Low Mean Arterial Pressure During Cardiopulmonary Bypass and the Risk of Acute Kidney Injury: A Propensity Score Matched Observational Study
Low MAP periods during CPB are associated with an increased occurrence of post-operative AKI, leading to 1) higher creatinine levels; 2) decreased GFR and 3) longer ICU and ward lengths of stay. Both consecutive and cumulative periods of low MAP are associated with an increased risk of AKI. MAP appears to be an important contributor to post-operative AKI and should be carefully managed during CPB. Further studies must address if MAP variations lead to definitive and long-term consequences.
Artificial Intelligence for Augmenting Perioperative Surgical Decision-Making—Are We There Yet?
These questions for translating AI into surgical care remain. However, this proof-of-concept study will undoubtedly stimulate surgeons, innovators, and data scientists to continue investigating the role of machine-learning methods to improve care.
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) is used to support patients with refractory cardiopulmonary failure. Given ECMO's increased use in adults and the fact that many ECMO patients are cared for by anesthesiologists, the Society of Cardiovascular Anesthesiologists ECMO working group created an expert consensus statement that is intended to help anesthesiologists manage adult ECMO patients who are cared for in the operating room. In the first part of this 2-part series, technical aspects of ECMO are discussed, and related expert consensus statements are provided.
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists— Part II, Intraoperative Management and Troubleshooting
In the first stage of creating the expert consensus statement, topics related to intraoperative ECMO management were proposed by group members. A literature review for each topic was performed using MEDLINE, and articles published after 1980 were included at the discretion of group members. The specific search terms that were queried varied for each topic area.
Real-Time Ventricular Volume Measured Using the Intracardiac Electromyogram
The DA of the iEMG proved to be a significant, independent predictor of EDV. The proposed LV volume sensor is simple to integrate into the inflow cannula of an LVAD and thus has the potential to inform the clinician about the state of LV volume in real time and to automatically control the LVAD.
Limb Amputation Following Extracorporeal Membrane Oxygenation Therapy Among Survivors: A Nationwide Cohort Study from South Korea
In South Korea, 1.6% of ECMO survivors underwent limb amputation within 365 days after initiating ECMO therapy; however, it was not significantly associated with the 3-year all-cause mortality. Our findings warrant future studies on the impact on the quality of life and morbidity-related implications among patients who undergo limb amputation due to ECMO therapy.
Mobile Devices and Wearable Technology for Measuring Patient Outcomes after Surgery: A Systematic Review
Despite the potential of DHI to improve postoperative patient care, current progress is severely restricted by limitations in methodological reporting. There is an urgent need to improve reporting for DHI following surgery to identify patient benefit, promote reproducibility and encoura
The Effect of Low Tidal Volume Ventilation on Inflammatory Cytokines During Cardiopulmonary Bypass
Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.
Early Experience with Donation after Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion in The United States
DCD heart transplantation outcomes have been excellent. Our DCD protocol is adoptable for more widespread use and will increase donor heart availability in the United States.
Adrenaline Improves Regional Cerebral Blood Flow, Cerebral Oxygenation and Cerebral Metabolism During CPR in A Porcine Cardiac Arrest Model Using Low-Flow Extracorporeal Support
This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.
Neuroprotective Effects of Dynamic Bubble Trap Use in Patients Undergoing Pulmonary Endarterectomy: A Two-Arm Randomized Controlled Trial
DBT positively influences memory function after PEA. This effect is most likely caused by the reduction of gaseous microemboli.
Outcomes and their State-Level Variation in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection in the USA: A Prospective Multicenter Study
Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.