International Perfusion Association

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IPA

Day: March 22, 2024

Coronary ECMO

Mortality in Patients with Normal LV Function Requiring Emergency VA-ECMO for Postcardiotomy Cardiogenic Shock

This retrospective study examines outcomes in patients with normal preoperative left ventricular ejection fraction (LVEF) who required venoarterial extracorporeal membrane oxygenation (VA-ECMO) for postcardiotomy cardiogenic shock (PCCS) related to coronary malperfusion. Among 62,125 cardiac surgeries, 59 patients with normal LVEF needed VA-ECMO due to coronary malperfusion-related PCCS, showing a 30-day mortality rate of 50.8%. Complications were common, and factors like lactate levels >9.9 mmol/l before VA-ECMO, delay in revascularization, and peripheral arterial disease were significant mortality predictors. Early VA-ECMO initiation and revascularization are crucial for survival.

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March 22, 2024
Cardioplegia 123

Myocardial Protection: Histological Effects of Single-Dose Cardioplegic Solutions in the CARDIOPLEGIA Trial

This study aims to compare the myocardial protection offered by single-dose cardioplegic solutions (Custodiol, del Nido, and modified del Nido) using histological analysis in a double-blind clinical trial. At least 90 patients undergoing cardiac surgery will be randomly assigned to one of the three solutions, with myocardial biopsies collected before and after cardiopulmonary bypass. The research seeks to determine the most effective solution for minimizing ischemic damage during cardiac surgery, which is critical for patient safety and outcome optimization. Results could influence clinical protocols and cardioplegic solution selection globally.

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March 22, 2024
Pig CPB

Cerebral Perfusion and Metabolism with Mild Hypercapnia vs. Normocapnia in Porcine Models Post Cardiac Arrest: Impacts of Targeted Temperature Management

This study evaluates the effects of mild hypercapnia compared to normocapnia on cerebral blood flow and metabolism in porcine models post-cardiac arrest, with and without targeted temperature management (TTM33). It involved resuscitating 39 pigs after 10 minutes of cardiac arrest and randomizing them to different conditions. Results indicate that hypercapnia increases cerebral flow in all groups, but raises intracranial pressure and lowers cerebral perfusion pressure in non-TTM animals. Hypercapnia with TTM33 showed reduced cerebral lactate, pyruvate, glycerol, and lactate/pyruvate ratios, highlighting the varying impacts of hypercapnia with TTM.

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March 22, 2024

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