International Perfusion Association

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Category: CPB

Pump Head

Target Flow Deviations on the Cardiopulmonary Bypass Cause Postoperative Delirium in Cardiothoracic Surgery – A Retrospective Study Evaluating Temporal Fluctuations of Perfusion Data

This study investigates the role of cardiopulmonary bypass (CPB) in postoperative delirium following cardiac surgery, employing algorithm-based data analysis on patient records from 2014 to 2019. It identifies not only demographic and comorbidity predictors but also highlights the significance of CPB parameters in delirium risk. Specifically, total blood volume and minimal blood flow rates during CPB were linked to delirium outcomes. The findings suggest that meticulous management of CPB parameters, especially flow rates and acid-base balance, could mitigate the risk of postoperative delirium, emphasizing the potential of precise CPB data processing in improving post-surgical care.

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February 5, 2024
CPU RBC

Development and Validation of a Machine Learning Method to Predict Intraoperative Red Blood Cell Transfusions in Cardiothoracic Surgery

A novel machine learning (ML) method has been developed to predict red blood cell (RBC) transfusion requirements in cardiothoracic surgery, enhancing blood inventory management and preoperative hemorrhage risk assessment. Utilizing data from 2410 surgeries between May 2014 and June 2019, with an additional 437 cases for validation, this method employs a hybrid approach combining Gaussian Process regression and classification algorithms. The model accurately predicts both minor (0 to 3 units) and significant (4+ units) RBC transfusions, showing promise for integrating ML into surgical planning and patient care optimization.

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February 4, 2024
Custom Blood

Association between Intraoperative Blood Salvage and Coagulation Disorder after Cardiopulmonary Bypass

This study assesses the relationship between intraoperative blood salvage and coagulation disorders following cardiopulmonary bypass (CPB), using conventional coagulation tests and thromboelastography (TEG). Enrolling 92 patients undergoing cardiovascular surgery with CPB, it explored coagulation function in scenarios with and without cell salvage blood transfusion. Despite 57.6% of patients receiving cell salvage, the occurrence of coagulation disorders post-CPB showed no significant difference between groups, indicating that intraoperative blood salvage does not significantly impact coagulation disorder risk as diagnosed by TEG or conventional tests.

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February 4, 2024
Electroacupuncture

Efficacy of Electroacupuncture on Myocardial Protection and Postoperative Rehabilitation in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis

This study evaluated the efficacy of electroacupuncture (EA) in myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass, using data from fourteen randomized controlled trials involving 836 patients. The results suggest that EA may reduce myocardial ischaemia-reperfusion injury and enhance postoperative recovery, with no reported adverse reactions, although the findings are based on evidence of mostly low or moderate quality, indicating a need for more high-quality, large-scale studies.

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January 26, 2024
The Rat

The Anti-Apoptotic Effect of Ranolazine on Cerebral Protection during Cardiopulmonary Bypass and Carotid Artery Surgery

This study investigated the neuroprotective effects of ranolazine (Rn) in a rat model of cerebral ischemia induced by carotid artery clamping. Results showed that Rn-treated groups had significant changes in various biochemical markers, indicating an antiapoptotic effect of Rn in brain ischemia-reperfusion, suggesting its potential usability in cardiac surgeries and carotid artery interventions.

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January 25, 2024
Exploding Heart Elephant

Surgical Management and Outcomes of Coronary Artery Involvement Secondary to Acute Type A Aortic Dissection: A Retrospective Cohort Study

In a study of patients with acute type A aortic dissection (ATAAD) undergoing total arch replacement (TAR) and frozen elephant trunk (FET) implantation, it was found that those with coronary artery involvement (CAI) experienced more complicated surgeries, longer hospital stays, and higher rates of in-hospital morbidity and mortality compared to those without CAI. Although coronary artery malperfusion (CAM) due to CAI was an independent risk factor for in-hospital mortality, short-term survival post-discharge was similar between patients with and without CAI.

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January 23, 2024
Blood Hemolysis

Finding a Common Definition of Heparin Resistance in Adult Cardiac Surgery: Communication from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis

Ensuring sufficient anticoagulation in cardiac surgery and cardiopulmonary bypass is crucial for preventing adverse outcomes. This review evaluates various definitions of heparin resistance in this context, proposing a standardized definition based on the inability to achieve an activated clotting time target of 480 or more after a dose of 500 U/kg of heparin.

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January 21, 2024
Elderly Patient CPB

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

This study on elderly patients undergoing cardiopulmonary bypass (CPB) found a high incidence (56.82%) of postoperative pulmonary complications (PPCs), identifying low serum albumin levels, specific types of surgery, prolonged CPB, blood transfusion, and pre-extubation intra-aortic balloon pump use as significant risk factors. These PPCs led to longer mechanical ventilation, extended hospital and ICU stays, increased mortality, and higher tracheotomy rates, highlighting the importance of recognizing these risk factors for better perioperative prevention in elderly CPB patients.

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January 11, 2024
Hypoxic Cell

Prospective Clinical Study Testing the Efficacy and Safety of a New Formula to Increase the Precision of Oxygen Therapy in the Initiation Phase of Cardiopulmonary Bypass

This study developed a formula for tailored oxygen therapy during cardiopulmonary bypass (CPB) to prevent cellular hypoxia and minimize the risk of hyperoxemia. In a pilot study, the formula aimed for a specific arterial partial oxygen pressure (PaO2) range, but only 38.75% of patients achieved the target range, indicating a need for further adjustments to the formula to enhance its effectiveness in guiding oxygen therapy during CPB.

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January 7, 2024
Photo Safety GPT

Simulated Cardiopulmonary Bypass: A High Fidelity Model for Developing and Accessing Clinical Perfusion Skills

The study describes a simulated cardiopulmonary bypass (CPB) model integrated into a mock operative theater, aiming to enhance the training of novice perfusionists. Results from 81 participants indicated high fidelity and effectiveness of the simulation in replicating real CPB scenarios and skills, suggesting its potential for educational use in clinical perfusion training.

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January 5, 2024
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