International Perfusion Association

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IPA

Category: CPB

DHCA

Temperature Management in Acute Type A Aortic Dissection Treatment: Deep vs. Moderate Hypothermic Circulatory Arrest

This study compares the clinical outcomes of deep hypothermic circulatory arrest (DHCA, <20°C) and moderate hypothermic circulatory arrest (MHCA, 20-28°C) in 143 patients undergoing acute type A aortic dissection surgery. DHCA was associated with higher rates of acute kidney injury (25.2% vs. 7.5%), delirium (22.3% vs. 5%), longer ICU stays, and greater complication risks compared to MHCA. While survival rates after two years were similar, MHCA proved to be safer and more beneficial in minimizing postoperative complications when feasible.

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November 17, 2024
Cerebral 2024

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

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November 17, 2024
AKI 2024

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

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.

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October 15, 2024
OPCABG 2024

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

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October 4, 2024
Protamine 101

Platelet Function Is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine

This study assessed platelet function and numbers in 39 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass (CPB). Platelet function was measured at six different points, including after protamine administration. Results showed no significant impairment of platelet function during CPB. However, platelet function was temporarily reduced after protamine but recovered within 3 hours post-surgery.

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October 4, 2024
Lung Ventilation

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

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October 1, 2024
Hemaglobin 2024

Association Between Perioperative Hemoglobin Decrease and Outcomes of Transfusion in Patients Undergoing On-Pump Cardiac Surgery: An Observational Study From Two Chinese Heart Centers

This study analyzed 8186 adult patients undergoing cardiac surgery to examine the impact of perioperative hemoglobin decrease (ΔHb) on red blood cell transfusion outcomes. Patients with greater hemoglobin decreases (≥50%) were found to have higher risks of complications like mortality and organ failure. Transfusions helped in some cases but became harmful when exceeding four units. The findings underscore the importance of careful transfusion management in cardiac surgery.

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October 1, 2024
Del Nido Cardioplegia

Comparison of Routine Del Nido Cardioplegia vs Two Types of Modified Del Nido Cardioplegias for Myocardial Protection in CABG: A Randomized Double-Blind Clinical Trial

This randomized, double-blind trial compared the effectiveness of routine del Nido cardioplegia with two modified versions (Ringer lactate-based and plain Ringer-based) in coronary artery bypass grafting (CABG) surgery. Among 120 adult patients, no significant differences were found in myocardial protection markers (CK-MB, Troponin T, Troponin I, lactate). However, Troponin T and lactate levels showed time-related effects. All cardioplegia solutions provided comparable protection, suggesting the need for further studies.

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September 27, 2024
WBC ECMO

Increased White Blood Cell Count is Associated with an Increased Demand for Unfractionated Heparin During Veno-Arterial Extracorporeal Oxygenation in Lung Transplantation

This retrospective study investigated whether increased white blood cell (WBC) counts correlate with higher unfractionated heparin (UFH) dosage needs during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) in lung transplantation. Among 27 patients, those with elevated WBC counts (above 10.2 × 10³/μL) required higher UFH doses to maintain targeted clotting times. The findings suggest WBC count could help determine optimal UFH dosing during surgery.

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September 26, 2024
Heparin CPB

Heparin Resistance Management During Cardiac Surgery: A Literature Review and Future Directions

This article reviews the complexities of heparin resistance (HR) during cardiac surgery, highlighting its causes, diagnosis, and management strategies. HR, characterized by insufficient response to heparin, can result in serious surgical complications. The authors discuss diagnostic methods like assessing activated clotting time (ACT) and propose management strategies such as heparin dosage adjustments, antithrombin supplementation, and alternative anticoagulants to improve patient outcomes.

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September 21, 2024
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