Association Between Perioperative Hypotension and Postoperative Delirium and Atrial Fibrillation after Cardiac Surgery: A Post-Hoc Analysis of the DECADE Trial
In patients having cardiac surgery with cardio-pulmonary bypass, neither intraoperative nor postoperative hypotension were associated with delirium. Postoperative hypotension was associated with atrial fibrillation, although intraoperative hypotension was not.
21st Century Evidence: Randomized Controlled Trials Versus Systematic Reviews and Meta-Analyses
In this foreword, we will review benefits and downsides of SRMAs and address the value of SRMAs in relation to RCTs and their respective roles in clinical decision-making.
Left Ventricular Assist Device Implants in Patients On Extracorporeal Membrane Oxygenation: Do We Need Cardiopulmonary Bypass?
Omitting CPB for an LVAD implant in patients on ECLS is safe and results in shorter operating time, less re-exploration for bleeding and fewer blood products. However, no survival benefit is observed.
Measures to Prevent Neurological Deficits in Urgent CABG Surgery with Bilateral Carotid Occlusion
Patients with previous CVA/TIA in the presence of carotid disease requiring coronary arterial bypass surgery (CABG) are associated with a higher risk of neurological ischemic event.
New Technology for the Use of Inhaled Nitric Oxide to Protect the Heart and Lungs during Operations with Cardiopulmonary Bypass
The developed technology for the use of inhaled NO in surgery with CPB provides a clinically marked protective effect on the heart and lungs. The effectiveness of the protective action of NO depends on the duration of its administration and is most pronounced when used during the entire operation, including CPB time.
Impact of Arterial Carbon Dioxide and Oxygen Content on Cerebral Autoregulation Monitoring Among Children Supported by ECMO
We observed a complex relationship between PaCO2 and CA, influenced by the level of blood pressure. Hypercapnia seems to be globally protective in normotensive or hypertensive condition, while, in case of very low MAP, hypercapnia may disturb CA as it increases LLA. These data add additional arguments for very cautiously lower PaCO2, especially after ECMO start.
Comparative Effects of On-Pump Versus Off-Pump Coronary Artery Bypass Grafting Surgery on Serum Cytokine and Chemokine Levels
Cardiopulmonary pump in patients under CABG surgery can activate systemic inflammation and the changes of serum cytokines levels in off-pump CABG were lower compared with on-pump CABG.
Extracorporeal Membrane Oxygenation for COVID-19: Evolving Outcomes from the International Extracorporeal Life Support Organization Registry
Mortality after ECMO for patients with COVID-19 worsened during 2020. These findings inform the role of ECMO in COVID-19 for patients, clinicians, and policy makers.
Anesthetic Management of Successful Extracorporeal Resuscitation After Six Hours of Cardiac Arrest Due to Severe Accidental Hypothermia
The case of a patient who experienced cardiac arrest due to severe AH and was resuscitated for more than six hours using extracorporeal life support recently was published. Herein that case is reviewed, with the anesthetic management during cannulation detailed.
Antifibrinolytic Drugs for the Prevention of Bleeding in Pediatric Cardiac Surgery on Cardiopulmonary Bypass: A Systematic Review and Meta-analysis
The available data demonstrate efficacy for all 3 antifibrinolytic drugs. Therefore, the agent with the most favorable safety profile should be used. As sufficient data are lacking, large comparative trials are warranted to assess the relative safety and appropriate dosing regimens in pediatrics.
Incidence of Postoperative Pulmonary Complications in Patients Undergoing Minimally Invasive Versus Median Sternotomy Valve Surgery: Propensity Score Matching
MIVS for isolated valve surgery reduces the risk of PPCs compared with the FS approach.
Clinical Characteristics Between Survivors and Nonsurvivors of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation (ECMO) Support: A Systematic Review and Meta-Analysis
We found advanced age, multiple comorbidities, lower pre-ECMO pH, greater RRT, and vasopressor requirements, and bleeding are predictors of death in COVID-19 patients requiring ECMO support. The duration of MV before ECMO support initiation and total ECMO support duration was similar among survivors and nonsurvivors. Our study results have important clinical implications when considering ECMO support in critically ill COVID-19 patients.