Perfusfind S.L.
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Treatment of device thrombus in the HeartWare HVAD: Success and outcomes depend significantly on the initial treatment strategy

Background Pump thrombosis is a major adverse event in patients supported with a left ventricular assist device (LVAD). Treatment approaches include device exchange, lytic therapy, or augmentation of anticoagulation or..

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Continuous-Flow Left Ventricular Assist Device Implantation in Patients With a Small Left Ventricle

Background Having a preoperative small  (LV) has been associated with higher complication and mortality rates after  (LVAD) implantation; however, the outcomes after continuous-flow LVAD implantation have not been well studied. This is..

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Clinical and In Vitro Evidence That Subclinical Hemolysis Contributes to LVAD Thrombosis

Background Recent data suggest that  contributes to  (LVAD) , but the mechanism is unknown. In a clinical study, we measured plasma free hemoglobin (pfHgb) and the incidence of LVAD thrombosis. In an in..

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Hetastarch Should be Avoided for Volume Expansion in Cardiac Surgery Patients

Abstract Blood conservation measures to reduce perioperative blood loss during cardiac surgery have been a subject of focus in recent years. This is due in part to the high cost..

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Comparison of Ringer’s Lactate and Plasmalyte-A as Cardiopulmonary Bypass Prime for Bypass Associated Acidosis in Valve Replacement Surgeries

Abstract Introduction A wide range of acid base fluctuations are seen during Cardiopulmonary bypass (CPB) and the development of metabolic acidosis is well recognized. We conducted a study tocompare the..

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Writing’s on the Wall: Improving the Who Surgical Safety Checklist

Abstract Background and problem  The WHO Surgical Safety Checklist has been shown to improve patient safety as well as improving teamwork and communication in theatres. In 2009, it was made..

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The Role of Frailty in Failure to Rescue After Cardiovascular Surgery

Abstract Background Failure to rescue (FTR) is gaining popularity as a quality metric. The relationship between patient frailty and FTR after cardiovascular surgery has not been fully explored. This study..

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Methodologic Considerations on Four Cardiovascular Interventions Trials With Contradictory Results

Abstract Background Contradictory findings from randomized trials addressing similar research questions are not uncommon in medicine. Although differing results may reflect true differences in the treatment effects or in the..

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Low Tidal Volume Mechanical Ventilation Against No Ventilation During Cardiopulmonary Bypass in Heart Surgery (MECANO): A Randomized Controlled Trial

Abstract Background Postoperative pulmonary complications are common after cardiac surgery and have been related to lung collapse during cardiopulmonary bypass (CPB). No consensus exists regarding the effects of maintaining mechanical..

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Variability in Anesthesia Models of Care in Cardiac Surgery

Abstract The operating room in a cardiothoracic surgical case is a complex environment, with multiple handoffs often required by staffing changes, and can be variable from program to program. This..

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Retrograde Autologous Priming in Cardiac Surgery: Results From a Systematic Review and Meta-analysis

Abstract Background:  Retrograde autologous priming (RAP) before cardiopulmonary bypass (CPB) may minimize allogeneic red cell transfusion. We conducted a systematic review of the literature to examine the impact of RAP..

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Comparative Pharmacological Profiles of Various Bovine, Ovine, and Porcine Heparins

Abstract Unfractionated heparin is the first anticoagulant drug and has been successfully used clinically for over 80 years. Heparin and its analogues are used during surgery and dialysis and are..

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Microvascular Alterations During Cardiac Surgery Using a Heparin or Phosphorylcholine-Coated Circuit

Abstract Objective Heparin biocompatible coating frequently is used to reduce inflammation and blood coagulation during cardiopulmonary bypass (CPB) in cardiac surgery. Whether heparin coating is protective or damaging to the..

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Retrograde autologous priming in surgery of thoracic aortic aneurysm

Abstract OBJECTIVES Surgery of thoracic aortic aneurysm (TAA) is associated with blood loss and coagulopathy and a high need for red blood cell (RBC) volume. Retrograde autologous priming (RAP) decreases..

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Recognizing and Reacting to Microaggressions in Medicine and Surgery

Abstract Diversity and inclusion in medicine, and in surgery in particular, still merit substantial attention in 2019. With each increase in academic rank there are fewer women, with only 24%..

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Oxygen delivery, oxygen consumption and decreased kidney function after cardiopulmonary bypass

Abstract Introduction Low oxygen delivery during cardiopulmonary bypass is related to a range of adverse outcomes. Previous research specified certain critical oxygen delivery levels associated with acute kidney injury. However,..

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Effect of sugammadex on coagulation as detected by rotational thromboelastometry in morbidly obese patients

Abstract BACKGROUND Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available..

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Role of Intraoperative Transesophageal Echocardiography in Cardiac Surgery: an Observational Study

Abstract AIM  This study is based on the hypothesis that the routine use of transesophageal echocardiography in cardiac surgery will influence the surgical decision taken by the surgeon intra-operatively in..

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Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

Abstract This study characterizes the pharmacodynamics of antimicrobial prophylaxis and sternal wound infections following cardiac surgery. Duration of surgery and cefazolin plasma concentration during wound closure were independently associated with..

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Impact of MELD score and cardiopulmonary bypass duration on post-operative hypoxic hepatitis in patients with liver cirrhosis undergoing open heart…

Abstract Background The outcome of open-heart surgery for patients with liver cirrhosis (LC) varies widely, indicating multifactorial influences on liver injury after cardiopulmonary bypass (CPB). Methods This observational single center..

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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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Effect of cardiac arrest with aortic cross-clamping during left ventricular assist device implantation

Abstract OBJECTIVES Some patients who undergo continuous-flow left ventricular assist device (CF-LVAD) implantation require concomitant procedures that can be performed with or without cardiac arrest under aortic cross-clamping (AXC). Procedures..

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Cartridge-Based Thromboelastography Can Be Used to Monitor and Quantify the Activity of Unfractionated and Low-Molecular-Weight Heparins

Abstract Thromboelastography is increasingly utilized in the management of bleeding and thrombotic complications where heparin management remains a cornerstone. This study assessed the feasibility of the cartridge-based TEG® 6s system (Haemonetics..

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How I wean patients from veno-venous extra-corporeal membrane oxygenation

Introduction Identifying patients who are ready for weaning and liberation from veno-venous extracorporeal membrane oxygenation (ECMO) is challenging in clinical practice. Compared to the several trials addressing the safety and..

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Low flow rate alters haemostatic parameters in an ex-vivo extracorporeal membrane oxygenation circuit

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving modality used to manage cardiopulmonary failure refractory to conventional medical and surgical therapies. Despite advances in ECMO equipment, bleeding and thrombosis..

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Serum lactate poorly predicts central venous oxygen saturation in critically ill patients: a retrospective cohort study

Abstract Background Serum lactate and central venous oxygen saturation (ScvO2) are commonly used and commonly recommended as markers of tissue oxygenation in shock states. Medical literature has both explicitly stated..

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Is blood a necessary component of the perfusate during isolated limb perfusion – a randomized controlled trial

Abstract Background: Isolated limb perfusion (ILP) is a treatment option for malignancies localized to an extremity and is performed by surgical isolation of the limb which is connected to an extracorporeal..

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A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO2 removal in a large metropolis area

Abstract Background Extracorporeal carbon dioxide removal (ECCO2R) is a promising technique for the management of acute respiratory failure, but with a limited level of evidence to support its use outside..

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Multidisciplinary transcatheter aortic valve replacement heart team programme improves mortality in aortic stenosis

Abstract Objectives To analyse the effect of the implementation of a transcatheter aortic valve replacement (TAVR) and multidisciplinary heart team programme on mortality in severe aortic stenosis (AS). Methods A retrospective, observational..

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Extracorporeal gas exchange: when to start and how to end?

Introduction In the last decade, primarily following the H1N1 pandemics [], the extracorporeal respiratory assist is increasingly used [, ]. The acronym “ECMO”, i.e., ExtraCorporeal Membrane Oxygenation, is, however, somehow misleading..

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