$Stepwise Rescue Therapy for Refractory Vasoplegia$

Evaluating the Impact of a Standardized Protocol for Managing Refractory Vasoplegia After Cardiopulmonary Bypass

March 2, 2026 No Comments

This single-center pre-post study evaluated a standardized stepwise protocol for refractory vasoplegia after cardiopulmonary bypass (CPB). Compared to provider-directed therapy, the protocol—escalating from methylene blue to angiotensin II and hydroxocobalamin—accelerated norepinephrine-equivalent reduction and reduced vasopressor costs by 26% at 48 hours, without worsening hemodynamic or clinical outcomes.

Nanoscale Impact of Cardiopulmonary Bypass on Red Blood Cells

The Impact of Cardiopulmonary Bypass on the Structure and Mechanics of Red Blood Cells: Pilot Study

March 1, 2026 No Comments

This pilot study evaluated how cardiopulmonary bypass (CPB), with and without hypothermic circulatory arrest (HCA), affects red blood cell (RBC) morphology, membrane nanostructure, and mechanical properties using atomic force microscopy. In 14 cardiac surgery patients, CPB increased RBC stiffness, while CPB+HCA caused more severe morphological damage and membrane roughness. The findings suggest distinct cellular injury mechanisms depending on perfusion strategy.

Leveraging the Perfusionist-Surgeon Dyad to Improve the Culture of Safety

February 27, 2026 No Comments

This article describes how a cardiac surgery program at Massachusetts General Hospital transformed its operating room culture by leveraging the unique perfusionist-surgeon relationship. By promoting psychological safety, challenging hierarchical assumptions, and implementing structured guidelines, checklists, and multidisciplinary briefings, the team improved communication, recruitment, teamwork, and resilience. The initiative demonstrates how deliberate cultural change enhances safety and performance.

Indexed Delivery of Oxygen Predicts In-Hospital Mortality and Morbidity in Reoperative Adult Cardiac Surgery Patients: A Retrospective Cohort Study

February 20, 2026 No Comments

This retrospective cohort study of 343 reoperative cardiac surgery patients found that low indexed oxygen delivery (DO₂i) during cardiopulmonary bypass independently predicted in-hospital mortality and major morbidity. A median DO₂i below 289 mL/min/m² was associated with a fourfold increase in mortality risk, higher rates of acute kidney injury, cardiac complications, and prolonged ventilation. Optimizing intraoperative oxygen delivery may improve outcomes in this high-risk population.

Emergency Repair of a Rupturing Ascending Aorta

Circulatory Arrest Time Above 30 Minutes Has Significantly Detrimental Effects on the Outcomes of Type A Aortic Dissection Repair

February 20, 2026 No Comments

This retrospective study of 109 patients undergoing emergent type A aortic dissection repair found that deep hypothermic circulatory arrest (DHCA) times exceeding 30 minutes were associated with significantly higher 30-day mortality, 12-month mortality, and postoperative stroke rates. Cerebral perfusion strategy did not alter stroke risk. The findings suggest that limiting circulatory arrest to under 30 minutes may improve survival and neurological outcomes.

The Evolving Role of the ECMO Perfusionist

Redefining the Role of Perfusionists in ECMO: From Technical Operators to Clinical Stakeholders

February 19, 2026 No Comments

This letter to the editor argues that perfusionists in ECMO programs should move beyond a narrowly defined technical role and be formally integrated as clinical stakeholders. The authors highlight perfusionists’ expertise in circuit management, anticoagulation, device troubleshooting, and physiology, advocating for their inclusion in ICU rounds, decision-making, quality improvement, and research. Greater integration could improve safety, efficiency, and patient outcomes in complex ECMO care.

Preoperative Anemia Management and Its Economic Impact on Red Blood Cell Transfusion in Cardiac Surgery

Predictors and Economic Impact of Red Blood Cell Transfusion in Cardiac Surgery: A Simulated Cost Reduction Model for Preoperative Anemia Management

February 16, 2026 No Comments

This retrospective cohort study of 661 elective cardiac surgery patients identified preoperative anemia as the strongest independent predictor of red blood cell (RBC) transfusion (OR 3.67). Transfusion was associated with longer hospital stay, higher infection rates, prolonged ventilation, and a median cost increase of €2264 per patient. A simulation model estimated that eliminating preoperative anemia could prevent 47 transfusions and save €106 429 over 13 months.

Intravenous Lidocaine Infusion During Cardiopulmonary Bypass Cardiac Surgery

Evaluation of the Effect of Intravenous Lidocaine on the Systemic Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized Clinical Trial

February 16, 2026 No Comments

This single-center, double-blind randomized clinical trial (LEONARD Trial) evaluates whether intravenous lidocaine reduces systemic inflammation triggered by cardiopulmonary bypass in elective valvular and/or coronary cardiac surgery. Ninety patients will receive lidocaine or placebo, with IL-6 at 6 hours postoperatively as the primary endpoint. Secondary outcomes include inflammatory biomarkers, organ dysfunction, atrial fibrillation, ICU stay, opioid use, and 30-day mortality.

Restoring Life to the Liver: Normothermic Regional Perfusion in Modern Transplantation

Normothermic Regional Perfusion in Controlled Donation After Circulatory Death: Growing Evidence for Liver Transplantation

February 7, 2026 No Comments

Normothermic regional perfusion (NRP) is reshaping controlled donation after circulatory death (cDCD) liver transplantation. By restoring oxygenated blood flow after death declaration, NRP reduces ischemia-reperfusion injury, lowers rates of early allograft dysfunction and biliary complications, and delivers graft and patient survival comparable to donation after brain death. This review synthesizes expanding global evidence supporting NRP as a new standard.

Minimally Invasive vs Conventional Coronary Bypass Surgery for Multivessel Coronary Disease

June 24, 2025 No Comments

This study compared minimally invasive coronary surgery (MICS-CABG) to traditional sternotomy-based CABG in patients with multivessel coronary artery disease. Analyzing matched cohorts of 244 patients each, the research found similar completeness of revascularization and comparable 5-year major adverse cardiac and cerebrovascular events (MACCE). MICS-CABG also had high graft patency (96.2%) and fewer transfusion needs, indicating it as a viable surgical alternative.