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Re-dosing of del Nido cardioplegia in adult cardiac surgery requiring prolonged aortic cross-clamp

Abstract Objectives: Few data exist on the use of del Nido cardioplegia in adults, specifically during operations requiring prolonged aortic cross-clamp. In this pilot study, we evaluate outcomes of patients undergoing..

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Kinetics of tissue oxygenation index during fast and slow cardiopulmonary bypass initiation

Abstract Introduction Despite being a daily clinical application in cardiac operating theaters, an evidence-based approach on how to optimally initiate the heart–lung machine (HLM) to prevent critical phases of cerebral..

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Hemodynamics of small arterial return cannulae for venoarterial extracorporeal membrane oxygenation

Abstract Background Venoarterial extracorporeal membrane oxygenation (ECMO) provides mechanical support for critically ill patients with cardiogenic shock. Typically, the size of the arterial return cannula is chosen to maximize flow...

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Impella to Unload the Left Ventricle During Peripheral Extracorporeal Membrane Oxygenation

Abstract Peripheral venoarterial extracorporeal membrane oxygenation (VA ECMO) for acute cardiac failure reestablishes normal oxygen delivery and perfusion. However, VA ECMO can be limited by insufficient ventricular unloading, resulting in..

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Prone position during venovenous extracorporeal membrane oxygenation: survival analysis needed for a time-dependent intervention

Abstract We read with great interest the paper of Giani and colleagues titled "Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data..

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The Fundamental Skills and Deconstructed Sub-Steps of Pediatric Cardiopulmonary Bypass

Abstract Perfusion education programs use simulation to provide students with clinical skills prior to entering the operating room. To teach the psychomotor execution of skills in a simulation lab requires..

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A Pharmacokinetic and Plasmin-Generation Pharmacodynamic Assessment of a Tranexamic Acid Regimen Designed for Cardiac Surgery With Cardiopulmonary Bypass

Abstract Objectives To examine the  (PK) and  of a tranexamic (TXA) regimen designed for cardiac surgery with  (CPB). Design A pilot study quantifying TXA concentrations,  markers, and a plasmin- generation (PG) assay. For comparison,..

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Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019

Abstract Respiratory failure caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with mortality. Patients unresponsive to conventional therapy may benefit from temporary venovenous extracorporeal membrane oxygenation (VV-ECMO). We..

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Awake ECMO for COVID-19 Induced Acute Respiratory Distress Syndrome

Abstract The outcome of COVID-19 patients treated on intensive care units (ICU) is unsatisfying (1). Veno-venous extracorporeal membrane oxygenation (vv-ECMO) can serve as a rescue strategy when patients deteriorate during..

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Effect of CPB Glucose Levels on Inflammatory Response After Pediatric Cardiac Surgery

Abstract Background: Systemic inflammatory response syndrome (SIRS) is a common complication after cardiac surgery. There are no definite optimal glycemic threshold for pediatric patients receiving open-heart surgery with CPB. The..

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Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care Ventilation on 90-Day Mortality in…

Abstract Importance  In patients who require mechanical ventilation for acute hypoxemic respiratory failure, further reduction in tidal volumes, compared with conventional low tidal volume ventilation, may improve outcomes. Objective  To determine whether..

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Modeling acid-base balance for in-series extracorporeal carbon dioxide removal and continuous venovenous hemofiltration devices

Abstract Patients with acute respiratory distress syndrome and acute kidney injury (AKI) treated by kidney replacement therapy may also require treatment with extracorporeal carbon dioxide removal (ECCO2R) devices to permit..

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Plasma and Platelet Transfusions Strategies in Neonates and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass or Neonates and Children Supported…

Abstract Objectives:  To present the recommendations and consensus statements with supporting literature for plasma and platelet transfusions in critically ill neonates and children undergoing cardiac surgery with cardiopulmonary bypass or..

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Acute respiratory distress syndrome in the cardiothoracic patient: State of the art and use of veno-venous extracorporeal membrane oxygenation

Acute respiratory distress syndrome (ARDS) encountered during the course of cardiothoracic (CT) surgery is a rare (1.1% incidence) unfortunate event increasing both morbidity and mortality., Cardiogenic shock occurring during CT..

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Retrograde Autologous Priming as a Safe and Easy Method to Reduce Hemodilution and Transfusion Requirements during Cardiac Surgery

Abstract Background: During the last decades many efforts have been made to reduce transfusion requirements and adverse clinical effects during cardiopulmonary bypass (CPB). The minimal extracorporeal circulation (MECC) system and the..

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To RAP or Not to RAP: A Retrospective Comparison of the Effects of Retrograde Autologous Priming

Abstract Retrograde autologous priming (RAP) is a process used to reduce hemodilution associated with the initiation of cardiopulmonary bypass (CPB). Previous studies have reported potential benefits to RAP; however, many..

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Bleeding and thrombotic events in adults supported with venovenous extracorporeal membrane oxygenation: an ELSO registry analysis

Abstract Purpose: This study aimed at analyzing the prevalence, mortality association, and risk factors for bleeding and thrombosis events (BTEs) among adults supported with venovenous extracorporeal membrane oxygenation (VV-ECMO). Methods:..

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Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation

Abstract Cessation of continuous analgesia and sedation in patients with acute respiratory distress syndrome (ARDS) receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO) facilitates early extubation, family, patient and provider engagement, and mobility...

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Atrial Arrhythmias During Venovenous ECMO: A Cry for Help?

Abstract WE READ with great interest the work by Li et al. in the Journal of Cardiothoracic and Vascular Anesthesia. In their work, the authors characterized the incidence and effect on outcomes..

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Normothermic Regional Perfusion Surgical Technique for the Procurement of Cardiac Donors after Circulatory Death

Central Message DCD heart transplant has not been routinely utilized in the United States. We describe a low cost, reproducible method for DCD heart procurement using NRP allowing for distant..

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Percentage of hematocrit decrease after the initiation of cardiopulmonary bypass—clinical implications and affecting factors

Abstract Decrease of patient’s hematocrit level is a natural process which occurs during the initiation of cardiopulmonary bypass. To some extent it is a beneficial occurrence, but excessive hematocrit decrease..

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Inflammatory Biomarker Levels After Propofol or Sevoflurane Anesthesia: A Meta-analysis

Abstract BACKGROUND:  The perioperative inflammatory response may be implicated in adverse outcomes including neurocognitive dysfunction and cancer recurrence after oncological surgery. The immunomodulatory role of anesthetic agents has been demonstrated..

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Renal and Cerebral Hypoxia and Inflammation During Cardiopulmonary Bypass

Abstract Cardiac surgery-associated acute kidney injury and brain injury remain common despite ongoing efforts to improve both the equipment and procedures deployed during cardiopulmonary bypass (CPB). The pathophysiology of injury..

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Effect of Cyclosporine on Cytokine Production in Elective Coronary Artery Bypass Grafting: A Sub-Analysis of the CiPRICS Study

Abstract Objectives The augmented inflammatory response to cardiac surgery is a recognized cause of postoperative acute kidney injury. The present study aimed to investigate the effects of preoperative cyclosporine treatment..

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Association of Arterial Hyperoxia With Outcomes in Critically Ill Children

Abstract Importance  Oxygen supplementation is a cornerstone treatment in pediatric critical care. Accumulating evidence suggests that overzealous use of oxygen, leading to hyperoxia, is associated with worse outcomes compared with patients..

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Risk and Safety Perceptions Contribute to Transfusion Decisions in Coronary Artery Bypass Grafting

Abstract Variability persists in intraoperative red blood cell (RBC) transfusion rates, despite evidence supporting associated adverse sequelae. We evaluated whether beliefs concerning transfusion risk and safety are independently associated with..

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Alternative Input for Perfusion Management Devices: Voice Recognition for Data Input and the Effects on Charting and Perioperative Calculation Use

Abstract Technology in healthcare has become increasingly prevalent and user friendly. In the last decade, advances in hands-free methods of data input have become more viable in a variety of..

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Effect of Moderate Hypothermia vs Normothermia on 30-Day Mortality in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation

Abstract Importance  The optimal approach to the use of venoarterial extracorporeal membrane oxygenation (ECMO) during cardiogenic shock is uncertain. Objective  To determine whether early use of moderate hypothermia (33-34 °C) compared with..

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Optimal Mean Arterial Pressure for Favorable Neurological Outcomes in Survivors after Extracorporeal Cardiopulmonary Resuscitation

Abstract We evaluated the optimal mean arterial pressure (MAP) for favorable neurological outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR). Adult patients who underwent ECPR were included. The average..

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How effective is extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest? A systematic review and meta-analysis

Abstract Background  cardiopulmonary resuscitation (ECPR) has gained increasing as a promising but resource-intensive intervention for out-of-hospital cardiac arrest (OHCA). There is little data to quantify the impact of this intervention..

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