A Polysomnography Study Examining the Association Between Sleep and Postoperative Delirium in Older Hospitalized Cardiac Surgical Patients
Polysomnography measures of sleep obtained the night preceding surgery in hospitalized older patients scheduled for elective major cardiac surgery with cardiopulmonary bypass are suggestive of an association between longer sleep duration and postoperative delirium.
A Cardiopulmonary Bypass Strategy to Support A Patient with Vein of Galen Malformation
We present a dissection of the patent ductus arteriosus and pulmonary artery for surgical repair utilising cardiopulmonary bypass in the setting of vein of Galen malformation.
Volatile and Intravenous Anesthetics for Brain Protection in Cardiac Surgery: Does the Choice of Anesthesia Matter?
Several studies have reported an association of using volatile anesthetics with improvement of biochemical markers of brain injury and postoperative neurocognitive function. However, there is a need for additional studies to define the optimal anesthetic drug for protecting the brain in patients undergoing cardiac surgery.
Extracellular Vesicles in Autologous Cell Salvaged Blood in Orthopedic Surgery
Retransfusate contains negligible amounts of potentially thrombogenic EVs from platelet and monocytic origin. Frequent EVs from erythrocytes may indicate red blood cell destruction and/or activation during autologous cell salvage. Further research is needed to investigate the clinical relevance of EVs from salvaged red blood cells.
Variability in Anesthesia Models of Care in Cardiac Surgery
Given that anesthesia is proven to have an influence on the outcome of cardiac procedures, this study indicates the opportunity to further study how this variability influences outcomes and to identify best practices.
Timeout Procedure in Paediatric Surgery: Effective Tool or Lip Service? A Randomised Prospective Observational Study
Errors in the timeout routine go unnoticed by the team in almost half of cases. Therefore, even if preoperative timeout routines are strictly implemented, mistakes may be overlooked. Hence, the timeout procedure in its current form appears unreliable. Future developments may be useful to improve the quality of the surgical timeout and should be studied in detail.
Perioperative Cryoprecipitate Waste Reduction
These results demonstrate that utilizing educational initiatives for optimization of blood product management can reduce unnecessary ordering, transfusions, and wastage; an outcome that could ultimately reduce costs.
Fraction of Expired Oxygen: An Additional Safety Approach to Monitor Oxygen Delivery to The Heart Lung Machine Oxygenator
Monitoring the FEO2 is a more reliable way to verify O2 delivery to an oxygenator. An alarm can be set on the FEO2 monitor to alert the perfusionist if the FEO2 falls below a predetermined threshold so any issue with O2 delivery will always be recognized.
Cerebrovascular Autoregulation and Arterial Carbon Dioxide in Patients with Acute Respiratory Distress Syndrome: A Prospective Observational Cohort Study
Our results suggest that moderate permissive hypercapnia during the acute phase of ARDS has no adverse effect on cerebrovascular autoregulation and may be tolerated to a certain extent to achieve low tidal volumes. In contrast, episodes of hypocapnia may compromise cerebral blood flow regulation.
Neurological Complications During Veno-Venous Extracorporeal Membrane Oxygenation: Does the Configuration Matter? A Retrospective Analysis of The ELSO Database
In this large registry, the occurrence of neurological complications was not related to the type of cannulation in patients undergoing V-V ECMO.
Different Mechanisms of Oxygenator Failure and High Plasma von Willebrand Factor Antigen Influence Success and Survival of Venovenous Extracorporeal Membrane Oxygenation
vWF:Ag levels alone cannot predict early MO failure and outcome in VV ECMO patients. Probably, the mechanism of clotting disorder in combination with the vWF:Ag level seems to be essential for clot formation within the MO. In addition, vWF:Ag levels allows the identification different patient populations In particular, WGT/high vWF:Ag represented a critically ill population with higher ECMO-associated mortality.
Modern Practice and Outcomes of Reoperative Cardiac Surgery
Reoperative cardiac surgery is associated with low operative morbidity and mortality at an experienced center. Early and late CPB strategies have comparable outcomes in the context of an image-guided, team-based strategy.