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.
Cannulas and Cannulation Options for Minimally Invasive Surgery
Traditionally, cardiac surgery has been practiced primarily through a median sternotomy; however, as instrumentation and experience continue to advance at exponential rates, the field of minimally invasive cardiac surgery (MICS) is rapidly expanding. When compared with a conventional sternotomy, alternative access offers patients the potential benefits of decreased infection risk, reduced transfusion requirements, decreased length of admission, quicker return to normal activity, and, perhaps most important for patients, improved cosmesis. We hereby discuss our approach to cannulation for MICS operations.
Measuring the Resting Energy Expenditure in Children on Extracorporeal Membrane Oxygenation: A Prospective Pilot Study
REE measurements can be obtained by indirect calorimetry in children receiving ECMO support. ECMO may not provide metabolic rest for all children as a wide variation in REE was observed. For optimal care, individual testing should be considered to match calories provided with the metabolic demand.
Effect Of Aortic Cannulation Depth on Air Emboli Transport during Cardiopulmonary Bypass: A Computational Study.
It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.
A Prospective Observational Study on the Effect of Emboli Exposure on Cerebral Autoregulation in Cardiac Surgery Requiring Cardiopulmonary Bypass.
Overall, change in mean velocity index before and after cross-clamp removal did not differ between groups. However, most emboli entered the right cerebral hemisphere where this change was significantly greater in the open-chamber group, suggesting a possible association between embolic exposure and dysautoregulation.
Trends, Advantages and Disadvantages in Combined Extracorporeal Lung and Kidney Support From a Technical Point of View
We conducted a review to provide technical background on existing techniques for extracorporeal lung and kidney support and give insight on important aspects to be addressed in the development of this novel highly integrated artificial lung device.
Effect of Nitric Oxide via Cardiopulmonary Bypass on Ventilator-Free Days in Young Children Undergoing Congenital Heart Disease SurgeryThe NITRIC Randomized Clinical Trial
In children younger than 2 years undergoing cardiopulmonary bypass surgery for congenital heart disease, the use of nitric oxide via cardiopulmonary bypass did not significantly affect the number of ventilator-free days. These findings do not support the use of nitric oxide delivered into the cardiopulmonary bypass oxygenator during heart surgery.
Ten Overlooked Mistakes During Early Mobilisation in the Intensive Care Unit
Here are ten overlooked mistakes during early mobilisation in the ICU.
Effect of Intraoperative Handovers of Anesthesia Care on Mortality, Readmission, or Postoperative Complications Among AdultsThe HandiCAP Randomized Clinical Trial
Among adults undergoing extended surgical procedures, there was no significant difference between the patients randomized to receive handover of anesthesia care from one clinician to another, compared with the no handover group, in the composite primary outcome of mortality, readmission, or serious postoperative complications within 30 days.
Key Characteristics Impacting Survival of COVID-19 Extracorporeal Membrane Oxygenation.
Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.
tHE wAITING gAME: O’s to the Toes…
_________________________________________________ – Editor’s Note: – Sometimes you just know… –It was gonna be a long pump run, huge patient, and the CT […]