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Using near-infrared reflectance spectroscopy (NIRS) to assess distal-limb perfusion on venoarterial (V-A) extracorporeal membrane oxygenation (ECMO) patients with femoral cannulation

Abstract Background: Patients requiring V-A ECMO who receive femoral cannulation have an associated risk of distal, lower-limb hypoperfusion and ischemia of the cannulated leg. This pilot study evaluated the usefulness..

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Early negative fluid balance is associated with lower mortality after cardiovascular surgery

Abstract Background: Early fluid expansion could prevent postoperative organ hypoperfusion. However, excessive fluid resuscitation adversely influences multiple organ systems. This retrospective, observational study aimed to investigate the relationship between early..

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Zero‐Balance Ultrafiltration of Priming Blood Attenuates Procalcitonin and Improves the Respiratory Function in Infants After Cardiopulmonary Bypass: A Randomized Controlled…

Abstract Blood priming is needed for cardiopulmonary bypass (CPB) in neonates and infants to avoid exceeding hemodilution; however, transfusion‐related inflammation affects post‐CPB outcomes in infant open‐heart surgery. Procalcitonin, a newly..

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Heparin–protamine balance after neonatal cardiopulmonary bypass surgery

Abstract Essentials   Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..

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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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National Benchmarks for Proportions of Patients Receiving Blood Transfusions During Pediatric and Congenital Heart Surgery: An Analysis of the STS…

Abstract Background To determine national benchmarks and assess variability across centers, The Society of Thoracic Surgeons Congenital Heart Surgery Database was analyzed to document proportions of patients receiving intraoperative transfusion..

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Patient Blood Management in Pediatric Cardiac Surgery: A Review

Abstract Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant..

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Calculation Algorithm Reduces Protamine Doses Without Increasing Blood Loss or the Transfusion Rate in Cardiac Surgery: Results of a Randomized…

Abstract Objectives The aim of the study was to investigate whether the HeProCalc algorithm affects heparin and  dosage, , and transfusion rate. Design Randomized controlled trial. Setting University hospital. Participants The..

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Red Blood Cell Disorders: Perioperative Considerations for Patients Undergoing Cardiac Surgery

Abstract Disorders affecting red blood cells (RBCs) are uncommon yet have many important physiologic considerations for patients undergoing cardiac surgery. RBC disorders can be categorized by those that are congenital..

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Thoracic Bleeding Complications in Patients With Venovenous Extracorporeal Membrane Oxygenation

Abstract Background Patients with respiratory failure are treated more frequently with venovenous  (vv-ECMO). These patients are at risk for bleeding due to complex multifactorial  resulting from the . Methods A retrospective analysis was conducted..

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The effect of air exposure on leucocyte and cytokine activation in an in-vitro model of cardiotomy suction

Abstract Introduction: Cardiopulmonary bypass (CPB) is known to cause a systemic inflammatory and immune response. Objective: An in-vitro model of cardiotomy suction was designed to quantify the effects of incrementally increased air-blood..

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Pharmacological and non‐surgical renal protective strategies for cardiac surgery patients undergoing cardiopulmonary bypass: a systematic review

Abstract Background Post‐operative acute kidney injury after cardiopulmonary bypass (AKI‐CPB) for cardiac surgery is a frequent complication. It may require renal replacement therapy (RRT), which is associated with an increased..

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Hematocrit and impact of transfusion in patients receiving extracorporeal life support

Abstract Introduction:  Increasing the hematocrit is considered to increase oxygen delivery to the patient, especially when hypoxic conditions exist and the patient may become more stable. The aim of this..

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Fluid Management With Peritoneal Dialysis After Pediatric Cardiac Surgery

Abstract Children who undergo cardiac surgery with cardiopulmonary bypass are a unique population at high risk for postoperative acute kidney injury (AKI) and fluid overload. Fluid management is important in..

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Short-term outcome of cardiac surgery under cardiopulmonary bypass in patients who refuse transfusion: a controlled study

Abstract BACKGROUND: Although bloodless cardiac surgery has been successfully performed for many years, studies with controls permitting transfusion are few and their results inconclusive. This study compares the outcome of..

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A prospective, observational study of cerebrovascular autoregulation and its association with delirium following cardiac surgery

Summary This aim of this prospective observational cohort study was to evaluate any association between postoperatively impaired cerebrovascular autoregulation and the onset of delirium following cardiac surgery. Previous studies have..

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Mechanical circulatory support in patients with cardiogenic shock in intensive care units: A position paper of the “Unité de Soins…

Summary  (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the  of CS, its management has only improved slightly. The prevalence of CS has remained stable over..

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Development of a practical prediction score for chronic kidney disease after cardiac surgery

Abstract Background Chronic kidney disease (CKD) is a frequent and serious complication of cardiac surgery. This study was designed to establish a scoring system, calculated in the immediate postoperative period,..

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Perioperative use of the intra-aortic balloon pump

Abstract Purpose of review  Intraaortic balloon pump (IABP) has been the most widely used device to help patients recover from circulatory disorder mainly because of cardiogenic shock; however, no evidence-based..

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Anatomy of the Functionally Univentricular Heart

Abstract The world of pediatric cardiac surgery and cardiac surgery as a whole lost one of the great pioneers with the passing, at the beginning of 2018, of Francis Fontan...

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The Effect of Modified Ultrafiltration on Serum Vancomycin Levels During Cardiopulmonary Bypass in Cardiac Surgery

Abstract Objective The aim of this study was to investigate whether the use of  at the end of  for cardiac surgical procedures significantly changes  serum concentrations. Design Prospective study. Setting Single tertiary cardiac..

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Increased blood transfusion and its impact in patients having tracheostomy while on extracorporeal membrane oxygenation

Abstract Introduction: Tracheostomy has been utilized in combination with venovenous extracorporeal membrane oxygenation (VV-ECMO) to enable early spontaneous breathing and minimize sedation requirements. Tracheostomy has been previously reported to be..

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Cardioplegia practice in paediatric cardiac surgery: a UK & Ireland survey

Abstract Introduction: Many techniques are available for cardioplegic arrest in children, but there is a lack of late phase clinical trials to guide practice. We surveyed paediatric cardiac surgeons and..

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Prospective, Randomized Un-Blinded Three Arm Controlled Study in Coronary Artery Revascularization with Minimal Invasive Extracorporeal Circulation Systems (MiECC): Surrogate Parameter…

Abstract Objectives: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused..

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Does full sternotomy have more significant impact than the cardiopulmonary bypass time in patients of mitral valve surgery?

Abstract Background Over the past decade, minimally invasive mitral valve surgery (MIMVS) has grown in popularity. Less invasive approaches to mitral valve surgery are increasingly used for improved cosmesis. We..

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The Starling Relationship and Veno-Arterial ECMO: Ventricular Distension Explained

Abstract The use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) to support patients with acute heart failure has been associated with ventricular distension and pulmonary edema, the mechanism of which..

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Feasibility of autologous intraoperative blood collection and retransfusion in small children with complex congenital heart defects undergoing cardiopulmonary bypass

Abstract Introduction Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may..

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Pediatric extracorporeal membrane oxygenation (ECMO): a guide for radiologists

Abstract Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for pediatric patients with respiratory and/or cardiac failure. The ECMO circuit oxygenates and sometimes pumps the blood, effectively replacing lung and/or..

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Validation of renal-risk models for the prediction of non-renal replacement therapy cardiac surgery-associated acute kidney injury

Abstract Background Cardiac surgery-associated acute kidney injury (AKI) is a serious complication of cardiac surgery, even when renal replacement therapy (RRT) is not required. The existing risk models for cardiac..

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Clinical Practice Guidelines What’s Next?

Abstract Clinical practice guidelines are a key component of medicine, as they provide evidence-based recommendations for physicians and other health care professionals about the management of care for patients with..

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