Perfusion.com Cardiovascular News Roundup: September 2, 2022
Weekly roundup of interesting reads for the perfusion community, this week including a re-cap on the continuous search for biocompatible materials, big studies in China, Norway and the Netherlands, along with new technologies and original research.
Deliberate Practices of Speaking Up and Responding Skills: The Speak-PREP E-Learning Module for Healthcare Professionals
The Speak-PREP module targeted deliberate practice in speaking up and responding skills. Future work should examine the application of these strategies in the clinical environment.
Prothrombin Complex Concentrate vs Plasma for Post-Cardiopulmonary Bypass Coagulopathy and Bleeding: A Randomized Clinical Trial
The results of this study suggest a similar overall safety and efficacy profile for PCCs compared with plasma in this clinical context, with fewer posttreatment intraoperative RBC transfusions, improved PT/INR correction, and higher likelihood of allogeneic transfusion avoidance in patients receiving PCCs.
Reliability of the Minto Model for Target-Controlled Infusion of Remifentanil during Cardiac Surgery with Cardiopulmonary Bypass
The Minto model accurately predicts plasma remifentanil concentrations during cardiac surgery with CPB.
Intraoperative Hypotension-Physiologic Basis and Future Directions
This new technology has the potential to reduce duration or even prevent IOH. In the authors’ opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
Awake Extracorporeal Life Support and Physiotherapy in Adult Patients: A Systematic Review of the Literature
Awake ECLS strategy associated with physiotherapy is performed regardless of cannulation approach. Ambulation, as main objective, is achieved in almost half the population examined. Prospective studies are needed to evaluate safety and efficacy of physiotherapy during Awake ECLS, and suitable patient selection. Guidelines are required to identify appropriate assessment/evaluation tools for Awake ECLS patients monitoring.
Incidence and Outcome of Anaphylaxis in Cardiac Surgical Patients
As all patients survived, our results provide preliminary support for proceeding with surgery although we cannot speculate on the likely outcomes of patients who were postponed, had their surgery proceeded. Based on our data, the incidence of anaphylaxis in cardiac surgical patients may be 10–20 times higher than in the general surgical population.
Impact of Cardiopulmonary Bypass Duration on Efficacy of Fibrinogen Replacement with Cryoprecipitate Compared with Fibrinogen Concentrate: A Post Hoc Analysis of the Fibrinogen Replenishment in Surgery (FIBRES) Randomised Controlled Trial
The haemostatic efficacy of FC was non-inferior to cryoprecipitate irrespective of CPB duration in cardiac surgery.
Arterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation
In conclusion, in a cohort with granular arterial blood gas (ABG) data and a standardized neuromonitoring protocol, higher pre-cannulation PaCO2 and larger ΔPaCO2 were associated with increased prevalence of ICH.
Effect of Hospital Case Volume on Clinical Outcomes of Patients Requiring Extracorporeal Membrane Oxygenation: A Territory-Wide Longitudinal Observational Study
In a territory-wide observational study, we observed that case volumes in extracorporeal membrane oxygenation centers were not associated with hospital mortality. Maintaining standards of care in low-volume centers is important and improves preparedness for surges in demand.
Imaging the Acute Respiratory Distress Syndrome: Past, Present and Future￼
This narrative review aims to draw a didactic and comprehensive picture of how modern imaging techniques improved our understanding of the syndrome, and have the potential to help the clinician guide ventilatory treatment and refine patient prognostication.
The Predictive Value of the 4Ts and HEP Score at Recommended Cutoffs in Patients With Mechanical Circulatory Support Devices
The 4Ts and HEP scores have a modest predictive performance for probable HIT in patients requiring MCS devices. A low 4Ts or HEP score does not reliably rule out HIT in patients requiring MCS, and clinical suspicion for HIT should be investigated, utilizing laboratory tests in this population.