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Rehabilitation for adult patients undergoing extracorporeal membrane oxygenation Perfusion (IF 1.2) Pub Date : 2024-04-23 Massimiliano Polastri, Allaina Eden, Justyna Swol
Background and purposeCurrent information on the latest rehabilitative practices is limited, with previous reviews only covering data up to October 2021, and some considering only patients on awake ECMO or with COVID-19. This review aims to present a concise overview of the latest findings on rehabilitation and highlight emerging trends for patients undergoing ECMO support.MethodsThis integrative review
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Abstracts from EuroELSO 2024 – 24th–27th April – Krakow, Poland Perfusion (IF 1.2) Pub Date : 2024-04-23
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Evolution of distal limb perfusion management in adult peripheral venoarterial extracorporeal membrane oxygenation with femoral artery cannulation Perfusion (IF 1.2) Pub Date : 2024-04-23 Jorik Simons, Barend Mees, Graeme MacLaren, John F Fraser, Akram M Zaaqoq, Sung-Min Cho, Bhavesh M Patel, Daniel Brodie, Jan Bělohlávek, Mirko Belliato, Jae-Seung Jung, Leonardo Salazar, Paolo Meani, Silvia Mariani, Michele Di Mauro, Demetris Yannopoulos, Lars Mikael Broman, Yih-Sharng Chen, Jordi Riera, Walther NKA van Mook, Roberto Lorusso
Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal
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Extracorporeal membrane oxygenation from last resort to indispensable tool in the treatment of respiratory and/or circulatory failure Perfusion (IF 1.2) Pub Date : 2024-04-23 Filip De Somer, Justyna Swol
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The approach to extracorporeal cardiopulmonary resuscitation (ECPR) in children. A narrative review by the paediatric ECPR working group of EuroELSO Perfusion (IF 1.2) Pub Date : 2024-04-23 HA Mensink, A Desai, M Cvetkovic, M Davidson, A Hoskote, M O’Callaghan, T Thiruchelvam, PP Roeleveld
Extracorporeal Cardiopulmonary Resuscitation (ECPR) has potential benefits compared to conventional Cardiopulmonary Resuscitation (CCPR) in children. Although no randomised trials for paediatric ECPR have been conducted, there is extensive literature on survival, neurological outcome and risk factors for survival. Based on current literature and guidelines, we suggest recommendations for deployment
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Mechanical ventilation during extracorporeal membrane oxygenation support – New trends and continuing challenges Perfusion (IF 1.2) Pub Date : 2024-04-23 Konstanty Szuldrzynski, Mariusz Kowalewski, Justyna Swol
BackgroundThe impact of mechanical ventilation on the survival of patients supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO) due to severe acute respiratory distress syndrome (ARDS) remains still a focus of researchMethodsRecent guidelines, randomized trials, and registry data underscore the importance of lung-protective ventilation during respiratory and cardiac support on
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Individual patient data meta-analysis on awake pediatric extracorporeal life support: Feasibility and safety of analgesia, sedation and respiratory support weaning, and physiotherapy Perfusion (IF 1.2) Pub Date : 2024-04-23 Marta Cucchi, Silvia Mariani, Michal J. Kawczynski, Emma Shkurka, Fabio Ius, Giuseppe Comentale, Aparna Hoskote, Roberto Lorusso
ObjectiveAwake Extracorporeal Life Support (aECLS) with active mobilization has gained consensus over time, also within the pediatric community. This individual patient data (IPD) meta-analysis summarizes available evidence on pediatric aECLS, its feasibility, and safety regarding sedation weaning, extubation, and physiotherapy.MethodsPubMed/Medline and Cochrane Database were screened until February
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Left ventricular unloading in patients supported with veno-arterial extra corporeal membrane oxygenation; an international EuroELSO survey Perfusion (IF 1.2) Pub Date : 2024-04-23 Saad M Ezad, Matthew Ryan, Nicholas Barrett, Luigi Camporota, Justyna Swol, Marta V Antonini, Dirk W Donker, Federico Pappalardo, Navin K Kapur, Louise Rose, Divaka Perera
IntroductionVeno-arterial extracorporeal membrane oxygenation (V-A ECMO) improves end-organ perfusion in cardiogenic shock but may increase afterload, which can limit cardiac recovery. Left ventricular (LV) unloading strategies may aid cardiac recovery and prevent complications of increased afterload. However, there is no consensus on when and which unloading strategy should be used.MethodsAn online
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What the pediatric nurse needs to know about the Impella cardiac assist device Perfusion (IF 1.2) Pub Date : 2024-04-23 Giorgia Borrelli, Ilaria Nittolo, Chiara Bochicchio, Laura Trainelli, Valerio Confalone, Tiziana Satta, Federica Cancani, Richard Kirk, Antonio Amodeo, Matteo Di Nardo
Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the
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The role of inflammation and antithrombin supplementation on thromboelastographic parameters during veno-venous ECMO for respiratory failure Perfusion (IF 1.2) Pub Date : 2024-04-23 Andrea Meli, Stefano De Falco, Cristina Novembrino, Massimo Boscolo Anzoletti, Antonio Arcadipane, Giovanna Panarello, Giovanna Occhipinti, Giacomo Grasselli, Mauro Panigada
IntroductionExtracorporeal membrane oxygenation (ECMO) may act as a driver or propagator of systemic inflammation. In turn, cytokine release can modify thromboelastographic (TEG) tests which are commonly used for anticoagulation monitoring. In this context, antithrombin (AT) supplementation might further modify TEG.MethodsThis is a pre-specified sub-study of the “Randomized Controlled Trial of Antithrombin
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The physiology of venoarterial extracorporeal membrane oxygenation - A comprehensive clinical perspective Perfusion (IF 1.2) Pub Date : 2024-04-23 Libera Fresiello, Jeannine A.J. Hermens, Lara Pladet, Christiaan L. Meuwese, Dirk W. Donker
Venoarterial extracorporeal membrane oxygenation (VA ECMO) has become a standard of care for severe cardiogenic shock, refractory cardiac arrest and related impending multiorgan failure. The widespread clinical use of this complex temporary circulatory support modality is still contrasted by a lack of formal scientific evidence in the current literature. This might at least in part be attributable
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Agreement between the thromboelastography reaction time parameter using fresh and citrated whole blood during extracorporeal membrane oxygenation with Teg®5000 and Teg®6s Perfusion (IF 1.2) Pub Date : 2024-04-23 Stefano De Falco, Andrea Meli, Alessio Caccioppola, Giacomo Grasselli, Mauro Panigada
PurposeWe aimed at assessing the correlation between TEG reaction time (TEG-R) in citrated and fresh blood samples with TEG5000 and TEG 6S during heparin administration in patients with and without ECMO support.Materials and MethodsPaired TEG5000 (fresh and citrated whole blood, kaolin and kaolin-heparinase) and TEG6S (citrated whole blood) samples were obtained, together with standard coagulation
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The intricate physiology of veno-venous extracorporeal membrane oxygenation: an overview for clinicians Perfusion (IF 1.2) Pub Date : 2024-04-23 Emilia Tomarchio, Francesca Momigliano, Lorenzo Giosa, Patrick Duncan Collins, Nicholas A Barrett, Luigi Camporota
During veno-venous extracorporeal membrane oxygenation (V-V ECMO), blood is drained from the central venous circulation to be oxygenated and decarbonated by an artificial lung. It is then reinfused into the right heart and pulmonary circulation where further gas-exchange occurs. Each of these steps is characterized by a peculiar physiology that this manuscript analyses, with the aim of providing bedside
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Clinical decision making for VA ECMO weaning in patients with cardiogenic shock A formative qualitative study Perfusion (IF 1.2) Pub Date : 2024-04-23 J. A. J. Hermens, J. A. van Til, C. L. Meuwese, D. van Dijk, D. W. Donker
Weaning and liberation from VA ECMO in cardiogenic shock patients comprises a complex process requiring a continuous trade off between multiple clinical parameters. In the absence of dedicated international guidelines, we hypothesized a great heterogeneity in weaning practices among ECMO centers due to a variety in local preferences, logistics, case load and individual professional experience. This
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A systematic review of cardiac surgery clinical prediction models that include intra-operative variables Perfusion (IF 1.2) Pub Date : 2024-04-23 Ceri Jones, Marcus Taylor, Matthew Sperrin, Stuart W. Grant
BackgroundMost cardiac surgery clinical prediction models (CPMs) are developed using pre-operative variables to predict post-operative outcomes. Some CPMs are developed with intra-operative variables, but none are widely used. The objective of this systematic review was to identify CPMs with intra-operative variables that predict short-term outcomes following adult cardiac surgery.MethodsOvid MEDLINE
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Effect of geography on the use of ultrafiltration during cardiac surgery with cardiopulmonary bypass Perfusion (IF 1.2) Pub Date : 2024-04-22 Kirti P Patel, Alfred H Stammers, Eric A Tesdahl, Jeffrey Chores, Scott R Beckmann, Jennifer Baeza, Craig M Petterson, Ty Thompson, Alexander Baginski, Michael Firstenberg, Jeffrey P Jacobs
BackgroundUltrafiltration (UF) is a common practice during cardiopulmonary bypass (CPB) where it is used as a blood management strategy to reduce red blood cell (RBC) transfusion, minimize adverse effects of hemodilution, and reduce proinflammatory mediators. However, its clinical utilization has been shown to vary throughout the continents.PurposeThe purpose of this investigation was to assess the
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Practical training concept for perfusionists at the heart and diabetes center Nordrhein-Westfalen Perfusion (IF 1.2) Pub Date : 2024-04-22 Christian Klüß, André Giesbrecht, Markus Rudloff, Vera von Dossow, Eugen Sandica, Jan Gummert
BackgroundIncreasing regulations and requirements of advisory bodies, in particular the Joint Federal Committee and the Medical Service of the health insurance funds, make it necessary to employ only demonstrably well-trained perfusionists. The minimum requirement for this staff is EBCP certification. Currently there is limited availability of such specialists on the German market. Therefore, the qualification
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The outcome of endovenous intervention for acute iliofemoral deep venous thrombosis with and without inferior vena cava filter Perfusion (IF 1.2) Pub Date : 2024-04-17 Mohammed Alsagheer Alhewy, Ibrahim Hanbal Hanbal, Abdelaziz Ahmed Abdelhafez, Mohamed Hamza Metwaly, Abdelhalim A Abdelmohsen, Ehab Abd elmoneim Ghazala, Alhussein M Khedr, Ahmed Atef Khamis, Hassan Gado, Wael Abdo Abdo Abd-Elgawad, Abdullah El Sayed, Awad Ibrahim, Yasser Elghoneimy, Sameh E Elimam
BackgroundCatheter-directed thrombolysis (CDT) for acute iliofemoral deep venous thrombosis (DVT) is an endovenous interventional therapy that can quickly remove the acute thrombus, thereby improving the clinical outcomes of proximal DVT. However, instrumentation of extensive fresh thrombus may be associated with iatrogenic pulmonary embolism (PE). Therefore, we aimed to compare CDT’s safety, complications
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Perioperative management of a double valve replacement and coronary artery bypass graft in a patient with carcinoid syndrome; a case report and literature review Perfusion (IF 1.2) Pub Date : 2024-04-16 Despoina G Sarridou, Anna Gkiouliava, Helena Argiriadou, Sophia Anastasia Mouratoglou, Jeremy B Mitchell, Christopher P Walker
IntroductionCarcinoid tumors are rare neuroendocrine tumors; about 5% of patients develop the carcinoid syndrome. We present the case of a patient with carcinoid syndrome undergoing cardiac surgery.Case reportA 74-year-old patient with carcinoid heart disease and hepatic metastases underwent double valve replacement and CABG. The patient was on octreotide therapy and antihypertensive medication. An
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Correction to ‘corrigendum to “Microplegia in paediatric hearts”’ Perfusion (IF 1.2) Pub Date : 2024-04-16
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Clinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia Perfusion (IF 1.2) Pub Date : 2024-04-16 Sonia Labarinas, Kalpana Norbisrath, Dana Johnson, Jon Meliones, Christopher Greenleaf, Jorge Salazar, Oliver Karam
IntroductionAs international guidelines suggest keeping the platelet count between 50 and 100 × 109 cells/L in children on extracorporeal membrane oxygenation (ECMO), platelet transfusions are administered to two-thirds of ECMO days, and up to 70% of these patients still bleed. We aim to describe outcomes in critically ill children who develop severe thrombocytopenia on ECMO.MethodsSingle-center retrospective
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Is ultrafiltration volume a predictor of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass? Perfusion (IF 1.2) Pub Date : 2024-04-09 Hamid Gerami, Javad Sajedianfard, Bahram Ghasemzadeh, Maryam AnsariLari
IntroductionIntraoperative ultrafiltration (UF) is a procedure used during cardiopulmonary bypass (CPB) to reduce haemodilution and prevent excessive blood transfusion. However, the effect of UF volume on acute kidney injury (AKI) is not well established, and the results are conflicting. Additionally, there are no set indications for applying UF during CPB.MethodsThis retrospective study analysed 641
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Effectiveness of exercise-based cardiac rehabilitation for patients with left ventricular assist device: A systematic review and meta-analysis Perfusion (IF 1.2) Pub Date : 2024-04-08 Yujin Wang, Yawen Wu, Shilin Wei, Sijie Lu, Jianting Zhao, Yanchun Zhang, Xiangyang Wu, Xiaowei Zhang, Yongnan Li
PurposeExercise-based cardiac rehabilitation (EBCR) improves functional capacity in heart failure (HF). However, data on the effect of EBCR in patients with advanced HF and left ventricular assist devices (LVADs) are limited. This meta-analysis aimed to evaluate the impact of EBCR on the functional ability of LVAD patients by comparing the corresponding outcome indicators between the EBCR and ST groups
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Sudden pump stop may cause air release in oxygenators, ‘The Hammer Effect ’: An in vitro evaluation Perfusion (IF 1.2) Pub Date : 2024-04-08 Paul van Kaam, Marco Stehouwer
BackgroundOxygenators, as used in cardiopulmonary bypass (CPB) circuits, are components with good air removal properties. However, under some conditions the semipermeable characteristics of hollow fibers allow air to accidentally enter the blood side of the CPB circuit. This may occur when a fluid in motion is stopped suddenly by which the rapid change in momentum may cause a relative negative pressure
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The safe addition of nitric oxide to the sweep gas of the extracorporeal membrane oxygenation circuit in a pediatric cardiac intensive care unit Perfusion (IF 1.2) Pub Date : 2024-04-06 Michael A Brock, Mohammed Ebraheem, Andrew Jaudon, Sukumar Suguna Narasimhulu, Zasha Vazquez-Colon, Joseph Philip, Dalia Lopez-Colon, Jeffrey P Jacobs, Mark S Bleiweis, Giles J Peek
Background: Nitric Oxide (NO) is a naturally occurring modulator of inflammation found in the human body. Several studies in the pediatric cardiothoracic surgery literature have demonstrated some beneficial clinical effects when NO is added to the sweep gas of the cardiopulmonary bypass circuit.Purpose: Our primary aim was to determine the safety of incorporating nitric oxide into the oxygenator sweep
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Book Review: Damage-Associated Molecular Patterns in Human Diseases, Volume 3: Antigen-Related Disorders Perfusion (IF 1.2) Pub Date : 2024-04-05 Valensa Yosephi, Chyntia Tresna Nastiti
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Globalization of perfusion education: Our profession’s contribution to addressing cardiac surgery inequity worldwide Perfusion (IF 1.2) Pub Date : 2024-04-03 Bruce Searles, Robert Groom
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Which strategy is better for lung transplantation: Cardiopulmonary bypass or extracorporeal membrane oxygenation? Perfusion (IF 1.2) Pub Date : 2024-04-01 Jianbao Yang, Xinling Xie, Jian Li, Yongnan Li, Bin Li, Cheng Wang, Peng Jiang
Background: In lung transplantation surgery, extracorporeal life support (ECLS) is essential for safety. Various support methods, including cardiopulmonary bypass (CPB) and off-pump techniques, are used, with extracorporeal membrane oxygenation (ECMO) gaining prominence. However, consensus on the best support strategy is lacking.Purpose: This article reviews risks, benefits, and outcomes of different
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The effects of tranexamic acid in patients treated with extracorporeal membrane oxygenation after cardiac surgery Perfusion (IF 1.2) Pub Date : 2024-03-30 Wei Chen, Zhongtao Du, Liangshan Wang, Mengjun Wang, Hong Wang, Xiaotong Hou
BackgroundThe lysine analog tranexamic acid (TXA) is used as a blood protective drug in cardiac surgery, but efficacy and safety outcomes in patients treated with extracorporeal membrane oxygenation (ECMO) after surgery remain poorly understood.MethodsFrom January 1, 2017 to December 31, 2022, we retrospectively analyzed patients assisted by ECMO after cardiac surgery and divided them into TXA and
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Direct aortic cannulation versus femoral arterial cannulation for early outcomes in acute type A aortic dissection: A study-level meta-analysis Perfusion (IF 1.2) Pub Date : 2024-03-27 Yoshiyuki Yamashita, Serge Sicouri, Stephanie Kjelstrom, Georgia Montone, Aleksander Dokollari, Khalid Ridwan, Nicholas Clarke, Roberto Rodriguez, Scott M. Goldman, Basel Ramlawi
PurposeTo investigate the impact of direct aortic cannulation (DAC) versus femoral arterial cannulation (FAC) on clinical outcomes of surgery for acute type A aortic dissection.MethodsPubMed/MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched until August 25, 2023, to conduct a meta-analysis. Primary endpoints of the study were operative mortality and postoperative stroke
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The role of fetal hemoglobin in the artificial placenta: A premature ovine model Perfusion (IF 1.2) Pub Date : 2024-03-23 Brianna L Spencer, Brian P Fallon, Jennifer S McLeod, Marie Cornell, Erin E Perrone, David M Manthei, Alvaro Rojas-Peña, Ronald B Hirschl, Robert H Bartlett, George B Mychaliska
IntroductionA radical paradigm shift in the treatment of premature infants failing conventional treatment is to recreate fetal physiology using an extracorporeal Artificial Placenta (AP). The aim of this study is to evaluate the effects of changing fetal hemoglobin percent (HbF%) on physiology and circuit function during AP support in an ovine model.MethodsExtremely premature lambs ( n = 5) were delivered
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Plasma hyperosmolality during cardiopulmonary bypass is a risk factor for postoperative acute kidney injury: Results from double blind randomised controlled trial Perfusion (IF 1.2) Pub Date : 2024-03-21 Staffan Svenmarker, Helena Claesson Lingehall, Gunnar Malmqvist, Micael Appelblad
IntroductionThe study objective was to investigate whether a Ringer’s acetate based priming solution with addition of Mannitol and sodium concentrate increases the risk of cardiac surgery associated kidney injury (CSA-AKI).MethodsThis is a double blind, prospective randomized controlled trial from a single tertiary teaching hospital in Sweden including patients aged ≥65 years ( n = 195) admitted for
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Comparison of percutaneous decannulation and open surgical repair for large-bore arterial access sites of extracorporeal membrane oxygenation Perfusion (IF 1.2) Pub Date : 2024-03-21 Alison Y Zhu, Charis QY Tan, Graham Meredith
IntroductionFollowing weaning of peripheral venoarterial extracorporeal membrane oxygenation (ECMO) support, removal of cannulas and repair of large-bore arterial sites is traditionally by open surgical repair (OSR). The use of a percutaneous vascular closure device (VCD) offers a minimally invasive alternative to OSR with potential for reduced operative complications, reduced hospital length of stay
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A novel approach to retrograde autologous priming for infant, pediatric and adult populations undergoing congenital heart surgery Perfusion (IF 1.2) Pub Date : 2024-03-18 Joseph Deptula, Vincent Olshove, Molly Oldeen, Deborah Kozik, Bahaaldin Alsoufi
IntroductionRetrograde Autologous Priming (RAP) of cardiopulmonary bypass (CPB) circuits is an effective way to reduce prime volume, commonly through the transfer of prime into separate reservoirs or circuit manipulation. We describe a simple and safe technique for RAP without the need for any circuit modifications or manipulations.MethodsFor this technique, a separate roller pump for ultrafiltration
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How to mange differential hypoxemia during veno-arterial extracorporeal membrane oxygenation Perfusion (IF 1.2) Pub Date : 2024-03-16 Xiaotong Hou
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Effect of blood conservation protocol on the utilisation of blood and outcome of patients undergoing open heart surgery Perfusion (IF 1.2) Pub Date : 2024-03-16 Vivek Bagaria, Lahari Badragiri, C S Hiremath
IntroductionCardiac surgery is fraught with increased consumption of blood and blood products. Various strategies for blood conservation have been described. Our aim was to study the impact of a structured blood conservation protocol (BCP) on the utilization of blood and patient outcome.MethodsRetrospective analysis of prospectively collected data comparing adult patients undergoing open heart surgery
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The association between cerebral blood flow variations during on-pump coronary artery bypass grafting surgery and postoperative delirium Perfusion (IF 1.2) Pub Date : 2024-03-15 Caterina Sampaolesi, Erika Casarotta, Giacomo Gresti, Giulia Mariotti, Leonardo Pisani, Diego Veccia, Marco Di Eusanio, Pietro Giorgio Malvindi, Abele Donati, Christopher Maria Münch
IntroductionPostoperative delirium (POD) has a major impact on patient recovery after cardiac surgery. Although its pathophysiology remains unclear, there could be a correlation between cerebral blood flow (CBF) variations during cardio-pulmonary bypass (CPB) and POD. Our study aimed to evaluate whether variations in on-pump CBF, compared to pre-anesthesia and pre-CPB values, are associated with POD
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Effect of oxygen delivery during cardiopulmonary bypass on postoperative neurological outcomes in patients undergoing cardiac surgery: A scoping review of the literature Perfusion (IF 1.2) Pub Date : 2024-03-15 Abdelrahman Elsebaie, Ayesha Shakeel, Shetuan Zhang, Marianne Alarie, Mohamed El Tahan, Mohammad El-Diasty
BackgroundReduced oxygen delivery (DO2) during cardiopulmonary bypass (CPB) was proposed as a risk factor for the development of postoperative neurological complications (PONCs), including cerebrovascular accidents (CVA), delirium, and postoperative cognitive dysfunction (POCD). We aimed to review the current evidence on the association between intraoperative DO2 and the incidence of PONCs.MethodsMEDLINE
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Extracorporeal cardio-pulmonary resuscitation in a patient with missed diagnosis of sodium nitrite intoxication Perfusion (IF 1.2) Pub Date : 2024-03-15 Francesco Gaiani, Marco Giani, Beatrice Vergnano, Jeff Sardella, Fabrizio Cappellini, Marco Casati, Matteo Pozzi, Giuseppe Foti
IntroductionCritical poisoning with sodium nitrite (NaNO2) can present challenges in promptly identifying and managing acute methemoglobinemia.Case reportWe report the case of an overt self-intoxication by an initially unknown agent, leading to cardiac arrest. Despite prodromal signs of cyanosis, coma, desaturation, and hypotension, methemoglobinemia went unrecognized during extracorporeal cardiopulmonary
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Utilizing cell salvage devices to return blood post extracorporeal membrane oxygenation circuit decannulation, A Letter to the Editor Perfusion (IF 1.2) Pub Date : 2024-03-14 Mazen F Odish, Samira Najmaii, Cassia Yi, Travis L Pollema
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Letter re: Loss of pioneer physician perfusionist Perfusion (IF 1.2) Pub Date : 2024-03-14 Dereck Wheeldon
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Meta-analysis of central and peripheral cannulation for type A aortic dissection Perfusion (IF 1.2) Pub Date : 2024-03-13 Noritsugu Naito, Hisato Takagi
BackgroundAcute type A aortic dissection necessitates rapid and effective arterial cannulation techniques for optimal outcomes. This meta-analysis compares the safety and effectiveness of direct aortic cannulation (AoC) with peripheral cannulation (PC) via the femoral or axillary arteries in aortic surgery for acute type A aortic dissection.MethodsA systematic review following PRISMA guidelines identified
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Comparing clinical outcomes of hybrid coronary revascularization with open coronary artery bypass in patients with multi-vessels lesions Perfusion (IF 1.2) Pub Date : 2024-03-08 Ji Lin, Guang Li, Yuan Ji, Yi Xu, Shuo Liu, Zheng Qu, Ping Li, Bin You
ObjectivesHybrid coronary revascularization (HCR) involves the use of minimally invasive direct coronary artery bypass grafting (CABG) to treat the left anterior descending artery (LAD), and percutaneous coronary intervention to treat non-LAD vessels. We reported the results of a comparative analysis between HCR and off-pump CABG via sternotomy (OPCABG).MethodsData were retrospectively collated from
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Endarterectomy may be an effective additional treatment for three diffuse coronary artery disease complicated with diabetes Perfusion (IF 1.2) Pub Date : 2024-03-06 Haiming Li, Chengxiong Gu, Bo Li
ObjectiveIn order to evaluate the clinical efficacy of coronary endarterectomy (CE) and coronary artery bypass grafting (CABG) in patients with diabetes complicated with three diffuse coronary artery stenosis.MethodsA retrospective analysis was conducted on 460 patients with diabetes mellitus and diffuse three-vessel coronary artery disease who underwent CABG in our department from September 2015 to
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Concomitant interventions in mitral valve surgery – A European perspective Perfusion (IF 1.2) Pub Date : 2024-03-02 Vinci Naruka, Arian Arjomandi Rad, Jacob Chacko, Guiqing Liu, Jonathan Afoke, Prakash P Punjabi
IntroductionIn recent years, major findings on concomitant procedures and anticoagulation management have occurred in Mitral Valve (MV) surgery. Therefore, we sought to evaluate the current practices in MV interventions across Europe.MethodsIn October 2021, all national cardio-thoracic societies in the European region were identified following an electronic search and sent an online survey of 14 questions
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The effect of air-free administration of intravenous drugs on microemboli during cardiopulmonary bypass Perfusion (IF 1.2) Pub Date : 2024-02-29 Amber den Ouden, Marco C Stehouwer, Bernd Geurts, Erik Hofman, Peter Bruins
ObjectiveDuring cardiopulmonary bypass (CPB), gaseous microemboli (GME) that originate from the extracorporeal circuit are released into the arterial blood stream of the patient. Gaseous microemboli may contribute to adverse outcome after cardiac surgery with CPB. Possibly, air may be collected in the right atrium during induction of anesthesia and released during CPB start. The aim of this study was
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The effects of prone position ventilation on patients with acute respiratory distress syndrome after cardiac surgery Perfusion (IF 1.2) Pub Date : 2024-02-27 Yujie Zhang, Wangtao Zhou, Jing Ma
BackgroundThis study aimed to investigate the effects of prone position ventilation treatment on patients with acute respiratory distress syndrome (ARDS) after cardiac surgery.MethodsClinical data were collected from 93 hospitalized patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) of cardiology from February 2021 to February 2023. Patients were divided into
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Perfusion education and training in Europe anno 2023 Perfusion (IF 1.2) Pub Date : 2024-02-27 Gerdy Debeuckelaere
Background: In the absence of uniform European regulations, there have been many differences in the training of perfusionists across Europe. Furthermore, there has been no uniform or single European accreditation of the profession. One of the objectives of The European Board of Cardiovascular Perfusion (EBCP) is to standardise and monitor training of perfusionists across Europe whilst offering support
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Assessment of a goal-directed perfusion strategy through an oxygen delivery audit Perfusion (IF 1.2) Pub Date : 2024-02-27 Andrew Lahanas, Paul W Argerakis, Beatrice A Hayward, Peter W Grant
IntroductionEvidence supports the role of oxygen delivery (DO2) in ameliorating acute kidney injury (AKI). While instrumentation for continuous DO2 measurement exists, a simplified method has been reported for targeting a specific DO2 index (DO2i), commonly referred to as a goal-directed perfusion (GDP) strategy, by using a reference table and available data such as body surface area and continuous
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Negative pressure therapy for ECMO cannula stabilization Perfusion (IF 1.2) Pub Date : 2024-02-24 Jennifer Gauntt, Virginia Kathleen Cox, Vicky Duffy, Matt Deitemyer, Eric Lloyd, Amee Bigelow, Patrick McConnell, Janet Simsic
Cannula stabilization for extracorporeal membrane oxygenation (ECMO) is important for patient mobilization and rehabilitation. Limitations to mobilization on ECMO include staff discomfort and cannula instability. We utilized the technique of negative pressure therapy for ECMO cannula stabilization to improve mobilization. Negative pressure therapy for ECMO cannula stabilization can be utilized safely
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Comparison of different porcine models simulating myocardial cold ischemia of pediatric donor hearts Perfusion (IF 1.2) Pub Date : 2024-02-23 Yuriy Stukov, Mark S Bleiweis, Laura Wilson, Giles J Peek, Keith March, Elaine M Richards, Edward D Staples, Jeffrey P Jacobs
BackgroundOur team previously identified a stem cell-derived cardioprotective additive that can be added to standard cardioplegia to extend myocardial viability during prolonged myocardial cold ischemic time (CIT) in rodent models. The purpose of this study was to utilize a porcine model to compare in-vivo versus ex-vivo porcine simulation of CIT that accompanies cardiac transplantation in humans,
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Thromboelastography versus thromboelastometry for unfractionated heparin monitoring in adult patients on extracorporeal membrane oxygenation Perfusion (IF 1.2) Pub Date : 2024-02-21 Ellen B Yin, Arthur W Bracey, Subhasis Chatterjee
Background: Monitoring the anticoagulant effect of unfractionated heparin (UFH) in extracorporeal membrane oxygenation (ECMO) patients is complex but critically important to balance the risks of treatment related bleeding and circuit thrombosis. While guidelines recommend using more than one method to monitor UFH activity, the use of thromboelastometry (ROTEM) to monitor UFH in ECMO patients has not
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Preserving flow, saving lives: Successful treatment of aortic valve failure in acute myocardial infarction without flow down-regulation using ECMO - a case report and mini review Perfusion (IF 1.2) Pub Date : 2024-02-07 Jing Yang, Xiao-Kang Zeng, Wei Hu, Ying Zhu
Direct percutaneous coronary intervention (PPCI) has significantly reduced cardiac mortality in patients with acute myocardial infarction (AMI), but the mortality rate remains high for those who develop cardiogenic shock (CS), reaching 40% to 50%. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) provides robust hemodynamic support and oxygen delivery for AMI patients with refractory CS
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Hypobaric type oxygenators – physics and physiology Perfusion (IF 1.2) Pub Date : 2024-02-07 Phatiwat Chotimol, William Lansdowne, David Machin, Kressle Binas, Gianni D Angelini, Ben Gibbison
Brain injury is still a serious complication after cardiac surgery. Gaseous microemboli (GME) are known to contribute to both short and longer-term brain injury after cardiac surgery. Hypobaric and novel dual-chamber oxygenators use the physical behaviors and properties of gases to reduce GME. The aim of this review was to present the basic physics of the gases, the mechanism in which the hypobaric
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Improving the effectiveness of CPR during interventional procedures Perfusion (IF 1.2) Pub Date : 2024-02-02 Christopher Gaisendrees, Kaveh Eghbalzadeh, Matti Adam, Ilija Djordjevic, Oliver Mehler, Thorsten Wahlers, Elmar W Kuhn
IntroductionThe number of interventional procedures, such as transcatheter aortic valve replacements or thoracic endovascular aortic repairs, is on the rise. Intraprocedural cardiac arrest is a rare occurrence during high-risk procedures. Modern hybrid-operating tables may adversely affect chest compression quality due to their flexibility. To investigate this relationship, we analyzed the blood pressure
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Vacuum assisted and gravitational venous drainage in aortic valve surgery: A propensity-match study Perfusion (IF 1.2) Pub Date : 2024-01-26 Raffaele Silvano, Pietro Giorgio Malvindi, Francesca Mazzocca, Stefania Genova, Emanuele Di Campli, Francesca Paterna, Jacopo M. D’Este, Jacopo Alfonsi, Paolo Berretta, Christopher Munch, Marco Di Eusanio
IntroductionVacuum assisted venous drainage (VAVD) is widely adopted in minimally invasive cardiac surgery. VAVD enables the advantage of using smaller cannulae in a reduced surgical field while allowing satisfactory drainage and pump flow. The production of gaseous micro-emboli is a recognized risk associated with VAVD, however no difference in clinical endpoints have been reported between patients
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Liberal use of veno-arterial extracorporeal membrane oxygenation in combined sequential heart-liver transplantation Perfusion (IF 1.2) Pub Date : 2024-01-23 Alice V Vinogradsky, Stephanie N Nguyen, Abhishek Mathur, Koji Takeda
Combined heart-liver transplantation (CHLT) is a rarely though increasingly performed procedure with evolving indications. Despite CHLT being performed at only a handful of centers, the use of intraoperative mechanical circulatory support to optimize hemodynamics and facilitate dual-organ transplantation varies widely. At our center, we liberally utilize veno-arterial extracorporeal membrane oxygenation
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Long-term results of percutaneous coronary intervention in no-touch vein grafts are significantly better than in conventional vein grafts Perfusion (IF 1.2) Pub Date : 2024-01-23 Gabriele Ferrari, Håkan Geijer, Yang Cao, Ulf Graf, Leif Bojö, Roland Carlsson, Domingos Souza, Ninos Samano
IntroductionConventional vein grafts have a high risk of thrombosis and early atherosclerosis. Percutaneous coronary intervention (PCI) in conventional vein grafts is associated with a higher incidence of late adverse cardiac events. The aim of this study was to evaluate the long-term results after PCI in saphenous vein grafts (SVG) harvested with the no-touch technique compared to the conventional
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Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report Perfusion (IF 1.2) Pub Date : 2024-01-19 Won-Sik Yun, Sanghyo Kim, Lae-Young Jung
IntroductionUnfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT).Case ReportA 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during