A Prospective Observational Study of Emboli Exposure in Open Versus Closed Chamber Cardiac Surgery
Patients undergoing open-chamber surgery are exposed to considerably higher numbers of cerebral arterial emboli after removal of the aortic cross-clamp than those undergoing closed-chamber surgery, and more emboli enter the right middle cerebral artery than the left. These results may help inform the evaluation of the pathophysiological impact of emboli exposure.
Hyponatremia: An Overlooked Risk Factor Associated With Adverse Outcomes After Cardiac Surgery
Preoperative hyponatremia is relatively common and is associated with adverse short-term and long-term outcomes after cardiac surgery. Preoperative hyponatremia can be used independently from standard risk factors to identify high-risk patients for cardiac surgery.
Evaluation of Extracorporeal Membrane Oxygenation Therapy as a Bridging Method
Our study suggests bridging ECMO patients to an LVAD before transplantation will result in improved 1-year survival compared with patients bridged to immediate transplantation. With the new heart allocation system, continued evaluation of outcomes is required to inform management strategies.
The Ethics of Extracorporeal Membrane Oxygenation: Revisiting the Principles of Clinical Bioethics
ECMO programs continue to grow in number and capacity. A deep appreciation of the bioethical dimensions of this technology and its application must be pursued, understood and applied to individual patient scenarios.
Association of Heparin Dose, Route, Timing, and Duration With Heparin-Induced Thrombocytopenia
Odds of HIT were increased 10-fold in adult cardiac surgery patients receiving preoperative or postoperative intravenous UFH infusion. Intraoperative UFH dose and subcutaneous route were not associated with HIT. Future study should evaluate incorporation of intravenous UFH administration, dose, and duration in HIT scoring tools for cardiac surgery patients.
Optimal Protamine Dosing after Cardiopulmonary Bypass: The PRODOSE Adaptive Randomised Controlled Trial
Using a mathematical model to guide protamine dosing in patients following CPB improved TEG r-time and reduced the dose administered relative to a fixed ratio. No differences were detected in postoperative mediastinal/pleural drainage or red blood cell transfusion requirement in our cohort of low-risk patients.
Hydroxyethyl Starch and Acute Kidney Injury in High-Risk Patients Undergoing Cardiac Surgery: A Prospective Multicenter Study
The use of modern hydroxyethyl starch 6% HES 130/0.4 was not associated with an increased risk of AKI nor dialysis in this cohort of patients at elevated risk for developing AKI after cardiac surgery.
Near-Infrared Spectroscopy Device Selection Affects Intervention Management for Cerebral Desaturation During Cardiopulmonary Bypass Surgery
It is inappropriate to use the same intervention criteria for different near-infrared spectroscopy oximetry devices. Moreover, brain atrophy influence rSO2 values depending on device selection. It is important to note that inappropriate device selection may misguide perfusionists into performing unnecessary or excessive intervention during CPB.
Extended Neuromonitoring in Aortic Arch Surgery: A Case Series
Monitoring consisting of BIS, NIRS, and TCD may have an impact on hemodynamic management in aortic arch operations.
The Effect of Using the Minimized Cardio-Pulmonary Bypass Systems for Coronary Artery Bypass Grafting in Diabetic Patients
The use of conventional cardiopulmonary bypass for Coronary Artery Bypass Grafting in diabetic patients was associated with higher use of postoperative vasogenic and inotropic support. However, that did not translate into higher complications rate or mortality.
Influence of Cardiopulmonary Bypass Set-Up and Management on Clinical Outcomes After Minimally Invasive Aortic Valve Surgery
In conclusion, despite differences in CPB parameters in patients undergoing CAVR and MIAVR, the incidences of adverse outcomes were similar. However, compared to CAVR, MIAVR was associated with shorter durations of mechanical ventilation and hospital stay as well as less transfusion of blood products.
Fluid Status After Cardiac Surgery Assessed by Bioelectrical Impedance Vector Analysis and the Effects of Extracorporeal Circulation
Fluid status assessment with BIVA in cardiac surgery showed an increase in total body water up to 24 hours after surgery. Off-pump surgery prevented overhydration, which partially could explain the reduction in some of the postoperative complications. BIVA could serve as a useful method for monitoring fluid status in the setting of goal-directed therapy to assist in maintaining euvolemia in cardiac surgical patients.