International Perfusion Association

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IPA

Category: Perfusion

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
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
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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September 29, 2024
Brain ECMO

Brain Death Donors on Extracorporeal Membrane Oxygenation Support

This study examines 15 brain death donors on extracorporeal membrane oxygenation (ECMO) support, admitted to a specialized intensive care unit between 2018 and 2023. The study evaluates the effect of a strict hemodynamic monitoring schedule during a 6-hour observation period on the utilization rate of organs. Results show an increase in utilization rates from 78% to 88% with no significant differences in donor characteristics or hemodynamic data between periods. Most donors required multiple vasoactive drugs to maintain adequate perfusion.

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September 1, 2024
Haemo

Intraoperative Haemoadsorption for Antithrombotic Drug Removal During Cardiac Surgery: Initial Report of the International Safe and Timely Antithrombotic Removal (STAR) Registry

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.

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August 20, 2024
CPB 2024

Standard Versus High Cardiopulmonary Bypass Flow Rate: A Randomized Controlled Subtrial Comparing Brain Injury Biomarker Release

This study aimed to compare the release of brain injury biomarkers between standard and high cardiopulmonary bypass (CPB) flow rates during elective cardiac surgery. Conducted at Sahlgrenska University Hospital in Sweden, forty patients were randomly assigned to either a standard (2.4 L/min/m²) or high (2.9 L/min/m²) CPB flow rate. The results indicated no significant differences in biomarker levels or the occurrence of postoperative delirium between the two groups. Age and sex were among factors associated with biomarker levels.

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August 8, 2024
OR Ready

Global Perfusion Practice Survey: Readiness of On-Call and Emergency Operation Rooms

This survey examines the readiness of on-call and emergency operation rooms for perfusion-related procedures during urgent situations in cardiac surgery. Data from 236 healthcare professionals highlight varied preferences for circuit readiness, influenced by caseload, response times, and other factors. The study underscores the need for standardized protocols to enhance perfusion safety and improve patient care.

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August 5, 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
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