From Less Invasive to Minimal Invasive Extracorporeal Circulation
MiECC use translates to improved end-organ protection and clinical outcome, as evidenced in multiple clinical trials and meta-analyses. MICS performed with MiECC provides the basis for developing a multidisciplinary intraoperative strategy towards a “more physiologic” cardiac surgery by combining small surgical trauma with minimum body’s physiology derangement. Integration of MiECC can advance MICS from non-full sternotomy for selected patients to a “more physiologic” surgery, which represents the real face of modern cardiac surgery in the transcatheter era.
Platelet Transfusion: Alloimmunization and Refractoriness
This review evaluates the indications for platelet transfusion, both prophylactic and therapeutic, in the light of recent studies and clinical trials. It highlights new developments in the fields of platelet storage and platelet substitutes, and novel ways to avoid complications associated with platelet transfusions.
Literature-Based Considerations Regarding Organizing and Performing Cardiac Surgery Against the Backdrop of the Coronavirus Pandemic
There is little evidence on the strategies to organize cardiac surgery in the Covid-19 pandemic. Most authors agree on reducing elective operations based on patients’ clinical condition and the status of the Covid-19 pandemic. Admission screenings and the use of percutaneous or minimally invasive approaches should be preferred to reduce in-hospital stays.
Anticoagulation in Critically Ill Adults during Extracorporeal Circulation
This review gives a practical view on current concepts of anticoagulation strategies in patients with extracorporeal assist devices.
Intraoperative Cell Saving: Is the Solution the Actual Problem?
Washing residual cardiopulmonary bypass pump blood with Balsol solution results in a resuspended red cell concentrate with a superior electrolyte profile and a strong ion difference similar to that of residual pump blood.
Clinical and Hematological Outcomes of Aminocaproic Acid Use During Pediatric Cardiac ECMO
ACA administration was not associated with specific adverse effects. A clinically significant reduction in bleeding amount, red blood cell transfusions, and other hematologic interventions occurred following ACA administration for pediatric patients on ECMO. Wider consideration for ACA use as a part of a multipronged strategy to manage bleeding during ECMO should be considered.
Effective Use of Reporting Guidelines to Improve the Quality of Surgical Research
Surgical investigators must continue to raise the bar for research across all specialties and aim for the highest standards by which evidence for surgical interventions is evaluated and disseminated. The routine use of reporting standards represents another incremental step toward meeting these goals.
Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality
Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of adverse events associated with administration of intravenous TXA and suggest that TXA is safe for use with undetermined utility for patients receiving neurological care.
Nnemo (Neonatal Neuromonitor) – A Hybrid Optical System to Characterize Perfusion and Metabolism in The Newborn Brain
Optical measures of perfusion and metabolism show potential to act as prognostic markers of injury and could aid clinicians in patient management before significant damage persists.
Thromboembolic and Bleeding Events in COVID-19 Patients receiving Extracorporeal Membrane Oxygenation
This study describes the incidences of TEE and BE in critically ill COVID-19 patients treated with ECMO. The most common adverse event during ECMO support was bleeding, which occurred at a comparable rate to non-COVID-19 patients treated with ECMO.
Oxygen Delivery-Guided Perfusion for The Prevention of Acute Kidney Injury: A Randomized Controlled Trial
An oxygen delivery strategy for cardiopulmonary bypass management was superior to a conventional strategy with respect to preventing the development of acute kidney injury.
Interventions to Reduce Medication Errors in Anesthesia: A Systematic Review
Multimodal interventions and improved labelling reduce medication errors in anesthetized patients.