International Perfusion Association

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IPA

Category: Perfusion

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
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
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
Surgery in Progress

New Approach to the Mitral Valve Through the Left Anterior Minithoracotomy for Combined Valve and Coronary Surgical Procedures

A new technique for accessing the mitral valve via the left anterior minithoracotomy has been developed for patients requiring both mitral valve surgery and coronary artery bypass grafting. From October 2020 to September 2022, 24 patients underwent this procedure, which involved specialized exposure maneuvers and conventional surgical techniques. The approach proved successful with no need for conversion to sternotomy, no major complications, and no mortality within 30 days post-procedure.

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June 8, 2024
Priming Solution

A Modified Low-Priming Cardiopulmonary Bypass System in Patients Undergoing Cardiac Surgery with Medium Risk of Transfusion: A Randomized Controlled Trial

This study evaluates the FUWAI-SAVE system, a modified low-priming cardiopulmonary bypass (CPB) system, in reducing perioperative blood transfusions in adult patients undergoing cardiac surgery with intermediate transfusion risk. Conducted as a single-center, single-blind, randomized controlled trial, 360 patients were divided into an intervention group (FUWAI-SAVE) and a control group (conventional CPB). Results showed the FUWAI-SAVE system significantly reduced red blood cell transfusion rates and amounts during the peri-CPB period without increasing major complications, indicating its potential in improving blood management in cardiac surgery.

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June 5, 2024
N Regional Lung

Lung Transplantation in Controlled Donation After Circulatory-Determination-of-Death Using Normothermic Abdominal Perfusion

The shortage of suitable lung donors remains a significant challenge in lung transplantation. While brain-death donors (DBD) currently provide most lung allografts, only 20% are suitable for transplantation. This review discusses the potential of using donors after circulatory-determination-of-death (DCD) to increase the donor pool. Emphasizing controlled DCD (cDCD) donors, the article outlines the importance of ICU management and expertise in organ procurement, presenting a protocol for lung retrieval using normothermic abdominal perfusion.

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June 1, 2024
FDA Warning

Safety and Quality Concerns with Getinge Cardiovascular Devices – Letter to Health Care Providers

On May 8, 2024, the FDA warned healthcare providers about ongoing safety concerns with Getinge/Maquet cardiovascular devices, specifically the Cardiosave Hybrid and Rescue IABP devices and the Cardiohelp system with HLS Sets. Despite corrective actions, these devices pose significant risks. The FDA advises transitioning to alternatives and reporting adverse events. Multiple recalls and serious injury reports have highlighted persistent issues with these devices, leading to enhanced FDA oversight.

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May 12, 2024
RBC Tube

Impact of Miniaturized vs. Conventional Tubing on Inflammatory Response and Blood Transfusion in Congenital Heart Disease Surgeries

This study compares inflammatory cytokine levels and blood transfusion rates in pediatric patients undergoing congenital heart surgeries using miniaturized or conventional extracorporeal circuits. Results indicate that miniaturized circuits may reduce certain cytokines and lower transfusion requirements, suggesting a potential advantage in reducing surgery-related complications.

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May 7, 2024
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