Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin in Cardiopulmonary Bypass for Cardiac Surgery

January 31, 2026 No Comments

This meta-analysis evaluated 12 randomized trials (908 patients) comparing 6% hydroxyethyl starch (HES) 130/0.4 with 5% albumin during cardiopulmonary bypass in cardiac surgery. Most outcomes—including blood loss, transfusion rates, ICU stay, hospital stay, and mortality—were similar between groups. However, HES use was associated with a significantly higher risk of acute kidney injury, highlighting renal safety concerns despite comparable hemodynamic efficacy.

Vasoplegic Syndrome in Cardiac Surgery: Bridging Therapeutic Gaps with Best Practices and Future Research

April 6, 2025 No Comments

This article explores vasoplegic syndrome (VS), a serious complication following cardiac surgery involving cardiopulmonary bypass. It discusses inconsistent definitions, risk factors, and treatment strategies. Methylene blue emerges as a promising therapy due to its ability to counteract the nitric oxide-cGMP pathway. The authors advocate for standardized definitions, early intervention, and large-scale trials to validate therapeutic protocols.

Intraoperative Renal Near-Infrared Spectroscopy Monitoring as a Predictor of Renal Outcomes in Cardiac Surgery

April 4, 2025 No Comments

This study assessed whether intraoperative renal near-infrared spectroscopy (NIRS) could predict acute renal failure (ARF) in 357 cardiac surgery patients. It found that longer durations of reduced renal oxygenation (rSO₂) below 80%, 70%, and 60% thresholds were significantly associated with ARF development. NIRS monitoring showed high sensitivity and specificity, indicating its potential for early detection and intervention during surgery.

CytoSorb Filter During Kidney Normothermic

Protocol for a Single-Centre Randomised Pilot Study to Assess the Safety and Feasibility of Adding a CytoSorb Filter During Kidney Normothermic Machine Perfusion to Remove Inflammatory and Immune Mediators Prior to Kidney Transplantation

April 3, 2025 No Comments

This pilot study assesses the safety and feasibility of using a CytoSorb filter during kidney normothermic machine perfusion (NMP) before transplantation. The goal is to reduce inflammation-related damage by filtering immune mediators. Twenty patients will be randomized to receive kidneys preserved with or without the filter. Outcomes include immune gene expression, delayed graft function, and kidney performance at intervals post-transplant.

Limiting the Gamble: Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

March 11, 2025 No Comments

This study investigates risk factors for renal replacement therapy (RRT) in patients receiving mechanical circulatory support (MCS). A retrospective analysis of 129 patients revealed an RRT incidence of 36%. Key risk factors include prior immunologic therapy and the presence of pacemakers or internal cardiac defibrillators. Unfractionated heparin showed minimal protection against RRT. Findings suggest systemic inflammation plays a role, emphasizing the need for alternative anticoagulation strategies.

Kidney Injury Under Diminished Pulsatile Flow Induced by V-A ECMO in Sheep

February 25, 2025 No Comments

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention used for critically ill patients, yet it is frequently associated with high incidences of kidney injury. This

Association Between Plasma-Free Haemoglobin and Postoperative Acute Kidney Injury in Paediatric Cardiac Surgery: A Prospective Observational Study

November 24, 2024 No Comments

This study investigates the link between plasma-free haemoglobin (PFH) and acute kidney injury (AKI) in children undergoing cardiopulmonary bypass (CPB) during cardiac surgery. Among 179 participants, 41% developed AKI. Peak PFH concentrations were significantly higher in patients with AKI, but multivariable analysis showed CPB duration and patient age, rather than PFH, as primary risk factors. This emphasizes CPB time management in mitigating AKI risk.

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

October 15, 2024 No Comments

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

Risk Factors Associated With Hospital Mortality in Non-Surgical Patients Receiving Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Treatment: A Retrospective Analysis

September 9, 2024 No Comments

This study identifies risk factors associated with hospital mortality in non-surgical patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Using data from December 2013 to April 2023, the analysis revealed that older age, longer duration of CRRT, and CRRT implantation were independent predictors of mortality. A prediction model was developed using these factors, demonstrating good accuracy and clinical utility in estimating patient outcomes.

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

August 20, 2024 No Comments

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.