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Pharmacokinetics and Pharmacodynamics of Analgesic and Anesthetic Drugs in Patients During Cardiac Surgery With Cardiopulmonary Bypass: A Narrative Review

Abstract Cardiopulmonary bypass (CPB) impacts pharmacokinetics and -dynamics of drugs used during cardiac surgery. These alterations can lead to changes in drug efficacy resulting in under- or overdosing. This review..

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Risk Factors and Predictive Model for Stress Hyperglycemia After Cardiac Surgery in Non-Diabetic Patients

Abstract Objective: To create and verify a model that predicts the risk of stress hyperglycemia (SHG) in patients without diabetes after cardiac surgery. Design: Retrospective analysis. Methods: This retrospective analysis analyzed patients without..

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Combining procalcitonin, c-reactive protein, and white blood cell count in predicting infections in pediatric open cardiac surgery with cardiopulmonary bypass

Abstract Objective This study aimed to evaluate the validity of models using Procalcitonin (PCT) alone and PCT combined with other biomarkers to predict early infection after pediatric open-heart surgery with..

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A prospective non-inferiority trial of pathogen reduced platelets compared to non-pathogen reduced platelets for correction of viscoelastic platelet function testing…

Abstract Background Cardiac surgery on cardiopulmonary bypass (CPB) may alter platelet (PLT) function causing bleeding. The goal of this study is to evaluate the hemostatic effect of PRT-PLTs compared to..

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Achieving Neuroprotection in the Setting of Early Extubation During Infant Cardiac Surgery: A Prospective, Randomized, and Blinded Study

Abstract Background: This study aimed to investigate the impact of early extubation on stress response and neurodevelopmental outcomes after pediatric cardiac surgery utilizing cardiopulmonary bypass (CPB). Methods: In this single-center prospective pilot..

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Clinical assessment of cannula performance during adult minimally invasive valve surgery using predictive mathematical models

Abstract OBJECTIVES Peripheral cannula selection in minimally invasive cardiac surgery (MICS) is crucial, as venous drainage limitations during cardiopulmonary bypass (CPB can impair end-organ perfusion and overall outcomes. This study..

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Probiotic mitigates gut hypoperfusion-associated acute gastrointestinal injury in patients undergoing cardiopulmonary bypass: a randomized controlled trial

Abstract Background Acute gastrointestinal injury (AGI) after cardiopulmonary bypass (CPB) is associated with poor prognosis. This study aimed to evaluate the effect of preoperative probiotic supplementation on the incidence of..

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Near-infrared spectroscopy to monitor cerebral and renal oxygen saturation during cardiopulmonary bypass surgery for paediatric congenital heart disease: study protocol…

Abstract Background Current indicators for monitoring intraoperative organ function remain predominantly indirect, delayed and non-specific, particularly in paediatric populations undergoing congenital heart surgery, where multifactorial influences further complicate functional assessments. Emerging..

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Maintaining ventilation with very low tidal volume and positive-end expiratory pressure versus no ventilation during cardiopulmonary bypass for cardiac surgery…

Abstract Purpose Cardiopulmonary bypass (CPB) during cardiac surgery mechanically circulates and oxygenates the blood, bypassing the heart and lungs. Despite limited evidence, maintaining mechanical ventilation (MV) during CPB is recommended,..

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Thrombus Migration Resulting From Cessation of Cardiopulmonary Bypass Flow in a Patient With Left Ventricular Thrombus

Introduction Left ventricular (LV) thrombus formation is a known complication associated with acute myocardial infarction and other conditions that impair LV function, carrying a risk for systemic embolization., In this report,..

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Comparison of Three Mathematical Models of the Pharmacokinetics of Heparin to Guide the Use of Protamine in a Large Simulated…

Abstract Background: In cardiac surgery, protamine is used to reverse the effects of heparin after separation from cardiopulmonary bypass (CPB). Excess of protamine has been demonstrated to cause platelet dysfunction and..

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The impact of arterial cannulation strategy on carotid perfusion during cardiopulmonary bypass: A computational fluid dynamics analysis from the perspective…

Abstract Introduction: Cardiopulmonary bypass (CPB) is utilized during cardiovascular surgery to maintain organ oxygen supply and blood perfusion instead of cardiopulmonary function. Three primary methods of artery cannulation used for CPB..

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Frontoparietal and temporal brain alterations post-cardiopulmonary bypass

Abstract Patients undergoing cardiopulmonary bypass (CPB) often experience neurological complications, but the neurobiological mechanisms remain unclear. This study combined resting-state fMRI, structural MRI, and cognitive testing to examine brain changes..

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Pulsatile cardiopulmonary bypass using a centrifugal pump reduces acute kidney injury after cardiac surgery: a propensity score-matched analysis

Abstract Objective Acute kidney injury (AKI) affects approximately 30% of patients undergoing cardiac surgery with conventional non-pulsatile cardiopulmonary bypass (CPB). Pulsatile flow has long been proposed for mitigating this complication...

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Kidney protection during surgery on the thoracoabdominal aorta: a systematic review

Abstract OBJECTIVES Acute kidney injury (AKI) is a common consequence of surgical repair of the thoraco-abdominal aorta (TAA). Perfusion techniques aim to facilitate renal protection through oxygenation or hypothermia. This..

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Impact of prolonged cardiopulmonary bypass on gastrointestinal complications in cardiac surgery: a retrospective cohort study

Abstract Background Gastrointestinal complications (GICs) following cardiac surgery with cardiopulmonary bypass (CPB) significantly impact postoperative recovery and clinical outcomes. Methods This single-center, retrospective cohort study evaluated the incidence, risk factors,..

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Thrombin Generation in Pediatric Cardiac Surgery Patients, a Prospective Single-center Cohort Study

Abstract Background:  The objective of this study was to describe thrombin generation in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Change in the endogenous thrombin potential (ETP) across three..

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Impact of cardiopulmonary bypass flow on the lower limit of cerebral autoregulation during cardiac surgery: a randomized cross-over pilot study

Abstract Assessment of cerebral autoregulation is challenging under different hemodynamic conditions during cardiac surgery and must be rapidly calculated in order to optimize mean arterial pressure (MAP). Whether systemic flow..

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Implementation of a goal directed perfusion strategy to reduce cardiac surgery associated kidney injury: A before and after study

Abstract Purpose Cardiac surgery associated acute kidney injury (CSA-AKI) is a frequent and severe complication. Goal Directed Perfusion (GDP) during cardiopulmonary bypass (CPB) has been developed to reduce post-operative complications,..

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Perfusionists, Surgeons, and Anesthesiologists: A History of Successful Multidisciplinary Collaboration: What's Next?

Abstract Licensure in medicine originated in London when a small group of physicians led by the scholar Thomas Linacre petitioned King Henry VIII to establish a college of physicians on..

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Multimodal Brain Monitoring in Cardiac Surgery and Postoperative Patient Outcomes

Abstract Objective To describe the occurrence of cerebral desaturation (≥10% decrease or <50% in regional cerebral oxygen saturation [rSO₂]), deep anesthetic states (processed electroencephalography patient state index [PSI] <25), and..

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Perioperative Nitric Oxide Conditioning Reduces Acute Kidney Injury in Cardiac Surgery Patients with Chronic Kidney Disease (the DEFENDER-trial): a Randomized…

Abstract Background:  Postoperative Acute kidney injury (AKI) is a significant concern for cardiac surgery patients with chronic kidney disease (CKD). Effective pharmacological interventions to mitigate these risks are urgently needed...

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Optimal brain perfusion pressure derived from the continuous monitoring of cerebral autoregulation status during neonatal heart surgery under cardiopulmonary bypass…

Abstract Background Understanding cerebral blood flow regulation and later optimizing brain perfusion is part of neuroprotection during cardiopulmonary bypass (CPB) in neonates. Methods A total of 38 neonates undergoing CPB..

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Inhaled vs. intravenous vasodilators in perioperative pulmonary hypertension during chest surgery using cardiopulmonary bypass: A systematic review and meta-analysis

Abstract Perioperative pulmonary arterial hypertension (PAH) is a common complication of chest surgery with cardiopulmonary bypass (CPB) and its etiology is multifactorial. Patients undergoing this surgery often have underlying conditions,..

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Fenoldopam use during Cardiopulmonary Bypass and Postoperative Rates of Acute Kidney Injury.

Abstract Acute kidney injury (AKI) is a complex clinical syndrome with a spectrum of clinical manifestations and outcomes (1); characterized by the deterioration of renal function over a period of..

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Minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery: a contemporary systematic review and meta-analysis

Abstract OBJECTIVES The question whether minimally invasive extracorporeal circulation (MiECC) represents the optimal perfusion strategy in cardiac surgery remains unanswered. We sought to systematically review the entire literature and thoroughly..

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Effect of cardiopulmonary bypass on late-onset hyperlactatemia after pediatric cardiac surgery

Abstract Background: This study aimed to investigate the effect of operative and postoperative parameters on late-onset hyperlactatemia (LOHL) after cardiac surgery in the pediatric patient population.Methods: One hundred fifty-nine ventricular septal defect..

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Cerebral Inflammation in an Animal Ischemia–Reperfusion Model Comparing Histidine-Tryptophan-α-Ketoglutarate and Del Nido Cardioplegia

Abstract Brain injury and cerebral inflammation are frequent complications following cardiopulmonary bypass (CPB) resulting in neurocognitive dysfunction, encephalopathy, or stroke. We compared cerebral inflammation induced by del Nido and histidine-tryptophan-α-ketoglutarate..

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Branch-first technique with continuous perfusion in aortic arch repair—our initial experience

Abstract The branch-first technique (BFT) for aortic arch replacement eliminates deep hypothermia and global circulatory arrest, reducing cardiopulmonary bypass and ischemic times. We present our initial experience with BFT in..

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Minimally invasive cardiac surgery in congenital heart diseases: the new horizon

Abstract Introduction Sternotomy has been the most common approach for the correction of congenital cardiac defects, and questions arise surrounding the safety, feasibility, and cost-effectiveness of implementing minimally invasive techniques..

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