International Perfusion Association

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Category: CPB

Priming Solution

A Modified Low-Priming Cardiopulmonary Bypass System in Patients Undergoing Cardiac Surgery with Medium Risk of Transfusion: A Randomized Controlled Trial

This study evaluates the FUWAI-SAVE system, a modified low-priming cardiopulmonary bypass (CPB) system, in reducing perioperative blood transfusions in adult patients undergoing cardiac surgery with intermediate transfusion risk. Conducted as a single-center, single-blind, randomized controlled trial, 360 patients were divided into an intervention group (FUWAI-SAVE) and a control group (conventional CPB). Results showed the FUWAI-SAVE system significantly reduced red blood cell transfusion rates and amounts during the peri-CPB period without increasing major complications, indicating its potential in improving blood management in cardiac surgery.

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Can a Low Prime Volume Arterial Filter Be Used as an Alternative for a Venous Bubble Trap in Minimal Extracorporeal Circulation? An In Vitro Investigation

This study examines whether an arterial filter with a small prime volume can effectively replace a venous bubble trap (VBT) in a minimal extracorporeal circulation (MiECC) system used during cardiac surgery. The study compared air removal capabilities of an arterial filter and three VBTs: VBT160, VBT8, and VARD. Results showed the AF100 arterial filter demonstrated similar, and in some cases better, performance in removing air and gaseous microemboli (GME) compared to VBTs. However, the placement of the arterial filter in the venous line is considered off-label use.

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ACT 480

Activated Clotting Time Value as an Independent Predictor of Postoperative Bleeding and Transfusion

This study examines the incidence and predictors of bleeding and thrombosis in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) after out-of-hospital cardiac arrest due to ventricular tachycardia/fibrillation. Among 200 patients, 67.5% experienced major bleeding, primarily from CPR-related trauma. Decreased fibrinogen levels were linked to bleeding, but bleeding did not significantly affect in-hospital mortality. Thrombosis occurred in 23.5% of patients and was not associated with in-hospital death.

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Heart Bandage

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

The STAR registry study explores the use of haemoadsorption for removing antithrombotic drugs during cardiac surgery to reduce bleeding risks. This report covers 165 patients from Austria, Germany, Sweden, and the UK. Patients on P2Y12 inhibitors and DOACs were assessed. The device, integrated into the cardiopulmonary bypass, showed promising results in mitigating bleeding risks. Group 1 (P2Y12) and Group 2 (DOAC) patients experienced similar bleeding events, suggesting the procedure’s safety and effectiveness.

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RBC Tube

Impact of Miniaturized vs. Conventional Tubing on Inflammatory Response and Blood Transfusion in Congenital Heart Disease Surgeries

This study compares inflammatory cytokine levels and blood transfusion rates in pediatric patients undergoing congenital heart surgeries using miniaturized or conventional extracorporeal circuits. Results indicate that miniaturized circuits may reduce certain cytokines and lower transfusion requirements, suggesting a potential advantage in reducing surgery-related complications.

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CPB Time

The Impact of Cardiopulmonary Bypass Time on the Sequential Organ Failure Assessment Score After Cardiac Surgery

This study investigates the effect of cardiopulmonary bypass (CPB) time on postoperative Sequential Organ Failure Assessment (SOFA) scores. The analysis of data from 1,032 patients reveals that longer CPB times correlate with higher SOFA scores, particularly affecting cardiovascular and renal functions. Prolonged CPB times (>200 minutes) are associated with an increased likelihood of severe dysfunction, emphasizing the predictive power of CPB duration on postoperative organ health.

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Infection 1

Nosocomial Infections After Pediatric Congenital Heart Disease Surgery: Data from National Center for Cardiovascular Diseases in China

This study evaluates nosocomial infections in pediatric patients post-cardiac surgery, analyzing data from the National Center for Cardiovascular Diseases in China. Out of 4776 patients, the nosocomial infection rate was 2.1%, with multidrug-resistant organisms (MDROs) found in 36 patients. Pneumonia and sepsis were the most common infections, with pneumonia showing an incidence density of 7.2/1000 patient-days. MDRO infections were associated with significantly longer intensive care unit stays compared to non-MDRO infections. The results highlight the impact of MDRO infections on surgical outcomes and the importance of infection prevention and control measures.

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Goal Directed Perfusion

Intraoperative Goal-Directed Perfusion in Cardiac Surgery with Cardiopulmonary Bypass: The Roles of Delivery Oxygen Index and Cardiac Index

This study explores the efficacy of intraoperative Goal-Directed Perfusion (GDP) in reducing postoperative complications, ICU, and hospital stay durations in cardiac surgery using cardiopulmonary bypass. By monitoring and optimizing oxygen delivery and cardiac index, GDP significantly lowered ICU stays and hospital lengths of stay, although it did not significantly affect mortality rates.

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DRESS

Heparin-Induced DRESS Syndrome in a Pediatric Patient and Successful Anaesthetic Management in Cardiovascular Bypass Surgery: Case Report

This case report discusses a pediatric patient with heparin-induced DRESS Syndrome managed successfully during cardiovascular bypass surgery. An 11-year-old with native aortic valve endocarditis developed DRESS after receiving unfractionated heparin. The syndrome, characterized by fever, eosinophilia, and a pruritic rash, was initially managed with corticosteroids. A subsequent episode prompted a shift to bivalirudin and fondaparinux, avoiding further complications and stabilizing the patient’s condition. This case emphasizes the need for alternative anticoagulation strategies in hypersensitive patients to improve outcomes.

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World Hemo

Effect of Geography on the Use of Ultrafiltration During Cardiac Surgery with Cardiopulmonary Bypass

This study explores geographic differences in ultrafiltration (UF) use during cardiopulmonary bypass in the US, analyzing data from 92,859 cardiac surgeries across four regions. Results reveal significant regional disparities in UF usage and volumes, with the Northeast and West employing UF more frequently than the Midwest and South. Variations were also noted in intraoperative urine output and red blood cell transfusion rates, prompting calls for further research into the causes of these differences.

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