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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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Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team

Abstract Previous experience has shown that transporting patients on extracorporeal membrane oxygenation (ECMO) is a safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to..

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Extracorporeal Membrane Oxygenation for Septic Shock in Children

Abstract Extracorporeal membrane oxygenation (ECMO) is a rescue treatment used in children and adults with reversible cardiorespiratory failure. The role of ECMO is not fully established in pediatric sepsis. In..

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Primary intra-aortic balloon support versus inotropes for decompensated heart failure and low output: a randomised trial

Abstract Aims: The haemodynamic effects of primary implantation of an intra-aortic balloon pump (IABP) versus inotropes in decompensated heart failure and low output (DHF-LO), but without an acute coronary syndrome, have..

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Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation

Abstract Objectives:  Children receiving prolonged extracorporeal membrane oxygenation (ECMO) support may benefit from tracheostomy during ECMO by facilitating rehabilitation; however, the procedure carries risks, especially hemorrhagic complications. Knowledge of tracheostomy practices and outcomes of..

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Systems-based investigation of patient safety incidents

Abstract Patient safety events are common in healthcare. We can learn from other safety-critical industries that further incidents are most likely to be prevented where lessons are learned at the..

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The contribution of human factors and ergonomics to the design and delivery of safe future healthcare

Abstract Human factors and ergonomics (HF/E) is concerned with the design of work and work systems. There is an increasing appreciation of the value that HF/E can bring to enhancing..

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Ambulatory home wearable lung: progress and future directions

Abstract Extracorporeal life support (ECLS) was first implemented as an extension of cardiopulmonary bypass technology. The early use of ECLS in patients with acute respiratory distress syndrome (ARDS) was discouraging,..

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Intraoperative support during lung transplantation

Abstract The role of intraoperative mechanical support during lung transplantation (LTx) is essential to provide a safe hemodynamic and ventilatory status during critical intraoperative events. This hemodynamic and ventilatory stability..

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Blood Pumps for Extracorporeal Membrane Oxygenation: Platelet Activation During Different Operating Conditions

Abstract Extracorporeal membrane oxygenation (ECMO) is a therapy used in severe cardiopulmonary failure. Blood is pumped through an artificial circuit exposing it to nonphysiologic conditions, which promote platelet activation and..

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The Disconnect Between Extracorporeal Circulation and the Microcirculation

Abstract Extracorporeal circulation (ECC) procedures, such as cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), take over the function of one or more organs, providing clinicians time to treat underlying..

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