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CRRT Particles

Spallation and Particles Infusion into the Extracorporeal Circuit During CRRT: A Preventable Phenomenon

This study investigates the infusion of microparticles in CRRT circuits, identifying disposable components like tubing and bags as sources. It highlights the effective role of in-line filters in reducing these particles, demonstrating a decrease in microparticle concentration from 14 mg/mL to 11 mg/mL post-filter. The study suggests that using in-line filters can mitigate iatrogenic damage and improve patient outcomes during extracorporeal treatments in intensive care.

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April 25, 2024
Noncompete

FTC Announces Rule Banning Noncompetes

The Federal Trade Commission (FTC) has issued a final rule banning noncompete agreements nationwide, aiming to enhance job mobility, increase innovation, and stimulate new business growth. The rule is anticipated to create over 8,500 new businesses annually and could raise worker wages by an average of $524 per year. It also projects to reduce healthcare costs by up to $194 billion over the next decade and potentially increase patent registrations significantly.

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April 24, 2024
Blue Legs

Evolution of Distal Limb Perfusion Management in Adult Peripheral Venoarterial Extracorporeal Membrane Oxygenation with Femoral Artery Cannulation

This narrative review explores the advancements in managing distal limb perfusion in venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. Initially, no specialized techniques like distal perfusion cannulae were used, leading to limb ischemia. Recent innovations include prophylactic measures, various cannulation methods, and improved venous drainage techniques to enhance limb perfusion and reduce ischemic complications. Advanced monitoring tools like near-infrared spectroscopy aid in decision-making and management.

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April 23, 2024
LVAD

Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score

This study evaluates the mortality risk associated with infections in patients with left ventricular assist devices (LVAD). It highlights the development of a clinical risk prediction score based on factors like diabetes, type of Staphylococcus aureus infection, and treatment approaches including surgical debridement and flap reconstruction. Results indicate varying survival rates based on risk scores, suggesting that tailored surgical interventions may improve outcomes for patients with LVAD infections.

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April 23, 2024
Coronary Clock

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After On-Pump Coronary Artery Bypass Surgery

A study investigating the role of the systemic immune-inflammation index (SII) in predicting outcomes for patients undergoing on-pump coronary artery bypass graft (CABG) surgery found significant correlations. High preoperative SII values were linked to prolonged surgery and cardiopulmonary bypass times, extended ICU and hospital stays, and increased risks of severe complications such as atrial fibrillation, cardiac arrest, and mortality.

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April 23, 2024
Critical Care Advances

21st Century Critical Care Medicine: An Overview

Critical care medicine has made significant advancements in the 21st century, notably improving patient outcomes in ICUs. Innovations such as Precision Medicine, Telemedicine, AI-driven tools, advanced Organ Support, new Infection Control tactics, refined Ventilation Strategies, and enhanced Sepsis Management reflect a dynamic landscape. These developments prioritize technology, research, and patient-centered approaches, showcasing a promising future for addressing modern medical challenges.

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April 23, 2024
World Hemo

Effect of Geography on the Use of Ultrafiltration During Cardiac Surgery with Cardiopulmonary Bypass

This study explores geographic differences in ultrafiltration (UF) use during cardiopulmonary bypass in the US, analyzing data from 92,859 cardiac surgeries across four regions. Results reveal significant regional disparities in UF usage and volumes, with the Northeast and West employing UF more frequently than the Midwest and South. Variations were also noted in intraoperative urine output and red blood cell transfusion rates, prompting calls for further research into the causes of these differences.

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April 22, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

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April 22, 2024
Mad Kidney

Risk Prediction Models for Renal Function Decline After Cardiac Surgery Within Different Preoperative Glomerular Filtration Rate Strata

This study focuses on developing risk prediction models to identify patients at risk of renal function decline post-cardiac surgery. Using data from 24,904 patients at Fuwai Hospital, the study found significant variances in renal decline risks across different preoperative glomerular filtration rate (eGFR) strata. Notably, patients with higher eGFR levels pre-surgery showed increased risk. The research produced distinct nomograms for each eGFR category, demonstrating good predictive accuracy and providing a practical tool for postoperative renal monitoring.

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April 21, 2024
Blood Hero

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluates the methodological quality and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery involving cardiopulmonary bypass (CPB). Analyzing guidelines using the AGREE II tool, it highlights varying consistency across documents, especially in stakeholder involvement. The study reviews drug therapy strategies including anemia therapy, perioperative antithrombotic administration, intraoperative anticoagulation, and hemostatic drug use, noting a lack of pediatric-specific evidence and the cautious use of certain drugs post-surgery.

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April 21, 2024
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