Monthly Archives: March 2023

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Prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis of non-pharmacological interventions

Abstract Background Cardiac surgery-associated acute kidney injury (CSA-AKI) is frequent. While two network meta-analyses assessed the impact of pharmacological interventions to prevent CSA-AKI, none focused on non-pharmacological interventions. We aim..

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Left Ventricular Unloading With Impella Versus IABP in Patients With VA-ECMO: A Systematic Review and Meta-Analysis

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) use for circulatory support in cardiogenic shock results in increased left ventricular (LV) afterload. The use of concomitant Impella or intra-aortic balloon pump (IABP)..

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Central venous-to-arterial CO2 difference as a biomarker of outcome in children who underwent surgery for congenital heart disease

Abstract Background: In congenital heart surgery, low cardiac output syndrome (LCOS) is a major cause of morbidity in the immediate post-operative period. A decrease in cardiac output leads to an increase..

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Renal medullary oxygenation during laparoscopic vs open surgery: the impact of blood pressure management—a pilot randomized controlled trial

Abstract The impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation (PuO2), a validated surrogate of renal medullary PO2, during general surgery, is unclear...

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Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: 10-year experience in a metropolitan cardiac arrest centre in Milan, Italy

Abstract Introduction Growing evidence supports  cardiopulmonary resuscitation (ECPR) for refractory out-of-hospital cardiac arrest (OHCA) patients, especially in experienced centres. We present characteristics, , and outcomes of patients treated with ECPR in a..

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A prospective feasibility trial exploring novel biomarkers for neurotoxicity after isolated limb perfusion

Abstract Background Isolated limb perfusion (ILP) is a regional cancer treatment in which high-dose chemotherapy is administered in an isolated extremity. The main side effect is regional toxicity, which occasionally..

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Bivalirudin for cardiopulmonary bypass in a patient with heparin allergy

Abstract Background Hypersensitivity reactions to heparin are uncommon conditions but pose a serious clinical problem for patients requiring cardiopulmonary bypass. Bivalirudin is a reversible direct thrombin inhibitor that can be..

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Historical Accounts of Congenital Heart Surgery

Abstract We present historical accounts of congenital heart surgery since the early 1900s, as our specialty evolved from individual heroic efforts into an established and sophisticated surgical specialty with consistent..

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Hypothermic Circulatory Arrest in Adult Aortic Arch Surgery: A Review of Hypothermic Circulatory Arrest and its Anesthetic Implications

Abstract Diseases affecting the aortic arch often require surgical intervention. Hypothermic circulatory arrest (HCA) enables a safe approach during open aortic arch surgeries. Additionally, HCA provides neuroprotection by reducing cerebral..

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Clinical Medicine Adjunctive Hemoadsorption Therapy with CytoSorb in Patients with Septic/Vasoplegic Shock: A Best Practice Consensus Statement

Abstract A dysregulated host response is a common feature in critically ill patients due to both infectious and non-infectious origins that can lead to life-threatening organ dysfunction, which is still..

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Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study

Abstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was..

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Predictors of thrombosis during VV ECMO: an analysis of 9809 patients from the ELSO registry

Abstract Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving therapy for critically ill patients, but it carries an increased risk of thrombosis due to blood interacting with non-physiological surfaces. While..

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Low-Volume Acute Normovolemic Hemodilution Does Not Reduce Allogeneic Red Blood Cell Transfusion in Cardiac Surgery in the Modern Era of…

Abstract Objectives Patients undergoing cardiac surgery often require , which are associated with increased morbidity and mortality. Patient blood management (PBM) strategies, including acute normovolemic  (ANH), have been implemented to minimize allogeneic..

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Anti-Xa assay monitoring improves the precision of anticoagulation in venovenous extracorporeal membrane oxygenation

Abstract Unfractionated heparin (UFH) is the most used anticoagulant in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO). Its therapeutic levels are monitored using activated partial thromboplastin time ratio (aPTTr) or..

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Prevalence of burnout among perfusionists in China: A nationwide survey

Abstract Background Burnout has gained increasing attention worldwide as a phenomenon that affects health care professionals. However, there is a lack of relevant research about its impact on practitioners in..

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Subclavian Artery Cannulation For Left Ventricular Unloading During Extracorporeal Membrane Oxygenation Support

Abstract Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective mechanical circulatory support for cardiac insufficiency following cardiac surgery especially cardiac surgery with extracorporeal circulation, which can quickly restore the perfusion..

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Should we give steroids after out‑of‑hospital cardiac arrest?

Abstract The pathophysiology of post-cardiac arrest syndrome features ischaemic/reperfusion injury and the release of high levels of inflammatory cytokines [1]. These inflammatory markers include interleukin-6 (IL-6), C-reactive protein (CRP), tumour..

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Contemporary Outcomes of Children With Acute Fulminant Myocarditis Supported With Peripheral Extracorporeal Membrane Oxygenation

Abstract Despite extracorporeal membrane oxygenation (ECMO) utilization in nearly 20% of cases, there are limited data in children with acute fulminant myocarditis (AFM) requiring ECMO. Herein we identify risk factors..

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Adjunctive Hemoadsorption Therapy with CytoSorb in Patients with Septic/Vasoplegic Shock: A Best Practice Consensus Statement

Abstract A dysregulated host response is a common feature in critically ill patients due to both infectious and non-infectious origins that can lead to life-threatening organ dysfunction, which is still..

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CytoSorb® in Combination with CRRT in A Patient Suffering from Septic Shock, Acute Respiratory Distress Syndrome (ARDS) and Acute Kidney…

This case reports on an 53-year-old female patient who was admitted to the hospital with an 8 day history of fever and chills, loose stools, vomiting, severe weakness, and reduced..

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Left Ventricle Unloading Through Pulmonary Artery in Patients With Venoarterial Extracorporeal Membrane Oxygenation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation for patients with cardiogenic shock or cardiac arrest is an attractive strategy since it provides a quick restoration of organ perfusion. One major..

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The Use of Impella 5.5 for Donor–Heart Hemodynamic Support in Heart Transplantation

Abstract Primary graft dysfunction is a feared complication and cause of mortality post–heart transplant. Primary graft dysfunction may require mechanical circulatory support, such as venoarterial extracorporeal membrane oxygenation, which carries..

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Percutaneous Left Ventricle Unloading During Venoarterial Extracorporeal Membrane Oxygenation

Abstract The issue of left ventricular (LV) distention during venoarterial extracorporeal membrane oxygenation (VA-ECMO) is crucial as it markedly impacts on patients’ weanability and, ultimately, outcome. Numerous techniques have been..

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Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Abstract Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary bypass for patients with acute respiratory or cardiac failure refractory to conventional therapy. Its usage has become increasingly widespread..

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Analysis of P(v-a)CO2/C(a-v)O2 Ratio and Other Perfusion Markers in a Population of 98 Pediatric Patients Undergoing Cardiac Surgery

Abstract Background:   The so-called Low Cardiac Output Syndrome (LCOS) is one of the most common complications in pediatric patients with congenital heart disease undergoing corrective surgery. LCOS requires high..

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Defining heparin resistance: communication from the ISTH SSC Subcommittee of Perioperative and Critical Care Thrombosis and Hemostasis

Abstract The term heparin resistance (HR) is used by clinicians without specific criteria. We performed a literature search and surveyed our SSC membership to better define the term when applied..

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Ambulatory extracorporeal membrane oxygenation simulator: The next frontier in clinical training

Abstract Background Current medical simulators for extracorporeal membrane oxygenation (ECMO) are expensive and rely on low-fidelity methodologies. This creates a challenge that demands a new approach to eliminate high costs..

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Standardized nomenclature for peripheral percutaneous cannulation of the pulmonary artery in extracorporeal membrane oxygenation: Current uptake and recommendations for improvement

Abstract The rising application of extracorporeal membrane oxygenation (ECMO) has emphasized the need for consistent and standardized terminology, especially concerning peripheral percutaneous cannulation of the pulmonary artery (PPC-PA). The Extracorporeal..

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ECMO simulation: How much, who to train, and a review of cost, fidelity and performance

Abstract Background Extracorporeal Membrane Oxygenation (ECMO) is a high-risk, low-volume procedure requiring repetition, skill and multiple disciplines with fidelity of communication. Yet many barriers exist to maintain proficiency and skills..

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The choice of perioperative inotropic support impacts the outcome of small infants undergoing complex cardiac surgery: an observational study

Abstract BACKGROUND: Vaso-inotropic agents are frequently used to prevent and/or treat low cardiac output syndrome in infants undergoing surgery for congenital heart disease. Due to the lack of comparative studies,..

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