Goal-Directed Perfusion Monitoring During Cardiopulmonary Bypass

Mini-Compendium on Goal-Directed Perfusion (GDP): Integrating Hemodynamic and Metabolic Determinants of Oxygen Delivery During Cardiopulmonary Bypass

This narrative review presents a mini-compendium on Goal-Directed Perfusion (GDP), a physiology-based strategy for optimizing cardiopulmonary bypass. GDP integrates oxygen delivery, metabolic indicators, and perfusion pressure to maintain tissue oxygenation and prevent organ injury. Key variables such as DO₂i, O₂ extraction, CO₂ production, and MAP are combined with time-dose models to detect oxygen debt early and personalize perfusion management.

March 5, 2026

$Stepwise Rescue Therapy for Refractory Vasoplegia$

Evaluating the Impact of a Standardized Protocol for Managing Refractory Vasoplegia After Cardiopulmonary Bypass

This single-center pre-post study evaluated a standardized stepwise protocol for refractory vasoplegia after cardiopulmonary bypass (CPB). Compared to provider-directed therapy, the protocol—escalating from methylene blue to angiotensin II and hydroxocobalamin—accelerated norepinephrine-equivalent reduction and reduced vasopressor costs by 26% at 48 hours, without worsening hemodynamic or clinical outcomes.

March 2, 2026

Nanoscale Impact of Cardiopulmonary Bypass on Red Blood Cells

The Impact of Cardiopulmonary Bypass on the Structure and Mechanics of Red Blood Cells: Pilot Study

This pilot study evaluated how cardiopulmonary bypass (CPB), with and without hypothermic circulatory arrest (HCA), affects red blood cell (RBC) morphology, membrane nanostructure, and mechanical properties using atomic force microscopy. In 14 cardiac surgery patients, CPB increased RBC stiffness, while CPB+HCA caused more severe morphological damage and membrane roughness. The findings suggest distinct cellular injury mechanisms depending on perfusion strategy.

March 1, 2026

Association Between Cardiopulmonary Bypass Weaning Time and Adverse Outcomes in Patients With Aortic Dissection Who Underwent Total Arch Replacement Combined With Stented Elephant Trunk Implantation

This retrospective single-center study of 475 patients with acute type A aortic dissection undergoing total arch replacement with stented elephant trunk implantation found that prolonged cardiopulmonary bypass (CPB) weaning time was independently associated with increased in-hospital mortality and postoperative stroke. A cutoff of 90 minutes strongly predicted early mortality and reduced short-term survival, though mid-term survival was unaffected.

February 28, 2026

Cardiopulmonary Bypass Supporting High-Risk PCI and TAVR

Cardiopulmonary Bypass as Safe and Effective Support for Concomitant High-Risk Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement

This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.

February 28, 2026

Seamless Transition: Single-Circuit ECMO to CPB in Pediatric Surgery

ECMO to CPB: A Single Circuit Approach

This technique article describes a novel method for converting pediatric patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to cardiopulmonary bypass (CPB) using a single circuit with the addition of a cardiotomy reservoir. In seven patients (eight procedures), the approach preserved circulating blood volume, limited donor exposure, and maintained effective surgical support. All patients were successfully decannulated, demonstrating feasibility and safety in complex congenital heart surgery.

February 27, 2026

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