Determining Thresholds for Three Indices of Autoregulation to Identify the Lower Limit of Autoregulation During Cardiac Surgery
This study identified thresholds of intact and impaired cerebral autoregulation for three indices and showed that mean arterial blood pressure below lower limit of autoregulation is a risk factor for acute kidney injury after cardiac surgery.
The Risk Factors for Delayed Recovery in Patients with Cardiopulmonary Bypass: Why Should We Care?
Extra attention and care are needed for those CPB patients with duration of CPB ≥132 minutes, BUN ≥9 mmol/L, infusion of red blood cell suspension, duration of surgery ≥350 minutes, and age ≥60.
Cardiothoracic Anesthesia and Critical Care in the United Kingdom (UK) Part 1: Some Insights Into the History and Development
In addition to advances in medical equipment, such as computed tomography, the UK contributed greatly to pharmacologic interventions that were unique at the time in such varied areas as nonflammable volatile anesthetic agents, heart failure treatments, and neuromuscular blocking agents for both cardiac and thoracic surgical practice.
Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study
No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19.
Cannulation Strategies & Circulation Management in Type-A Aortic Dissection
Different strategies have been used to establish adequate true lumen perfusion with varying success rates, with the most common still being femoral cannulation. More recently axillary and central cannulation strategies have shown satisfactory results by allowing more reliable true lumen flow. Cannulation approach should, therefore, depend on individual patient characteristics, presentation, and true lumen anatomy.
Predicting Acute Kidney Injury Following Nonemergent Cardiac Surgery: A Preoperative Scorecard
Preoperative eGFR is the strongest predictor of postoperative AKI in individuals undergoing nonemergent cardiac surgery. A practical scorecard incorporating preoperative predictors of AKI may allow informed decision‐making and predict AKI following nonemergent cardiac surgery.
Thromboelastography During Rewarming for Management of Pediatric Cardiac Surgery Patients
Lower MA during rewarming is associated with increased risk of perioperative bleeding. In patients with rewarming MA<45mm, intraoperative platelet transfusion may reduce the risk of subsequent bleeding. Individualized platelet transfusion therapy based on rewarming TEG may reduce the risk of bleeding while minimizing unnecessary platelet transfusion.
Same Data, Opposite Results?A Call to Improve Surgical Database Research
Surgical database research is here to stay, and its use will only increase. Decisions made from the time the data set is imported to the final regression model can impact the validity of the findings. A system that questions these steps will pay off with replicable, valid data that are more likely to be accurate and beneficial when informing clinical practice.
Perioperative Circulatory Support for Lung Transplantation
The use of ECMO during lung transplantation seems to reduce postoperative complications and improve short-term outcomes, relative to CPB. However, additional data should be collected through large multicenter randomized controlled trials. Furthermore, preoperative ECMO as a bridge to lung transplantation appears to provide favorable outcomes, although additional data are also needed from experienced transplant centers.
Intra-Operative Autologous Blood Donation for Cardiovascular Surgeries in Japan: A Retrospective Cohort Study
Intra-operative autologous blood donation could reduce the transfusion rate or amount of red blood cells and fresh frozen plasma for patients undergoing index cardiovascular surgery and could be an effective blood transfusion strategy in cardiovascular surgery for Japanese patients.
Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation: Heparin Versus Bivalirudin
Patients receiving bivalirudin for systemic anticoagulation on venovenous extracorporeal membrane oxygenation experienced a decrease in the number of extracorporeal membrane oxygenation circuit-related thrombotic events as well as a significant decrease in volume of blood products administered.
Hydroxyethyl Starch on Kidney and Haemostatic Function in Cardiac Surgical Patients: Is A Non-Inferiority Study Design Appropriate for This Setting?
In light of the existing concerns on HES use, this study leaves several unanswered questions: how should patients be informed when they are asked to participate in a clinical trial that may randomise them to receive HES? How can a prestigious research group consider it appropriate to adopt a ’non‐inferiority’ study design to evaluate the safety profile of a controversial drug such as HES, when any proven beneficial effects (if there are any) remain unanswered?