Variability of Three Activated Clotting Time Point-Of-Care Systems in Cardiac Surgery: Reinforcing Available Evidence
The differences found in comparisons are considered to be clinically relevant, which is why it is considered important to make the variability of the different monitoring systems known and to take them into account for optimal control of this parameter and its clinical repercussions.
Perfusion Art: “Crimson Tubes”
Perfusion Art: “Crimson Tubes” Photographer: Frank Aprile, CCP, BBA, LP Equipment: I Phone 8+ Editing: Photoshop Narrative: An Aortic Root Reconstruction Time & Place: 2021: MidWest About The […]
STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management
Our intent is to present the most comprehensive set of guidelines possible, and we hope that this will serve as a resource so as to improve the outcomes of patients undergoing cardiothoracic surgery.
Acute Respiratory Distress Syndrome in the Perioperative Period of Cardiac Surgery: Predictors, Diagnosis, Prognosis, Management Options, and Future Directions
More research in the setting of ARDS after cardiac surgery is needed at multiple levels (risk factors, diagnosis, treatment options). Prevention of lung injury appears to be of the utmost importance, and a better characterization of the risk factors is needed. Avoiding excessive perioperative transfusions and the optimization of ventilation and hemodynamics seem to be the most modifiable risk factors. In patients who develop ARDS after cardiac surgery, extracorporeal techniques may represent a valid choice in experienced hands. The use of NMBAs, prone positioning, and iNO can be considered on a case-by-case basis, whereas aggressive lung recruitment and oscillatory ventilation probably should be avoided.
Towards Manufactured Red Blood Cells for the Treatment of Inherited Anemia
This review discusses recent progress in the erythroid culture field as well as opportunities for further scaling up of manufactured RBC production for transfusion practice.
Cerebral Microemboli in Mini-Sternotomy Compared to Mini- Thoracotomy for Aortic Valve Replacement: A Cross Sectional Cohort Study
There is no difference in microembolic load between the groups. Total intraoperative microembolic signals count was associated with cardiopulmonary bypass duration. Age, but not micorembolic signals load, was associated with postoperative neurologic decline.
Patient Characteristics and Cardiac Surgical Outcomes at A Tertiary Care Hospital in Kenya, 2008-2017: A Retrospective Study
Awareness of demographic and peri-surgical factors that are predictors of complications is useful in guiding clinical decisions to reduce morbidity and mortality. Identification of co-morbidities as the most useful predictors of post-surgical complications suggests that patient characteristics may be a larger contributor to the incidence of complications than surgical practices.
Emergent Cardiopulmonary Bypass During Cesarean Delivery. A Case Report
Successful management of Cesarean Delivery complicated by emergent CPB and AVR requires meticulous multidisciplinary planning. This case also represents the volatility that can arise from severe aortic regurgitation during pregnancy.
Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States
Compared with the 2013 pediatric population, extracorporeal membrane oxygenation center anticoagulation and blood transfusion approaches continue to vary widely. Most report continued use of heparin as their primary anticoagulant and follow a combination of monitoring assays with the majority using the antifactor Xa assay in their practices, a significant shift from prior results. Antithrombin activity levels and viscoelastic tests are followed by a growing number of centers. Platelet transfusion thresholds continue to vary widely. Future research is needed to establish optimal anticoagulation and blood transfusion management.
Perioperative Serum Free Hemoglobin and Haptoglobin Levels in Valvular and Aortic Surgery With Cardiopulmonary Bypass: Their Associations With Postoperative Kidney Injury
This study found that the perioperative increase of the free hemoglobin level and the decrease of the haptoglobin level had independent associations with the risk of pAKI.
Retrograde Autologous Priming During Cardiopulmonary Bypass Reduces Blood Transfusion Rate in Adult Cardiac Surgery: A Prospective Randomized Clinical Trial
In this experiment, the lowest HCT value during CPB in the study group was significantly higher and only 20% of patients received a blood transfusion. The overall transfusion rate and intraoperative transfusion volume of homologous PRBC units in the RAP group were lower than those in the standard priming group.
Cell Salvage in Trauma
Autotransfusion or cell salvage is markedly under utilized in trauma. Opportunities exist for significant blood savings if it is used more frequently. More research is clearly needed to assess the safety of autotransfusion in the traumatized patient.