Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury in On-pump Cardiac Surgery—A Post-hoc Analysis of a Randomized Clinical Trial

April 1, 2025 No Comments

A post-hoc analysis of the ALBICS randomized trial with 1,386 cardiac surgery patients found that perioperative bleeding, as classified by the Universal Definition of Perioperative Bleeding (UDPB), was not independently linked to acute kidney injury (AKI). Rather, bleeding indirectly contributed to AKI through hypotension and fluid overload. The only transfusion product independently associated with AKI was fresh frozen plasma.

Innominate Artery Graft Cannulation for Selective Antegrade Cerebral Perfusion in Aortic Surgery: Clinical Findings and Feasibility

March 29, 2025 No Comments

This retrospective study evaluates the safety and efficacy of innominate artery (IA) graft cannulation for selective antegrade cerebral perfusion (SACP) in aortic surgery. Analyzing 196 patients, including those with Type A acute aortic dissection and Marfan syndrome, the results showed low rates of stroke (2.04%), mortality (3.06%), and acute renal failure (3.06%). IA graft cannulation emerged as a reliable and efficient technique for cerebral protection during complex aortic procedures.

CytoSorb Hemoadsorption of Apixaban During Cardio-Pulmonary Bypass for Heart Transplantation

March 29, 2025 No Comments

This case study reports on the successful intraoperative removal of apixaban using a CytoSorb hemoadsorption device during emergency heart transplantation. The 61-year-old patient, previously on apixaban, underwent cardiopulmonary bypass (CPB), during which the device significantly reduced anticoagulant levels without complications. The results suggest CytoSorb may offer a viable method to manage DOACs in urgent cardiac surgery settings.

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

March 25, 2025 No Comments

This randomized clinical study assessed how varying sweep gas flow rates affect respiratory alkalosis and cerebral oxygenation during cardiopulmonary bypass (CPB) in 84 open-heart surgery patients. The findings revealed that lower sweep gas flow rates help maintain normal carbon dioxide levels and enhance cerebral oxygen saturation post-rewarming. Adjusting the sweep gas flow rate before rewarming may prevent complications associated with respiratory alkalosis.

Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

March 17, 2025 No Comments

This study investigates the impact of sex on systemic inflammatory response syndrome (SIRS) and outcomes after cardiac surgery. Analyzing 1,005 patients, researchers found that women had a higher incidence of SIRS (41.8% vs. 22.8%) and worse outcomes, including prolonged ICU stays and increased need for vasopressor support. SIRS mediated over 50% of the sex-related risks, with preoperative anemia and hyperlactatemia as contributing factors. Addressing inflammation may improve outcomes for female patients.

Assistance from a Mixing Zone Model to Perform Aortic Femoral Perfusion Strategy with Severe Atherosclerotic and Artheromic Aortic Disease for Endoscopic Minimally Invasive Redo Mitral Valve Repair

March 15, 2025 No Comments

This study explores a novel perfusion strategy for minimally invasive redo mitral valve surgery in patients with severe atherosclerotic and artheromic aortic disease. Using a combination of antegrade and retrograde perfusion, the study evaluates the mixing zone during cardiopulmonary bypass (CPB) to optimize outcomes. A case study demonstrates the effectiveness of this approach, with no postoperative cerebral complications. Findings suggest that adjusting cannulation sizes can improve perfusion safety.

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

March 15, 2025 No Comments

This study examines the impact of gradual oxygen exposure during emergency coronary bypass surgery for acute myocardial infarction (MI). A retrospective cohort of 66 patients was analyzed, comparing outcomes between those receiving venous blood cardioplegia with controlled oxygen exposure and those undergoing standard hyperoxic procedures. The findings indicate a significant reduction in mortality, improved ventricular function, lower readmission rates for heart failure, and reduced need for defibrillators.

Effect of Intraoperative Fluid Volume on Postoperative Pulmonary Complications in Thoracic Surgeries: A Systematic Review and Meta-Analysis

March 9, 2025 No Comments

This systematic review and meta-analysis investigates the impact of intraoperative fluid volume on postoperative pulmonary complications (PPCs) in thoracic surgeries. Analyzing 11 studies, the review finds that higher intraoperative fluid infusion is associated with an increased risk of PPCs. A restrictive fluid strategy may be safer, though high heterogeneity and potential biases necessitate further randomized controlled trials to establish definitive recommendations.

A Review of Recent Advances in Anesthetic Drugs for Patients Undergoing Cardiac Surgery

March 8, 2025 No Comments

This review explores recent advancements in anesthetic drugs for cardiac surgery. With no standard protocol for anesthesia in these procedures, the article examines commonly used agents such as opioids (fentanyl, sufentanil, remifentanil), volatile anesthetics, and novel drugs like dexmedetomidine and remimazolam. The study highlights opioid-free anesthesia approaches, innovative drug delivery systems, and enhanced recovery techniques to improve patient outcomes and reduce complications.

The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

March 6, 2025 No Comments

This study evaluates the role of continuous monitoring of venous drainage flow and oxygen extraction (ERiO2) using near-infrared spectroscopy (NIRS) in cerebral perfusion during aortic arch surgery. A retrospective review of 10 patients undergoing selective antegrade cerebral perfusion (SACP) found a strong correlation (r = 0.91, p < 0.01) between ERiO2 and NIRS-derived regional oxygen saturation (rSO2). The study suggests that integrated monitoring improves perfusion management and neurological outcomes.

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Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury in On-pump Cardiac Surgery—A Post-hoc Analysis of a Randomized Clinical Trial

Innominate Artery Graft Cannulation for Selective Antegrade Cerebral Perfusion in Aortic Surgery: Clinical Findings and Feasibility

CytoSorb Hemoadsorption of Apixaban During Cardio-Pulmonary Bypass for Heart Transplantation

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

Assistance from a Mixing Zone Model to Perform Aortic Femoral Perfusion Strategy with Severe Atherosclerotic and Artheromic Aortic Disease for Endoscopic Minimally Invasive Redo Mitral Valve Repair

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

Effect of Intraoperative Fluid Volume on Postoperative Pulmonary Complications in Thoracic Surgeries: A Systematic Review and Meta-Analysis

A Review of Recent Advances in Anesthetic Drugs for Patients Undergoing Cardiac Surgery

The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

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