Thoracoabdominal Normothermic Regional Perfusion: Real-World Experience and Outcomes of DCD Liver Transplantation

March 16, 2025 No Comments

This study evaluates the effectiveness of thoracoabdominal normothermic regional perfusion (TA-NRP) in liver transplantation from donation after circulatory death (DCD) donors. Compared to static cold storage (SCS), TA-NRP significantly reduces ischemic cholangiopathy (IC) at six months (1.2% vs. 9.5%, p = 0.03), despite higher-risk donor-recipient pairs. The findings suggest TA-NRP improves organ utilization and supports its integration into liver transplantation protocols.

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

March 15, 2025 No Comments

This study examines the impact of gradual oxygen exposure during emergency coronary bypass surgery for acute myocardial infarction (MI). A retrospective cohort of 66 patients was analyzed, comparing outcomes between those receiving venous blood cardioplegia with controlled oxygen exposure and those undergoing standard hyperoxic procedures. The findings indicate a significant reduction in mortality, improved ventricular function, lower readmission rates for heart failure, and reduced need for defibrillators.

Variability in Triggers for Mechanical Left Ventricular Unloading in VA-ECMO: A Literature Search

March 13, 2025 No Comments

VA-ECMO provides critical cardiopulmonary support but increases left ventricular afterload, potentially leading to left ventricular distension (LVD). This literature review explores various clinical, hemodynamic, and imaging-based triggers for mechanical LV unloading. Findings highlight significant variability in defining LVD and initiating mechanical unloading. The study underscores the need for standardized criteria to optimize patient outcomes while minimizing risks associated with invasive procedures.

Limiting the Gamble: Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

March 11, 2025 No Comments

This study investigates risk factors for renal replacement therapy (RRT) in patients receiving mechanical circulatory support (MCS). A retrospective analysis of 129 patients revealed an RRT incidence of 36%. Key risk factors include prior immunologic therapy and the presence of pacemakers or internal cardiac defibrillators. Unfractionated heparin showed minimal protection against RRT. Findings suggest systemic inflammation plays a role, emphasizing the need for alternative anticoagulation strategies.

Perfusion Instability During Hyperthermic Intraperitoneal Chemotherapy: The Utility of a Problem-solving Flowchart

March 6, 2025 No Comments

This study examines perfusion instability (PI) during hyperthermic intraperitoneal chemotherapy (HIPEC), where maintaining proper flow and temperature is crucial. A retrospective review of 208 HIPEC cases found a 10.1% incidence of PI. A step-by-step problem-solving flowchart was implemented, significantly improving perfusion stability. The study concludes that structured interventions can mitigate PI, though further research is needed to refine perfusion techniques.

Kidney Injury Under Diminished Pulsatile Flow Induced by V-A ECMO in Sheep

February 25, 2025 No Comments

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention used for critically ill patients, yet it is frequently associated with high incidences of kidney injury. This

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

February 22, 2025 No Comments

This study examines risk factors affecting survival in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) treated with extracorporeal membrane oxygenation (ECMO). Analyzing 63 cases from 2020–2023, findings indicate that elevated arterial blood lactate, prolonged time to PCI, and higher vasoactive-inotropic scores (VIS) are key predictors of poor prognosis. Early intervention, including timely PCI and metabolic stabilization, is crucial to improving survival outcomes.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

February 6, 2025 No Comments

This expert consensus document from the American Association for Thoracic Surgery outlines standardized best practices for donor lung procurement and preservation. It highlights significant variability in existing techniques and emphasizes the role of ex vivo lung perfusion (EVLP), cold storage, and normothermic regional perfusion. The document provides 34 evidence-based recommendations aimed at improving organ utilization and lung transplant outcomes.

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

January 2, 2025 No Comments

This study evaluates the effectiveness of Trendelenburg position and carotid ultrasound in predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Findings reveal that carotid corrected flow time (FTcBaseline) and stroke volume index variation (ΔSVITrend) are accurate and non-invasive predictors. These methods outperform traditional markers like pulse pressure variation, enhancing fluid management strategies in critical care.