International Perfusion Association

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IPA

Category: Blood

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

This study examines risk factors affecting survival in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) treated with extracorporeal membrane oxygenation (ECMO). Analyzing 63 cases from 2020–2023, findings indicate that elevated arterial blood lactate, prolonged time to PCI, and higher vasoactive-inotropic scores (VIS) are key predictors of poor prognosis. Early intervention, including timely PCI and metabolic stabilization, is crucial to improving survival outcomes.

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February 22, 2025
The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

This study examines different techniques for processing post-cardiopulmonary bypass (CPB) residual blood and their impact on intraoperative red blood cell (RBC) transfusions. Analyzing data from over 77,000 adult cardiac surgeries, the study found that using Hemobag (HB) resulted in the lowest transfusion risk, while not processing blood (NO) led to the highest. The findings highlight the importance of effective blood conservation strategies in cardiac surgery.

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February 20, 2025
The Mystery of Methylene Blue and Its Role in Managing Post-Cardiac Surgery Vasoplegic Shock

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

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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February 5, 2025
Development and Validation of a Nomogram for Predicting Perioperative Transfusion in Children Undergoing Cardiac Surgery with CPB

Development and Validation of a Nomogram for Predicting Perioperative Transfusion in Children Undergoing Cardiac Surgery with CPB

This study develops and validates a predictive model for perioperative red blood cell transfusion (PRT) risk in pediatric cardiac surgery with cardiopulmonary bypass (CPB). Using data from 19,155 children, eight key predictors—including age, weight, preoperative hemoglobin, CPB duration, and cyanotic congenital heart disease—were identified. The nomogram demonstrated high accuracy (AUC 0.886) and clinical utility, aiding personalized blood management strategies to optimize outcomes and reduce transfusion risks.

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February 3, 2025
Platelet Inhibitor Withdrawal and Outcomes After Coronary Artery Surgery: An Individual Patient Data Meta-Analysis

Platelet Inhibitor Withdrawal and Outcomes After Coronary Artery Surgery: An Individual Patient Data Meta-Analysis

This study analyzes the impact of preoperative withdrawal of P2Y12 receptor inhibitors on bleeding and ischemic outcomes in coronary artery bypass grafting (CABG). Using individual patient data from 4,837 patients across seven observational studies, the meta-analysis finds that guideline-conforming withdrawal reduces severe bleeding (BARC-4) risk by 50% without increasing mortality or postoperative ischemic events. These findings support adherence to standardized preoperative withdrawal guidelines.

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February 3, 2025
Predictive Value of Trendelenburg Position

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

This study evaluates the effectiveness of Trendelenburg position and carotid ultrasound in predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Findings reveal that carotid corrected flow time (FTcBaseline) and stroke volume index variation (ΔSVITrend) are accurate and non-invasive predictors. These methods outperform traditional markers like pulse pressure variation, enhancing fluid management strategies in critical care.

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January 2, 2025
Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

This review explores fluid management in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). It highlights the lack of evidence for optimal fluid strategies, comparing liberal vs. restrictive approaches, or types like crystalloids and albumin. Fluid overload negatively affects survival and kidney outcomes, emphasizing the need for precise strategies. The study calls for rigorous research to determine effective fluid resuscitation approaches and improve clinical outcomes.

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December 24, 2024
Cytocaine CPB

Removal of Cytokines During Cardiac Surgery (RECCAS): A Randomised Controlled Trial

This randomized controlled trial evaluates the efficacy of intraoperative haemoadsorption (HA) using CytoSorb® during cardiac surgery with cardiopulmonary bypass (CPB). The primary focus was on reducing interleukin-6 (IL-6) levels post-surgery. Despite a significant reduction in cytokine levels within the HA device during surgery, there was no difference in IL-6 levels between the treatment and control groups upon ICU admission or during the ICU stay. Some haemodynamic benefits, such as reduced fluid and fibrinogen requirements and shorter need for renal replacement therapy, were observed, though these did not translate into improved clinical outcomes like ICU length of stay or mortality rates. The study underscores the need for further large-scale trials to refine patient selection and HA application strategies.

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December 14, 2024
ECMO Scale

Novel Risk Scoring Model to Predict the Implementation of Veno-Arterial Extracorporeal Membrane Oxygenation in Patients With Acute Myocarditis

This study introduces the Korean Acute Myocarditis (KAM) score, a predictive model for assessing the likelihood of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) use in acute myocarditis. Analyzing data from 841 patients across seven Korean hospitals, eight clinical parameters were identified as predictors, including cardiac arrest and left ventricular ejection fraction <40%. The KAM score demonstrated excellent discriminant ability, supporting its potential to guide timely interventions and improve patient outcomes.

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December 13, 2024
Cold Platelets

Delayed Cold-Stored vs. Room Temperature Stored Platelet Transfusions in Bleeding Adult Cardiac Surgery Patients—A Randomized Multicentre Pilot Study (PLTS-1)

This study investigates the feasibility of using delayed cold-stored platelets (DCSP) compared to standard room-temperature platelets (RTP) in bleeding cardiac surgery patients. DCSP, stored initially at 22°C and then refrigerated, may address platelet supply challenges by extending shelf life and enhancing hemostatic activity. The multicentre pilot aims to assess recruitment, adherence, and product availability to inform a future definitive trial. The trial could improve transfusion logistics and patient outcomes.

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December 10, 2024
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