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Pilot validation of an individualised pharmacokinetic algorithm for protamine dosing after systemic heparinisation for cardiopulmonary bypass

Abstract Introduction: This manuscript represents a pilot study assessing the feasibility of a single-compartment, individualised, pharmacokinetic algorithm for protamine dosing after cardiopulmonary bypass. Methods: A pilot cohort study in a..

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Platelet, Red Cell, and Endothelial Activation and Injury During Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) can be lifesaving but suffers from high rates of bleeding and repeated transfusions. Current monitoring of blood cell damage during ECMO is limited to platelet..

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Evaluating Pulmonary Function: An Assessment of Pao2/Fio2

Abstract Objectives:  Pao2/Fio2 is used commonly for diagnosis of lung injury (acute respiratory distress syndrome and transfusion-related acute lung injury), for assessment of pulmonary disease course and therapy, and in pulmonary..

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Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement

Abstract Background Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in  has been purported to reduce  and bleeding complications, although there are limited data supporting this claim. This study aimed to..

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Extracorporeal membrane oxygenation improves coagulopathy in an experimental traumatic hemorrhagic model

Abstract Purpose Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation..

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Thromboelastometry guided fibrinogen replacement therapy in cardiac surgery: a retrospective observational study

Abstract This retrospective, observational study compared the impact of a point-of-care rotational thromboelastometry (ROTEM®) method versus conventional bleeding management in terms of postoperative (24-h) blood loss, intraoperative and postoperative (24-h)..

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Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study

Abstract Background Post–cardiac surgery pulmonary dysfunction may be underreported. Therefore, we evaluated associated risk factors for prolonged pulmonary support after cardiac surgery. Methods and materials We conducted a retrospective, observational..

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The Munich Lung Transplant Group: Intraoperative Extracorporeal Circulation in Lung Transplantation

Abstract Background This retrospective single-center study aimed to analyze transfusion requirements, coagulation parameters, and outcome parameters in patients undergoing lung transplantation (LuTx) with intraoperative extracorporeal circulatory support, comparing cardiopulmonary bypass..

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Effects of circuit albumin coating on coagulation and inflammatory response for patients receiving aortic arch replacement: a randomized controlled trial

Abstract Objective: To investigate whether human serum albumin coating before cardiopulmonary bypass (CPB) could improve platelet function and hemostasis and mitigate the inflammatory response among patients receiving aortic arch replacement..

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Dynamic Predictive Scores for Cardiac Surgery–Associated Acute Kidney Injury

Abstract Background Cardiac surgery–associated acute kidney injury (CSA‐AKI) is a common complication with a poor prognosis. In order to identify modifiable perioperative risk factors for AKI, which existing risk scores are..

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Comparison of Thrombelastography-Derived Fibrinogen Values at Rewarming and Following Cardiopulmonary Bypass in Cardiac Surgery Patients

Abstract BACKGROUND:  The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest..

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Efficacy of the RemoweLL cardiotomy reservoir for fat and leucocyte removal from shed mediastinal blood: a randomized controlled trial

Abstract Introduction: Re-transfusion of lipid particles and activated leucocytes with shed mediastinal blood (SMB) can aggravate cardiopulmonary bypass-associated inflammation and increase the embolic load. This study evaluated the fat and..

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Preoperative hemostatic testing and the risk of postoperative bleeding in coronary artery bypass surgery patients

Abstract BACKGROUND We sought to assess predictability of excessive bleeding using thrombelastography (TEG), multiplate impedance aggregometry, and conventional coagulation tests including fibrinogen in patients undergoing coronary artery bypass graft (CABG)..

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Long‐Term Intra‐Aortic Balloon Pump Support as Bridge to Left Ventricular Assist Device Implantation

Abstract Background The intra‐aortic balloon pump (IABP) can be used to bridge critically ill end‐stage heart failure patients to left ventricular assist device (LVAD) implantation. However, the IABP's potential association..

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The incidence and importance of anaemia in patients undergoing cardiac surgery in the UK – the first Association of Cardiothoracic…

Abstract The importance and variability of pre‐operative anaemia in cardiac surgical patients across the UK is not known, and there is debate about its association with patient outcomes. The Association..

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Optimizing Thrombin Generation with 4-Factor Prothrombin Complex Concentrates in Neonatal Plasma After Cardiopulmonary Bypass

Abstract BACKGROUND:  Bleeding is a serious complication after pediatric cardiopulmonary bypass (CPB) that is associated with an increase in perioperative morbidity and mortality. Four-factor prothrombin complex concentrates (4F-PCCs) have been..

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Poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit can reduce transfusion of platelet products compared to heparin-coated circuit during aortic arch surgery

Abstract Several coating techniques for extracorporeal circulation have been developed to reduce the systemic inflammatory response during cardiopulmonary bypass (CPB). We compared the clinical effectiveness and biocompatibility of poly-2-methoxyethylacrylate (PMEA)-..

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Blood Transfusion and 30-Day Mortality in Patients With Coronary Artery Disease and Anemia Following Noncardiac Surgery

Abstract Importance  Although liberal blood transfusion thresholds have not been beneficial following noncardiac surgery, it is unclear whether higher thresholds are appropriate for patients who develop postoperative myocardial infarction (MI). Objective  To..

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Processing of stored packed red blood cells using autotransfusion devices decreases potassium and microaggregates: a prospective, randomized, single-blinded in vitro…

Abstract Abstract The aim of the study was to compare the potential of autotransfusion devices to reduce non-infectious complications related to transfusion of long-stored packed red blood cells (PRBC; n=..

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Bedside Allogeneic Erythrocyte Washing with a Cell Saver to Remove Cytokines, Chemokines, and Cell-derived Microvesicles: A Clinical Feasibility Study

Abstract Background Removal of cytokines, chemokines, and microvesicles from the supernatant of allogeneic erythrocytes may help mitigate adverse transfusion reactions. Blood bank–based washing procedures present logistical difficulties; therefore, we tested..

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Blood Conservation in Cardiac Surgery: In Need of a Transfusion Revolution

Abstract Blood transfusion is the most common procedure in cardiac surgery. Increasing evidence exists that excess transfusions are harmful to patients. Transfusion reactions and complications, including infection, immune modulation, and..

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Risks of Anemia in Cardiac Surgery Patients

Abstract Anemia is an common condition in patients undergoing cardiac surgery, and it is often present in one quarter to half of patients at admission. Several studies have indicated that..

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Hyperbilirubinemia after cardiac surgery: An observational study

Abstract Background We aimed to assess the incidence and perioperative risk factors for hyperbilirubinemia after cardiac surgery, and determine its influence on early operative outcome. Methods This prospective observational study..

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Hypofibrinogenemia can be estimated by the predictive formula in aortic surgery

Abstract Objective Aortic surgery often causes massive bleeding due to hypofibrinogenemia. Predicting hypofibrinogenemia is useful for developing a hemostasis strategy, including preparing for blood transfusion. We made a formula for..

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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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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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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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Coronary artery bypass surgery without blood transfusion; is it possible?

Abstract Background:  Coronary artery bypass surgery is the most commonly performed cardiac operation and approximately 40-70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. Some preventive..

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In vitro assays and clinical trials in red blood cell aging: Lost in translation

Abstract The age of  (EC) in  and the  when transfusing long-term-stored EC are highly controversial issues. Whereas the definition of a short-term-stored EC or a long-term-stored EC is unclear in clinical trials, data..

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The Efficacy, Safety and Cost-Effectiveness of Intra-Operative Cell Salvage in High-Bleeding-Risk Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Randomized and…

Abstract Objective: Intra-operative cell salvage (CS) was reported to be ineffective, safe and not cost-effective in low-bleeding-risk cardiac surgery with cardiopulmonary bypass (CPB), but studies in high-bleeding-risk cardiac surgery are limited...

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