Reliability of the Minto Model for Target-Controlled Infusion of Remifentanil during Cardiac Surgery with Cardiopulmonary Bypass
The Minto model accurately predicts plasma remifentanil concentrations during cardiac surgery with CPB.
Intraoperative Hypotension-Physiologic Basis and Future Directions
This new technology has the potential to reduce duration or even prevent IOH. In the authors’ opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
Awake Extracorporeal Life Support and Physiotherapy in Adult Patients: A Systematic Review of the Literature
Awake ECLS strategy associated with physiotherapy is performed regardless of cannulation approach. Ambulation, as main objective, is achieved in almost half the population examined. Prospective studies are needed to evaluate safety and efficacy of physiotherapy during Awake ECLS, and suitable patient selection. Guidelines are required to identify appropriate assessment/evaluation tools for Awake ECLS patients monitoring.
Incidence and Outcome of Anaphylaxis in Cardiac Surgical Patients
As all patients survived, our results provide preliminary support for proceeding with surgery although we cannot speculate on the likely outcomes of patients who were postponed, had their surgery proceeded. Based on our data, the incidence of anaphylaxis in cardiac surgical patients may be 10–20 times higher than in the general surgical population.
Impact of Cardiopulmonary Bypass Duration on Efficacy of Fibrinogen Replacement with Cryoprecipitate Compared with Fibrinogen Concentrate: A Post Hoc Analysis of the Fibrinogen Replenishment in Surgery (FIBRES) Randomised Controlled Trial
The haemostatic efficacy of FC was non-inferior to cryoprecipitate irrespective of CPB duration in cardiac surgery.
Arterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation
In conclusion, in a cohort with granular arterial blood gas (ABG) data and a standardized neuromonitoring protocol, higher pre-cannulation PaCO2 and larger ΔPaCO2 were associated with increased prevalence of ICH.
Effect of Hospital Case Volume on Clinical Outcomes of Patients Requiring Extracorporeal Membrane Oxygenation: A Territory-Wide Longitudinal Observational Study
In a territory-wide observational study, we observed that case volumes in extracorporeal membrane oxygenation centers were not associated with hospital mortality. Maintaining standards of care in low-volume centers is important and improves preparedness for surges in demand.
Imaging the Acute Respiratory Distress Syndrome: Past, Present and Future￼
This narrative review aims to draw a didactic and comprehensive picture of how modern imaging techniques improved our understanding of the syndrome, and have the potential to help the clinician guide ventilatory treatment and refine patient prognostication.
The Predictive Value of the 4Ts and HEP Score at Recommended Cutoffs in Patients With Mechanical Circulatory Support Devices
The 4Ts and HEP scores have a modest predictive performance for probable HIT in patients requiring MCS devices. A low 4Ts or HEP score does not reliably rule out HIT in patients requiring MCS, and clinical suspicion for HIT should be investigated, utilizing laboratory tests in this population.
Cannulas and Cannulation Options for Minimally Invasive Surgery
Traditionally, cardiac surgery has been practiced primarily through a median sternotomy; however, as instrumentation and experience continue to advance at exponential rates, the field of minimally invasive cardiac surgery (MICS) is rapidly expanding. When compared with a conventional sternotomy, alternative access offers patients the potential benefits of decreased infection risk, reduced transfusion requirements, decreased length of admission, quicker return to normal activity, and, perhaps most important for patients, improved cosmesis. We hereby discuss our approach to cannulation for MICS operations.
Measuring the Resting Energy Expenditure in Children on Extracorporeal Membrane Oxygenation: A Prospective Pilot Study
REE measurements can be obtained by indirect calorimetry in children receiving ECMO support. ECMO may not provide metabolic rest for all children as a wide variation in REE was observed. For optimal care, individual testing should be considered to match calories provided with the metabolic demand.
Effect Of Aortic Cannulation Depth on Air Emboli Transport during Cardiopulmonary Bypass: A Computational Study.
It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.