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.

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

October 15, 2024 No Comments

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

October 4, 2024 No Comments

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

Platelet Function Is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine

October 4, 2024 No Comments

This study assessed platelet function and numbers in 39 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass (CPB). Platelet function was measured at six different points, including after protamine administration. Results showed no significant impairment of platelet function during CPB. However, platelet function was temporarily reduced after protamine but recovered within 3 hours post-surgery.

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

October 1, 2024 No Comments

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

Association Between Perioperative Hemoglobin Decrease and Outcomes of Transfusion in Patients Undergoing On-Pump Cardiac Surgery: An Observational Study From Two Chinese Heart Centers

October 1, 2024 No Comments

This study analyzed 8186 adult patients undergoing cardiac surgery to examine the impact of perioperative hemoglobin decrease (ΔHb) on red blood cell transfusion outcomes. Patients with greater hemoglobin decreases (≥50%) were found to have higher risks of complications like mortality and organ failure. Transfusions helped in some cases but became harmful when exceeding four units. The findings underscore the importance of careful transfusion management in cardiac surgery.

Comparison of Routine Del Nido Cardioplegia vs Two Types of Modified Del Nido Cardioplegias for Myocardial Protection in CABG: A Randomized Double-Blind Clinical Trial

September 27, 2024 No Comments

This randomized, double-blind trial compared the effectiveness of routine del Nido cardioplegia with two modified versions (Ringer lactate-based and plain Ringer-based) in coronary artery bypass grafting (CABG) surgery. Among 120 adult patients, no significant differences were found in myocardial protection markers (CK-MB, Troponin T, Troponin I, lactate). However, Troponin T and lactate levels showed time-related effects. All cardioplegia solutions provided comparable protection, suggesting the need for further studies.

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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

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

Platelet Function Is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

Association Between Perioperative Hemoglobin Decrease and Outcomes of Transfusion in Patients Undergoing On-Pump Cardiac Surgery: An Observational Study From Two Chinese Heart Centers

Comparison of Routine Del Nido Cardioplegia vs Two Types of Modified Del Nido Cardioplegias for Myocardial Protection in CABG: A Randomized Double-Blind Clinical Trial

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