Neurocognitive Disorders Amongst Patients with Congenital Heart Disease Undergoing Procedures in Childhood
Increased surgical complexity, male sex and younger AAI were associated with increased risk of NCDs in pediatric CHD patients. Surveillance protocols should be considered to identify NCDs in CHD patients after cardiac intervention.
Metabolic Disturbance Affects Postoperative Cognitive Function in Patients Undergoing Cardiopulmonary Bypass
Postoperative metabolic disturbance and electrolyte imbalances are closely related to the development of delirium after CABG and need to be considered more carefully. Aging, DM, and preoperative use of narcotics are strong predictors of delirium following CABG.
The Impact of Exogenous Nitric Oxide During Cardiopulmonary Bypass for Cardiac Surgery
This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.
Daytime Variation of Clinical Outcome in Cardiac Surgery: A Propensity-Matched Cohort Study
These results did not support the hypothesis that the timing of the surgery could influence the tolerance to ischemia and reperfusion injury, at least in patients undergoing nonemergent AVR or a combined AVR with coronary artery bypass graft.
Comparison of Circulatory Unloading Techniques for Venoarterial Extracorporeal Membrane Oxygenation
This study identified clinically significant hemodynamic variability between the different circulatory unloading techniques evaluated. However, the applicability of these techniques will vary with different patient disease etiology. Further studies on ECMO unloading will help to quantify hemodynamic benefits and establish treatment guidelines.
The Paradox of Exceptionalism: Setting Priorities Straight
Unless we reprioritize the delivery of higher quality care at a reduced cost, robotic surgery will not deliver on its promises to better care for our patients.
Utility of Gas Inlet Pressure Monitoring in Extracorporeal Membrane Oxygenation
This study confirmed that monitoring the gas inlet pressure changes of an oxygenator during ECMO is clinically useful.
Inhaled Nitric Oxide Reduces Injury and Microglia Activation in Porcine Hippocampus after Deep Hypothermic Circulatory Arrest
Using DHCA for 30 minutes, consistent with clinical exposure, we noted that iNO reduces neuronal degeneration in the hippocampus. In addition, iNO reduces microglial activation in the hippocampus after DHCA. The data suggest that iNO reduces neuronal degeneration by ameliorating inflammation and may be a practical mode of neuroprotection for infants undergoing DHCA.
Comparative Effectiveness and Safety of Anticoagulants for the Treatment of Heparin-Induced Thrombocytopenia
Effectiveness and safety outcomes were similar among various anticoagulants, and significant factors affecting these outcomes were not identified. These findings support fondaparinux and DOACs as viable alternatives to conventional anticoagulants for treatment of acute HIT in clinical practice.
The Hemodynamic Effects of Warm Versus Room-Temperature Crystalloid Fluid Bolus Therapy in Post-Cardiac Surgery Patients
In postoperative cardiac surgery patients, warm FBT preserved core temperature and induced smaller but more sustained CI increases among responders. Fluid temperature appears to impact both core temperature and the duration of CI response.
Extracorporeal Cytokine Adsorption Therapy As a Preventive Measure in Cardiac Surgery and As a Therapeutic Add-On Treatment in Sepsis: An Update Systematic Review of Comparative Efficacy and Safety
Given the available evidence, the efficacy and safety of extracorporeal cytokine adsorption therapy in combination with standard care in the investigated indications was not established. We strongly recommend considering well-powered studies with patient-relevant endpoints instead of investing further research funds on studies that may not shed light on the clinical benefit of extracorporeal cytokine adsorption therapy.
Does A Balanced Colloid Decrease Perioperative Blood Loss in Paediatric Cardiac Surgery: A Double-Blinded Randomized Controlled Trial?
The use of a balanced colloid for peri-operative fluid therapy compared with a saline one is not associated with decreased blood loss or exposure to blood products.