ECLS) practice combined with physiotherapy is increasing. However, available evidence for this approach is limited, with unclear indications on timing, management, and protocols...

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Intraoperative Hypotension–Physiologic Basis and Future Directions

Abstract Intraoperative hypotension (IOH) is a major concern to the anesthesiologist. Its appropriate identification and management require an understanding of the physiology of blood pressure regulation, prudent blood pressure monitoring,..

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First Transcatheter TricValve System Implanted for Tricuspid Regurgitation in North America

Abstract In February 2022, Cleveland Clinic interventional cardiologists performed the first implantation of the TricValve® Transcatheter Bicaval Valves System in a patient in North America. The successful case, completed in an..

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Imaging the acute respiratory distress syndrome: past, present and future

Abstract In patients with the acute respiratory distress syndrome (ARDS), lung imaging is a fundamental tool in the study of the morphological and mechanistic features of the lungs. Chest computed..

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Reliability of the Minto model for target-controlled infusion of remifentanil during cardiac surgery with cardiopulmonary bypass

Abstract Background The Minto pharmacokinetic model is used for target-controlled infusion of remifentanil. The reliability of this model has never been evaluated during normothermic cardiac surgery with cardiopulmonary bypass (CPB)...

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Deliberate practices of speaking up and responding skills: the Speak-PREP e-learning module for healthcare professionals

Abstract Purpose Speaking up and responding to others’ concerns promotes patient safety. We describe health professionals’ utilisation of these important skills. Method We developed an interactive e-learning module, Speak-PREP, to train healthcare..

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Veno-arterial extracorporeal membrane oxygenation without allogeneic blood transfusion: An observational cohort study

Abstract Introduction It remains unclear whether patients who will not accept allogeneic blood transfusion can be managed successfully with veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO). The objective of our study..

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Cardiac Arrest, E-CPR, & Post-Arrest Care with Dr. Jason Bartos

Abstract Approximately 350,000 adults per year in the US experienced out-of-hospital cardiac arrest (OHCA). Only about 10% of such patients survive their initial hospitalization. The key drivers of successful resuscitation..

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Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery

Abstract Objective Custodiol® and St. Thomas cardioplegia are widely employed in mini-thoracotomy mitral valve (MV) operations. One-dose of the former provides 3 h of myocardial protection. Conversely, St. Thomas solution is..

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Nosocomial infections during extracorporeal membrane oxygenation

Abstract Purpose of the review  The aim of this review is to present the latest evidence regarding the prevention, diagnosis and treatment of nosocomial infections during extracorporeal membrane oxygenation (ECMO)..

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Central venous pressure (CVP)

Abstract Until recently, the central venous pressure (CVP) was the preferred variable to guide fluid therapy [1]. The interest for CVP has declined in the last few years, mainly after..

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Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine

Abstract Aim  Head and thorax elevation during cardio-pulmonary resuscitation improves cerebral hemodynamics and ultimate neurological outcome after cardiac arrest. Its effect during extracorporeal cardiopulmonary resuscitation (E-CPR) is unknown. We tested..

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