Protamine 101

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

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.

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Lung Ventilation

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

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.

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Hemaglobin 2024

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

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.

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Del Nido Cardioplegia

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

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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WBC ECMO

Increased White Blood Cell Count is Associated with an Increased Demand for Unfractionated Heparin During Veno-Arterial Extracorporeal Oxygenation in Lung Transplantation

This retrospective study investigated whether increased white blood cell (WBC) counts correlate with higher unfractionated heparin (UFH) dosage needs during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) in lung transplantation. Among 27 patients, those with elevated WBC counts (above 10.2 × 10³/μL) required higher UFH doses to maintain targeted clotting times. The findings suggest WBC count could help determine optimal UFH dosing during surgery.

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Heparin CPB

Heparin Resistance Management During Cardiac Surgery: A Literature Review and Future Directions

This article reviews the complexities of heparin resistance (HR) during cardiac surgery, highlighting its causes, diagnosis, and management strategies. HR, characterized by insufficient response to heparin, can result in serious surgical complications. The authors discuss diagnostic methods like assessing activated clotting time (ACT) and propose management strategies such as heparin dosage adjustments, antithrombin supplementation, and alternative anticoagulants to improve patient outcomes.

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Haemo

Intraoperative Haemoadsorption for Antithrombotic Drug Removal During Cardiac Surgery: Initial Report of the International Safe and Timely Antithrombotic Removal (STAR) Registry

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.

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AKI 2024

Monocytes to Lymphocytes Multiplying Platelets Ratio as an Early Indicator of Acute Kidney Injury in Cardiac Surgery with Cardiopulmonary Bypass: A Retrospective Analysis

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.

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CPB 2024

Standard Versus High Cardiopulmonary Bypass Flow Rate: A Randomized Controlled Subtrial Comparing Brain Injury Biomarker Release

This study aimed to compare the release of brain injury biomarkers between standard and high cardiopulmonary bypass (CPB) flow rates during elective cardiac surgery. Conducted at Sahlgrenska University Hospital in Sweden, forty patients were randomly assigned to either a standard (2.4 L/min/m²) or high (2.9 L/min/m²) CPB flow rate. The results indicated no significant differences in biomarker levels or the occurrence of postoperative delirium between the two groups. Age and sex were among factors associated with biomarker levels.

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Cardioplegia 2024

Comparative Analysis of Del Nido Cardioplegia Versus Blood Cardioplegia in Isolated Coronary Artery Bypass Grafting

This study examined the efficacy of del Nido cardioplegia compared to traditional blood cardioplegia in adult coronary artery bypass grafting. Among 119 patients, the del Nido group showed superior myocardial protection, indicated by lower Troponin I levels and fewer defibrillation attempts post-surgery. Additionally, this group experienced shorter surgery durations, including reduced aortic cross-clamping and total operative times. The findings suggest del Nido cardioplegia as a viable option for these procedures, necessitating a standardized protocol.

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