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The MAMBO Framework and the Future of Modern Perfusion: Artificial Intelligence, Cognitive Ergonomics, and Sustainable Workflow Integration

Abstract Artificial intelligence (AI), predictive analytics, and digital health technologies are progressively reshaping extracorporeal circulation and perioperative cardiovascular care. In this evolving landscape, cardiopulmonary bypass management is transitioning from a..

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The Role of Recirculation-Guided Blood Flow Adjustment in Venovenous Extracorporeal Membrane Oxygenation: A Pilot Study

Abstract Recirculation reduces the efficiency of venovenous extracorporeal membrane oxygenation (V-V ECMO), but patient-specific determinants of recirculation and the feasibility of recirculation-guided flow adjustment are not well defined. In this..

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Laboratory Monitoring Unfractionated Heparin Treatments: Unanswered Issues

Abstract Unfractionated heparin (UFH) has long been an anticoagulant of choice. Despite the increasing use of low molecular weight heparin derivatives and more recently direct oral anticoagulants, UFH is still..

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Sevoflurane diffusion across four paediatric cardiopulmonary bypass oxygenators: a laboratory investigation

Abstract In children, validated tools to monitor anaesthetic depth are lacking. In routine practice, dosing of volatile agents relies on surrogate markers such as minimum alveolar concentration and autonomic responses. In..

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The association of estimated citrate load with frozen plasma versus four-factor prothrombin complex concentrate for coagulopathy after cardiac surgery: a…

Abstract Background Frozen plasma (FP) is the standard haemostatic therapy after cardiopulmonary bypass, but recent trials indicate that FP is inferior to four-factor prothrombin complex concentrate (PCC). Citrate content may..

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How I do it Creating a Program for Neurologic Prognostication after Cardiac Arrest

Abstract Multimodal neurologic prognostication (MM-NP) after cardiac arrest has been shown to enhance prognostic accuracy, however, it is vastly underutilized in real-world settings. Guideline-discordant practices and healthcare disparities in post-cardiac..

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Sex-Related Long-Term Outcomes in On-Pump Coronary Artery Bypass Grafting—A Propensity Score-Matched Analysis

Abstract Objectives Coronary artery bypass grafting shows impaired outcomes in women compared to men. Investigation of sex-related outcome differences mostly comprises different operative strategies, potentially hampering interpretation of data. We..

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Neonatal enterovirus myocarditis outcomes following extracorporeal membrane oxygenation (NEMO-ECMO): An ELSO registry analysis

Abstract Background Neonates with enterovirus myocarditis may require extracorporeal membrane oxygenation (ECMO). The contemporary prognosis and risk factors for mortality of neonates with enterovirus myocarditis supported on ECMO is unknown...

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Feasibility and safety of a novel activated leukocyte adsorption device during cardiopulmonary bypass: a first-in-human pilot study

Abstract Cardiopulmonary bypass (CPB) induces inflammation partly via leukocyte activation. We conducted a first-in-human pilot study assessing the feasibility and perioperative safety of a novel activated leukocyte adsorption device during..

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Real-time cardiac power output index predicts imminent need for extracorporeal membrane oxygenation after heart transplantation

Abstract Background Primary graft dysfunction (PGD) remains the leading cause of early morbidity and mortality after heart transplantation. Despite consensus definitions, clinicians still rely on subjective, indirect assessments of graft..

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Fluid balance during PICU stay in children after cardiac surgery with cardiopulmonary bypass

Abstract Background Pediatric patients undergoing cardiac surgery are at risk for developing positive cumulative fluid balance (CFB). Our goal was to study postoperative CFB in this population, its explanatory variables,..

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Levosimendan for Weaning from VA-ECMO: Two Trials, Two Timings

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for providing adequate organ support in cardiogenic shock. While the intervention provides circulatory and respiratory support in the critical stage, it..

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Extracorporeal Life Support Use During Severe Anaphylaxis: A Systematic Review and Pooled Analysis of Individual Patient Data

Abstract Objective Severe anaphylaxis is a rare but life-threatening condition that may require extracorporeal life support (ECLS). A systematic review was conducted to evaluate the outcomes of patients receiving ECLS..

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Head–core temperature discordance during hypothermic circulatory arrest in acute type A aortic dissection

Abstract Objectives Core temperature is routinely used to guide hypothermic circulatory arrest (HCA) for acute type A aortic dissection (ATAAD). However, it remains unclear whether impaired carotid artery flow alters..

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Clinical Effectiveness of Acute Normovolemic Hemodilution in Cardiac Surgery: A Systematic Review and Meta-analysis

Abstract BACKGROUND: Acute normovolemic hemodilution (ANH) is endorsed by contemporary patient blood management guidelines as a cost-effective strategy for reducing allogeneic transfusion in cardiac surgery. However, evidence remains inconsistent due..

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Mortality-related predictors in patients receiving extracorporeal membrane oxygenation after coronary artery bypass grafting: a retrospective study

Abstract Background This study aimed to evaluate in-hospital mortality and to identify predictors of mortality in coronary artery bypass grafting (CABG) patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. Methods..

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Long-term psychological outcomes after extracorporeal membrane oxygenation: A systematic review and meta-analysis

Abstract Background Use of extracorporeal membrane oxygenation (ECMO) for cardiorespiratory failure has increased substantially. While long-term outcomes for psychological health are increasingly assessed and addressed in critical care survivorship research,..

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Comparison of clinical outcomes between pulsatile and non-pulsatile perfusion during cardiopulmonary bypass: A prospective randomized study

Abstract Background: The clinical benefits of pulsatile perfusion during cardiopulmonary bypass (CPB) remain a subject of debate. This study aimed to compare clinical outcomes between pulsatile and non-pulsatile perfusion during..

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Heparin Dose-Response Curve for Heparin Dose Determination During Cardiopulmonary Bypass for Pediatric Cardiac Surgery: A Prospective Randomized Controlled Study

Abstract Objectives To determine whether individualized heparin dosing guided by a heparin dose-response (HDR) curve is noninferior to conventional weight-based dosing in achieving target activated clotting time (ACT) of ≥480..

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Extracorporeal membrane oxygenation initiation timing and prognosis: a systematic review and meta-analysis

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a critical life-support intervention for patients with severe respiratory and circulatory failure. Nevertheless, identifying the optimal timing of ECMO initiation and its correlation..

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Extracorporeal Membrane Oxygenation Prior to Death: Standardized Terminology for ECMO-Supported Organ Donation Pathways

Abstract The expanding use of extracorporeal cardiopulmonary resuscitation (ECPR) has introduced new clinical scenarios at the intersection of extracorporeal life support and organ donation. Current donor classification systems do not..

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Simulation use in perfusion education: A 2025 survey of United States programs

Abstract Background: Simulation-based education (SBE) is increasingly used in training students in allied healthcare, yet data on its role in United States (U.S.) perfusion programs are limited. This study surveyed perfusion..

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Conceptions of human factors in simulation-based education: a phenomenographic study

Abstract Background Human factors (HF) are integral to patient safety. Simulation-based education (SBE) is widely used to teach HF, yet facilitators conceptualise HF in varied ways. This study explored facilitators’..

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Promoting Psychological Safety for All Participants During a High-Intensity Interprofessional Simulation Event

Abstract Simulation is an excellent educational methodology for healthcare learners to practice skills for medical scenarios that are low in frequency but high in emotional intensity. However, these educational experiences..

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Estimation of hemoglobin concentration at the initiation of cardiopulmonary bypass using support vector regression

Abstract Background: Hemodilution during cardiopulmonary bypass (CPB) is a standard perfusion strategy used to reduce blood viscosity and enhance microcirculatory flow. The hemodilution rate, expressed as hemoglobin (Hb) concentration, is..

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Development and Validation of an Integrated Artificial Intelligence-Powered Clinical Decision Support Application for Cardiac Critical Care: Combining Coagulation Management, Blood…

Abstract This study describes the development and preliminary validation of an integrated clinical decision support application (Cardiac Critical Care Advisor Pro, CCA Pro v6.0) that combines viscoelastic coagulation analysis, arterial..

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Evaluating the impact of implementing an ECPR protocol on prehospital resuscitation quality: a randomized controlled simulation study

Abstract Background Extracorporeal Cardiopulmonary Resuscitation (ECPR) is increasingly considered for prehospital cardiac arrest management; however, its impact on resuscitation performance remains unclear. This study aimed to determine whether integrating an..

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Pulses that predict: Postoperative perfusion index and outcomes in high-risk pediatric cardiac surgery

Abstract Background Children undergoing high-risk cardiac surgery face significant postoperative morbidity and mortality risk, and early recognition of impaired systemic perfusion is critical. Current monitoring modalities, such as lactate, central..

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Understanding pressure excursions in extracorporeal technologies: The role of shear stress and hematologic predisposition

Abstract Platelets play a pivotal role in hemostasis, where their activation is tightly regulated by biochemical agonists such as thrombin, collagen, and adenosine diphosphate, all of which signal through calcium-mediated..

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Timing of spontaneous breathing in veno-venous extracorporeal membrane oxygenation: An exploratory analysis of intensive care outcomes

Abstract Background The clinical impact of early spontaneous breathing during veno-venous extracorporeal membrane oxygenation (VV ECMO) for acute respiratory distress syndrome (ARDS) is unclear, balancing potential benefits (reducing sedation and..

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