International Perfusion Association

Perfusion News

AKI 2024

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

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VA ECMO

A Comparative Study of Femoral Artery and Combined Femoral and Axillary Artery Cannulation in Veno-Arterial Extracorporeal Membrane Oxygenation Patients

This study investigates the clinical outcomes of two cannulation strategies—femoral artery (FA) cannulation and combined femoral and axillary artery (FA+AA) cannulation—in patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac surgery. The FA+AA group showed significant benefits in reducing chronic renal failure, platelet drop, and creatinine levels. Despite similar 30-day mortality rates, the combined approach led to fewer complications and faster recovery.

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OPCABG 2024

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

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Protamine 101

Platelet Function Is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine

This study assessed platelet function and numbers in 39 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass (CPB). Platelet function was measured at six different points, including after protamine administration. Results showed no significant impairment of platelet function during CPB. However, platelet function was temporarily reduced after protamine but recovered within 3 hours post-surgery.

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CABG Block

In-Hospital Graft Occlusion in Post-Coronary Artery Bypass Grafting Patients in the Early Postoperative Period: A Systematic Review and Meta-Analysis

This study evaluates the incidence and risk factors of early in-hospital graft occlusion in post-coronary artery bypass grafting (CABG) patients. The meta-analysis, including 22 studies with 35,798 patients, found a 5% occlusion rate. The rate varied based on symptom-driven or systematic graft patency assessments. Vein graft presence, female gender, and other factors like composite grafts may increase the risk of early occlusion.

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Lung Ventilation

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

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Hemaglobin 2024

Association Between Perioperative Hemoglobin Decrease and Outcomes of Transfusion in Patients Undergoing On-Pump Cardiac Surgery: An Observational Study From Two Chinese Heart Centers

This study analyzed 8186 adult patients undergoing cardiac surgery to examine the impact of perioperative hemoglobin decrease (ΔHb) on red blood cell transfusion outcomes. Patients with greater hemoglobin decreases (≥50%) were found to have higher risks of complications like mortality and organ failure. Transfusions helped in some cases but became harmful when exceeding four units. The findings underscore the importance of careful transfusion management in cardiac surgery.

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Hemoperfusion

Efficacy of Adjunct Hemoperfusion Compared to Standard Medical Therapy on 28-Day Mortality in Leptospirosis Patients with Renal Failure and Shock: A Single-Center Randomized Controlled Trial

This study evaluates the impact of hemoperfusion (HP) on 28-day mortality in leptospirosis patients with renal failure and septic shock. A total of 37 patients were randomized to receive either standard medical therapy (SMT) or SMT with HP. The HP group showed a 36.84% risk reduction in 28-day mortality and significant improvements in inflammatory markers, renal function, and pulmonary function. Hemoperfusion was shown to be a safe and effective adjunct therapy, promoting faster recovery and increased survival rates.

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Thromboembolic Complications ECMO

Thromboembolic Complications in Continuous Versus Interrupted Anticoagulation During Venovenous Extracorporeal Membrane Oxygenation: A Multicenter Study

This study investigates thromboembolic complications in patients undergoing venovenous extracorporeal membrane oxygenation (ECMO) with continuous versus interrupted anticoagulation. Data from 346 patients across three ECMO centers were analyzed. Results showed no significant difference in thrombotic complications between the groups, although interruptions in anticoagulation were linked to increased thrombotic events as the frequency and duration of interruptions rose.

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IABP Cardiogenic Shock

The Intra-Aortic Balloon Pump as a Rescue Device: Do We Need to Shift Our Strategy for Cardiogenic Shock Rescue After Cardiac Surgery?

This study evaluates the efficacy of the intra-aortic balloon pump (IABP) as a rescue strategy for patients experiencing complications following cardiac surgery. Data from 10,591 patients between 2012 and 2020 were analyzed, revealing that IABP use is associated with increased early and one-year mortality, especially when deployed for more than four days or after cardiac arrest. The findings suggest alternative mechanical circulatory support methods may be more appropriate for severe cardiogenic shock.

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