Perfusion.com Cardiovascular News Roundup: December 20, 2022
Relevant reading, listening, or viewing – curated by the creator of Tiny Perfusion Letter, Luc Puis
Every week, we collect 10 or 20 articles from the peer-reviewed literature that we think will be of interest to the perfusionist community. Feel free to comment on the findings or suggest entries for the newsletter by emailing the Editor – Luc Puis.
Medical Safety
Safety has always been and will always be an important issue in perfusion: not only the safety of our patients but also ourselves and our colleagues. One part of that safety is gender equity. In this simple study looking at the infrastructure available in operating room lockers, women had proportionately fewer lockers and hygiene structures and less space, although women compose most of the overall OR workforce. There is work to do!!
Next to patient harm, medical errors cost a lot of money to the health care systems. This systematic review of systematic reviews concludes that patient safety has not significantly improved in recent years, and this costs tens of billions of dollars to the system.
Luckily, we also learn from our mistakes, and this safety-II approach is gaining more and more widespread use and acceptance in healthcare.
Now that we know it, now we can teach it. Engaging students in learning about human factors cannot be underestimated in this day and age. It’s better to start early instead of having to unlearn it in the OR.
Blood Management
Patient blood management is never far away. That counts for this edition of the RoundUp too. The discussion of which protamine-to-heparin ratio is best is still ongoing, but the lower ratio is still gaining more support to optimize coagulation after cardiopulmonary bypass (admit it, we all know that).
Sickle-cell disease. We all know it, and many of us have seen it, but we always love to have a protocol to guide us. This retrospective cohort study offers a simple protocol for sickle-cell patients undergoing mitral valve surgery.
ECLS
Some of us have to deal with ventricle assist devices, and they are often used in acute cardiogenic shock. This propensity-matched cohort study compared a microaxial intravascular pump with a good old IABP, and concluded that the intravascular pump was associated with higher 30-day and one-year mortality, bleeding, kidney replacement therapy, and total health care costs. Yikes!
When using two single-stage venous cannulas for VV ECMO, we always have to be wary of recirculation. This study compared the recirculation fraction between femoro-jugular and jugulo-femoral VV ECMO configurations. Spoiler alert: the femoro-jugular configuration came out best…
Circulatory Death, AI Algorithm, and more
To conclude this RoundUp, we have a review article on the history, outcomes, clinical challenges, and opportunities of donation after circulatory death. Extending the donor pool is the goal.
Another study used an artificial intelligence algorithm to calculate left ventricular ejection fraction in pediatrics and was able to reproduce results within clinically acceptable error.
Enjoy the read!
Sources
Safety
- Operating Room Lockers and Gender Equity in the Surgical Workforce.
- Interventions to Reduce the Incidence of Medical Error and Its Financial Burden in Health Care Systems: A Systematic Review of Systematic Reviews.
- Positive Approaches to Safety: Learning from What We Do Well.
- Engaging Perioperative Students in Online Learning: Human Factors.
PBM
- In Vitro Comparison of Spatiotemporal Fibrin Clot Formation Dynamics in Plasma Treated with Different Protamine-Heparin Ratios.
- Simple Open-Heart Surgery Protocol for Sickle-Cell Disease Patients: A Retrospective Cohort Study Comparing Patients Undergoing Mitral Valve Surgery.
ECLS – VAD
- Clinical Outcomes and Cost Associated with an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump in Patients Presenting with Acute Myocardial Infarction Complicated by Cardiogenic Shock.
- Recirculation in Single Lumen Cannula Venovenous Extracorporeal Membrane Oxygenation: A Non-Randomized Bi-Centric Trial.
Miscellaneous
