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Patient Blood Management

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

This study evaluated the methodology and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery under cardiopulmonary bypass (CPB). It analyzed nine guidelines using the AGREE II tool, finding that “Stakeholder involvement” scored lowest. Drug therapy strategies include anemia therapy, antithrombotic and anticoagulation drugs, and hemostatic drugs, with distinct recommendations for pediatric and adult patients.

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June 29, 2024
Haemoadsorption

Impact of Extracorporeal Haemoadsorption During Prolonged Cardiopulmonary Bypass on the Incidence of Acute Kidney Injury

This study investigates the effects of haemoadsorption (HA) therapy on inflammatory markers and renal damage indices during cardiopulmonary bypass (CPB) and the early postoperative period. Conducted at a single tertiary care center, the retrospective analysis compared three groups of patients who underwent CPB for over 120 minutes. The results showed that haemoadsorption therapy did not significantly reduce the incidence of acute kidney injury (AKI) but decreased the need for renal replacement therapy.

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June 26, 2024
Perform Report

Perfusion Measures and Outcomes (PERForm) Registry: First Annual Report

The first annual report of the Perfusion Measures and Outcomes (PERForm) registry details patient characteristics and cardiopulmonary bypass (CPB) practices from 2019 to 2022 across 42 hospitals. Covering data from 40,777 adult patients, the report highlights trends in myocardial protection, glucose, anticoagulation, temperature, anemia, and fluid management. Key findings include the stability of hematocrit levels and increased pump sucker termination before protamine administration, indicating improved compliance with evidence-based guidelines but identifying areas for enhanced patient safety.

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June 23, 2024
ECMO Pressure Monitoring

Quantifying Potential Fluid Transfused Through Pressure Monitoring and Circuit Flushes in Pediatric ECMO Patients

This study investigates the fluid volume transfused to pediatric ECMO patients via pressure monitoring circuits, an area currently lacking published data or guidelines. Using in vitro experiments with Edwards True Wave transducers and pressure bags, the study measured fluid volumes from passive and active flushing methods. Results showed that maintaining patency with a pressurized IV bag can transfuse approximately 319.6 mL daily, close to a neonate’s total blood volume. Automated syringe pumps, however, significantly reduce this volume to 24 mL per day. The findings suggest the need for further research to establish best practices.

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June 22, 2024
Perfusion Learning

Adapting and Applying Student-Centered Learning in a Perfusion Clinical Rotation

This study outlines the transformation of perfusion clinical education from a teacher-centered to a student-centered model. By incorporating reflective practice, self-evaluation, and problem-based learning, the Mayo Clinic’s Perfusion Work Group aims to enhance the clinical training of student perfusionists. Changes include reversing student preceptor evaluations, biweekly student-led educational sessions, and establishing clear skill levels. These methods foster reflective practice, self-assessment, and evidence-based learning, ultimately promoting lifelong reflective perfusionists.

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June 22, 2024
Liver Bypass

Venovenous Bypass in Liver Transplantation: Exploring the Benefits, Efficacy, and Safety

This article explores the utilization of venovenous bypass (VVB) in liver transplantation (LT), highlighting its benefits, efficacy, and safety. Although VVB helps maintain hemodynamic stability and improve patient outcomes, its global use has declined due to concerns about heparinization, major bleeding, and the need for specialized expertise. Recent advancements in percutaneous cannulation techniques and extracorporeal technology have enhanced the safety of VVB. Studies show that VVB reduces the incidence of acute kidney injury, operative time, and blood loss without increasing morbidity or mortality. Despite these benefits, alternative techniques are being increasingly adopted. The article emphasizes the role of VVB in complex clinical scenarios and calls for continued research to optimize its application in liver transplantation.

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June 19, 2024
AI TEE

Continuous Monitoring of Left Ventricular Function in Postoperative Intensive Care Patients Using Artificial Intelligence and Transesophageal Echocardiography

This study explores the efficacy of using artificial intelligence (autoMAPSE) with transesophageal echocardiography (TEE) to continuously monitor left ventricular (LV) function in postoperative intensive care patients. The prospective observational study involved 50 patients, monitored for 120 minutes post-cardiac surgery. Results showed that autoMAPSE provided precise, low-bias, and concordant measurements compared to manual methods, demonstrating excellent feasibility and trending ability.

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June 13, 2024
Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

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June 12, 2024
Easy Flow Simulation

Easy Flow: An Eclectic Cardiopulmonary Bypass Simulation Model

The “Easy Flow Cardiopulmonary Bypass Simulation Model” offers a cost-effective, innovative approach to perfusion training using standard CPB equipment found in operating rooms. Unique features include double reservoirs and two pumps, enhancing skill development, team management, communication, and disaster response training. This model, requiring an instructor, turns theoretical knowledge into practical competence, making it accessible and beneficial for global healthcare education.

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June 11, 2024
Honduras Mission Summary

IPA Honduras Mission with Duke Health and Mass General

Our Honduras Mission team, in collaboration with Duke University and Harvard (Mass General), successfully completed a cardiac surgery mission trip in Tegucigalpa, Honduras. Thirty-two clinicians volunteered to perform surgeries on 38 patients, including 15 children, with highly positive outcomes. This mission was supported by local partners, financial backers, and various companies providing essential resources. The trip highlights the profound impact of collaborative efforts in providing critical healthcare to underserved communities.

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June 10, 2024
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