International Perfusion Association

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IPA

Day: February 4, 2024

CPU RBC

Development and Validation of a Machine Learning Method to Predict Intraoperative Red Blood Cell Transfusions in Cardiothoracic Surgery

A novel machine learning (ML) method has been developed to predict red blood cell (RBC) transfusion requirements in cardiothoracic surgery, enhancing blood inventory management and preoperative hemorrhage risk assessment. Utilizing data from 2410 surgeries between May 2014 and June 2019, with an additional 437 cases for validation, this method employs a hybrid approach combining Gaussian Process regression and classification algorithms. The model accurately predicts both minor (0 to 3 units) and significant (4+ units) RBC transfusions, showing promise for integrating ML into surgical planning and patient care optimization.

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February 4, 2024
ECMO 101

Long-Term Outcome in Patients Treated with Veno-Venous Extracorporeal Membrane Oxygenation: A Prospective Observational Study

This prospective observational study at an Italian University Hospital assessed the long-term outcomes of 33 patients treated with VV-ECMO for severe respiratory failure, from January 2018 to May 2021. Follow-up evaluations at 6 and 12 months post-ICU discharge showed good cognitive and psychological outcomes, with improvements in PTSD symptoms, especially among COVID-19 survivors. The study underscores the importance of long-term follow-up and rehabilitation for ICU survivors, highlighting that VV-ECMO patients, including those with COVID-19, have outcomes comparable to ARDS patients managed without ECMO.

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February 4, 2024
Solar ECMO

Venoarterial Extracorporeal Membrane Oxygenation for Cardiopulmonary Resuscitation: A Retrospective Study Comparing Outcomes with Fluoroscopy

This study investigates the impact of using fluoroscopy during venoarterial extracorporeal membrane oxygenation (VA-ECMO) for out-of-hospital cardiac arrest on vascular complications. Comparing procedures performed in the emergency department without fluoroscopy to those transferred to a fluoroscopy room, the research found a significant reduction in vascular complications with fluoroscopy-guided ECMO, without extending the time to ECMO initiation. These findings support fluoroscopy’s role in enhancing patient safety during ECMO, indicating that even when the emergency department and fluoroscopy room are distant, utilizing fluoroscopy does not delay treatment.

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February 4, 2024
LivaNova Protek

ProtekDuo Percutaneous Ventricular Support System: Physiology and Clinical Applications

The ProtekDuo cannula is a dual-lumen device used for right ventricular (RV) mechanical circulatory support (MCS) and extracorporeal membrane oxygenation (ECMO) support when connected to a pump and oxygenator. Inserted via the right internal jugular vein, it improves pulmonary flow, left atrial filling pressures, and left ventricular preload in RV failure cases. This review covers its clinical applications in managing critically ill patients, including RV myocardial infarction, LV assist device implantation-associated RVF, post-heart transplantation, and post-lung transplantation care. The ProtekDuo system’s easy deployment, mobility, and compatibility with various pumps and oxygenators highlight its significance in RVF management and the need for further research to optimize its use.

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February 4, 2024
Liver Perfusion

The Use of Ex Situ Normothermic Machine Perfusion in Combined Cardiac and Liver Transplantation Procedures

Combined heart-liver transplantation (CHLT) is increasingly prevalent due to surgical and immunosuppression advancements. Indications for CHLT include familial amyloidosis, cardiac cirrhosis, dilated cardiomyopathy, and homozygous familial hypercholesterolemia. Challenges include hemodynamic instability and prolonged cold ischemia. Ex situ normothermic machine perfusion (NMP) offers a paradigm shift, allowing extended preservation times, facilitating hemodynamic stabilization post-cardiac surgery, and reducing metabolic disturbances during hepatic reperfusion. This article describes the first three CHLT procedures using ex situ NMP at Mayo Clinic Florida, highlighting its potential benefits.

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February 4, 2024
Custom Blood

Association between Intraoperative Blood Salvage and Coagulation Disorder after Cardiopulmonary Bypass

This study assesses the relationship between intraoperative blood salvage and coagulation disorders following cardiopulmonary bypass (CPB), using conventional coagulation tests and thromboelastography (TEG). Enrolling 92 patients undergoing cardiovascular surgery with CPB, it explored coagulation function in scenarios with and without cell salvage blood transfusion. Despite 57.6% of patients receiving cell salvage, the occurrence of coagulation disorders post-CPB showed no significant difference between groups, indicating that intraoperative blood salvage does not significantly impact coagulation disorder risk as diagnosed by TEG or conventional tests.

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February 4, 2024
A FIB 2024

Predictors of Developing Postoperative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Graft: A Systematic Review and Meta-Analysis

This comprehensive meta-analysis aimed to identify predictors of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. Analyzing data from 16 studies involving 6200 patients, the research highlighted that advanced age, lower preoperative left ventricular ejection fraction, history of myocardial infarction, intra-aortic balloon pump use, and prolonged cardiopulmonary bypass time significantly increase the risk of developing POAF. These findings emphasize the need for targeted screening and management strategies for at-risk CABG patients.

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February 4, 2024
ECMO Color

A Comprehensive Review of Extracorporeal Membrane Oxygenation: The Lifeline in Critical Moments

This simple review details the evolution of Extracorporeal Membrane Oxygenation (ECMO) as a crucial life-support intervention in critical care, highlighting its history, technological advancements, and significant role in treating severe respiratory or cardiac failure. It emphasizes the importance of patient selection, management strategies for complications, and ECMO’s contribution to improving survival rates, mobility, and the application of remote medical expertise, marking it as a key innovation in critical care.

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February 4, 2024

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