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Noninvasive strategies in COVID-19: epistemology, randomised trials, guidelines, physiology

Abstract COVID-19 is producing seismic changes in society at large and the action of doctors is receiving greater attention from the public than ever in our lifetime. The medical care..

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Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Abstract Vasoplegia observed post cardiopulmonary bypass (CPB) is associated with substantial morbidity, multiple organ failure and mortality. Circulating counts of hematopoietic stem cells (HSCs) and endothelial progenitor cells (EPC) are..

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Effects of modified ultrafiltration and conventional ultrafiltration combination on perioperative clinical outcomes in pediatric cardiac surgery

Abstract Background: This meta-analysis was performed to review the effects of the addition of modified ultrafiltration (MUF) and conventional ultrafiltration (CUF) to CUF alone on postoperative hemoglobin, surgical and ultrafiltration..

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Provision of ECPR during COVID-19: evidence, equity, and ethical dilemmas

Abstract The use of extracorporeal cardiopulmonary resuscitation (ECPR) to restore circulation during cardiac arrest is a time-critical, resource-intensive intervention of unproven efficacy. The current COVID-19 pandemic has brought additional complexity..

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Impact of massive blood transfusion during adult extracorporeal membrane oxygenation support on long-term outcomes: a nationwide cohort study in Taiwan

Abstract Objectives Bleeding is a common problem during adult extracorporeal membranes oxygenation (ECMO) support, requiring blood transfusion for correction of volume depletion and coagulopathy. The goal of this study is..

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Enhanced recovery after cardiac surgery and its impact on outcomes: A systematic review

Abstract Background and Aim: Enhanced Recovery After Surgery (ERAS) protocols are a series of perioperative interventions well-established in improving the care and outcomes of patients. With recent emergence of studies..

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Nitric Oxide Attenuates the Inflammatory Effects of Air During Extracorporeal Circulation

Abstract Cardiopulmonary bypass causes a systemic inflammatory response reaction that may contribute to postoperative complications. One cause relates to the air/blood interface from the extracorporeal circuit. The modulatory effects of..

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Effect of different types of cerebral perfusion for acute type A aortic dissection undergoing aortic arch procedure, unilateral versus bilateral

Abstract Background Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used for cerebral protection in aortic surgery. There is still no consensus on the superiority of the..

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Modified ultrafiltration reduces postoperative blood loss and transfusions in adult cardiac surgery: a meta-analysis of randomized controlled trials

Abstract OBJECTIVES Cardiopulmonary bypass in cardiac surgery has been associated with several deleterious effects including haemodilution and systemic inflammation. Modified ultrafiltration (MUF) has been well established in paediatric cardiac surgery..

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Rationale for the Role of Heparin and Related GAG Antithrombotics in COVID-19 Infection

Abstract The SARS-CoV-2 pandemic has focused attention on prevention, restriction and treatment methods that are acceptable worldwide. This means that they should be simple and inexpensive. This review examines the..

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Remote Ischemic Preconditioning Prevents Deterioration of Short-Term Postoperative Cognitive Function After Cardiac Surgery Using Cardiopulmonary Bypass: Results of a Pilot…

Abstract Objective Remote  (RIPC) exerts  effects in models of cerebral . The authors tested the hypothesis that RIPC decreases the incidence of  and prevents deterioration of short-term postoperative cognitive function in isoflurane-fentanyl-anesthetized patients undergoing..

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Fontan Physiology Revisited

Abstract The Fontan operation places the systemic and pulmonary circulations in series, driven by a single ventricular chamber. It has become the treatment strategy of choice for palliating single-ventricle congenital..

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An Adjusted Calculation Model Allows for Reduced Protamine Doses without Increasing Blood Loss in Cardiac Surgery

Abstract Background Heparin dosage for anticoagulation during cardiopulmonary bypass (CPB) is commonly calculated based on the patient's body weight. The protamine–heparin ratio used for heparin reversal varies widely among institutions..

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Cardiovascular consequences of cocaine use

Abstract The cardiovascular consequences of cocaine use are numerous and can be severe, with mechanisms of cardiotoxicity unique to cocaine that include sympathomimetic effects, blockade of sodium and potassium channels,..

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Unexplained hemolysis in patients undergoing ECMO: beware of hypertriglyceridemia

Abstract Hemolysis is a common complication of extracorporeal membrane oxygenation (ECMO) support and is associated with increased mortality. Frequent monitoring of markers of hemolysis is performed at ECMO centers. We..

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Designing a new scoring system (QualyP Score) correlating the management of cardiopulmonary bypass to postoperative outcomes

Abstract Aim: The aim of this study was to ascertain if a score, directly derived from CPB records, could correlate to major postoperative outcomes. Methods: An additive score (QualyP Score)..

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Remote ischaemic preconditioning: is it a flag on the field?

Abstract Ischaemic preconditioning is one of several different techniques that have been proposed to render the heart more resistant to ischaemia/reperfusion injuries. A significant reduction of troponin release is ‘proof..

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Postoperative Critical Care of the Adult Cardiac Surgical Patient

Abstract Objectives:  The armamentarium of cardiac surgery continues to expand, and the cardiac intensivist must be familiar with a broad spectrum of procedures and their specific management concerns. In the..

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Impact of Acute Kidney Injury on Outcome in Patients With Severe Acute Respiratory Failure Receiving Extracorporeal Membrane Oxygenation

Abstract Objectives:  Extracorporeal lung support is currently used in the treatment of patients with severe respiratory failure until organ recovery and as a bridge to further therapeutic modalities. The aim..

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Hyperinsulinemic Normoglycemia Does Not Meaningfully Improve Myocardial Performance during Cardiac Surgery: A Randomized Trial

Abstract Background: Glucose–insulin–potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance..

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The effects of hyperoxaemia on tissue oxygenation in patients with a nadir haematocrit lower than 20% during cardiopulmonary bypass

Abstract Excessive haemodilution and the resulting anaemia during CPB is accompanied by a decrease in the total arterial oxygen content, which may impair tissue oxygen delivery. Hyperoxic ventilation has been..

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Extracorporeal circulation increases proliferation in the intestinal mucosa in a large animal model

Abstract Objective  induces  in the small . One reason for this damage is a perfusion shift from the muscular toward the mucosal layer. This study investigated the effect of this perfusion shift..

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: long‐term results at St George Hospital, Australia

Abstract Background Peritoneal carcinomatosis (PC) results from the secondary spread of many intraabdominal tumour types, such as colorectal malignancy (colorectal cancer, CRC), disseminated peritoneal adenomucinosis (DPAM), appendiceal cancer, ovarian carcinoma,..

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Smarter Clinical Checklists

Abstract Widespread use of clinical checklists is relatively new to health care. Anesthesiology has borrowed lessons from aviation safety since the late 1970s, but checklists only reached a tipping point..

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Association of Hospital-Level Volume of Extracorporeal Membrane Oxygenation Cases and Mortality. Analysis of the Extracorporeal Life Support Organization Registry

Abstract Rationale:  Recent pediatric studies suggest a survival benefit exists for higher-volume extracorporeal membrane oxygenation (ECMO) centers. Objectives:  To determine if higher annual ECMO patient volume is associated with lower..

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Intraoperative Tight Glucose Control Using Hyperinsulinemic Normoglycemia Increases Delirium after Cardiac Surgery

Abstract Background: Postoperative delirium is common in patients recovering from cardiac surgery. Tight glucose control has been shown to reduce mortality and morbidity. Therefore, the authors sought to determine the..

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Proposed Recommendations for Myocardial Revascularisation

Abstract This discussion paper presents proposed recommendations for  in the Australasian clinical setting based on underlying evidence-based principles and an understanding of local factors which may limit the provision of ideal..

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Peri-operative Levosimendan in Patients Undergoing Cardiac Surgery: An Overview of the Evidence

Abstract , a , has recently emerged as a valuable agent in the peri-operative management of cardiac surgery patients. Levosimendan is a calcium-sensitising ionodilator. By binding to  C and reducing its  co-efficient, it..

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Respiratory Electrodialysis. A Novel, Highly Efficient Extracorporeal CO2 Removal Technique

Abstract Rationale:  We developed an innovative, minimally invasive, highly efficient extracorporeal CO2 removal (ECCO2R) technique called respiratory electrodialysis (R-ED). Objectives:  To evaluate the efficacy of R-ED in controlling ventilation compared with..

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Red blood cell storage time and the outcome after coronary surgery

Abstract Background The impact of transfusion of aged red blood cells (RBCs) on the outcome after  (CABG) is controversial. This issue has been investigated in the present study. Materials and methods..

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