International Perfusion Association

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IPA

Category: CPB

Blood Hero

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluates the methodological quality and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery involving cardiopulmonary bypass (CPB). Analyzing guidelines using the AGREE II tool, it highlights varying consistency across documents, especially in stakeholder involvement. The study reviews drug therapy strategies including anemia therapy, perioperative antithrombotic administration, intraoperative anticoagulation, and hemostatic drug use, noting a lack of pediatric-specific evidence and the cautious use of certain drugs post-surgery.

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April 21, 2024
Brain Hemmorage

Impact of Postoperative Cerebral Complications in Acute Infective Endocarditis: A Retrospective Single-Center Study

This retrospective study at a single center explored the impact of preoperative cerebral complications on patients with acute infective endocarditis (IE). Among 31 patients analyzed, those with intracranial findings prior to surgery did not experience a worse postoperative course despite being older and having more complex clinical profiles. Notably, one patient without previous cerebral issues developed a cerebral hemorrhage postoperatively, highlighting the need for careful monitoring and preventative strategies for all IE patients, regardless of initial cerebral status.

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April 21, 2024
Del Nido Cardio

Comparison of Del Nido Cardioplegia and Crystalloid Blood Cardioplegia on Arrhythmia and Early Results

This study compares the efficacy of Del Nido cardioplegia (DN) and traditional crystalloid blood cardioplegia in patients undergoing coronary artery bypass surgery, focusing on their effects on arrhythmias and early surgical outcomes. The research involved 175 patients using crystalloid cardioplegia and 150 patients using DN solution. Findings suggest that DN solution, particularly when part of the dose is administered through grafts, leads to better control of arrhythmias post-surgery, reduced need for pacing, and shorter hospital and intensive care unit stays.

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April 21, 2024
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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April 19, 2024
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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April 19, 2024
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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April 17, 2024
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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April 12, 2024
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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April 9, 2024
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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April 4, 2024
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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March 30, 2024
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