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.
We have three big themes today – more or less!
Patient blood management is always something. We’re working with blood every day, so it’s no surprise to find half of the publications around that topic. To begin with, we have a consensus document on preoperative anemia and iron deficiency management in cardiac surgery patients. Full of useful evidence-based recommendations and open access. No excuses!
Next, in conjunction with that, there’s a group from France that determined the critical hemoglobin value to predict complications after cardiac surgery (it was 13 g/dL for men and 11.8 g/dL for women), and that is very close to the WHO definitions for anemia.
We know von Willebrand disease (VWD) as a complication of the use of ECMO, but VWD is also one of the most common inherited bleeding disorders. Researchers in Europe tried to estimate the financial burden of Von Willebrand disease. A not so easy task… But it’s a lot!
The case report of giving a bag of autologous blood to the wrong patient might seem like it’s coming from yonder days, but it’s still a thing to be wary of. In this case, the authors made a full description of what went wrong and what measures were taken to avoid the problem in the future. Very educational!
Lastly in bloody stuff, researchers from Australia evaluated the association between post-operative hyperbilirubinemia and mortality and morbidity in cardiac surgery patients. Something worth looking at in your patient cohort, apparently.
The next topic in line is neuromonitoring and neurologic dysfunction. First, a systematic review of literature on the use of cerebral oximetry in surgery in general. Although there was an association with a significant reduction of postoperative cognitive dysfunction, the evidence might have been a little stronger.
This is followed by a narrative review of neuromonitoring and neurocognitive outcomes, specifically in cardiac surgery. Very informative and very open access, so you better start reading!
In neurologic topics, researchers in Japan looked at risk factors for postoperative delirium in patients who underwent cardiopulmonary bypass with oxygen delivery-guided perfusion (DO2i > 300 ml/min/m2).
Lastly, we have the ever-present topic of ECMO. A case report describing the use of two parallel oxygenators in a very obese patient on ECMO for COVID-19 ARDS (BMI: 60 kg/m2, BSA: 2.8 m2!!).
And to end this edition, we have a call for the use of nursing ECMO specialists to look after ECMO to maintain care sustainable financially. Interesting discussion!
Enjoy the read!
PBM – Hemostasis
- Perioperative Quality Initiative and Enhanced Recovery After Surgery-Cardiac Society Consensus Statement on the Management of Preoperative Anemia and Iron Deficiency in Adult Cardiac Surgery Patients.
- Critical Preoperative Hemoglobin Value to Predict Anemia-Related Complications After Cardiac Surgery.
- The Cost of von Willebrand Disease in Europe: The CVESS Study.
- Serious Hazards of Transfusion: Evaluating the Dangers of A Wrong Patient Autologous Salvaged Blood in Cardiac Surgery.
- The Prognostic Significance of Postoperative Hyperbilirubinemia in Cardiac Surgery: Systematic Review and Meta-Analysis.
Neuromonitoring – Neurologic Dysfunction
- The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
- Neuromonitoring and Neurocognitive Outcomes in Cardiac Surgery: A Narrative Review.
- Risk Factors for Postoperative Delirium on Oxygen Delivery-Guided Perfusion.