Improved Creatinine-Based Early Detection of Acute Kidney Injury after Cardiac Surgery
Model DynaLab’ improves early detection of CSA-AKI within 12 h after surgery. This simple Cr-based framework poses a fundament for further endeavours towards reduction of CSA-AKI incidence and severity.
Dynamic Responses of Renal Oxygenation at the Onset of Cardiopulmonary Bypass in Sheep and Man
Renal medullary hypoxia is an early event during CPB. It starts to develop even before CPB, presumably due to a pressure-dependent decrease in renal blood flow. Medullary hypoxia during CPB appears to be promoted by hypotension and is not ameliorated by increasing blood hemoglobin concentration.
Computational Numerical Analysis of Different Cannulation Methods During Cardiopulmonary Bypass of Type A Aortic Dissection Model Based on Computational Fluid Dynamics
Different cannulation modes have an effect on the hemodynamic characteristic of the tear, but this effect is related to different states of CPB. AAC was found to superior to IAC, especially in reducing velocity, stress, and shear stress of site of tear. However, IAC and AAC are more conductive to blood supply than FAC in branch vessels of the aortic arch without being affected by the CPB state.
Hemolysis Testing In Vitro: A Review of Challenges and Potential Improvements
In this article, the main challenges of hemolysis testing are described, namely the difficult blood sourcing, the high experimental workload, and the low reproducibility of test results. Several approaches to address the challenges identified are proposed and the respective literature is reviewed. These include the replacement of blood as the “shear-sensitive fluid” by alternative test fluids, the replacement of sparse, manual sampling and blood damage assessment by a continuous and automated monitoring, as well as an analysis of categories and causes of variability in hemolysis test results that may serve as a structural template for future studies.
Combined Platelet and Erythrocyte Salvage: Evaluation of a New Filtration-based Autotransfusion Device
This study demonstrated the performance of the SAME device. Platelets and red blood cells were salvaged without significant impact on cell integrity and function. In the meantime, leukocytes were not activated, and the washing quality of the device prevented reinfusion of high concentrations of heparin and plasma proteins.
Neurocognitive Disorders Amongst Patients with Congenital Heart Disease Undergoing Procedures in Childhood
Increased surgical complexity, male sex and younger AAI were associated with increased risk of NCDs in pediatric CHD patients. Surveillance protocols should be considered to identify NCDs in CHD patients after cardiac intervention.
Metabolic Disturbance Affects Postoperative Cognitive Function in Patients Undergoing Cardiopulmonary Bypass
Postoperative metabolic disturbance and electrolyte imbalances are closely related to the development of delirium after CABG and need to be considered more carefully. Aging, DM, and preoperative use of narcotics are strong predictors of delirium following CABG.
The Impact of Exogenous Nitric Oxide During Cardiopulmonary Bypass for Cardiac Surgery
This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.
Daytime Variation of Clinical Outcome in Cardiac Surgery: A Propensity-Matched Cohort Study
These results did not support the hypothesis that the timing of the surgery could influence the tolerance to ischemia and reperfusion injury, at least in patients undergoing nonemergent AVR or a combined AVR with coronary artery bypass graft.
Comparison of Circulatory Unloading Techniques for Venoarterial Extracorporeal Membrane Oxygenation
This study identified clinically significant hemodynamic variability between the different circulatory unloading techniques evaluated. However, the applicability of these techniques will vary with different patient disease etiology. Further studies on ECMO unloading will help to quantify hemodynamic benefits and establish treatment guidelines.
The Paradox of Exceptionalism: Setting Priorities Straight
Unless we reprioritize the delivery of higher quality care at a reduced cost, robotic surgery will not deliver on its promises to better care for our patients.
Utility of Gas Inlet Pressure Monitoring in Extracorporeal Membrane Oxygenation
This study confirmed that monitoring the gas inlet pressure changes of an oxygenator during ECMO is clinically useful.