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Towards goal-directed perfusion - Part II: Temperature dependence of Q10, oxygen-demand dependence on age and weight, further clinical insights

Abstract Background Goal-directed perfusion (GDP) during cardiopulmonary bypass (CPB) seeks to match oxygen delivery with patient-specific metabolic demand, yet determinants of oxygen demand and dynamics of oxygen extraction ratio (OER)..

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Congenital diaphragmatic hernia: Exclusion criteria for repair or ECMO?

Abstract Background Mortality in congenital diaphragmatic hernia (CDH) approximates 30 %. Both severe lung hypoplasia and other anomalies contribute to demise regardless of repair and/or extracorporeal membrane oxygenation (ECMO). We..

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Knowledge and behaviours of the operating room personnel regarding protection from ionising radiation

Abstract Introduction: Ensuring radiation safety in healthcare settings is crucial to minimising risks associated with ionising radiation exposure. This study aimed to evaluate the knowledge and behaviours of operating room..

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Clinical study of area-decreasing technique and conventional post-closure technique for V-A ECMO weaning application: study protocol of a randomised controlled…

Abstract Introduction Two techniques are commonly used for the femoral artery puncture closure during decannulation in venoarterial extracorporeal membrane oxygenation (V-A ECMO): the conventional post-closure technique and the small-sheath technique, also..

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Association between parenteral nutrition and extracorporeal membrane oxygenation circuit dysfunction in critically ill adults requiring extracorporeal life support: A retrospective…

Abstract Background Extracorporeal life support is influenced by membrane integrity and nutrition. The impact of parenteral nutrition with lipid injectable emulsions on membrane function remains uncertain. Methods This retrospective cohort..

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Effect of Perioperative Dexmedetomidine in Cardiac Surgery: A Narrative Review

Abstract Cardiac procedures carry a higher perioperative risk than other operations for major adverse cardiovascular events and kidney injury, especially since patients with multiple comorbidities have been accepted as candidates..

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ISHLT Consensus Statement on the Perioperative use of ECLS in Lung Transplantation: Part I: Preoperative Considerations

Abstract The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no..

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The TEG6s-Derived R ratio accurately reflects the anti-Xa level after cardiac surgery: A proof-of-concept study

Abstract Introduction In the postoperative intensive care setting after cardiac surgery with cardiopulmonary bypass (CPB), particularly in patients requiring continued anticoagulation for prosthetic devices such as mechanical valves or extracorporeal..

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Safely combining renal replacement therapy and extracorporeal membrane oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is an extracorporeal technique used in acute circulatory and respiratory failures refractory to conventional therapies. ECMO patients are at risk of developing severe acute kidney..

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Risk Models for Monitoring Postoperative Complication Rates After Paediatric Cardiac Surgery

Abstract Objectives As postoperative mortality for paediatric cardiac surgery is very low, we aimed to develop methods for monitoring of postoperative complication rates, given their impact upon children’s health and..

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Impact of changes in cardiopulmonary bypass circuit design on pressure loss, wall shear stress, and venous drainage flow

Abstract Introduction Blood damage during cardiopulmonary bypass can trigger postoperative inflammatory responses and organ injury. Therefore, optimizing the blood circuit design to minimize damage remains essential. However, variations in venous..

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Current State of Patient Blood Management in Cardiovascular Surgery: Insights from a Survey of Leading Centers

Abstract Objective To determine the state of patient blood management (PBM) practice in leading US cardiac surgery centers. Design A survey tool addressing PBM program structure and PBM program operations..

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Aerosolization of Mycobacterium chelonae from heater-cooler-devices: a continuing risk of exposure during cardiac surgery

Abstract Background Following identification of widespread Mycobacterium chimaera infections in 2013 associated with aerosolization from Sorin heater-cooler-devices (HCD), microbiological monitoring of HCDs has become mandatory in Switzerland. Methods Since 01/2016, four Maquet..

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Early Haptoglobin Decrease During a Microaxial Flow Pump Support: Association With High Pump Performance Level

Abstract Hemolysis is a recognized complication of a microaxial flow pump (Impella CP) support, but its incidence and associated risk factors remain unclear. We retrospectively analyzed 24 patients with cardiogenic..

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Patient blood management for patients undergoing cardiac surgery in Middle Eastern countries: Multicenter survey

Abstract Background:  The purpose of this survey was to delineate and compare patient blood management (PBM) approaches in cardiac surgery across nine Middle Eastern countries while identifying the main challenges..

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Entropy-guided sevoflurane administration during cardiopulmonary bypass surgery in the paediatric population

Abstract Background Maintaining optimal anesthetic depth during cardiopulmonary bypass (CPB) in pediatric patients is challenging due to altered physiology and unreliable conventional monitoring. Entropy, a processed electroencephalogram metric, offers a..

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Mobile ECMO for inter-hospital transport of pediatric patients: experience from 22 cases

Abstract Objective To summarize the management experience of inter-hospital transport of critically ill children with extracorporeal membrane oxygenation (ECMO) in our hospital and provide evidence for the mobile ECMO for..

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Practice of Apnea Testing and Determination of Brain Death During Extracorporeal Membrane Oxygenation: A Multicenter Retrospective Analysis

Abstract To explore whether reducing airflow and maintaining blood flow can improve the success rate of the apnea test (AT) and whether two auxiliary test strategies can improve the completion..

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Between Air and Artery: A History of Cardiopulmonary Bypass and the Rise of Modern Cardiac Surgery

Abstract Cardiopulmonary bypass (CPB) is one of the most groundbreaking medical innovations in history, enabling safe and effective heart surgery by temporarily replacing the function of the heart and lungs...

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Outcomes of central versus peripheral arterial cannulation for intraoperative extracorporeal membrane oxygenation support in lung transplantation

Abstract Background Intraoperative venoarterial extracorporeal membrane oxygenation (VA ECMO) is becoming the most common mode of extracorporeal life support (ECLS) in lung transplantation (LTx). We compared rates of primary graft..

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Impact of medical safety huddles on patient safety: a stepped-wedge cluster randomised study

Abstract Background Medical safety huddles are short, structured meetings for physicians to proactively discuss and respond to profession-specific patient safety concerns, with the goal of decreasing future adverse events. Prior observational..

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Risk factors associated with the use of red blood cells in elective cardiac surgeries: A patient blood management (PBM) view

Abstract Background Blood is a biological, irreplaceable, and perishable resource, provided through voluntary, altruistic, and free donation in Brazil. Although blood components are widely used in hospital settings, several challenges..

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Inadequate Oxygen Delivery During Cardiopulmonary Bypass Drives Inflammatory Reaction after Cardiac Surgery

Abstract Objectives Systemic inflammatory response syndrome (SIRS) is a common complication following cardiopulmonary bypass (CPB), associated with increased mortality. We assessed the relationship between indexed oxygen delivery (DO2i) during CPB..

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Development of nursing quality evaluation indicators for extracorporeal membrane oxygenation based on Donabedian theory: A Delphi study

Abstract Extracorporeal membrane oxygenation (ECMO) serves as a vital therapy for refractory severe respiratory and circulatory failure. With its expanding application in China and the heightened demand for high-quality medical..

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Impact of Low Hematocrit on On-Pump Coronary Artery Bypass Graft Surgery Outcomes

Abstract Background: Low hematocrit level is a hematological problem that is frequently encountered during cardiopulmonary bypass (CPB) in patients undergoing on-pump coronary artery bypass grafting (CABG). This study aimed to..

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Successful use of pulsatile flow and goal directed perfusion in a high-risk patient

Abstract The development of multi-organ failure resulting from cardiopulmonary bypass (CPB) is acknowledged as a significant contributor to increased morbidity and mortality rates during the postoperative period. This report discusses..

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A Novel Low-Profile Full-Flow Percutaneous Ventricular Assist Device

Abstract Percutaneous ventricular assist devices (pVAD) decrease mortality in cardiogenic shock (CS) patients, but at a high adverse event rate. Novel pVADs need to improve cardiac power output (CPO) to..

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Extracorporeal Membrane Oxygenation in Liver Transplantation: Mayo Clinic Experience—A Case Series and Review

Abstract Extracorporeal membrane oxygenation (ECMO) use during liver transplantation is a complex and evolving aspect of critical care. This retrospective analysis presents the largest North American case series to date,..

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Reducing perioperative red blood cell transfusion in adult aortic surgery: innovative application and process optimization of autologous plateletpheresis

Abstract Purpose Coagulopathy is a common perioperative complication in aortic surgery, increasing the risk of bleeding and transfusion requirements. This study aimed to evaluate the impact of autologous plateletpheresis on..

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Silk-based multilayer coatings for anticoagulation and durability improvement in ECMO hollow fiber membranes

Abstract In clinical extracorporeal membrane oxygenation (ECMO), prolonged blood residence time in oxygenators can lead to thrombus formation and complications. Heparin-based bioactive coatings are commonly used for anticoagulation, but prolonged..

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