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

September 21, 2024 No Comments

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.

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

August 20, 2024 No Comments

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.

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

August 20, 2024 No Comments

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

August 8, 2024 No Comments

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.

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

July 17, 2024 No Comments

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.

Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU

July 12, 2024 No Comments

This study examines the relationship between hyperoxia during cardiopulmonary bypass (CPB) and postoperative delirium in pediatric patients in a cardiac ICU. Analyzing data from 148 patients, researchers found that 24% experienced delirium within 72 hours post-CPB. However, no significant association was found between hyperoxia and delirium. Exploratory analysis suggested that nutritional status, specifically weight z scores, might influence delirium risk, indicating a need for further research on risk factors.

Exploring Differences in Surgical Outcomes Depending on the Arterial Cannulation Strategy for Acute Type A Aortic Dissection: A Single-Center Study

July 6, 2024 No Comments

This single-center retrospective study evaluated the impact of different arterial cannulation strategies on surgical outcomes for patients with acute type A aortic dissection (AD) and intramural hematoma (IMH). By comparing 32 patients who underwent antegrade cannulation with 114 patients who underwent retrograde cannulation, the study found significant differences in total surgical time and intensive care unit stay duration. However, no significant differences were observed in 30-day mortality or postoperative cerebrovascular accident rates. The findings suggest that the choice of cannulation strategy should be tailored to individual patient needs.

A Modified Low-Priming Cardiopulmonary Bypass System in Patients Undergoing Cardiac Surgery with Medium Risk of Transfusion: A Randomized Controlled Trial

June 5, 2024 No Comments

This study evaluates the FUWAI-SAVE system, a modified low-priming cardiopulmonary bypass (CPB) system, in reducing perioperative blood transfusions in adult patients undergoing cardiac surgery with intermediate transfusion risk. Conducted as a single-center, single-blind, randomized controlled trial, 360 patients were divided into an intervention group (FUWAI-SAVE) and a control group (conventional CPB). Results showed the FUWAI-SAVE system significantly reduced red blood cell transfusion rates and amounts during the peri-CPB period without increasing major complications, indicating its potential in improving blood management in cardiac surgery.

Can a Low Prime Volume Arterial Filter Be Used as an Alternative for a Venous Bubble Trap in Minimal Extracorporeal Circulation? An In Vitro Investigation

May 22, 2024 No Comments

This study examines whether an arterial filter with a small prime volume can effectively replace a venous bubble trap (VBT) in a minimal extracorporeal circulation (MiECC) system used during cardiac surgery. The study compared air removal capabilities of an arterial filter and three VBTs: VBT160, VBT8, and VARD. Results showed the AF100 arterial filter demonstrated similar, and in some cases better, performance in removing air and gaseous microemboli (GME) compared to VBTs. However, the placement of the arterial filter in the venous line is considered off-label use.

Activated Clotting Time Value as an Independent Predictor of Postoperative Bleeding and Transfusion

May 8, 2024 No Comments

This study examines the incidence and predictors of bleeding and thrombosis in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) after out-of-hospital cardiac arrest due to ventricular tachycardia/fibrillation. Among 200 patients, 67.5% experienced major bleeding, primarily from CPR-related trauma. Decreased fibrinogen levels were linked to bleeding, but bleeding did not significantly affect in-hospital mortality. Thrombosis occurred in 23.5% of patients and was not associated with in-hospital death.

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

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

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

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

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

Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU

Exploring Differences in Surgical Outcomes Depending on the Arterial Cannulation Strategy for Acute Type A Aortic Dissection: A Single-Center Study

A Modified Low-Priming Cardiopulmonary Bypass System in Patients Undergoing Cardiac Surgery with Medium Risk of Transfusion: A Randomized Controlled Trial

Can a Low Prime Volume Arterial Filter Be Used as an Alternative for a Venous Bubble Trap in Minimal Extracorporeal Circulation? An In Vitro Investigation

Activated Clotting Time Value as an Independent Predictor of Postoperative Bleeding and Transfusion

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