International Perfusion Association

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IPA

Category: Perfusion

EBCP 2024 Guidelines

2024 EACTS/EACTAIC/EBCP Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery

The 2024 EACTS/EACTAIC/EBCP guidelines provide updated, evidence-based recommendations for cardiopulmonary bypass (CPB) in adult cardiac surgery. They cover advancements in perfusion strategies, organ protection, monitoring techniques, and safety measures. Key updates include AI-driven perfusion, enhanced neuromonitoring, and refined protocols for blood management and CPB separation. These guidelines aim to standardize practices, improve outcomes, and ensure patient safety in modern cardiac surgery.

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February 16, 2025
Balloon IABP

Innovative Balloon-Inflatable Venous Cannula for Enhanced Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery

This study introduces the Aulus venous cannula, a novel device for minimally invasive cardiac surgery (MICS) designed to improve cardiopulmonary bypass (CPB). The cannula features heparin coating and internal balloons for superior and inferior vena cava occlusion, reducing external manipulation. Preclinical tests, including ex-vivo and large animal studies, demonstrated effective anticoagulation, precise positioning, and favorable safety outcomes, highlighting its potential for clinical use.

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February 9, 2025
Traditional vs. Modified Ringer Lactate-Based del Nido Cardioplegia

Traditional vs. Modified Ringer Lactate-Based del Nido Cardioplegia: Impacts on Clinical Outcomes in Coronary Artery Bypass Grafting

This prospective, randomized, and blinded study compared the impacts of traditional Plasma-Lyte A-based del Nido cardioplegia (PL DN) and a modified Ringer’s lactate-based formulation (LR DN) on clinical outcomes in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Results showed that while both formulations had similar effects on several clinical parameters, PL DN offered superior myocardial protection, as indicated by lower postoperative cardiac enzyme levels and reduced need for epinephrine.

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December 26, 2024
A Technique Avoiding Cardioplegia Delivery Complications: A Case Using Systemic Hyperkalemia Cardiopulmonary Bypass Combined with Circulatory Arrest

A Technique Avoiding Cardioplegia Delivery Complications: A Case Using Systemic Hyperkalemia Cardiopulmonary Bypass Combined with Circulatory Arrest

This case study details a novel approach to avoid cardioplegia delivery complications during a high-risk redo mitral valve replacement. The 75-year-old patient, with severe mitral regurgitation and mild aortic regurgitation, underwent minimally invasive surgery using systemic hyperkalemia and circulatory arrest. The method eliminated the need for aortic cross-clamping, achieving effective myocardial protection and an uneventful recovery, despite complex surgical challenges.

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December 24, 2024
Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

This study addresses the critical issue of oxygenator failure during cardiopulmonary bypass (CPB), a rare but high-risk event. It explores protocols and techniques for addressing oxygenator malfunction, including traditional oxygenator change-outs and alternative approaches like arterial and venous piggyback methods. The authors emphasize the need for institutional preparation, including written protocols and routine emergency drills, and propose a venous piggyback technique as a safer first-line response to improve patient outcomes.

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December 23, 2024
Perfusion Ladder

Development of a Professional Advancement Model for Perfusionists

The article introduces a Professional Advancement Model (PAM) tailored for perfusionists to address high turnover and enhance retention. Drawing from PAM frameworks in other healthcare professions like nursing and advanced practice providers, the author proposes a four-tier system: Perfusionist I through IV. Progression is determined by points earned in categories such as leadership, clinical excellence, education, and service, alongside experience requirements. The PAM offers structured career growth, salary increments, and institutional benefits, serving as a retention strategy and professional growth tool for perfusionists.

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December 22, 2024
Monitoring Oxygen Delivery

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.

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December 21, 2024
Cerebral Perfusion

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Associated with Postoperative Delirium in Cardiac Surgery Patients: A Prospective Observational Study

This study investigates the relationship between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Despite reduced cortical metabolism, patients with POD exhibited increased cerebral blood flow, measured via transcranial Doppler. Low bispectral index (BIS) values indicated reduced metabolism, but no differences in autoregulation impairments were noted. The findings suggest a mismatch between cerebral blood flow and metabolism contributes to POD, independent of cerebral autoregulation.

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December 21, 2024
Hypertrophic Cardiomyopathy

Anesthetic Precision in Severe Hypertrophic Cardiomyopathy: Navigating Perioperative Challenges

This case report details the anesthetic management of a 77-year-old female with hypertrophic obstructive cardiomyopathy (HOCM), undergoing surgery for ileal adenocarcinoma. It highlights challenges such as preventing left ventricular outflow tract obstruction and maintaining hemodynamic stability. A tailored approach, including vigilant monitoring, goal-directed fluid therapy, and careful use of vasopressors, ensured successful outcomes. The report underscores the importance of meticulous perioperative planning in HOCM cases.

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December 10, 2024
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