Advancing Cardiotomy Suction Practices for Coronary Surgery via Multidisciplinary Collaborative Learning

March 3, 2024 No Comments

This study evaluates a quality-improvement intervention aimed at standardizing cardiotomy suction practices during coronary artery bypass grafting (CABG), promoting cessation before protamine administration. Involving 32 Michigan centers and comparing with four non-Michigan centers, the intervention included surgeon and perfusionist feedback, lectures, and evaluating change barriers. Results showed an 80.7% adherence to the practice among Michigan patients, with significant improvements post-intervention without negative clinical outcomes. This underscores the effectiveness of multidisciplinary collaboration in enhancing cardiotomy suction practices and patient care during CABG.

Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation

March 3, 2024 No Comments

This systematic review and meta-analysis evaluated the efficacy and safety of bivalirudin compared to heparin in patients undergoing extracorporeal membrane oxygenation (ECMO). After reviewing eleven studies focusing on short-term mortality, findings revealed that bivalirudin is associated with significantly lower short-term mortality than heparin, with an odds ratio of 0.71. This suggests bivalirudin may be a preferable anticoagulant for patients on ECMO, though further prospective research is needed to confirm these results.

Higher Perfusion Pressure and Pump Flow During Cardiopulmonary Bypass Are Beneficial for Kidney Function-A Single-Centre Prospective Study

March 3, 2024 No Comments

This study investigates the impact of higher mean arterial pressure (MAP) and pump flow during cardiopulmonary bypass (CPB) on kidney function. One hundred nine patients were divided into groups with standard and increased CPB pump flow to maintain MAP > 90 mmHg. Results showed that a higher MAP did not affect the incidence of acute kidney injury but improved intraoperative and postoperative diuresis and reduced renin release. Additionally, higher MAP did not increase cerebrovascular complications and may reduce postoperative delirium incidence, suggesting that maintaining MAP > 90 mmHg during CPB is beneficial for kidney function and potentially for the central nervous system.