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Category: CPB

Heart Stopper

Efficacy and Safety of the Blood-Based Cardioplegia Solution Huaxi-1 in Cardiopulmonary Bypass Surgery: Protocol for a Multicentre Randomised Controlled Trial

This study evaluates the safety and efficacy of the Huaxi-1 blood-based cardioplegia solution compared to the widely used HTK solution in cardiopulmonary bypass surgery. A randomized, multicenter trial involving 160 adult patients across four hospitals in China will measure myocardial injury markers, cardiac function, and post-surgical recovery. The goal is to establish Huaxi-1’s viability as a standardized cardioplegia solution for improved myocardial protection.

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February 20, 2025
The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

This study examines different techniques for processing post-cardiopulmonary bypass (CPB) residual blood and their impact on intraoperative red blood cell (RBC) transfusions. Analyzing data from over 77,000 adult cardiac surgeries, the study found that using Hemobag (HB) resulted in the lowest transfusion risk, while not processing blood (NO) led to the highest. The findings highlight the importance of effective blood conservation strategies in cardiac surgery.

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February 20, 2025
Protamine 101

On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration

This study investigates whether on-pump FIBTEM-A5 values measured during cardiopulmonary bypass (CPB) accurately predict post-protamine administration values. Conducted at a single cardiac center, the retrospective analysis of 70 patients found a strong correlation (R² = 0.813) between the two measurements. Despite a statistically significant but clinically negligible difference, the findings support using on-pump FIBTEM-A5 to guide fibrinogen supplementation in cardiac surgery.

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February 18, 2025
EBCP 2024 Guidelines

2024 EACTS/EACTAIC/EBCP Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery

The 2024 EACTS/EACTAIC/EBCP guidelines provide updated, evidence-based recommendations for cardiopulmonary bypass (CPB) in adult cardiac surgery. They cover advancements in perfusion strategies, organ protection, monitoring techniques, and safety measures. Key updates include AI-driven perfusion, enhanced neuromonitoring, and refined protocols for blood management and CPB separation. These guidelines aim to standardize practices, improve outcomes, and ensure patient safety in modern cardiac surgery.

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February 16, 2025
Nitric Oxide

Neurodevelopmental Outcomes After Nitric Oxide During Cardiopulmonary Bypass for Open Heart Surgery: A Randomized Clinical Trial

This randomized clinical trial examined whether nitric oxide (NO) administered during cardiopulmonary bypass (CPB) improves neurodevelopmental and health-related quality of life (HRQOL) outcomes in infants undergoing open heart surgery. Conducted across six centers, the study followed 927 infants at 12 months post-surgery. Results showed no significant differences in neurodevelopment or HRQOL between the NO and standard CPB groups, suggesting NO does not enhance long-term neurological outcomes.

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February 8, 2025
Platelet Inhibitor Withdrawal and Outcomes After Coronary Artery Surgery: An Individual Patient Data Meta-Analysis

Platelet Inhibitor Withdrawal and Outcomes After Coronary Artery Surgery: An Individual Patient Data Meta-Analysis

This study analyzes the impact of preoperative withdrawal of P2Y12 receptor inhibitors on bleeding and ischemic outcomes in coronary artery bypass grafting (CABG). Using individual patient data from 4,837 patients across seven observational studies, the meta-analysis finds that guideline-conforming withdrawal reduces severe bleeding (BARC-4) risk by 50% without increasing mortality or postoperative ischemic events. These findings support adherence to standardized preoperative withdrawal guidelines.

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February 3, 2025
Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

This study addresses the critical issue of oxygenator failure during cardiopulmonary bypass (CPB), a rare but high-risk event. It explores protocols and techniques for addressing oxygenator malfunction, including traditional oxygenator change-outs and alternative approaches like arterial and venous piggyback methods. The authors emphasize the need for institutional preparation, including written protocols and routine emergency drills, and propose a venous piggyback technique as a safer first-line response to improve patient outcomes.

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December 23, 2024
Cerebral Perfusion

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Associated with Postoperative Delirium in Cardiac Surgery Patients: A Prospective Observational Study

This study investigates the relationship between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Despite reduced cortical metabolism, patients with POD exhibited increased cerebral blood flow, measured via transcranial Doppler. Low bispectral index (BIS) values indicated reduced metabolism, but no differences in autoregulation impairments were noted. The findings suggest a mismatch between cerebral blood flow and metabolism contributes to POD, independent of cerebral autoregulation.

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December 21, 2024
ECMO Lung

Intraoperative Extracorporeal Support for Lung Transplant: A Systematic Review and Network Meta-Analysis

This systematic review and network meta-analysis investigates the comparative effectiveness of veno-arterial extracorporeal membrane oxygenation (V-A ECMO), cardiopulmonary bypass (CPB), and OffPump strategies for lung transplantation (LT). Based on 27 observational studies with 6113 patients, the study finds that OffPump approaches outperform both ECMO and CPB in all major outcomes, including reduced ICU stay, mechanical ventilation duration, and mortality. Among extracorporeal supports, V-A ECMO showed better performance than CPB. Factors such as age, gender, and BMI significantly influenced postoperative outcomes.

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December 20, 2024
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