Appropriate Clinical Trial Registration Is the Key to Transparent Reporting and Publication
In summary, since the advent of the ClinicalTrials.gov platform, the importance of trial registration has been recognized gradually but consistently throughout the globe. However, challenges remain, including the reluctance to participate on the part of pharmaceutical companies and a mindset among the individual researchers that registration is onerous and may result in the report of insignificant primary outcomes.
Brain Injury in Extracorporeal Membrane Oxygenation: A Multidisciplinary Approach
Extracorporeal membrane oxygenation (ECMO) represents an established technique to provide temporary cardiac and/or pulmonary support. ECMO, in veno-venous, veno-arterial or in extracorporeal carbon dioxide removal modality, is associated with a high rate of brain injuries.
Minimally Invasive Cardiac Surgical Procedures in Children
In this summary we will review the approaches that have been described and comment on the evidence that they achieve the desired goal of minimizing the trauma of the surgical procedure and enhancing recovery.
Development and Validation of a Risk Score for Respiratory Failure After Cardiac Surgery
This risk score can stratify patients by risk for developing postoperative respiratory failure after major cardiac surgery, which may help in the development of preventive measures.
From Less Invasive to Minimal Invasive Extracorporeal Circulation
MiECC use translates to improved end-organ protection and clinical outcome, as evidenced in multiple clinical trials and meta-analyses. MICS performed with MiECC provides the basis for developing a multidisciplinary intraoperative strategy towards a “more physiologic” cardiac surgery by combining small surgical trauma with minimum body’s physiology derangement. Integration of MiECC can advance MICS from non-full sternotomy for selected patients to a “more physiologic” surgery, which represents the real face of modern cardiac surgery in the transcatheter era.
Platelet Transfusion: Alloimmunization and Refractoriness
This review evaluates the indications for platelet transfusion, both prophylactic and therapeutic, in the light of recent studies and clinical trials. It highlights new developments in the fields of platelet storage and platelet substitutes, and novel ways to avoid complications associated with platelet transfusions.
Literature-Based Considerations Regarding Organizing and Performing Cardiac Surgery Against the Backdrop of the Coronavirus Pandemic
There is little evidence on the strategies to organize cardiac surgery in the Covid-19 pandemic. Most authors agree on reducing elective operations based on patients’ clinical condition and the status of the Covid-19 pandemic. Admission screenings and the use of percutaneous or minimally invasive approaches should be preferred to reduce in-hospital stays.
Anticoagulation in Critically Ill Adults during Extracorporeal Circulation
This review gives a practical view on current concepts of anticoagulation strategies in patients with extracorporeal assist devices.
Intraoperative Cell Saving: Is the Solution the Actual Problem?
Washing residual cardiopulmonary bypass pump blood with Balsol solution results in a resuspended red cell concentrate with a superior electrolyte profile and a strong ion difference similar to that of residual pump blood.
Clinical and Hematological Outcomes of Aminocaproic Acid Use During Pediatric Cardiac ECMO
ACA administration was not associated with specific adverse effects. A clinically significant reduction in bleeding amount, red blood cell transfusions, and other hematologic interventions occurred following ACA administration for pediatric patients on ECMO. Wider consideration for ACA use as a part of a multipronged strategy to manage bleeding during ECMO should be considered.
Effective Use of Reporting Guidelines to Improve the Quality of Surgical Research
Surgical investigators must continue to raise the bar for research across all specialties and aim for the highest standards by which evidence for surgical interventions is evaluated and disseminated. The routine use of reporting standards represents another incremental step toward meeting these goals.
Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality
Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of adverse events associated with administration of intravenous TXA and suggest that TXA is safe for use with undetermined utility for patients receiving neurological care.