Category: CPB

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

This randomized clinical study assessed how varying sweep gas flow rates affect respiratory alkalosis and cerebral oxygenation during cardiopulmonary bypass (CPB) in 84 open-heart surgery patients. The findings revealed that lower sweep gas flow rates help maintain normal carbon dioxide levels and enhance cerebral oxygen saturation post-rewarming. Adjusting the sweep gas flow rate before rewarming may prevent complications associated with respiratory alkalosis.

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Cardiopulmonary Bypass and Cross-Clamping Times in Aortic Valve Replacement Surgery by Ministernotomy with Sutureless Prosthesis Implantation Compared to Conventional Prosthesis: A Cross-Sectional Study

Cardiopulmonary Bypass and Cross-Clamping Times in Aortic Valve Replacement Surgery by Ministernotomy with Sutureless Prosthesis Implantation Compared to Conventional Prosthesis: A Cross-Sectional Study

This study compares cardiopulmonary bypass (CPB) and cross-clamping times in aortic valve replacement surgeries performed via ministernotomy using either sutureless PERCEVAL® or conventional bioprostheses. Among 93 patients, both techniques showed similar outcomes regarding CPB and cross-clamping times, hospital stays, and early postoperative complications. Echocardiographic results improved postoperatively in both groups.

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Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

This study investigates the impact of sex on systemic inflammatory response syndrome (SIRS) and outcomes after cardiac surgery. Analyzing 1,005 patients, researchers found that women had a higher incidence of SIRS (41.8% vs. 22.8%) and worse outcomes, including prolonged ICU stays and increased need for vasopressor support. SIRS mediated over 50% of the sex-related risks, with preoperative anemia and hyperlactatemia as contributing factors. Addressing inflammation may improve outcomes for female patients.

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Buckberg vs. Del Nido

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

This study compares Buckberg (BS) and Del Nido (DNS) cardioplegia in isolated aortic valve replacement (AVR) through a two-center randomized trial with 311 patients. While postoperative creatine kinase and troponin levels showed no significant differences, the DNS group had better intraoperative glycemic control, higher spontaneous rhythm rates, and fewer cases of ventricular fibrillation requiring defibrillation. The study supports DNS as a viable alternative with workflow advantages.

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Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

This study evaluates whether magnesium administration is necessary following cardioplegic arrest with del Nido cardioplegia (dNC) solution at Cincinnati Children’s Hospital Medical Center (CCHMC). Analyzing serum magnesium levels in 100 patients, results showed hypermagnesemia in most cases. Given the potential risks of excessive magnesium, findings suggest eliminating routine post-cross-clamp magnesium administration in dNC settings.

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Development and Validation of a Checklist for Cardiopulmonary Bypass

Development and Validation of a Checklist for Cardiopulmonary Bypass

This study focuses on developing and validating a checklist for cardiopulmonary bypass (CPB) to enhance patient safety and reduce adverse events. Using the Delphi method, five expert perfusionists refined an initial 42-item checklist down to 41 crucial elements. The final checklist standardizes CPB procedures, ensuring systematic verification of equipment and protocols. The study highlights the importance of structured guidelines in improving surgical outcomes and preventing errors.

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Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

This review examines microvascular dysfunction following cardioplegic arrest and cardiopulmonary bypass (CP/CPB), with a focus on diabetes and hypertension. It explores endothelial and vasomotor dysfunction, gene/protein expression changes, endothelial adherens junction impairment, and programmed cell death. The study highlights the role of oxidative stress, inflammation, and metabolic disruptions, providing insight into potential pharmacological interventions for improving surgical outcomes.

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Protamine Test Dose: Impact on Activated Clotting Time and Circuit Integrity

Protamine Test Dose: Impact on Activated Clotting Time and Circuit Integrity

This study examines the effect of a protamine test dose (PTD) on activated clotting times (ACTs) and cardiopulmonary bypass (CPB) circuit integrity in 120 cardiac surgery patients. The study found that PTDs led to unpredictable and often significant reductions in ACT, increasing the risk of clot formation in the CPB circuit. The authors recommend discontinuing the recovery of mediastinal shed blood into the CPB circuit before protamine administration to enhance patient safety.

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The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

This study evaluates the role of continuous monitoring of venous drainage flow and oxygen extraction (ERiO2) using near-infrared spectroscopy (NIRS) in cerebral perfusion during aortic arch surgery. A retrospective review of 10 patients undergoing selective antegrade cerebral perfusion (SACP) found a strong correlation (r = 0.91, p < 0.01) between ERiO2 and NIRS-derived regional oxygen saturation (rSO2). The study suggests that integrated monitoring improves perfusion management and neurological outcomes.

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

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

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.

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