A Systematic Approach to Reduce Blood Transfusions in Acute Type A Aortic Dissection Surgery

December 7, 2024 No Comments

This clinical study evaluates a systematic approach to reducing blood transfusions in patients undergoing acute type A aortic dissection (ATAAD) surgery. Techniques included Liu’s aortic root repair, moderate hypothermia circulatory arrest, and the use of a centrifugal pump in cardiopulmonary bypass. Among 326 patients, 53.37% avoided transfusions. Transfusion-free patients had lower mortality (1.72% vs. 9.21%) and complications. The findings support transfusion-free ATAAD surgeries for selected cases.

Relation Between Serum Sodium Trajectory and Survival in Septic Patients with Cardiopulmonary Bypass Surgery

December 3, 2024 No Comments

This study examined the impact of serum sodium trajectory on 30-day mortality in septic patients after cardiopulmonary bypass (CPB) surgery using the MIMIC-IV database. Among 1,038 patients, serum sodium trajectories were classified into three groups, with higher levels linked to increased mortality. Elevated fluctuations, even within normal sodium ranges, were associated with adverse outcomes. These findings highlight the need for close monitoring and sodium management in critically ill patients undergoing CPB.

Association Between Plasma-Free Haemoglobin and Postoperative Acute Kidney Injury in Paediatric Cardiac Surgery: A Prospective Observational Study

November 24, 2024 No Comments

This study investigates the link between plasma-free haemoglobin (PFH) and acute kidney injury (AKI) in children undergoing cardiopulmonary bypass (CPB) during cardiac surgery. Among 179 participants, 41% developed AKI. Peak PFH concentrations were significantly higher in patients with AKI, but multivariable analysis showed CPB duration and patient age, rather than PFH, as primary risk factors. This emphasizes CPB time management in mitigating AKI risk.

Association Between Perioperative Hemoglobin Decrease and Outcomes of Transfusion in Patients Undergoing On-Pump Cardiac Surgery: An Observational Study From Two Chinese Heart Centers

October 1, 2024 No Comments

This study analyzed 8186 adult patients undergoing cardiac surgery to examine the impact of perioperative hemoglobin decrease (ΔHb) on red blood cell transfusion outcomes. Patients with greater hemoglobin decreases (≥50%) were found to have higher risks of complications like mortality and organ failure. Transfusions helped in some cases but became harmful when exceeding four units. The findings underscore the importance of careful transfusion management in cardiac surgery.

Increased White Blood Cell Count is Associated with an Increased Demand for Unfractionated Heparin During Veno-Arterial Extracorporeal Oxygenation in Lung Transplantation

September 26, 2024 No Comments

This retrospective study investigated whether increased white blood cell (WBC) counts correlate with higher unfractionated heparin (UFH) dosage needs during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) in lung transplantation. Among 27 patients, those with elevated WBC counts (above 10.2 × 10³/μL) required higher UFH doses to maintain targeted clotting times. The findings suggest WBC count could help determine optimal UFH dosing during surgery.

Cardiopulmonary Bypass in a Pediatric Patient with Factor XII Deficiency

September 21, 2024 No Comments

This case report discusses the challenges of managing cardiopulmonary bypass (CPB) in an 8-month-old pediatric patient with factor XII deficiency, a rare coagulopathy that complicates anticoagulation monitoring. The use of the Hemochron Signature Elite with ACT+ cartridges provided reliable anticoagulation monitoring during surgery. The report reviews current strategies for managing CPB in patients with this condition, highlighting the importance of specialized tools for predictable results.

Top 5 Reasons to Obtain an IBBM Certification in Blood Management and ECMO

August 24, 2024 No Comments

In the competitive healthcare industry, certification in blood management or ECMO through the AmSECT International Board of Blood Management (IBBM) can significantly elevate your career. Certification demonstrates leadership, earns respect from peers, sharpens your skills, enhances career opportunities, and boosts earning potential. Specialized certifications such as PBMT, PBMS, CES-A, and CES-P mark you as a committed expert in patient care.

Acute Normovolemic Hemodilution in Cardiac Surgery: Rationale and Design of a Multicenter Randomized Trial

August 9, 2024 No Comments

This study explores whether Acute Normovolemic Hemodilution (ANH) can reduce the need for Red Blood Cell (RBC) transfusions after cardiac surgery. The multicenter, randomized controlled trial involves patients scheduled for elective cardiac surgery with cardiopulmonary bypass. Participants are assigned to receive either ANH or standard treatment. The primary outcome is the rate of RBC transfusion, with secondary outcomes including mortality and complications.

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

June 29, 2024 No Comments

This study evaluated the methodology and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery under cardiopulmonary bypass (CPB). It analyzed nine guidelines using the AGREE II tool, finding that “Stakeholder involvement” scored lowest. Drug therapy strategies include anemia therapy, antithrombotic and anticoagulation drugs, and hemostatic drugs, with distinct recommendations for pediatric and adult patients.

Can a Low Prime Volume Arterial Filter Be Used as an Alternative for a Venous Bubble Trap in Minimal Extracorporeal Circulation? An In Vitro Investigation

May 22, 2024 No Comments

This study examines whether an arterial filter with a small prime volume can effectively replace a venous bubble trap (VBT) in a minimal extracorporeal circulation (MiECC) system used during cardiac surgery. The study compared air removal capabilities of an arterial filter and three VBTs: VBT160, VBT8, and VARD. Results showed the AF100 arterial filter demonstrated similar, and in some cases better, performance in removing air and gaseous microemboli (GME) compared to VBTs. However, the placement of the arterial filter in the venous line is considered off-label use.