Zero-Balance Ultrafiltration Reduces Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Controlled Trial

February 5, 2026 No Comments

This single-center randomized controlled trial evaluated whether adding zero-balance ultrafiltration (Z-BUF) to conventional ultrafiltration during cardiopulmonary bypass reduces postoperative delirium after cardiac surgery. Among 106 analyzed patients, Z-BUF significantly lowered delirium incidence within 7 postoperative days compared with conventional ultrafiltration alone, while no significant differences were observed in longer-term cognitive outcomes at 1 or 3 months.

Precision and Protection: Advanced Myocardial Preservation in Complex Cardiac Surgery

Custodial-HTK Cardioplegia in Conventional Cardiac Surgery: A Retrospective Analysis From UiTM

February 4, 2026 No Comments

This retrospective cohort study from a Malaysian tertiary cardiac center compares Custodial-HTK cardioplegia with conventional blood cardioplegia in elective on-pump cardiac surgery. Although Custodial-HTK was preferentially used in higher-risk and more complex cases with lower baseline LVEF and longer bypass times, postoperative outcomes, ICU stay, hospital stay, and 30-day mortality were comparable, supporting its safety and effectiveness.

Global Teamwork in Modern Myocardial Protection: Alternative Base Solutions for del Nido Cardioplegia

Alternative Base Solutions for del Nido Cardioplegia: Composition, Rationale, and Clinical Evidence

January 31, 2026 No Comments

This comprehensive review examines alternative crystalloid and whole-blood base solutions for del Nido cardioplegia, including normal saline, lactated Ringer’s, plain Ringer’s, Isolyte S, Ionosteril, and whole blood. Drawing on experimental models, randomized trials, and clinical studies, the article demonstrates that these alternatives provide myocardial protection and postoperative outcomes comparable to Plasma-Lyte A when appropriately buffered, supporting cost-effective and globally accessible cardiac surgery practice.

Active Myocardial Protection During Cardioplegic Arrest

Molecular and Cellular Mechanisms of Cardioplegic Protection in Surgical Myocardial Revascularization

January 31, 2026 No Comments

This comprehensive review explores how cardioplegia actively protects the myocardium during coronary artery bypass grafting. Beyond inducing cardiac arrest, cardioplegic solutions modulate calcium homeostasis, mitochondrial function, oxidative stress, inflammation, and apoptosis. By suppressing electromechanical activity and metabolic demand, cardioplegia prolongs ischemic tolerance and mitigates reperfusion injury, offering critical insights for optimizing myocardial protection strategies in modern cardiac surgery.

Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin in Cardiopulmonary Bypass for Cardiac Surgery

January 31, 2026 No Comments

This meta-analysis evaluated 12 randomized trials (908 patients) comparing 6% hydroxyethyl starch (HES) 130/0.4 with 5% albumin during cardiopulmonary bypass in cardiac surgery. Most outcomes—including blood loss, transfusion rates, ICU stay, hospital stay, and mortality—were similar between groups. However, HES use was associated with a significantly higher risk of acute kidney injury, highlighting renal safety concerns despite comparable hemodynamic efficacy.

Tranexamic Acid Does Not Have a Dose-Dependent Effect on Postoperative Delirium After Cardiac Surgery — A Retrospective Cohort Study

January 28, 2026 No Comments

This retrospective study examined over 5,500 patients undergoing cardiac surgery to assess whether higher doses of tranexamic acid (TXA) reduce postoperative delirium (PD). Despite TXA’s known anti-inflammatory effects and role in stabilizing the blood-brain barrier, the study found no significant dose-dependent reduction in PD. CAM-ICU assessments showed similar PD rates across all dosing groups, highlighting PD’s multifactorial nature and the need for further prospective trials.

An In-Vitro Study of the Timing Between Protamine Sulfate Administration and Cardiotomy Suction Termination

January 28, 2026 No Comments

This in-vitro study evaluates the optimal timing for discontinuing cardiotomy suction during cardiopulmonary bypass (CPB) when reversing heparin anticoagulation with protamine sulfate. Using porcine blood samples, the researchers assessed activated clotting times (ACTs) after administering a protamine test dose (PTD) and 1/3 of the full dose. Results showed significant ACT reductions after each stage, suggesting early suction termination is vital to preserve circuit integrity.

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury

Comparable Renal Effects of Histidine-Tryptophan-Ketoglutarate and DelNido Cardioplegia in a Porcine Model of Cardiac Arrest

November 20, 2025 No Comments

This study evaluated the renal impact of two cardioplegic solutions—HTK and DelNido—in pigs undergoing cardiac arrest. Despite DelNido showing better electrolyte and hemoglobin stability, both solutions induced comparable levels of renal injury. Biomarkers (NGAL, FABP-1, cystatin C), histological damage, oxidative/nitrosative stress, and apoptosis indicators revealed no significant differences, supporting similar renal safety profiles during 90-minute cardiac arrest.

A Tribute to Dr. Robert Pascotto, MD

August 31, 2025 No Comments

On August 27”th, 2025 surrounded by family, Dr. Robert Daniel Pascotto passed peacefully into God’s open arms. “Dr. Bob” believed in faith, family and the American dream. He dedicated his life to those tenets. With hard work and perseverance, he led compassionately by example and will continue to inspire others to achieve their dreams with his loving legacy.

The Novel St Thomas’ Hospital Polarizing Blood Cardioplegia: Results in Hearts With Reduced Ejection Fraction

July 13, 2025 No Comments

This study investigates the efficacy of a new St Thomas’ Hospital polarizing cardioplegia (STH-pol) versus standard depolarizing cardioplegia (STH-control) in rats with chronic myocardial infarction. Although STH-pol showed trends toward better coronary flow and reduced myocardial oxygen consumption, no statistically significant difference in myocardial protection was found. Both solutions demonstrated comparable recovery and energy preservation.