Predicting Intensive Care Unit Length of Stay After Acute Type A Aortic Dissection Surgery Using Machine Learning
Machine learning has the potential to predict ICU-LOS for acute type A aortic dissection. This tool could improve the management of ICU resources and patient-throughput planning, and allow better communication with patients and their families.
Evaluation of Seizure Risk in Infants After Cardiopulmonary Bypass in the Absence of Deep Hypothermic Cardiac Arrest
Seizure incidence was similar to recent estimates even in the absence of deep hypothermic cardiac arrest. By employing random forest analysis, we were able to identify novel risk factors for postoperative seizure in this population and generate a robust model of seizure risk. Further work to validate our model in an external population is needed.
Noninvasive Urine Oxygen Monitoring and the Risk of Acute Kidney Injury in Cardiac Surgery
Low urinary oxygen partial pressures after CPB may be associated with the subsequent development of AKI after cardiac surgery.
Month-long Respiratory Support by a Wearable Pumping Artificial Lung in an Ovine Model
These results demonstrate the ability of the ModELAS to provide safe month-long support without consistent deterioration of pumping or gas exchange capabilities.
Veno-Arterial Extracorporeal Membrane Oxygenation with Concomitant Impella Versus Concomitant Intra-Aortic-Balloon-Pump for Cardiogenic Shock
Impella was not shown to offer a statistically significant clinical benefit compared with IABP in conjunction with ECMO. Clinicians should be aware of the specific complications of using Impella.
Use Of Bivalirudin for Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation (ECMO)
This study describes the use of bivalirudin in children on extracorporeal membrane oxygenation (ECMO). Pediatric patients receiving bivalirudin were compared to patients receiving heparin as the anticoagulant on ECMO. Bivalirudin may provide stable and successful anticoagulation in children. Further large, multicenter studies are needed to confirm these finding
Reversal of Renal Tissue Hypoxia During Experimental Cardiopulmonary Bypass in Sheep by Increased Pump Flow And Arterial Pressure
Renal hypoxia during experimental CPB can be corrected by increasing target pump flow and mean arterial pressure within a clinically feasible range.
Sequestration of Dexmedetomidine in Ex Vivo Cardiopulmonary Bypass Circuits
The percent sequestration of DEX was lower in CPB circuits at lower DEX doses compared to higher doses. A combination of DEX initial loading dose and continuous infusion resulted in steady concentrations of DEX over 4 hours. At therapeutically relevant concentrations of DEX (485–1,013 pg/ml), lower sequestration was observed in ex vivo CPB circuits compared to higher doses. The sequestration of DEX to circuits should be considered to achieve the optimal concentration of DEX during CPB surgery.
Synthetic Material Abdominal Swabs Reduce Activation of Platelets and Leukocytes Compared to Cotton Materials
Our data show for the first time that cotton materials can activate platelets and leukocytes despite a high anticoagulation and that this activation is lower with synthetic materials. This additional activation due to the material on top of the activation exerted by the tissue contact that blood is exposed to during CPB surgery can propagate further reactions in patients after surgery, which poses a risk for this already vulnerable patient group.
Complications of Peripheral Cannulation Site in Obese Patients on Adult Extracorporeal Membrane Oxygenation
There is significant increased risk of bleeding with peripheral VA cannulation of obese patients with BMI > 35. Cannulating surgeon should be aware of this bleeding risk in morbidly obese patient who undergo VA ECMO.
Comparative Clinical Efficacy of Novel Bidirectional Cannula in Cardiac Surgery via Peripheral Cannulation for Cardiopulmonary Bypass
This study demonstrates that in patients undergoing femoral arterial cannulation for CPB during cardiac surgery, the use of a novel bidirectional cannula is safe and easy to insert and provides stable distal perfusion of the cannulated limb.
Effect of Strict Intraoperative Blood Pressure Management Strategy on Postoperative Acute Kidney Injury in Non-Cardiac Surgery: A Meta-Analysis of Randomised Controlled Trials
Strict BP management is significantly more effective than conventional therapy for the prevention of postoperative AKI. Supranormal target of intraoperative BP management may be considered a more appealing option for the prevention of AKI.