Antiphospholipid Syndrome and Cardiac Bypass: The Careful Balance between Clotting and Bleeding
We present a patient with APS undergoing coronary artery bypass grafting with cardiopulmonary bypass. We delineate our strategy for managing anticoagulation in the presence of this syndrome using the Hepcon Hemostasis Management System Plus (Medtronic, Inc. Minneapolis, MN) device by targeting whole blood heparin concentration to monitor anticoagulation.
Cerebral Oxygen Saturation (Rso2) During Cardiopulmonary Bypass (CPB) Measured Using the INVOS Oximeter Closely Correlates with Baseline Rso2
Our findings suggest that low baseline rSO2 in patients with high BNP due to cardiac and/or renal diseases is more likely to result from tissue edema causing alterations in optical pathlength and thus in calculated rSO2 values, not readily modifiable with CPB, rather than actual cerebral hemodynamic alterations readily modifiable with CPB. These may partly explain why the INVOS oximeter is a trend monitor requiring baseline measures.
ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables
The new modules of the systemic circulation and ECMO support allowed the study of the effects induced by concomitant mechanical ventilation and circulatory support. Based on our clinical experience during the COVID-19 pandemic, numerical simulations may help clinicians with data analysis and treatment optimisation of patients requiring both mechanical ventilation and circulatory support.
Long-Term Cognitive Outcomes and Sleep in Adults After Extracorporeal Life Support
In this small retrospective case series, no significant differences were found in sleep or cognitive outcomes between extracorporeal life support and non–extracorporeal life support survivors.
Physiological Basis of Extracorporeal Membrane Oxygenation and Extracorporeal Carbon Dioxide Removal in Respiratory Failure
In this review, we will present the physiological basis of gas exchange in ECMO and ECCO2R, and the implications of their interaction with native lung function. We will also discuss the rationale for their use in clinical practice, their current advances, and future directions.
Preoperative Intra-Aortic Balloon Pumps in Cardiac Surgery: A Propensity Score Analysis
In patients undergoing isolated CABG surgery, preoperative IABP use was associated with increased 30-day mortality and adverse outcomes. Large randomised controlled trials are required to confirm our findings.
We Asked the Experts: Autotransfusion for the Provision of Blood in Lower-and-Middle-Income Countries
Since this is a safe option with low risk of adverse events it is time for all LMICs to actively work toward ensuring accessibility to such low-cost devices and thus enable more severe-trauma patients to get blood products with the expectation of an increase in survival, given the challenges of bank-blood availability and safety.
Minimally Invasive Versus Sternotomy for Mitral Surgery in the Elderly: A Systematic Review and Meta-Analysis
MIMVS in elderly patients is associated with lower postoperative complications, blood transfusion, shorter ICU, and hospital LOS, and longer cross-clamp and bypass times.
Bedside Angiography of Distal Perfusion Catheter for Veno-Arterial Extracorporeal Membrane Oxygenation
Bedside angiography of the distal perfusion catheter is feasible and can be a useful adjunct in informing the need for further intervention to the ipsilateral lower extremity.
Quantification of Recirculation During Veno-Venous Extracorporeal Membrane Oxygenation: In Vitro Evaluation of a Thermodilution Technique
This study proved the technical feasibility and computation validity of the applied thermodilution technique in computing vv-ECMO RF.
Usefulness of Self-Expanding Drainage Cannula in Venovenous Extracorporeal Membrane Oxygenation: Tips, Tricks, and Results of an Early Experience
We present a retrospective series of selfexpanding venous cannula 430 or 530 mm in length in six consecutive patients undergoing venovenous (VV) ECMO. No vascular or cardiac iatrogenic injury was caused during implantation. Target flows were reached, and no clinically significant recirculation was described in any case. The use of selfexpanding drainage cannulas was safe, and efficient drainage was achieved with easy and definitive unique positioning during cannulation.
Extracellular Vesicles in Autologous Cell Salvaged Blood in Orthopedic Surgery
Retransfusate contains negligible amounts of potentially thrombogenic EVs from platelet and monocytic origin. Frequent EVs from erythrocytes may indicate red blood cell destruction and/or activation during autologous cell salvage. Further research is needed to investigate the clinical relevance of EVs from salvaged red blood cells.