Essence of Cardiopulmonary Bypass Circuit and Intra-Aortic Balloon Pump
This chapter outlines the fundamentals of cardiopulmonary bypass, associated physiological derangements and utilisation of intra-aortic balloon pumps in cardiac surgical patients.
The Use of Artificial Neural Networks to Determine In-Hospital Mortality After Coronary Artery Bypass Surgery
The ANN model tended to outperform multiple linear regression models in predicting in-hospital mortality among patients who have undergone coronary artery bypass graft surgery. Physicians can make use of this information as an aid in performing treatments and ensuring that more accurate quality of surgical care is achieved.
Intraoperative Red Blood Cell Transfusion Decision-making: A Systematic Review of Guidelines
This review has identified several clinical practice guidelines providing recommendations for intraoperative transfusion. The existing guidelines were noted to be highly variable in their recommendations and to lack a sufficient evidence base from the intraoperative setting. This represents a major knowledge gap in the literature.
Efficacy And Cost-Effectiveness Of Cell Saver Usage In The Repair Of Thoracic Aortic Aneurysms And Dissections
There was a significant association between the use of cell savers and the decreased need for red blood cell and total blood product transfusions. Considering the cost of the cell saver set, transfusion costs in the two groups were comparable.
Neonatal Respiratory and Cardiac ECMO in Europe
ECMO is a life support with a potential impact on long-term patients’ outcomes. In the next years, advances in knowledge, technology, and expertise may push neonatal ECMO boundaries towards more premature and increasingly complex infants, with the final aim to reduce the burden of ECMO-related complications and improve overall patients’ outcomes.
Pro: Priming the Cardiopulmonary Bypass Circuit With Fresh Frozen Plasma Reduces Bleeding in Complex Cardiac Surgery
Reports in the literature estimate that 50%-to-65% of all patients undergoing surgery with CPB will require a blood transfusion in the perioperative period.
Con: Routine Use of Fresh Frozen Plasma Should Not Be Used to Prime Cardiopulmonary Bypass Circuits During Cardiac Surgery
In this review, the authors examine the use of fresh frozen plasma (FFP) for priming the cardiopulmonary bypass (CPB) circuit and discuss the lack of evidence supporting its routine use in this population.
The Association of Bispectral Index Values and Metrics of Cerebral Perfusion During Cardiopulmonary Bypass
There was an association of BIS and metrics of cerebral perfusion during a period of constant anesthetic administration, but the absolute magnitude of change in BIS as MAP decreased below the LLA was small.
Comparison of Clinical Scoring Tools to Predict Heparin-Induced Thrombocytopenia in Cardiac Surgery
The CPB score is the preferred HIT clinical scoring tool in adult cardiac surgery patients, whereas the 4Ts score performed less effectively. A cut-off of ≥ 3 points on the CPB score could increase specificity while preserving high sensitivity, which should be validated in a prospective evaluation.
Evaluation of the Impact of HMS Plus on Postoperative Blood Loss Compared with ACT Plus in Cardiac Surgery
HMS Plus did not reduce the mean blood-loss volume during the first 24 postoperative hours compared with ACT Plus. Its utility for potential transfusion rate reduction remains to be proven.
The Efficacy of Resin Hemoperfusion Cartridge on Inflammatory Responses during Adult Cardiopulmonary Bypass
The HA380 hemoperfusion cartridge could effectively reduce the systemic inflammatory responses and improve postoperative recovery of patients during adult CPB.
Preliminary Study of Serum Biomarkers Associated With Delirium After Major Cardiac Surgery
FGF-21, FGF-23, interleukin-6, and monocyte chemotactic protein-3 serum levels were increased postoperatively in patients who developed delirium after major cardiac surgery. This study identified two members of the FGF family as potential putative systemic biomarkers for postoperative delirium after cardiac surgery, suggesting a possible role for metabolic recovery in the pathophysiologic mechanisms underlying neurocognitive dysfunction.