International Perfusion Association

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IPA

Category: Cardiac Surgery

Heart Bandage

Intraoperative Haemoadsorption for Antithrombotic Drug Removal During Cardiac Surgery: Initial Report of the International Safe and Timely Antithrombotic Removal (STAR) Registry

The STAR registry study explores the use of haemoadsorption for removing antithrombotic drugs during cardiac surgery to reduce bleeding risks. This report covers 165 patients from Austria, Germany, Sweden, and the UK. Patients on P2Y12 inhibitors and DOACs were assessed. The device, integrated into the cardiopulmonary bypass, showed promising results in mitigating bleeding risks. Group 1 (P2Y12) and Group 2 (DOAC) patients experienced similar bleeding events, suggesting the procedure’s safety and effectiveness.

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May 8, 2024
CPB Time

The Impact of Cardiopulmonary Bypass Time on the Sequential Organ Failure Assessment Score After Cardiac Surgery

This study investigates the effect of cardiopulmonary bypass (CPB) time on postoperative Sequential Organ Failure Assessment (SOFA) scores. The analysis of data from 1,032 patients reveals that longer CPB times correlate with higher SOFA scores, particularly affecting cardiovascular and renal functions. Prolonged CPB times (>200 minutes) are associated with an increased likelihood of severe dysfunction, emphasizing the predictive power of CPB duration on postoperative organ health.

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May 6, 2024
Infection 1

Nosocomial Infections After Pediatric Congenital Heart Disease Surgery: Data from National Center for Cardiovascular Diseases in China

This study evaluates nosocomial infections in pediatric patients post-cardiac surgery, analyzing data from the National Center for Cardiovascular Diseases in China. Out of 4776 patients, the nosocomial infection rate was 2.1%, with multidrug-resistant organisms (MDROs) found in 36 patients. Pneumonia and sepsis were the most common infections, with pneumonia showing an incidence density of 7.2/1000 patient-days. MDRO infections were associated with significantly longer intensive care unit stays compared to non-MDRO infections. The results highlight the impact of MDRO infections on surgical outcomes and the importance of infection prevention and control measures.

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May 4, 2024
Ischemic Heart

Remote Ischemic Preconditioning and Cognitive Dysfunction Following Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review and meta-analysis evaluates the effectiveness of remote ischemic preconditioning (RIPC) in preventing cognitive dysfunction after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. Despite hypothesized benefits, the meta-analysis of five studies encompassing 1,843 participants showed that RIPC does not significantly reduce the incidence or severity of postoperative cognitive dysfunction. The findings suggest that RIPC is not effective as a neuroprotective strategy in CABG patients.

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April 27, 2024
Predication Models

A Systematic Review of Cardiac Surgery Clinical Prediction Models That Include Intra-operative Variables

This systematic review assesses clinical prediction models (CPMs) that incorporate intra-operative variables to predict outcomes following adult cardiac surgery. It highlights the identification of 24 CPMs, predominantly predicting acute kidney injury and peri-operative mortality, using common variables like cardiopulmonary bypass time. Despite acceptable discrimination in internally validated models, poor calibration and high bias risk limit their practical use. The review suggests potential improvement in model accuracy with intra-operative data, advocating for more robust studies.

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April 26, 2024
Coronary Clock

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After On-Pump Coronary Artery Bypass Surgery

A study investigating the role of the systemic immune-inflammation index (SII) in predicting outcomes for patients undergoing on-pump coronary artery bypass graft (CABG) surgery found significant correlations. High preoperative SII values were linked to prolonged surgery and cardiopulmonary bypass times, extended ICU and hospital stays, and increased risks of severe complications such as atrial fibrillation, cardiac arrest, and mortality.

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April 23, 2024
Critical Care Advances

21st Century Critical Care Medicine: An Overview

Critical care medicine has made significant advancements in the 21st century, notably improving patient outcomes in ICUs. Innovations such as Precision Medicine, Telemedicine, AI-driven tools, advanced Organ Support, new Infection Control tactics, refined Ventilation Strategies, and enhanced Sepsis Management reflect a dynamic landscape. These developments prioritize technology, research, and patient-centered approaches, showcasing a promising future for addressing modern medical challenges.

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April 23, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

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April 22, 2024
Mad Kidney

Risk Prediction Models for Renal Function Decline After Cardiac Surgery Within Different Preoperative Glomerular Filtration Rate Strata

This study focuses on developing risk prediction models to identify patients at risk of renal function decline post-cardiac surgery. Using data from 24,904 patients at Fuwai Hospital, the study found significant variances in renal decline risks across different preoperative glomerular filtration rate (eGFR) strata. Notably, patients with higher eGFR levels pre-surgery showed increased risk. The research produced distinct nomograms for each eGFR category, demonstrating good predictive accuracy and providing a practical tool for postoperative renal monitoring.

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April 21, 2024
Brain Hemmorage

Impact of Postoperative Cerebral Complications in Acute Infective Endocarditis: A Retrospective Single-Center Study

This retrospective study at a single center explored the impact of preoperative cerebral complications on patients with acute infective endocarditis (IE). Among 31 patients analyzed, those with intracranial findings prior to surgery did not experience a worse postoperative course despite being older and having more complex clinical profiles. Notably, one patient without previous cerebral issues developed a cerebral hemorrhage postoperatively, highlighting the need for careful monitoring and preventative strategies for all IE patients, regardless of initial cerebral status.

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April 21, 2024
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