Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

This study evaluates whether magnesium administration is necessary following cardioplegic arrest with del Nido cardioplegia (dNC) solution at Cincinnati Children’s Hospital Medical Center (CCHMC). Analyzing serum magnesium levels in 100 patients, results showed hypermagnesemia in most cases. Given the potential risks of excessive magnesium, findings suggest eliminating routine post-cross-clamp magnesium administration in dNC settings.

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Development and Validation of a Checklist for Cardiopulmonary Bypass

Development and Validation of a Checklist for Cardiopulmonary Bypass

This study focuses on developing and validating a checklist for cardiopulmonary bypass (CPB) to enhance patient safety and reduce adverse events. Using the Delphi method, five expert perfusionists refined an initial 42-item checklist down to 41 crucial elements. The final checklist standardizes CPB procedures, ensuring systematic verification of equipment and protocols. The study highlights the importance of structured guidelines in improving surgical outcomes and preventing errors.

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Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

This review examines microvascular dysfunction following cardioplegic arrest and cardiopulmonary bypass (CP/CPB), with a focus on diabetes and hypertension. It explores endothelial and vasomotor dysfunction, gene/protein expression changes, endothelial adherens junction impairment, and programmed cell death. The study highlights the role of oxidative stress, inflammation, and metabolic disruptions, providing insight into potential pharmacological interventions for improving surgical outcomes.

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Protamine Test Dose: Impact on Activated Clotting Time and Circuit Integrity

Protamine Test Dose: Impact on Activated Clotting Time and Circuit Integrity

This study examines the effect of a protamine test dose (PTD) on activated clotting times (ACTs) and cardiopulmonary bypass (CPB) circuit integrity in 120 cardiac surgery patients. The study found that PTDs led to unpredictable and often significant reductions in ACT, increasing the risk of clot formation in the CPB circuit. The authors recommend discontinuing the recovery of mediastinal shed blood into the CPB circuit before protamine administration to enhance patient safety.

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The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

This study evaluates the role of continuous monitoring of venous drainage flow and oxygen extraction (ERiO2) using near-infrared spectroscopy (NIRS) in cerebral perfusion during aortic arch surgery. A retrospective review of 10 patients undergoing selective antegrade cerebral perfusion (SACP) found a strong correlation (r = 0.91, p < 0.01) between ERiO2 and NIRS-derived regional oxygen saturation (rSO2). The study suggests that integrated monitoring improves perfusion management and neurological outcomes.

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Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

This study compares centrifugation (CF) and multiple-pass hemoconcentration (MPH) for salvaging residual blood after cardiopulmonary bypass. A randomized trial with 61 patients found that MPH resulted in higher postoperative albumin, total protein, fibrinogen, and platelet levels compared to CF. While CF processed blood faster and cleared heparin more consistently, MPH was associated with lower allogeneic transfusion needs and reduced fluid retention. Overall, MPH demonstrated improved biochemical and clinical outcomes.

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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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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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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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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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