Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery

December 8, 2024 No Comments

This study compares the immune responses of patients undergoing coronary artery bypass grafting (CABG) via on-pump and off-pump methods. On-pump CABG induced a more significant immune response, with notable increases in extracellular vesicles (EVs) derived from platelets, endothelial cells, and B-cells. Off-pump surgery was associated with milder changes in cytokine and EV profiles. Findings highlight EVs’ role in regulating postoperative inflammation and suggest a potential mechanism for immune modulation.

The Value of Off-Pump Coronary Artery Bypass Grafting in Surgery for Combined Valvular and Coronary Heart Disease

December 8, 2024 No Comments

This study explores the benefits of off-pump coronary artery bypass grafting (OPCABG) in surgeries combining valve and coronary interventions. Among 884 patients, the OPCABG group showed reduced incidences of postoperative atrial fibrillation (29.5% vs. 39.5%) and acute kidney injury (14.5% vs. 21.2%) compared to on-pump CABG. No differences in mortality or stroke rates were observed. The results suggest OPCABG is a safe and effective approach for improved short-term outcomes in complex cardiac surgeries.

Algorithm of High-Risk Massive Pulmonary Thromboembolism with Extracorporeal Membrane Oxygenation

December 4, 2024 No Comments

This study evaluates the use of extracorporeal membrane oxygenation (ECMO) in treating high-risk massive pulmonary embolism (PE) in 27 patients from 2018 to 2023. ECMO was initiated pre-, intra-, or post-operatively in conjunction with surgical embolectomy or catheter-based thrombectomy. ECMO demonstrated significant benefits, including hemodynamic stabilization, reduced right ventricular overload, and improved survival (81.5%). Challenges included Harlequin syndrome and procedural complications. Findings support ECMO as a bridge to recovery, emphasizing the need for optimized patient selection and management strategies.

Relation Between Serum Sodium Trajectory and Survival in Septic Patients with Cardiopulmonary Bypass Surgery

December 3, 2024 No Comments

This study examined the impact of serum sodium trajectory on 30-day mortality in septic patients after cardiopulmonary bypass (CPB) surgery using the MIMIC-IV database. Among 1,038 patients, serum sodium trajectories were classified into three groups, with higher levels linked to increased mortality. Elevated fluctuations, even within normal sodium ranges, were associated with adverse outcomes. These findings highlight the need for close monitoring and sodium management in critically ill patients undergoing CPB.

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

December 3, 2024 No Comments

A conceptual representation of the “Five Pillars” framework for aRHF therapy. The image shows five pillars, each labeled with key aspects: Etiological Treatment, Hemodynamic Support, Ventilation, Fluid Optimization, and Mechanical Support. A heart is balanced on top of these pillars, symbolizing stability. The design is clean and professional, with subtle arrows indicating the interconnectedness of the pillars.

Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery: Benign or Malignant?

November 28, 2024 No Comments

This retrospective study examined paediatric patients undergoing cardiac surgery with crystalloid priming to evaluate outcomes related to postoperative hyperlactataemia. Among 186 patients, 53% experienced hyperlactataemia, which was associated with longer cardiopulmonary bypass and ICU stays but did not increase ventilation duration. Findings suggest transient hyperlactataemia may not indicate tissue hypoxaemia, but longer inotropic support and ICU stays necessitate careful management post-surgery.

Protamine Dosing for Heparin Reversal After Cardiopulmonary Bypass: A Double-Blinded Prospective Randomized Control Trial Comparing Two StrategieS

November 24, 2024 No Comments

This study compared two protamine dosing strategies for heparin reversal after cardiopulmonary bypass: a fixed 250-mg dose versus a 1:1 (1 mg:100 U heparin) ratio-based approach. The trial included 125 elective adult cardiac surgery patients. Both methods showed similar activated clotting times and postoperative bleeding, but the fixed-dose group used significantly less protamine. These results suggest fixed dosing may optimize drug conservation without compromising safety or efficacy.

Predictive Role of Cardiopulmonary Bypass Exposure Indexed to Body Surface Area on Postoperative Organ Dysfunction: A Retrospective Cohort Study

November 24, 2024 No Comments

This study analyzed the relationship between cardiopulmonary bypass (CPB) exposure indexed to body surface area (bypass index) and postoperative outcomes in 2,413 cardiac surgery patients. A higher bypass index was predictive of increased hospital stay and organ dysfunction, particularly renal and cardiac rhythm issues, but not pulmonary dysfunction. These findings highlight the bypass index as a valuable metric for assessing risk and optimizing resource use during cardiac surgery.

Temperature Management in Acute Type A Aortic Dissection Treatment: Deep vs. Moderate Hypothermic Circulatory Arrest

November 17, 2024 No Comments

This study compares the clinical outcomes of deep hypothermic circulatory arrest (DHCA, <20°C) and moderate hypothermic circulatory arrest (MHCA, 20-28°C) in 143 patients undergoing acute type A aortic dissection surgery. DHCA was associated with higher rates of acute kidney injury (25.2% vs. 7.5%), delirium (22.3% vs. 5%), longer ICU stays, and greater complication risks compared to MHCA. While survival rates after two years were similar, MHCA proved to be safer and more beneficial in minimizing postoperative complications when feasible.

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

November 17, 2024 No Comments

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

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Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery

The Value of Off-Pump Coronary Artery Bypass Grafting in Surgery for Combined Valvular and Coronary Heart Disease

Algorithm of High-Risk Massive Pulmonary Thromboembolism with Extracorporeal Membrane Oxygenation

Relation Between Serum Sodium Trajectory and Survival in Septic Patients with Cardiopulmonary Bypass Surgery

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery: Benign or Malignant?

Protamine Dosing for Heparin Reversal After Cardiopulmonary Bypass: A Double-Blinded Prospective Randomized Control Trial Comparing Two StrategieS

Predictive Role of Cardiopulmonary Bypass Exposure Indexed to Body Surface Area on Postoperative Organ Dysfunction: A Retrospective Cohort Study

Temperature Management in Acute Type A Aortic Dissection Treatment: Deep vs. Moderate Hypothermic Circulatory Arrest

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

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