How to Turn It Down: The Evidence and Opinions Behind Adult Venoarterial Extracorporeal Membrane Oxygenation Weaning
We have reviewed the literature to summarize the evidence and expert opinions behind VA ECMO weaning, and give an example of the protocol used at our center. We believe this protocol optimizes patient selection for weaning and helps to predict successful decannulation.
Enhancement of the Anticoagulant Capacity of Polyvinyl Chloride Tubing for Cardiopulmonary Bypass Circuit Using Aluminum Oxide Nanoscale Coating Applied Through Atomic Layer Deposition
This study revealed that deposition of Al2O3 films by T-ALD can improve anticoagulation of the PVC tubing system.
Flow Characteristics and Hemolytic Performance of the New Breethe Centrifugal Blood Pump in Comparison with the Centrimag and Rotaflow Pumps
It can be concluded based on both the computational and experimental data that the Breethe pump is a viable pump for clinical use and it has better biocompatibility compared to the clinically accepted pumps.
Utility of Neuromonitoring in Hypothermic Circulatory Arrest Cases for Early Detection of Stroke: Listening Through the Noise
Despite a low positive predictive value requiring a high level of discrimination when interpreting abnormal findings, NIOM has high sensitivity and specificity for the early stroke detection. Furthermore, its high negative predictive valve is reassuring for low risk of stroke in the absence of alerts.
How Do We Use Dashboards to Enhance Quality in Cardiac Anesthesia?
In this article, the authors describe how they designed a clinical cardiac anesthesia dashboard for quality efforts at their institution.
Quality Management of a Comprehensive Blood Conservation Program During Cardiopulmonary Bypass
The comprehensive blood conservation program during CPB is safe and effective in adult cardiac surgery, reducing blood utilization with no adverse outcomes. For the patients who are older, male and EuroSCORE 3-5, blood transfusion should be more cautious.
Del Nido Cardioplegia in Adult Cardiac Surgery: Analysis of Myocardial Protection and Post-Operative High-Sensitivity Troponin T
In a broad cohort of adult cardiac surgery patients, including those undergoing coronary artery bypass surgery and those with recent myocardial infarction, del Nido provides equivalent myocardial protection and clinical outcomes when compared to hyperkalemic blood cardioplegia. Post-operative high-sensitivity Troponin T values were also equivalent between the groups.
Critical Oxygen Delivery Threshold During Cardiopulmonary Bypass in Older Cardiac Surgery Patients with Increased Frailty Risk
Low DO2 increased the risk for CSA-AKI in older patients who had cardiac surgery. A critical DO2 threshold of 270 ml/min/m2 was applicable for frail and non-frail patients. The efficacy of a DO2 >270 ml/min/m2 to reduce CSA-AKI in older patients needs further evaluation.
Blood Pressure Variability during Pediatric Cardiac Surgery is Associated with Acute Kidney Injury
Greater BPV during cardiac surgery with CPB was associated with development of postoperative AKI in infants, suggesting that BPV is a potentially modifiable risk factor for AKI in this high-risk population.
Dextran-Based Priming Solution during Cardiopulmonary Bypass Attenuates Renal Tubular Injury – A Secondary Analysis of Randomized Controlled Trial in Adult Cardiac Surgery Patients
In patients undergoing cardiac surgery with CPB, colloid-based priming solution (dextran 40) induced less renal tubular injury compared to a crystalloid-based priming solution. Whether a colloid-based priming solution will improve renal outcome in high-risk cardiac surgery, or not, needs to be evaluated in future studies on higher risk cardiac surgery patients.
The Optimal Cell Salvage Settings to Maximize Hematocrit and Minimize Potassium Using the Cobe BRAT2 Autologous Blood Recovery Unit
Red-cell washing produces higher hematocrit and lower potassium as infusion rate and wash rate decrease. A 340-mL unit of RBC can be processed in 4.26 minutes without loss of hematocrit or an increase in potassium when both infusion and wash rates are set to 400 mL/min.
Effects of Acute Normovolemic Hemodilution on Post-Cardiopulmonary Bypass Coagulation Tests and Allogeneic Blood Transfusion in Thoracic Aortic Repair Surgery: An Observational Cohort Study
ANH is a safe blood conservation strategy for surgical repairs of the thoracic aorta. Laboratory data suggests ANH can improve some coagulation values after separation from CPB, and significantly reduce the number of transfused FFP, platelets and cryoprecipitate.