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Category: Organ Perfusion

Cerebral 2024

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

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November 17, 2024
Cerebral 2024

Wavelet and Time-Based Cerebral Autoregulation Analysis Using Diffuse Correlation Spectroscopy on Adults Undergoing Extracorporeal Membrane Oxygenation Therapy

This study examines cerebral autoregulation (CA) in adult patients on extracorporeal membrane oxygenation (ECMO) therapy using diffuse correlation spectroscopy (DCS), a noninvasive approach to monitoring cerebral blood flow. Neurological injuries, common in ECMO patients due to underlying conditions or the therapy itself, can impair CA, potentially worsening brain damage. Using wavelet coherence analysis (WCA), researchers found that DCS-based markers identified significant CA differences in ECMO patients with brain injuries versus those without, highlighting the potential of DCS as a monitoring tool for this population.

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November 3, 2024
Heart Function

A Modified Intraventricular Balloon Method for Functional Assessment of Hearts From Donation After Circulatory Death

This study evaluates a modified intraventricular balloon method for functional assessment of hearts from donation after circulatory death. By using a saline-filled balloon in the left atrium, the study measures left ventricular pressure during reperfusion in juvenile pigs. Results show significant correlations between contractility and relaxation parameters measured by the modified method and those in working mode. This technique offers a mitral valve-sparing option for early heart viability assessment during ex-vivo heart perfusion.

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May 6, 2024
CytoSorb Drowning

Does Adjunctive Hemoadsorption Provide Benefit in the Management of Ischemia-Reperfusion Syndrome Following Near-Drowning? A Case Report

This case report examines the efficacy of adjunctive hemoadsorption using CytoSorb® in managing ischemia-reperfusion injury (IRI) following a near-drowning incident. Highlighting a critical case involving an adolescent, the study details the use of CytoSorb® alongside veno-venous extracorporeal membrane oxygenation (vvECMO) to address hyperinflammation triggered by reoxygenation after drowning. The intervention showed potential in mitigating the surge of pro-inflammatory mediators, suggesting a promising role for hemoadsorption in severe drowning cases.

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April 20, 2024
Cerebral Protection

Cannula Placement for Cerebral Protection Without Circulatory Arrest in Patients Undergoing Hemiarch Aortic Aneurysm Repair

This retrospective study evaluates the efficacy and outcomes of left carotid antegrade cerebral perfusion (LCP) versus traditional right-sided perfusion with hypothermic circulatory arrest in hemiarch aortic aneurysm repairs. The study, encompassing 68 patients between 2015 and 2019, suggests that LCP via distal arch cannulation is a viable and safer alternative, showing comparable clinical outcomes but reduced cardiopulmonary bypass and cerebral perfusion times. The findings advocate for LCP as a method that potentially reduces the risks associated with circulatory arrest.

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April 16, 2024
Liver Perfusion

The Use of Ex Situ Normothermic Machine Perfusion in Combined Cardiac and Liver Transplantation Procedures

Combined heart-liver transplantation (CHLT) is increasingly prevalent due to surgical and immunosuppression advancements. Indications for CHLT include familial amyloidosis, cardiac cirrhosis, dilated cardiomyopathy, and homozygous familial hypercholesterolemia. Challenges include hemodynamic instability and prolonged cold ischemia. Ex situ normothermic machine perfusion (NMP) offers a paradigm shift, allowing extended preservation times, facilitating hemodynamic stabilization post-cardiac surgery, and reducing metabolic disturbances during hepatic reperfusion. This article describes the first three CHLT procedures using ex situ NMP at Mayo Clinic Florida, highlighting its potential benefits.

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February 4, 2024

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