Monitoring of the Progression of the Perioperative Serum Lactate Concentration Improves the Accuracy of the Prediction of Acute Mesenteric Ischemia Development After Cardiovascular Surgery
Late intraoperative and early postoperative lactate levels >3 mmol/L and increases >200%, even when remaining within the normal range, should raise the suspicion of subsequent mesenteric ischemia development.
Intraoperative Urinary Biomarkers and Acute Kidney Injury After Cardiac Surgery
Intraoperative KIM1 but not IL-18 excretion was associated with postoperative development of AKI.
Myocardial Protection in Adult Cardiac Surgery With del Nido Versus Blood Cardioplegia: A Systematic Review and Meta-Analysis
Although this meta-analysis failed to find any mortality benefits with del Nido cardioplegia, significant benefits were seen in a number of intraoperative and postoperative variables. del Nido cardioplegia is a safe and favourable alternative to blood cardioplegia in adult cardiac surgery.
Is Extracorporeal Membrane Oxygenation the Standard Care for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Compared with CMV, ECMO contributed to lower 60-day and 1-year mortality, and increased ICU mortality in patients with ARDS. However, H1N1 ARDS was independently associated with higher ICU mortality and nosocomial pneumonia. The results were not affected by removing retrospective control studies or articles published >20 years ago from the sensitivity analysis. This meta-analysis demonstrates the effectiveness of ECMO and its importance in standard treatment of patients with ARDS.
Computed Tomography Angiography as an Adjunct to Computational Fluid Dynamics for Prediction of Oxygenator Thrombus Formation
In the studied oxygenator, clot burden follows a pattern consistent with clinical observations. Computed tomography angiography–based flow analysis provides a useful adjunct to computational fluid dynamics–based flow analysis in understanding oxygenator thrombus formation.
Identification of Risk Factors for Renal Failure After Cardiac Surgery by RFILE Classification
This study identified several risk factors for the development of AKI after cardiac surgery. Further validation of these risk factors could allow the implementation of adequate patient management, and the appropriate implementation of risk-adverse interventions in cardiovascular surgery.
Antiphospholipid Syndrome and Cardiac Bypass: The Careful Balance between Clotting and Bleeding
We present a patient with APS undergoing coronary artery bypass grafting with cardiopulmonary bypass. We delineate our strategy for managing anticoagulation in the presence of this syndrome using the Hepcon Hemostasis Management System Plus (Medtronic, Inc. Minneapolis, MN) device by targeting whole blood heparin concentration to monitor anticoagulation.
Cerebral Oxygen Saturation (Rso2) During Cardiopulmonary Bypass (CPB) Measured Using the INVOS Oximeter Closely Correlates with Baseline Rso2
Our findings suggest that low baseline rSO2 in patients with high BNP due to cardiac and/or renal diseases is more likely to result from tissue edema causing alterations in optical pathlength and thus in calculated rSO2 values, not readily modifiable with CPB, rather than actual cerebral hemodynamic alterations readily modifiable with CPB. These may partly explain why the INVOS oximeter is a trend monitor requiring baseline measures.
The Inverse Relationship Between Endothelium-Dependent Vasodilation and Blood Pressure is Lost After Cardiopulmonary Bypass
These data suggest that the measurement of endothelium impairment after CPB may be more reflective of cardiovascular health than SBP alone.
ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables
The new modules of the systemic circulation and ECMO support allowed the study of the effects induced by concomitant mechanical ventilation and circulatory support. Based on our clinical experience during the COVID-19 pandemic, numerical simulations may help clinicians with data analysis and treatment optimisation of patients requiring both mechanical ventilation and circulatory support.
Pump Flow Setting and Assessment of Unloading in Clinical Practice
If a left-sided Impella device is used, it should be run at the highest possible performance level during treatment while avoiding suction events. When combined with VA-ECMO, the Impella device should be run at a lower performance level, ensuring sufficient left ventricular emptying but avoiding suction.
Long-Term Cognitive Outcomes and Sleep in Adults After Extracorporeal Life Support
In this small retrospective case series, no significant differences were found in sleep or cognitive outcomes between extracorporeal life support and non–extracorporeal life support survivors.