International Perfusion Association
This study investigated the relationship between plasma free hemoglobin levels and changes in urine color in cardiac surgery patients undergoing cardiopulmonary bypass. It found that changes in urine color or increases in urinary free hemoglobin occurred considerably later than elevations in plasma free hemoglobin levels.
This study analyzed 677 patients to investigate the correlation between the number of bypassed vessels, cardiopulmonary bypass duration, blood transfusion requirements, revision rates, and mortality in coronary artery bypass grafting surgeries. Results indicated that higher revision rates were associated with six-vessel bypasses, longer bypass and cross-clamp times, increased blood transfusions, and mortality, with specific blood thinners affecting transfusion needs and mortality outcomes.
This meta-analysis investigated the effect of perioperative antithrombin (AT) supplementation on patients undergoing cardiopulmonary bypass (CPB) surgery, analyzing 13 randomized controlled trials with 996 participants. The study found that perioperative AT did not significantly reduce postoperative blood loss or the need for blood transfusions, and it was associated with increased in-hospital mortality and acute kidney injury incidence.
In a study comparing the new oxygenator system RemoweLL 2 with the conventional Inspire device in elderly patients undergoing cardiopulmonary bypass, RemoweLL 2 showed a trend towards reduced incidence of severe post-operative delirium and lower levels of inflammation biomarkers. The study, assessing cognitive decline and inflammation in 154 patients, suggests that advanced CPB oxygenator technologies may lead to better neurocognitive outcomes in the elderly undergoing cardiac surgery.
The Society of Thoracic Surgeons Adult Cardiac Surgery Database, which includes data from over nine million procedures, underpins multiple risk models and has been pivotal in shaping health policy and cardiac surgery practices. This annual report updates on the database’s status, introduces new risk models, details current surgical trends, and outlines research and future directions for this extensive clinical resource.
Postoperative delirium (POD) following cardiac surgery, potentially influenced by cardiopulmonary bypass, is linked to increased morbidity and mortality despite understanding its causative factors and risk mitigation strategies. This review article discusses the incidence, impact, and primary risk factors of POD in cardiac surgical patients, along with anesthetic and postoperative therapeutic approaches to reduce its occurrence.
This study explores urinary collectrin as a potential biomarker for early detection of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass. It found significant perioperative changes in collectrin levels, particularly on postoperative day 1, indicating its promise for timely AKI diagnosis and intervention, though further research is needed for clinical validation.
The abstract outlines the evolving management of cardiogenic shock, highlighting the transition to using temporary mechanical circulatory support (t-MCS) like IABP, VA-ECMO, Impella, and ECPELLA, informed by advances in circulatory physiology. It emphasizes the importance of selecting appropriate t-MCS devices based on patient-specific conditions, shock stage, and risk, guided by hemodynamic monitoring and a multidisciplinary team approach.
Longer cardiopulmonary bypass (CPB) times were associated with increased ICU and in-hospital mortality, as well as longer ICU stays, in patients who developed acute respiratory distress syndrome (ARDS) after cardiac surgery. This study suggests that CPB duration is a significant predictor of short-term mortality in these patients, with times over 160.5 minutes increasing the risk of worse outcomes.
A study developed an ultrafiltration membrane method to measure colloid osmotic pressure (COP) and compared it with colloidal osmometer measurements, finding high accuracy, reproducibility, and positive correlation with existing methods. This new method shows potential for improved COP monitoring in clinical settings, suggesting implications for future research and clinical applications.
