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Cardiopulmonary Effects of Vasopressin Versus Norepinephrine in Cardiac Surgery Patients: a Single Cluster-Randomized Cross-over Trial

Abstract Background Laboratory research suggests that vasopressin restores systemic arterial pressure without significantly increasing pulmonary artery pressures, compared with norepinephrine. We therefore tested the hypotheses that treatment of intraoperative vasoplegia..

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Shear-induced dysregulation of haemostasis during extracorporeal membrane oxygenation: From cells to circuit

Abstract Extracorporeal membrane oxygenation (ECMO) is increasingly being utilized in critical care globally to allow for adequate oxygenation in patients with cardiac and/or respiratory failure. Unfortunately, haemostatic complications – both..

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Antithrombin Supplementation in Extracorporeal Membrane Oxygenation: A Systematic Review With Meta-Analysis

Abstract Background The Extracorporeal Life Support Organization recommends daily antithrombin monitoring and supplementation to achieve > 50%–80% activity during extracorporeal membrane oxygenation (ECMO). Evidence supporting this practice is uncertain, and whether..

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Transfusion thresholds and other strategies for guiding red blood cell transfusion

Abstract Background The optimal haemoglobin threshold for use of red blood cell (RBC) transfusions in anaemic patients remains an active area of research. Blood is a limited resource, and there..

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Functional Status Change in Pediatric Extracorporeal Membrane Oxygenation Survivors is Equivalent to Propensity-Matched Patients Managed Without Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is now commonly used to manage refractory pediatric cardiac or respiratory failure. Traditionally, ECMO has been associated with high morbidity. However, despite advancements in ECMO..

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State-of-the-Art Update in Extracorporeal Cardiopulmonary Resuscitation for Out-of-hospital Cardiac Arrest

Abstract ECPR Efficacy and Use: Extracorporeal cardiopulmonary resuscitation (ECPR) improves survival and neurologic outcomes in refractory out-of-hospital cardiac arrest, with global adoption and center availability expanding significantly.

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Thresholds for Transfusion Practice During ECMO Support. A Systematic Review and Network Meta-Analysis

Abstract Purpose The benefits of adopting restrictive transfusion strategies, as opposed to a liberal approach, during extracorporeal membrane oxygenation (ECMO) remain unclear. This network meta-analysis aims to determine whether a..

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Evaluation of water loss during extracorporeal membrane oxygenation

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) can cause blood water loss due to insensible perspiration via oxygenators and plasma leakage. The accurate quantification of water loss is crucial for maintaining..

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Preoperative Endothelial Activation and Stress Index as a predictor of in-hospital mortality and postoperative complications in cardiac surgery with cardiopulmonary…

Abstract BACKGROUND  Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk for peri-operative complications, often linked to endothelial dysfunction. The Endothelial Activation and Stress Index (EASIX) has shown..

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Cost-effectiveness of eCPR: accounting for organ donation

Abstract Extracorporeal cardiopulmonary resuscitation (eCPR) is a highly resource-intensive procedure, and its cost-effectiveness remains a subject of debate []. Hospital-based eCPR for refractory out-of-hospital cardiac arrest has been shown to..

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Experience With Pediatric Extracorporeal Membrane Oxygenation (ECMO) Standby at Two High-Volume Centers

Abstract Extracorporeal membrane oxygenation (ECMO) can provide an option for high-risk procedures that may result in cardiopulmonary collapse. The indications for ECMO standby are not well delineated. We describe the..

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Effects of noradrenaline, vasopressin, phenylephrine or metaraminol on kidney and brain microcirculation in ovine cardiopulmonary bypass: a randomised trial

Abstract Introduction Intra-operative hypotension is common during cardiopulmonary bypass and may contribute to tissue hypoxia. Tissue hypoxia has been linked to the development of postoperative kidney and brain injury. Vasopressors..

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Thromboelastography in Children Undergoing Extracorporeal Membrane Oxygenation

Abstract Background Children undergoing extracorporeal membrane oxygenation (ECMO) are at risk of hematologic and coagulation complications, including intracranial hemorrhage. Thromboelastography is used to monitor anticoagulation in patients receiving ECMO, but..

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Prospective Observational Study Comparing Systemic Inflammatory Responses Across Different Perfusion Systems During Isolated On-Pump Coronary Artery Bypass Grafting

Abstract Objectives Minimal invasive Extracorporeal Circulation (MiECC) and Hybrid System (HS) have been introduced to potentially reduce the inflammatory response compared to conventional Cardiopulmonary Bypass (cCPB). The HS combines elements..

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Liberal or Restrictive Postoperative Transfusion in Patients at High Cardiac Risk

Abstract Importance  Postoperative red blood cell transfusion guidelines recommend transfusion for hemoglobin levels less than 7 g/dL. However, the safety of this strategy in patients at high risk of cardiac events..

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Ethical Considerations for Patients Requiring Extracorporeal Cardiopulmonary Resuscitation

Abstract Immediate recognition of cardiac arrest and the initiation of cardiopulmonary resuscitation (CPR) can significantly improve survival chances. The use of extracorporeal membrane oxygenation during CPR (eCPR) could further enhance..

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Is body mass index associated with hypoxic-ischemic brain injury risk in extracorporeal cardiopulmonary resuscitation?

Abstract Aim To characterize the impact of BMI (body mass index) on HIBI (hypoxic-ischemic brain injury) in patients receiving ECPR, with the hypothesis that elevated BMI is associated with increased..

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Prolonged intra-aortic balloon pump support successfully reversed severe pulmonary hypertension prior to heart transplantation

Abstract Background Heart transplantation remains the gold standard for the treatment of end-stage heart failure, but severe pulmonary hypertension (PH) poses a significant challenge due to the increased risk of..

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Effect of surgical site infection bundles in cardiac surgery: Incidence, microbiology, and risk factors

Abstract Background: Surgical site infections are the second most common type of healthcare-associated infection. Objective: This study aimed to assess the incidence and associated risk factors of surgical site infection..

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Anticoagulation-free strategy within the first 24 h of extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest patients: a retrospective cohort study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR), involving VA-ECMO during refractory cardiac arrest, has been linked to improved outcomes. While systemic anticoagulation is commonly used to prevent circuit thrombosis, bleeding and..

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Arterial Changes After Vascular Reconstruction Following Decannulation From Extracorporeal Life Support: Single-Center, Retrospective Cohort 2002–2022

Abstract Objectives:  Decannulation after pediatric extracorporeal life support (ECLS) may be accompanied by arterial reconstruction. There is a paucity of data on arterial morphology following reconstruction. We sought to characterize..

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Smart technologies and digital innovations for improving perioperative patient safety: a review

Abstract Background Smart digital technologies are rapidly transforming perioperative care through tools such as clinical decision support systems, wearable sensors, and electronic checklists. Despite growing adoption, their specific impact on..

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3D Membrane Microstructures for Increased Efficiency in Blood-Gas Transfer

Abstract Treating severe lung diseases with extracorporeal membrane oxygenation (ECMO) is often accompanied by serious complications, restricting applicability and adversely affecting outcomes. Membrane oxygenators, based on hollow fiber membranes (HFM),..

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Preparation of a cardiopulmonary bypass priming solution for infants and neonates – effect of pre-bypass ultrafiltration on heparinization

Abstract Introduction Heparin is usually added to infant cardiopulmonary bypass circuit primes. Ultrafiltration is often used to minimise prime volume before commencing bypass. The extent of heparin removal from bypass..

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Multidisciplinary Applications of VR & AR Technologies in Professional Training: A Multi-centre Simulation Study

Abstract This study focuses on the impact of virtual reality (VR) technologies on educational processes and professional training, particularly in the fields of medicine, aviation, and the arts. The purpose..

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Multisite Venovenous Extracorporeal Membrane Oxygenation in Pediatric Patients Under 15 kg: Three-Center, Analysis of Surgical Versus Percutaneous Approach and Thrombosis…

Abstract Objectives:  An increasing number of pediatric centers use the femoral vein in neonates and smaller children to provide venovenous multisite (VVMS) extracorporeal membrane oxygenation (ECMO), but there are no..

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Acute Brain Injury in COVID-19 Versus Influenza A Patients on Venovenous Extracorporeal Membrane Oxygenation: A Propensity Score Matching Analysis of…

Abstract Objectives:  Limited data exist on outcomes in COVID-19- vs. influenza A (H1N1)-associated acute respiratory distress syndrome (ARDS) patients when supported on venovenous extracorporeal membrane oxygenation (ECMO). We aimed to..

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Network Meta-Analysis of Axillary, Femoral, and Central Arterial Cannulation in Minimally Invasive Cardiac Surgery

Abstract The optimal arterial cannulation site in minimally invasive cardiac surgery (MICS) remains debated. While axillary, femoral, and central approaches each offer distinct advantages, no prior network meta-analysis has compared..

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The Global Outbreak of M. chimaera Infection Following Cardiac Surgery: Another Piece of the Puzzle

Abstract Invasive cases of Mycobacterium chimaera have been found in Europe, and beyond, and have been associated with the use of heater–cooler units necessary to regulate the temperature of blood in extracorporeal..

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A nitric oxide-releasing organic selenium-grafted phosphorylcholine coating for thrombosis and inflammation prevention in extracorporeal membrane oxygenation

Abstract Thrombosis and inflammation represent major challenges limiting the functionality of asymmetric poly(4-methyl-1-pentene) (PMP) hollow fiber membranes in extracorporeal membrane oxygenation (ECMO) systems. Moreover, the interplay between these two pathological..

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