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Anticoagulation with VADs and ECMO: walking the tightrope

Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac..

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Addressing the challenges of ECMO simulation

Abstract Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with..

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A Table Mounted Cardiopulmonary Bypass System for Pediatric Cardiac Surgery

Abstract Systemic inflammatory response and  are prominent factors associated with  and result in increased morbidity and mortality in children. Miniaturized systems have evolved to decrease such effects and restrict use of blood..

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Albumin priming improves the efficiency of the Minntech HPH Jr. hemoconcentrator

Abstract The desired use of the HPH Jr. is optimal due to the low priming volume; however, the lower rate of volume removal necessitates utilization of a larger hemofilter. Larger..

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A red cell preservation strategy reduces postoperative transfusions in pediatric heart surgery patients

Summary Background Blood transfusion has well‐documented adverse effects. As part of a blood conservation initiative at our center, we began routine use of cell saver for all congenital heart surgery..

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Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study

Abstract Introduction and objective Children admitted to the pediatric intensive care unit after cardiovascular surgery usually require treatment with antibiotics due to suspicion of infection. The aim of this study..

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Editorial: Improving Extracorporeal Life Support Outcomes in Children

Abstract Extracorporeal life support (ECLS, also known as extracorporeal membrane oxygenation or ECMO) emerged in the 1970s as a potentially useful life-support therapy for refractory cardiac or respiratory failure in..

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Factors involved in initiation and regulation of complement lectin pathway influence postoperative outcome after pediatric cardiac surgery involving cardiopulmonary bypass

Abstract Congenital heart disease (CHD) often requires surgical intervention, and is sometimes associated with life-threatening post-operative complications. We have investigated some factors of the innate immune system involved in the..

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Switching to Centrifugal Pumps May Decrease Hemolysis Rates Among Pediatric ECMO Patients

Abstract Recent advances in ECLS technology have led to the adoption of centrifugal pumps for the majority of patients worldwide. Despite several advantages of centrifugal pumps, they remain controversial because..

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Audit of transfusion of blood products in paediatric congenital heart surgery on cardiopulmonary bypass

Abstract Background: Cardiac surgery is associated with peri-operative bleeding, which may result in the need for blood transfusion, particularly in paediatric congenital cardiac surgery on cardiopulmonary bypass (CPB). There is..

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Functional Performance of Different Venous Limb Options in Simulated Neonatal/Pediatric Cardiopulmonary Bypass Circuits

Abstract Objective: Hemodilution is a concern in cardiopulmonary bypass (CPB). Using a smaller dual tubing rather than a single larger inner diameter (ID) tubing in the venous limb to decrease..

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Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients

Abstract OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have..

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Predictors of Poor Outcomes in Pediatric Venoarterial Extracorporeal Membrane Oxygenation

Abstract Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in..

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The use of acute normovolemic hemodilution in paediatric cardiac surgery

Abstract Background Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood‐loss surgeries. We determined the association between ANH and the..

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Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer’s chase technique – a…

Abstract Introduction: Residual pump blood from the cardiopulmonary bypass (CPB) circuit is often collected into an infusion bag (IB) and re-transfused. An alternative is to chase the residual blood into..

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Optimizing patient care and outcomes through the congenital heart center of the 21st century

Abstract Pediatric cardiovascular services are responding to the dynamic changes in the medical environment, including the business of medicine. The opportunity to advance our pediatric cardiology field through collaboration is..

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Cerebral near‐infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults

Background Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near‐infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain..

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Influence of the type of congenital heart defects on epithelial lining fluid composition in infants undergoing cardiac surgery with cardiopulmonary…

Abstract Background In children with congenital heart disease (CHD), altered pulmonary circulation compromises gas exchange. Moreover, pulmonary dysfunction is a complication of cardiac surgery with cardiopulmonary bypass (CPB). No data..

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Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children

ABSTRACT Background Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of..

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An Absorbable Hydrogel Spray Reduces Postoperative Mediastinal Adhesions After Congenital Heart Surgery

Abstract Background Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a..

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Red Blood Cell Exosome Hemoglobin Content Increases After Cardiopulmonary Bypass and Mediates Acute Kidney Injury in an Animal Model

Abstract Objective Hemolysis, characterized by formation of free hemoglobin (Hb), occurs in patients undergoing cardiopulmonary bypass (CPB). However, there is no study of the dynamic changes in red blood cell..

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Dose Estimation for Bivalirudin during Pediatric Cardiopulmonary Bypass

Abstract Aim A typical adult based bivalirudin regimen during cardiopulmonary bypass uses a loading dose of 1 mg.kg‐1 and a circuit prime (volume L x 13 mg) with a subsequent intravenous..

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Cardiopulmonary Bypass-Induced Coagulopathy in Paediatric Patients: The Role of Platelets in Postoperative Bleeding. A Preliminary Study

Abstract Introduction Paediatric patients are particularly prone to cardiopulmonary bypass (CPB)‐induced coagulopathy mainly due to haemodilution, consumption of coagulation factors and hypothermia. The aim of the present study was to..

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The Norwood Stage 1 procedure - conduct of perfusion: 2017 Survey results from NPC-QIC member institutions

Abstract Hypoplastic left heart syndrome (HLHS) is a rare and severe congenital cardiac defect. Approximately 1000 infants are born with HLHS in the United States every year. Healthcare collaboratives over..

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Prediction of Bleeding in Pediatric Cardiac Surgery Using Clinical Characteristics and Prospective Coagulation Test Results

Abstract Bleeding caused by coagulopathy is common in children undergoing cardiac surgery and causes adverse outcomes. Coagulation testing assists selection of treatments to stop bleeding but has an uncertain role..

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Management of Congenital Cardiac Surgery During COVID-19 Pandemic

Abstract The new coronavirus infection, which was first seen in China in late December, 2019 and eventually became a worldwide pandemic, poses a serious threat to public health. After a..

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Preoperative extracorporeal membrane oxygenation as a bridge to cardiac surgery in children with congenital heart disease

Background The efficacy of extracorporeal membrane oxygenation (ECMO) in bridging children with unrepaired heart defects to a definitive or palliative surgical procedure has been rarely reported. The goal of this..

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Continuous Monitoring of Cerebral Autoregulation in Children Supported by Extracorporeal Membrane Oxygenation: A Pilot Study

The use of extracorporeal membrane oxygenation has had a positive impact on the outcomes after lung transplantation. Extracorporeal membrane oxygenation has a role in all phases of lung transplantation—preoperative, intraoperative,..

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Continuous Monitoring of Cerebral Autoregulation in Children Supported by Extracorporeal Membrane Oxygenation: A Pilot Study

Objective Cerebral autoregulation (CA) impairment may pose a risk factor for neurological complications among children supported by extracorporeal membrane oxygenation (ECMO). Our first objective was to investigate the feasibility of..

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Dual Carbon Dioxide Capture to Achieve Highly Efficient Ultra-Low Blood Flow Extracorporeal Carbon Dioxide Removal

Abstract Extracorporeal CO2 removal is a highly promising support therapy for patients with hypercapnic respiratory failure but whose clinical implementation and patient benefit is hampered by high cost and highly specialized..

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