Finding a Common Definition of Heparin Resistance in Adult Cardiac Surgery: Communication from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis

January 21, 2024 No Comments

Ensuring sufficient anticoagulation in cardiac surgery and cardiopulmonary bypass is crucial for preventing adverse outcomes. This review evaluates various definitions of heparin resistance in this context, proposing a standardized definition based on the inability to achieve an activated clotting time target of 480 or more after a dose of 500 U/kg of heparin.

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

January 11, 2024 No Comments

This study on elderly patients undergoing cardiopulmonary bypass (CPB) found a high incidence (56.82%) of postoperative pulmonary complications (PPCs), identifying low serum albumin levels, specific types of surgery, prolonged CPB, blood transfusion, and pre-extubation intra-aortic balloon pump use as significant risk factors. These PPCs led to longer mechanical ventilation, extended hospital and ICU stays, increased mortality, and higher tracheotomy rates, highlighting the importance of recognizing these risk factors for better perioperative prevention in elderly CPB patients.

Prospective Clinical Study Testing the Efficacy and Safety of a New Formula to Increase the Precision of Oxygen Therapy in the Initiation Phase of Cardiopulmonary Bypass

January 7, 2024 No Comments

This study developed a formula for tailored oxygen therapy during cardiopulmonary bypass (CPB) to prevent cellular hypoxia and minimize the risk of hyperoxemia. In a pilot study, the formula aimed for a specific arterial partial oxygen pressure (PaO2) range, but only 38.75% of patients achieved the target range, indicating a need for further adjustments to the formula to enhance its effectiveness in guiding oxygen therapy during CPB.

Simulated Cardiopulmonary Bypass: A High Fidelity Model for Developing and Accessing Clinical Perfusion Skills

January 5, 2024 No Comments

The study describes a simulated cardiopulmonary bypass (CPB) model integrated into a mock operative theater, aiming to enhance the training of novice perfusionists. Results from 81 participants indicated high fidelity and effectiveness of the simulation in replicating real CPB scenarios and skills, suggesting its potential for educational use in clinical perfusion training.

Hemolysis Precedes Urine Color Change in Patients Undergoing Open-Heart Surgery on Cardiopulmonary Bypass

January 5, 2024 No Comments

This study investigated the relationship between plasma free hemoglobin levels and changes in urine color in cardiac surgery patients undergoing cardiopulmonary bypass. It found that changes in urine color or increases in urinary free hemoglobin occurred considerably later than elevations in plasma free hemoglobin levels.

Effects of Blood Transfusion, Cardiopulmonary Bypass Time, and Bypassed Vessels on Mortality Following Isolated and Combined Coronary Artery Bypass Grafting

January 4, 2024 No Comments

This study analyzed 677 patients to investigate the correlation between the number of bypassed vessels, cardiopulmonary bypass duration, blood transfusion requirements, revision rates, and mortality in coronary artery bypass grafting surgeries. Results indicated that higher revision rates were associated with six-vessel bypasses, longer bypass and cross-clamp times, increased blood transfusions, and mortality, with specific blood thinners affecting transfusion needs and mortality outcomes.

The Effect of Perioperative Antithrombin Supplementation on Blood Conservation and Postoperative Complications After Cardiopulmonary Bypass Surgery: A Systematic Review, Meta-Analysis and Trial Sequential Analysis

January 4, 2024 No Comments

This meta-analysis investigated the effect of perioperative antithrombin (AT) supplementation on patients undergoing cardiopulmonary bypass (CPB) surgery, analyzing 13 randomized controlled trials with 996 participants. The study found that perioperative AT did not significantly reduce postoperative blood loss or the need for blood transfusions, and it was associated with increased in-hospital mortality and acute kidney injury incidence.

Post-Operative Delirium and Cognitive Dysfunction in Aged Patients Undergoing Cardiac Surgery: A Randomized Comparison between Two Blood Oxygenators

December 31, 2023 No Comments

In a study comparing the new oxygenator system RemoweLL 2 with the conventional Inspire device in elderly patients undergoing cardiopulmonary bypass, RemoweLL 2 showed a trend towards reduced incidence of severe post-operative delirium and lower levels of inflammation biomarkers. The study, assessing cognitive decline and inflammation in 154 patients, suggests that advanced CPB oxygenator technologies may lead to better neurocognitive outcomes in the elderly undergoing cardiac surgery.

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2023 Update on Procedure Data and Research

December 30, 2023 No Comments

The Society of Thoracic Surgeons Adult Cardiac Surgery Database, which includes data from over nine million procedures, underpins multiple risk models and has been pivotal in shaping health policy and cardiac surgery practices. This annual report updates on the database’s status, introduces new risk models, details current surgical trends, and outlines research and future directions for this extensive clinical resource.

Delirium after Cardiac Surgery-A Narrative Review

December 30, 2023 No Comments

Postoperative delirium (POD) following cardiac surgery, potentially influenced by cardiopulmonary bypass, is linked to increased morbidity and mortality despite understanding its causative factors and risk mitigation strategies. This review article discusses the incidence, impact, and primary risk factors of POD in cardiac surgical patients, along with anesthetic and postoperative therapeutic approaches to reduce its occurrence.

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Finding a Common Definition of Heparin Resistance in Adult Cardiac Surgery: Communication from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

Prospective Clinical Study Testing the Efficacy and Safety of a New Formula to Increase the Precision of Oxygen Therapy in the Initiation Phase of Cardiopulmonary Bypass

Simulated Cardiopulmonary Bypass: A High Fidelity Model for Developing and Accessing Clinical Perfusion Skills

Hemolysis Precedes Urine Color Change in Patients Undergoing Open-Heart Surgery on Cardiopulmonary Bypass

Effects of Blood Transfusion, Cardiopulmonary Bypass Time, and Bypassed Vessels on Mortality Following Isolated and Combined Coronary Artery Bypass Grafting

The Effect of Perioperative Antithrombin Supplementation on Blood Conservation and Postoperative Complications After Cardiopulmonary Bypass Surgery: A Systematic Review, Meta-Analysis and Trial Sequential Analysis

Post-Operative Delirium and Cognitive Dysfunction in Aged Patients Undergoing Cardiac Surgery: A Randomized Comparison between Two Blood Oxygenators

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2023 Update on Procedure Data and Research

Delirium after Cardiac Surgery-A Narrative Review

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