Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

March 4, 2025 No Comments

This case study explores a neonate with congenital diaphragmatic hernia (CDH) who experienced a lethal myocardial infarction (MI) while on extracorporeal membrane oxygenation (ECMO). The patient developed a large thrombus extending from the arterial cannula into the left main coronary artery, leading to severe cardiac dysfunction. Despite anticoagulation efforts, the clot progressed, resulting in a fatal outcome. The study highlights the challenges of managing neonatal ECMO and intracardiac thrombosis.

Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

March 4, 2025 No Comments

This study compares centrifugation (CF) and multiple-pass hemoconcentration (MPH) for salvaging residual blood after cardiopulmonary bypass. A randomized trial with 61 patients found that MPH resulted in higher postoperative albumin, total protein, fibrinogen, and platelet levels compared to CF. While CF processed blood faster and cleared heparin more consistently, MPH was associated with lower allogeneic transfusion needs and reduced fluid retention. Overall, MPH demonstrated improved biochemical and clinical outcomes.

Transfusion Use and Hemoglobin Levels by Blood Conservation Method After Cardiopulmonary Bypass

March 4, 2025 No Comments

This study evaluates three blood conservation techniques—online modified ultrafiltration (MUF), off-line MUF, and centrifugation—following cardiopulmonary bypass. A cohort of 99 patients was analyzed for transfusion rates, hemoglobin levels, and fluid balance. Results indicated no significant advantage of online MUF in reducing transfusions. Off-line MUF had the lowest transfusion rates, while online MUF showed greater hemoglobin improvement, likely due to fluid shifts.

Pulmonary Artery Systolic Pressure Associated with Inflammatory Factors Among Pediatric Congenital Heart Disease with Pulmonary Arterial Hypertension After Cardiopulmonary Bypass

March 3, 2025 No Comments

This study investigates the relationship between pulmonary artery systolic pressure (PASP) and inflammatory factors in pediatric congenital heart disease (CHD) patients with pulmonary arterial hypertension (PAH) after cardiopulmonary bypass (CPB). The study found that elevated preoperative PASP correlates with increased postoperative inflammatory cytokines, particularly IL-6 and IL-10. Higher PASP (>52 mmHg) predicted prolonged ventilation time (>21 hours), suggesting worsened postoperative outcomes.

Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments

March 1, 2025 No Comments

Vasoplegic syndrome (VS) is a severe circulatory condition occurring post-cardiopulmonary bypass (CPB), affecting up to 44% of high-risk patients with mortality rates reaching 50%. It is characterized by profound hypotension, vasopressor resistance, and vascular collapse. The review explores pathophysiology, risk factors, and treatments, including nitric oxide synthase inhibitors (methylene blue, hydroxocobalamin), vasopressors, and fluid management to mitigate complications and improve survival.

On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration

February 18, 2025 No Comments

This study investigates whether on-pump FIBTEM-A5 values measured during cardiopulmonary bypass (CPB) accurately predict post-protamine administration values. Conducted at a single cardiac center, the retrospective analysis of 70 patients found a strong correlation (R² = 0.813) between the two measurements. Despite a statistically significant but clinically negligible difference, the findings support using on-pump FIBTEM-A5 to guide fibrinogen supplementation in cardiac surgery.

Neurodevelopmental Outcomes After Nitric Oxide During Cardiopulmonary Bypass for Open Heart Surgery: A Randomized Clinical Trial

February 8, 2025 No Comments

This randomized clinical trial examined whether nitric oxide (NO) administered during cardiopulmonary bypass (CPB) improves neurodevelopmental and health-related quality of life (HRQOL) outcomes in infants undergoing open heart surgery. Conducted across six centers, the study followed 927 infants at 12 months post-surgery. Results showed no significant differences in neurodevelopment or HRQOL between the NO and standard CPB groups, suggesting NO does not enhance long-term neurological outcomes.

Perioperative Mechanical Circulatory Support: Transitioning from Sequential to Parallel Recovery

February 7, 2025 No Comments

This editorial explores the evolution of mechanical circulatory support (MCS) in perioperative cardiac care. It discusses advancements in venoarterial extracorporeal membrane oxygenation (VA-ECMO) and micro-axial flow pumps, highlighting the shift from sequential to parallel recovery. The article emphasizes early MCS intervention, left ventricular unloading, and minimizing adverse events. Insights from the DanGer Shock trial suggest improved survival with early MCS use, but further research is needed for perioperative applications.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

The Mystery of Methylene Blue and Its Role in Managing Post-Cardiac Surgery Vasoplegic Shock

February 5, 2025 No Comments

This study examines the effectiveness of methylene blue (MB) in managing vasoplegic syndrome (VS) following cardiac surgery with cardiopulmonary bypass. A retrospective cohort of 2753 patients identified 200 with VS, of whom 84 received MB. Results showed MB shortened ICU stays, reduced norepinephrine requirements, and improved serum lactate levels, but did not significantly impact in-hospital mortality. The study suggests MB may aid recovery but calls for further research on its broader effectiveness.

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Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

Transfusion Use and Hemoglobin Levels by Blood Conservation Method After Cardiopulmonary Bypass

Pulmonary Artery Systolic Pressure Associated with Inflammatory Factors Among Pediatric Congenital Heart Disease with Pulmonary Arterial Hypertension After Cardiopulmonary Bypass

Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments

On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration

Perioperative Mechanical Circulatory Support: Transitioning from Sequential to Parallel Recovery

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

The Mystery of Methylene Blue and Its Role in Managing Post-Cardiac Surgery Vasoplegic Shock

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