International Perfusion Association

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IPA

Category: Blood

ACT 480

Activated Clotting Time Value as an Independent Predictor of Postoperative Bleeding and Transfusion

This study examines the incidence and predictors of bleeding and thrombosis in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) after out-of-hospital cardiac arrest due to ventricular tachycardia/fibrillation. Among 200 patients, 67.5% experienced major bleeding, primarily from CPR-related trauma. Decreased fibrinogen levels were linked to bleeding, but bleeding did not significantly affect in-hospital mortality. Thrombosis occurred in 23.5% of patients and was not associated with in-hospital death.

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May 8, 2024
ECPR

Bleeding and Thrombosis in Patients With Out-of-Hospital Ventricular Tachycardia/Ventricular Fibrillation Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation

This study examines the incidence and predictors of bleeding and thrombosis in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) after out-of-hospital cardiac arrest due to ventricular tachycardia/fibrillation. Among 200 patients, 67.5% experienced major bleeding, primarily from CPR-related trauma. Decreased fibrinogen levels were linked to bleeding, but bleeding did not significantly affect in-hospital mortality. Thrombosis occurred in 23.5% of patients and was not associated with in-hospital death.

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May 8, 2024
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
World Hemo

Effect of Geography on the Use of Ultrafiltration During Cardiac Surgery with Cardiopulmonary Bypass

This study explores geographic differences in ultrafiltration (UF) use during cardiopulmonary bypass in the US, analyzing data from 92,859 cardiac surgeries across four regions. Results reveal significant regional disparities in UF usage and volumes, with the Northeast and West employing UF more frequently than the Midwest and South. Variations were also noted in intraoperative urine output and red blood cell transfusion rates, prompting calls for further research into the causes of these differences.

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April 22, 2024
Blood Hero

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluates the methodological quality and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery involving cardiopulmonary bypass (CPB). Analyzing guidelines using the AGREE II tool, it highlights varying consistency across documents, especially in stakeholder involvement. The study reviews drug therapy strategies including anemia therapy, perioperative antithrombotic administration, intraoperative anticoagulation, and hemostatic drug use, noting a lack of pediatric-specific evidence and the cautious use of certain drugs post-surgery.

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April 21, 2024
Del Nido Cardio

Comparison of Del Nido Cardioplegia and Crystalloid Blood Cardioplegia on Arrhythmia and Early Results

This study compares the efficacy of Del Nido cardioplegia (DN) and traditional crystalloid blood cardioplegia in patients undergoing coronary artery bypass surgery, focusing on their effects on arrhythmias and early surgical outcomes. The research involved 175 patients using crystalloid cardioplegia and 150 patients using DN solution. Findings suggest that DN solution, particularly when part of the dose is administered through grafts, leads to better control of arrhythmias post-surgery, reduced need for pacing, and shorter hospital and intensive care unit stays.

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April 21, 2024
CytoSorb Drowning

Does Adjunctive Hemoadsorption Provide Benefit in the Management of Ischemia-Reperfusion Syndrome Following Near-Drowning? A Case Report

This case report examines the efficacy of adjunctive hemoadsorption using CytoSorb® in managing ischemia-reperfusion injury (IRI) following a near-drowning incident. Highlighting a critical case involving an adolescent, the study details the use of CytoSorb® alongside veno-venous extracorporeal membrane oxygenation (vvECMO) to address hyperinflammation triggered by reoxygenation after drowning. The intervention showed potential in mitigating the surge of pro-inflammatory mediators, suggesting a promising role for hemoadsorption in severe drowning cases.

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April 20, 2024
Heart Nurse

The Systemic Immune-Inflammation Index Predicts In-Hospital Mortality in Patients Who Underwent On-Pump Cardiac Surgery

This study explores the role of the Systemic Immune-Inflammation Index (SII), derived from platelet, neutrophil, and lymphocyte counts, as a predictor of in-hospital mortality for patients undergoing on-pump cardiac surgery. Analyzing data from 480 patients, it was found that a higher preoperative SII is independently associated with an increased risk of mortality. With a sensitivity and specificity of 65%, SII, along with neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), provides valuable prognostic information, potentially guiding more effective treatments.

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April 19, 2024
Transplant Heart

Novel Portable Hypothermic Machine Perfusion Preservation Device Enhances Cardiac Viability of Donated Human Hearts

This study investigates a novel portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE®, designed to extend preservation times for donated human hearts. Utilizing hearts from 11 brain-dead donors, the research compared the efficacy of preservation across different durations (4, 6, and 8 hours) against standard static cold storage (SCS). Findings indicate that the VP.S ENCORE® significantly maintains cardiac viability and function, matching levels observed in healthy hearts, particularly in 6-hour perfusion scenarios which showed improved ventricular relaxation and reduced inflammation marker expression.

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April 18, 2024
CABG Hema

Antithrombotic Drug Removal with Hemoadsorption During Off-Pump Coronary Artery Bypass Grafting

This study evaluates the efficacy of using a hemoadsorption cartridge to remove antithrombotic drugs during off-pump coronary artery bypass grafting (OPCAB). Ten patients, predominantly male and with a mean age of 67.4 years, were treated with antithrombotics like ticagrelor and rivaroxaban. Hemoadsorption was integrated into the perioperative management using either a dialysis device or a standalone apheresis pump, showing a mean treatment time of 145 minutes. Results indicated low rates of bleeding, no deaths, or further interventions during a mean follow-up of 19.5 months, demonstrating that this method is feasible and safe.

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April 18, 2024
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