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Inflammatory Responses During Cardiopulmonary Bypass: Mechanisms, Mediators, and Management Strategies

Abstract: Cardiopulmonary bypass (CPB) induces a multifactorial systemic inflammatory response that significantly contributes to postoperative complications such as acute lung injury, renal dysfunction, and increased morbidity. This response is initiated..

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Prothrombotic Microvesicle Generation in Pediatric Cardiopulmonary Bypass: A Pilot Observational Study

Abstract Over 10% of children develop thrombosis after cardiac surgery for congenital heart disease. Children with a single ventricle physiology have the highest risk of thrombosis associated with increased length..

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Principles and Functions of Cardiopulmonary Bypass (CPB).

Cardiopulmonary Bypass (CPB) is one of the most critical advancements in cardiac surgery. It allows the surgical team to operate on a non-beating heart by temporarily taking over the functions..

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Early endovascular reperfusion during extracorporeal support for massive pulmonary embolism

Abstract In massive pulmonary embolism (PE), endovascular therapies and extracorporeal membrane oxygenation (ECMO) are increasingly utilised. However, the impact of combining endovascular therapies with ECMO on shock resolution and clinical recovery remains..

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Variations in thromboelastography levels in blood exposed to membrane oxygenators

Abstract Introduction Thromboelastography (TEG), which indicates hemostatic ability, is useful for monitoring coagulation during extracorporeal circulation (ECC). However, the extent to which TEG levels are independently affected by ECC exposure..

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Theoretical Foundations of Cardiopulmonary Bypass: Bridging Science, Engineering, and Clinical Practice

Introduction: A Heart That Pauses, A Circuit That Lives When the heart is arrested during cardiac surgery, life continues—thanks to cardiopulmonary bypass (CPB). The theoretical underpinnings of CPB stem from..

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Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal

Abstract Extracorporeal carbon dioxide removal (ECCO2R) is an emerging technique designed to reduce carbon dioxide (CO2) levels in venous blood while enabling lung-protective ventilation or alleviating the work of breathing...

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High-risk pulmonary embolism: thesignificance and perspectives of pulmonaryreperfusion

Abstract Rapid hemodynamic stabilization and restoration of pulmonary perfusion are the cornerstones of treatment for high-risk pulmonary embolism (PE). While all current guidelines recommend systemic thrombolysis (SYS) as the first-line..

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Case Report: Oxygenator Burst During Minimally Invasive Coronary Artery Bypass Grafting (CABG) – A Critical Perfusion Incident

Abstract This case report discusses a rare and critical perfusion accident during a minimally invasive coronary artery bypass grafting (CAGB) procedure, where a Eurosets Skipper oxygenator burst 3 minutes after..

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ECMO Transport: Moving Critically Ill Patients Safely

Introduction Extracorporeal Membrane Oxygenation (ECMO) is a life-saving intervention for patients with severe cardiac and respiratory failure. However, the need for specialized ECMO care often necessitates the transport of critically..

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ECMO for Refractory Cardiogenic Shock: When Is It the Right Choice?

Introduction Refractory cardiogenic shock (RCS) is a life-threatening condition where the heart fails to supply adequate blood flow to the body's organs, despite maximal medical therapy. It is a major..

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Continuous Kidney Replacement Therapies: Core Curriculum 2025

Abstract Critically ill patients that require kidney replacement therapy (KRT) are among the most ill and complex patients routinely encountered in the intensive care unit (ICU). Continuous KRT (CKRT) is..

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Artificial Intelligence in Perfusion: The Future of Data-Driven Decision-Making

Introduction Artificial Intelligence (AI) is rapidly transforming perfusion, particularly in cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO). By leveraging machine learning (ML) and real-time data analysis, AI enhances decision-making,..

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ECMO in Cardiac Surgery: When and How to Implement It

Introduction Extracorporeal Membrane Oxygenation (ECMO) has become a vital intervention in cardiac surgery, offering temporary mechanical support for patients experiencing severe cardiac dysfunction. It stabilizes hemodynamics, allowing time for myocardial..

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A clinical comparison of the effects of six disposable cardiopulmonary bypass circuits on bleeding and coagulation: a quality assurance project

Abstract Purpose Cardiac surgery requiring cardiopulmonary bypass (CPB) is frequently complicated by excessive bleeding because of coagulopathy. Contact of blood with the CPB circuit is a major contributor. While several..

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Monitoring Hemostatic Function during Cardiac Surgery with Point-of-Care Viscoelastic Assays: A Narrative Review

Abstract Bleeding is a well-known and severe complication of cardiac surgery. Cardiopulmonary bypass, along with heparinization and hemodilution, is thought to affect all pathways of the hemostatic process, leading to..

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Advances in CPB Circuit Coatings: Impact on Biocompatibility and Inflammatory Response

Introduction Cardiopulmonary bypass (CPB) is a lifesaving technology in cardiac surgery, but it introduces blood-material interactions that trigger inflammatory and coagulative responses. To address these issues, advancements in biocompatible CPB..

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Low- vs. Moderate-Intensity Anticoagulation for Venovenous Extracorporeal Membrane Oxygenation: The SAFE-ECMO Pilot Trial

Abstract Background Bleeding is a common and sometimes fatal complication of venovenous extracorporeal membrane oxygenation (ECMO). Whether lowering the intensity of anticoagulation during venovenous ECMO is safe or effective is..

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Anticoagulation in ECMO: Target Values to Reduce Hemorrhagic Complications in Adults. A Retrospective Cohort Study

Abstract The 2021 Adult and Pediatric Anticoagulation Guidelines for patients on extracorporeal membrane oxygenation (ECMO) recommend a target partial thromboplastin time (PTT) between 60 and 85 seconds when unfractionated heparin..

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Enhanced Hemodynamics of Anisometric TPMS Topology Reduce Blood Clotting in 3D Printed Blood Contactors

Abstract Artificial organs, such as extracorporeal membrane oxygenators, dialyzers, and hemoadsorber cartridges, face persistent challenges related to the flow distribution within the cartridge. This uneven flow distribution leads to clot..

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Survey of Extracorporeal Life Support Application in Lung Transplantation

Abstract Introduction Lung transplantation has been evolving since its inception in 1963. Over recent years, literature has suggested a shift in the perioperative strategy of mechanical support toward extracorporeal membrane..

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Blood Purification Membranes Used in Liquid–Gas Environments: Artificial Lungs

Abstract Extracorporeal membrane oxygenation (ECMO), the key component of which is a membrane oxygenator, known as the artificial lung, could provide irreplaceable respiratory support for patients with cardiopulmonary failure. The..

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Anticoagulation Monitoring Strategies During Extracorporeal Membrane Oxygenation (ECMO) Therapy – Differences Between Simultaneously Obtained Coagulation Tests: A Retrospective Single-Center Cohort…

Abstract Introduction During extracorporeal membrane oxygenation (ECMO) systemic anticoagulation with unfractionated heparin (UFH) is standard-of-care. However, there is uncertainty regarding optimal anticoagulation monitoring strategies. Methods We retrospectively investigated venovenous and..

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ECMO in Resource-Limited Settings: Challenges and the Way Forward

Introduction Extracorporeal Membrane Oxygenation (ECMO) has revolutionized the management of patients with severe cardiac and respiratory failure. Once considered a last-resort therapy, ECMO is now an integral part of critical..

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Optimizing Priming Solutions in Cardiopulmonary Bypass: Balancing Hemodynamics, Organ Protection, and Patient Outcomes

Introduction Cardiopulmonary bypass (CPB) is a life-saving technology that temporarily replaces the heart and lungs during cardiac surgery. The choice of priming solution plays a crucial role in maintaining hemodynamic..

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Isolated Limb Perfusion (ILP) and Hyperthermia in Cancer Treatment

Introduction Isolated Limb Perfusion (ILP) is a targeted chemotherapy technique used primarily for treating locally advanced limb malignancies, such as soft tissue sarcomas and melanoma. By isolating the limb’s vascular..

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Left Heart Bypass

Left Heart Bypass: An Overview Introduction Left Heart Bypass (LHB) is a surgical technique used to temporarily divert blood from the left side of the heart to maintain distal perfusion..

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Managing Anticoagulation in Cardiopulmonary Bypass: Best Practices

Cardiopulmonary bypass (CPB) is a cornerstone of modern cardiac surgery, enabling complex procedures by temporarily taking over the heart and lung functions. However, one of the most critical aspects of..

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Common Mistakes in Perfusion and How to Avoid Them.

Perfusionists play a critical role in cardiac surgery and extracorporeal support, ensuring optimal oxygenation and circulation during procedures. However, given the complexity of the field, even experienced professionals can make..

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The effects of changes in thrombocyte indices, on-on-pump time on prognosis in open heart surgery

Abstract Extracorporeal perfusion systems utilized in open-heart surgeries with cardiopulmonary bypass can affect multiple body systems. The primary adverse effects of Extracorporeal Perfusion Systems (EPS) on the hematological system include..

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