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Protamine Done

Protamine Dosing for Heparin Reversal After Cardiopulmonary Bypass: A Double-Blinded Prospective Randomized Control Trial Comparing Two StrategieS

This study compared two protamine dosing strategies for heparin reversal after cardiopulmonary bypass: a fixed 250-mg dose versus a 1:1 (1 mg:100 U heparin) ratio-based approach. The trial included 125 elective adult cardiac surgery patients. Both methods showed similar activated clotting times and postoperative bleeding, but the fixed-dose group used significantly less protamine. These results suggest fixed dosing may optimize drug conservation without compromising safety or efficacy.

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November 24, 2024
BSA CPB

Predictive Role of Cardiopulmonary Bypass Exposure Indexed to Body Surface Area on Postoperative Organ Dysfunction: A Retrospective Cohort Study

This study analyzed the relationship between cardiopulmonary bypass (CPB) exposure indexed to body surface area (bypass index) and postoperative outcomes in 2,413 cardiac surgery patients. A higher bypass index was predictive of increased hospital stay and organ dysfunction, particularly renal and cardiac rhythm issues, but not pulmonary dysfunction. These findings highlight the bypass index as a valuable metric for assessing risk and optimizing resource use during cardiac surgery.

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November 24, 2024
ELSO Awake

“Awake” Cannulation of Patients for Venovenous Extracorporeal Membrane Oxygenation: An Analysis of the Extracorporeal Life Support Organization Registry

This study analyzed the outcomes of “awake” cannulation, where patients remain breathing spontaneously during venovenous ECMO cannulation, using data from over 28,000 patients. Only 2.8% underwent awake cannulation, which was associated with similar survival rates to mechanical ventilation cannulation after propensity score matching. Awake cannulation, increasingly utilized over time, shows potential for reducing ventilator-related lung injury but requires further research to identify optimal patient cohorts.

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November 24, 2024
HGB AKI 2024

Association Between Plasma-Free Haemoglobin and Postoperative Acute Kidney Injury in Paediatric Cardiac Surgery: A Prospective Observational Study

This study investigates the link between plasma-free haemoglobin (PFH) and acute kidney injury (AKI) in children undergoing cardiopulmonary bypass (CPB) during cardiac surgery. Among 179 participants, 41% developed AKI. Peak PFH concentrations were significantly higher in patients with AKI, but multivariable analysis showed CPB duration and patient age, rather than PFH, as primary risk factors. This emphasizes CPB time management in mitigating AKI risk.

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November 24, 2024
Robo MVR

A Historical Perspective and Update on Robotic Mitral Valve Surgery

This study reviews the evolution of minimally invasive mitral valve repair, emphasizing the use of robotic platforms from 2005 to 2023. Analyzing 1,412 robotic repairs, it highlights improvements in outcomes, including reduced cross-clamp and bypass times and high repair durability. Degenerative disease was the most common indication, with 98.1% repair success and a ten-year survival rate exceeding 91%. The findings support robotic surgery as a durable, teachable, and safe option for mitral valve repair.

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November 19, 2024
DHCA

Temperature Management in Acute Type A Aortic Dissection Treatment: Deep vs. Moderate Hypothermic Circulatory Arrest

This study compares the clinical outcomes of deep hypothermic circulatory arrest (DHCA, <20°C) and moderate hypothermic circulatory arrest (MHCA, 20-28°C) in 143 patients undergoing acute type A aortic dissection surgery. DHCA was associated with higher rates of acute kidney injury (25.2% vs. 7.5%), delirium (22.3% vs. 5%), longer ICU stays, and greater complication risks compared to MHCA. While survival rates after two years were similar, MHCA proved to be safer and more beneficial in minimizing postoperative complications when feasible.

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November 17, 2024
Cerebral 2024

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

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November 17, 2024
IPA Mission Tanzania

Cardiac Institute in Tanzania: An Unforgettable Experience Empowered by the IPA Mission Scholarship

Joining a CardioStart mission to the Jakaya Kikwete Cardiac Institute in Tanzania provided an invaluable experience in delivering cardiac care in a low-resource setting. Supported by an International Perfusion Association (IPA) scholarship, I coordinated logistics, collected patient data, and collaborated with a global team of medical professionals. This experience highlighted the critical need for cardiac care in underserved regions and deepened my commitment to contributing to similar missions in the future.

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November 14, 2024
Cardioplegia 2024

Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

This study explores the potential benefits of gradual reperfusion in cardiac surgery patients experiencing cardioplegia-induced cardiac arrest, aiming to reduce ischemia-reperfusion injury. Fifty elective cardiac surgery patients were randomized into two groups: a hyperoxemic control group with conventional reoxygenation and a normoxemic study group with gradual reoxygenation. Results showed that gradual reperfusion was safe but did not significantly reduce ischemia-reperfusion injury compared to standard methods, although potassium levels were lower in the normoxemic group.

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November 3, 2024
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