International Perfusion Association

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IPA

Category: Blood

Abstract Kidney

Using Cardiohelp, Quadrox, and Nautilus Extracorporeal Membrane Oxygenators as Vascular Access for Hemodialysis, Continuous Renal Replacement Therapy, and Plasmapheresis: A Brief Technical Report

This technical report details methods for performing dialytic therapies, such as intermittent hemodialysis (iHD) and continuous renal replacement therapy (CRRT), safely and effectively through an ECMO circuit, eliminating the need for a separate dialysis catheter in patients with acute kidney injury (AKI) and end-stage renal disease (ESRD). It outlines the connection of these kidney replacement therapies to various oxygenators and discusses performing plasmapheresis alongside ECMO and iHD or CRRT, emphasizing the technique’s safety as it doesn’t require modifications to ECMO cannulas/tubing.

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January 2, 2024
AlphaVac Art

Percutaneous Debulking of Tricuspid Valve Infective Endocarditis Vegetations Using a Large Bore Manual Aspiration Device – AlphaVac

While most infectious endocarditis cases are managed medically, non-responsive patients or those with complications like septic emboli may need mechanical interventions such as AngioVac, which has limitations like the need for a perfusionist and large-bore accesses. The AlphaVac system, omitting the motor element, offers a simpler alternative for manual percutaneous aspiration of tricuspid valve vegetations, as demonstrated in two reported cases.

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December 31, 2023

Protamine Dose to Neutralize Heparin at the Completion of Cardiopulmonary Bypass Can be Reduced Significantly Without Affecting Post-Operative Bleeding

The study investigated reducing the protamine-to-heparin ratio (P-to-H) from 1:1 to 0.9:1 and 0.8:1 in cardiac surgery patients to determine its effect on post-operative bleeding. Results showed a significant reduction in the actual protamine dose without an increase in post-op bleeding, suggesting that a ratio as low as 0.75:1 might be sufficient for effective neutralization of heparin.

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December 27, 2023

Investigating the Complications and Causes of Failure of the AngioVac System: A Post-Marketing Surveillance From the MAUDE Database

The AngioVac aspiration thrombectomy device, approved for removing thrombi during bypass, has been reported to commonly fail due to physical damage and is associated with adverse events such as pulmonary embolism and vessel perforation, as per data from the Manufacturer and User Facility Device Experience database between April 2013 and March 2022. Physicians should be cognizant of these potential complications and the fact that the device’s most frequent failures are attributed to its physical damage.

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December 22, 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

Our Initial Experience of Monitoring the Autoregulation of Cerebral Blood Flow During Cardiopulmonary Bypass

This study investigates the application of the cerebral oxygenation index (COx) in monitoring cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass surgeries. Despite the complexity and challenges involved, the study emphasizes the critical analysis of COx, highlighting limitations and suggesting caution before its implementation in clinical practice.

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December 20, 2023
HL Machine

Comparison of 6% Hydroxyethyl Starch 130/0.4 and Ringer’s Lactate as Priming Solutions in Patients Undergoing Isolated Open Heart Valve Surgery: A Double-Blind Randomized Controlled Trial

This study compared the outcomes of heart valve surgery patients undergoing cardiopulmonary bypass with two different priming solutions: 6% hydroxyethyl starch (HES) 130/0.4 and ringer’s lactate (RL). The results indicate that using HES in addition to RL for priming increased the risk of blood product transfusion during hospitalization compared to using RL alone in this patient population.

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December 18, 2023
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