International Perfusion Association

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IPA

Day: December 21, 2023

Impact of Pre-Bypass Ultrafiltration on Prime Values and Clinical Outcomes in Neonatal and Infant Cardiopulmonary Bypass

Pre-bypass Ultrafiltration (PBUF) was found to standardize and make more physiologic the values for electrolytes, glucose, and lactate in blood primes used for cardiopulmonary bypass in congenital cardiac surgery, without significantly affecting in-hospital outcomes. This retrospective study compared patients ≤ 1 year old undergoing cardiac surgery with PBUF to those without, showing significant improvements in the physiologic values of PBUF-treated circuits.

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December 21, 2023

An in vitro Comparison of Intra-Operative Isohemagglutinin and Human Leukocyte Antigen Removal Techniques in Pediatric Heart Transplantation

This study compared two plasmapheresis techniques, membrane-based (MP) and centrifuge-based (CP), for their effectiveness in reducing isohemagglutinin titers (IT) and human leukocyte antigen (HLA) antibodies in highly sensitized pediatric patients awaiting heart transplants. Both methods, incorporated into extracorporeal circuits, effectively reduced circulating antibodies, with CP showing slightly greater efficiency in reducing ITs and anti-HLA class II antibody mean fluorescence intensity, although further in vivo studies are needed for confirmation.

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December 21, 2023
ECMO CPT2

Direct and Continuous Dosing of Propofol can Saturate Ex vivo ECMO Circuit to Improve Propofol Recovery

This study investigates the adsorption of propofol in extracorporeal membrane oxygenation (ECMO) circuits, noting that drugs prescribed to ECMO patients often lack optimized dosing strategies due to the circuit’s ability to adsorb drugs. It found that while only 27% of propofol was recovered after a bolus dose, more than 80% was recovered following a continuous infusion, suggesting direct dosing into ECMO circuits could mitigate altered drug exposure due to adsorption.

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December 21, 2023
Pediatric ECPR

ECPR for Prolonged Pediatric Cardiac Arrest, an Autcome Without Major Neurological Compromise

Pediatric in-hospital cardiac arrest (IHCA) occurs in 1-6% of pediatric ICU admissions, with survival rates improving from 9% to 35% over the past 25 years, partly due to the use of ECMO as a rescue strategy. A case is reported of a 4-month-old patient with ventricular and septal defects who underwent surgery, experienced complications leading to a prolonged cardiac arrest, and was successfully treated with ECMO.

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December 21, 2023
Valve Surgery

Fifth-Time Redo Mitral Valve Replacement via Right Thoracotomy Under Systemic Hyperkalemia Cardiopulmonary Bypass Without Aortic Cross-Clamp

The surgical management of prosthetic valvular endocarditis in a 46-year-old female with a history of multiple cardiac surgeries was addressed using a mitral valve replacement through right thoracotomy. This complex operation utilized systemic hyperkalemia for cardiac arrest during cardiopulmonary bypass, leading to successful patient recovery without aortic cross-clamping.

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December 21, 2023

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