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Category: CPB

Exploding Aorta

Inflammation in Aortic Surgery: Postoperative Evolution of Biomarkers According to Pathologies and Segments of the Aorta

This study analyzes the postoperative trends of inflammatory biomarkers in 193 patients who underwent various types of aortic surgery. The research focused on the differing responses across four main surgical interventions: Type A aortic dissection repair, aortic root replacement, combined aortic arch and Frozen elephant trunk procedures, and descending/thoraco-abdominal aortic repair. Findings highlighted that inflammation levels, measured by WBC and CRP, vary significantly depending on the surgery type and aortic segment involved, with some groups showing prolonged inflammation.

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Heart Nurse

The Systemic Immune-Inflammation Index Predicts In-Hospital Mortality in Patients Who Underwent On-Pump Cardiac Surgery

This study explores the role of the Systemic Immune-Inflammation Index (SII), derived from platelet, neutrophil, and lymphocyte counts, as a predictor of in-hospital mortality for patients undergoing on-pump cardiac surgery. Analyzing data from 480 patients, it was found that a higher preoperative SII is independently associated with an increased risk of mortality. With a sensitivity and specificity of 65%, SII, along with neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), provides valuable prognostic information, potentially guiding more effective treatments.

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TA

The Efficacy of Tranexamic Acid in Reducing Perioperative Drainage in Cardiac Surgery with Cardiopulmonary Bypass

This study evaluates the effectiveness of tranexamic acid in reducing bleeding during and after cardiac surgery involving cardiopulmonary bypass. It compared 40 patients who received tranexamic acid to 40 who did not, finding significant differences in bleeding and transfusion rates, and improvements in hematological parameters for the treated group. These results suggest tranexamic acid effectively minimizes bleeding in such surgeries.

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Suction

Advancing Cardiotomy Suction Practices for Coronary Surgery via Multidisciplinary Collaborative Learning

This study focuses on a multidisciplinary quality-improvement intervention to standardize cardiotomy suction practices at the end of cardiopulmonary bypass during coronary artery bypass grafting. Conducted across 32 centers, the initiative showed significant improvements in adherence to recommended practices in Michigan centers compared to non-participating centers, with no adverse effects on clinical outcomes.

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Exploding Kidney

Is Ultrafiltration Volume a Predictor of Postoperative Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass?

This study investigates the relationship between intraoperative ultrafiltration (UF) volume during cardiopulmonary bypass (CPB) and the incidence of acute kidney injury (AKI) post-coronary artery bypass graft (CABG) surgery. Analyzing data from 641 patients, it found that higher UF volumes are significantly associated with an increased risk of AKI. Other identified predictors of AKI include patient age, the lowest mean arterial pressure during surgery, and red blood cell transfusions. These results underscore the importance of careful UF management during CPB to mitigate the risk of postoperative AKI.

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Blood Purification

Preliminary Report of Extracorporeal Blood Purification Therapy in Patients Receiving LVAD: Cytosorb or Jafron HA330

This study investigates the effects of extracorporeal blood purification therapy using Cytosorb and Jafron HA330 in patients undergoing Left Ventricular Assist Device (LVAD) implantation, aimed at mitigating immune dysregulation and infectious complications by reducing proinflammatory cytokine levels. Data from 15 patients receiving HeartMate 3™ LVADs were analyzed, with groups assigned to Cytosorb therapy, Jafron HA330, or control (usual care without filters). Results indicated that despite LVAD implantation increasing levels of various inflammatory markers, neither Cytosorb nor Jafron therapies had a significant impact on these markers, in-hospital mortality, or overall survival. The study suggests the need for larger, prospective studies to explore the potential benefits of hemoadsorption therapies in improving outcomes for LVAD patients.

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Robotic Surgery

Transferring Surgical Expertise: Analyzing the Learning Curve of Robotic Cardiac Surgery Operative Time Reduction When Surgeon Moves from One Experienced Center to Another

This study examines how the learning curve for robotic cardiac surgery operative time evolves when a surgeon with prior experience moves to a new team. A retrospective analysis of 103 cases at Weill Cornell Medicine shows that total operative time decreased significantly after the first 30 cases, indicating a period of adaptation to the new surgical environment. This adaptation did not affect the complication rates or cross-clamp times, highlighting the importance of understanding these dynamics for planning and managing surgical transitions to ensure optimal patient care and surgical outcomes.

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HCT Blood

A Comparison of the Clinical Outcomes of Minimum and Maximum Hematocrit Levels During Cardiopulmonary Bypass (CPB) in Low-risk Patients Undergoing Coronary Artery Bypass Graft Surgery (CABG): A Cross-sectional Study

This cross-sectional study explores the clinical outcomes of minimum and maximum hematocrit (HCT) levels during cardiopulmonary bypass (CPB) in low-risk coronary artery bypass graft (CABG) surgery patients. It found that lower HCT levels (16-18%) resulted in significantly less post-surgery drainage and lower incidence of cognitive disorders compared to higher HCT levels (25-27%), which required more transfusions of packed red blood cells and fresh frozen plasma, leading to an increased risk of cognitive impairments.

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Photo Text

Plasma Hyperosmolality as a Risk Factor for Postoperative Acute Kidney Injury in Cardiopulmonary Bypass Patients

This double-blind, randomized controlled trial from a tertiary teaching hospital in Sweden aimed to evaluate the impact of hyperosmolar priming solutions on cardiac surgery-associated acute kidney injury (CSA-AKI). Including patients aged ≥65 years undergoing routine cardiac surgery with cardiopulmonary bypass, the study compared the effects of a Ringer’s acetate based solution with Mannitol and sodium concentrate to a control group. Results indicated that while the hyperosmolar prime solution itself did not increase postoperative CSA-AKI incidence, high plasma osmolality was identified as an independent risk factor, increasing CSA-AKI risk by 30%. The findings underscore the need for further investigation into plasma hyperosmolality’s role in CSA-AKI risk.

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Pig CPB

Cerebral Perfusion and Metabolism with Mild Hypercapnia vs. Normocapnia in Porcine Models Post Cardiac Arrest: Impacts of Targeted Temperature Management

This study evaluates the effects of mild hypercapnia compared to normocapnia on cerebral blood flow and metabolism in porcine models post-cardiac arrest, with and without targeted temperature management (TTM33). It involved resuscitating 39 pigs after 10 minutes of cardiac arrest and randomizing them to different conditions. Results indicate that hypercapnia increases cerebral flow in all groups, but raises intracranial pressure and lowers cerebral perfusion pressure in non-TTM animals. Hypercapnia with TTM33 showed reduced cerebral lactate, pyruvate, glycerol, and lactate/pyruvate ratios, highlighting the varying impacts of hypercapnia with TTM.

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