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Complexities, Benefits, Risks, and Clinical Implications of Sodium Bicarbonate Administration in Critically Ill Patients: A State-of-the-Art Review

Abstract Sodium bicarbonate has been used in the treatment of different pathologies, such as hyperkalemia, cardiac arrest, tricyclic antidepressant toxicity, aspirin toxicity, acute acidosis, lactic acidosis, diabetic ketoacidosis, rhabdomyolysis, and..

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Intraoperative high and low blood pressures are not associated with delirium after cardiac surgery: A retrospective cohort study

Abstract Study objective To evaluate the associations between high and low intraoperative time-weighted average mean arterial pressures before, during and after cardiopulmonary bypass on postoperative delirium. Design Single center retrospective..

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WARM BLOOD CARDIOPLEGIA VERSUS COLD CRYSTALLOID CARDIOPLEGIA IN PATIENTS AFFECTED BY ACUTE CORONARY SYNDROMES UNDERGOING CORONARY ARTERY BYPASS GRAFTING

Abstract Aim:  We investigated in a single-center retrospective study early outcomes of intermittent warm blood and cold crystalloid St. Thomas cardioplegia in patients referred to CABG due to acute coronary..

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Long-term heart function in refractory out-of-hospital cardiac arrest treated with prehospital extracorporeal cardiopulmonary resuscitation

Abstract Introduction Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment for refractory out-of-hospital cardiac arrest (OHCA), often due to acute coronary syndrome (ACS). However, the long-term impact of prehospital ECPR on..

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Totally endoscopic coronary bypass: do we need a robot, a pump or both?

Abstract In the issue of the journal, Claessens et al. [] present a large case series of non-robotic totally endoscopic coronary artery bypass (TECAB) surgery. They summarize the outcomes of 1500 patients..

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ECPR—the evolving role in cardiac arrest

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) describes the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) to restore blood circulation in patients during refractory cardiac arrest. So far, ECPR is not the..

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Potential new treatment for inferior vena cava injury using extracorporeal membrane oxygenation applying flow diversion effect

Abstract Background Retrohepatic inferior vena cava (IVC) injuries remain among the most lethal and serious liver injuries. Gauze packing is currently the first choice for IVC injuries; however, laparotomy itself poses..

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The Pre-ECPR Score: Developing and Validating a Multivariable Prediction Model for Favorable Neurological Outcomes in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation

Abstract Objectives Extracorporeal cardiopulmonary resuscitation (ECPR) can save patients with refractory cardiac arrest; however, according to recent meta-analyses, only 20% of patients achieve favorable outcomes (Modified Rankin Scale 0-3). We..

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Outcomes of extracorporeal life support in hypothermic cardiac arrest: Revisiting ELSO guidelines

Abstract Aim of the study Predictive factors for poor outcomes in hypothermic cardiac arrest (HCA) differ from those in normothermic out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the..

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Extracorporeal membrane oxygenation in severe traumatic brain injury: Is it safe?

Abstract BACKGROUND  Patients with severe traumatic brain injury (TBI) are at an increased risk of respiratory failure refractory to traditional therapies. The safety of extracorporeal membrane oxygenation (ECMO) in this..

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Evaluation of staged autologous blood transfusion during extracorporeal membrane oxygenation decannulation: A retrospective study

Abstract Background Clinical blood resources are scarce and autologous blood transfusion for extracorporeal membrane oxygenation (ECMO) withdrawal is less studied. Objectives To assess the use of staged autotransfusion during ECMO..

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Autoptic Findings in Patients Treated with (VA-ECMO) after Cardiac Arrest

Abstract Background: This study examines the results of autopsy examinations specifically aimed at documenting complications arising from the implantation phase and treatment with veno–arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with..

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Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

Abstract Background and Objectives: The majority of cardiac surgical procedures are performed using cardiopulmonary bypass and cardioplegia-induced cardiac arrest. Cardiac arrest and reperfusion may lead to ischemia-reperfusion injury of the..

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Hematocrit and Renal Failure in Aortic Arch Surgery: A Society of Thoracic Surgeons Database Study

Abstract Background This study examined the association between cardiopulmonary bypass (CPB) hematocrit and postoperative acute renal failure (ARF) in patients undergoing aortic arch surgery with hypothermic circulatory arrest. Methods The..

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Practical considerations on hypoxemia and hypoxia in V-V ECMO patients

Abstract We would like to express our gratitude to Aravind Bommiasamy and his coauthors for their detailed analysis on the physiological impacts of cardiac output (CO) on oxygen supply in..

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Age as a Mortality Predictor in ECPR Patients

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an advanced technique using extracorporeal membrane oxygenation (ECMO) to support patients with refractory cardiac arrest. Age significantly influences ECPR outcomes, with younger patients generally..

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Prophylactic corticosteroids for infants undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials

Abstract Background Prophylactic corticosteroids have been widely used to mitigate the inflammatory response induced by cardiopulmonary bypass (CPB). However, the impact of this treatment on clinically important outcomes in infants..

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Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review

Abstract Background Across the world, many systems have implemented extracorporeal cardiopulmonary resuscitation (ECPR) as a potential treatment strategy for patients in refractory cardiac arrest. To date, there are no universally..

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Histidine-Tryptophan-Ketoglutarate Cardioplegia Yields Different Results in Aortic Valve Surgery Depending on Patient Gender: A Pilot Study

Abstract Background: Histidine-tryptophan-ketoglutarate (HTK) cardioplegia induces cardiac arrest through membrane hyperpolarization. Aortic valve pathology leads to pathophysiological changes in left ventricular vascularization that may prevent adequate cardioplegic distribution. The objective..

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Ventilation and Oxygenation During and After Adult Cardiopulmonary Resuscitation: Changing Paradigms

Abstract Cardiac arrest (CA) remains a major cause of death despite advancements in cardiopulmonary resuscitation (CPR), post-resuscitation care, and international efforts to develop evidence-based guidelines. Effectively managing ventilation and oxygenation..

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Accidental Lumbar Vein Cannulation During Emergent Veno-Venous Extracorporeal Membrane Oxygenation Initiation: Case Report

Abstract A 31-year-old woman at 41 weeks gestation presented after a home-delivery attempt, resulting in an intrauterine fetal demise. A cesarean section revealed purulent amniotic fluid. The patient had a..

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Spinal Cord Infarction During Extracorporeal Membrane Oxygenation:A Case Series and Review of the Literature

Abstract Background:  Little is known about extracorporeal membrane oxygenation (ECMO)-related spinal cord infarction (SCI), and reports regarding this rare and catastrophic complication are rare. Here, we report two cases of..

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Post-Cardiac Arrest Care in Extracorporeal Cardiopulmonary Resuscitation

Abstract OBJECTIVES: Extracorporeal cardiopulmonary resuscitation (ECPR) serves as a lifesaving intervention for patients experiencing refractory cardiac arrest. With its expanding usage, there’s a burgeoning focus on improving patient outcomes through..

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Heart rhythm at hospital admission: A factor for survival and neurological outcome among ECPR recipients?

Abstract Background The initial rhythm is a known predictor of survival in extracorporeal cardiopulmonary resuscitation (ECPR) patients. However, the effect of the rhythm at hospital admission on outcomes in these..

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Escalation from IABP to ECMO is associated with increased mortality in patients undergoing VA-ECMO

Abstract Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used for refractory cardiogenic shock (CS). Although guidelines have downgraded the recommendations for intra-aortic balloon pump (IABP) in CS, escalation from..

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VA-ECMO as a Bridge to Recovery in Refractory Circulatory Failure due to Bupropion Overdose

Abstract We present a case of successfully treating an adult woman with a lethal bupropion overdose with VA-ECMO. The patient presented to the hospital with severe encephalopathy, which progressed to..

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Using machine learning to predict neurologic injury in venovenous extracorporeal membrane oxygenation recipients: An ELSO Registry analysis

Abstract Background Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with acute brain injury (ABI), including central nervous system (CNS) ischemia (defined as ischemic stroke or hypoxic-ischemic brain injury [HIBI]) and..

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Association Between Persistent Hypothermia After Cardiopulmonary Bypass in Neonates and Odds of Serious Complications

Abstract IMPORTANCE:  Persistent hypothermia after cardiopulmonary bypass (CPB) in neonates with congenital heart defects (CHD) has been historically considered benign despite lack of evidence on its prognostic significance. OBJECTIVES:  Examine..

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High Risk ECMO Cannula to Circuit Connection

Abstract A patient with a percutaneously inserted cardiopulmonary bypass cannula into the right internal jugular vein, connected to an extracorporeal membrane oxygenation (ECMO) circuit using tape, was referred for transport..

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Temperature and Neurologic Outcomes in Neonates Undergoing Cardiac Surgery: A Society of Thoracic Surgeons Study

Abstract Background There is significant variability in postoperative neurological injury rates in patients with , with early injuries impacting long-term neurodevelopmental outcomes; therefore, there is an urgent need for identifying effective..

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