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IPA

Category: Cardiac Surgery

AKI 2024

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

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October 15, 2024
OPCABG 2024

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

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October 4, 2024
CABG Block

In-Hospital Graft Occlusion in Post-Coronary Artery Bypass Grafting Patients in the Early Postoperative Period: A Systematic Review and Meta-Analysis

This study evaluates the incidence and risk factors of early in-hospital graft occlusion in post-coronary artery bypass grafting (CABG) patients. The meta-analysis, including 22 studies with 35,798 patients, found a 5% occlusion rate. The rate varied based on symptom-driven or systematic graft patency assessments. Vein graft presence, female gender, and other factors like composite grafts may increase the risk of early occlusion.

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October 2, 2024
Lung Ventilation

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

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October 1, 2024
Hemaglobin 2024

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

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.

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October 1, 2024
IABP Cardiogenic Shock

The Intra-Aortic Balloon Pump as a Rescue Device: Do We Need to Shift Our Strategy for Cardiogenic Shock Rescue After Cardiac Surgery?

This study evaluates the efficacy of the intra-aortic balloon pump (IABP) as a rescue strategy for patients experiencing complications following cardiac surgery. Data from 10,591 patients between 2012 and 2020 were analyzed, revealing that IABP use is associated with increased early and one-year mortality, especially when deployed for more than four days or after cardiac arrest. The findings suggest alternative mechanical circulatory support methods may be more appropriate for severe cardiogenic shock.

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September 28, 2024
Del Nido Cardioplegia

Comparison of Routine Del Nido Cardioplegia vs Two Types of Modified Del Nido Cardioplegias for Myocardial Protection in CABG: A Randomized Double-Blind Clinical Trial

This randomized, double-blind trial compared the effectiveness of routine del Nido cardioplegia with two modified versions (Ringer lactate-based and plain Ringer-based) in coronary artery bypass grafting (CABG) surgery. Among 120 adult patients, no significant differences were found in myocardial protection markers (CK-MB, Troponin T, Troponin I, lactate). However, Troponin T and lactate levels showed time-related effects. All cardioplegia solutions provided comparable protection, suggesting the need for further studies.

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September 27, 2024
WBC ECMO

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

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.

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September 26, 2024
Factor VII

Cardiopulmonary Bypass in a Pediatric Patient with Factor XII Deficiency

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.

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September 21, 2024
Transfusion 2024

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

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.

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August 9, 2024
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