Perfusion Instability During Hyperthermic Intraperitoneal Chemotherapy: The Utility of a Problem-solving Flowchart

March 6, 2025 No Comments

This study examines perfusion instability (PI) during hyperthermic intraperitoneal chemotherapy (HIPEC), where maintaining proper flow and temperature is crucial. A retrospective review of 208 HIPEC cases found a 10.1% incidence of PI. A step-by-step problem-solving flowchart was implemented, significantly improving perfusion stability. The study concludes that structured interventions can mitigate PI, though further research is needed to refine perfusion techniques.

Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments

March 1, 2025 No Comments

Vasoplegic syndrome (VS) is a severe circulatory condition occurring post-cardiopulmonary bypass (CPB), affecting up to 44% of high-risk patients with mortality rates reaching 50%. It is characterized by profound hypotension, vasopressor resistance, and vascular collapse. The review explores pathophysiology, risk factors, and treatments, including nitric oxide synthase inhibitors (methylene blue, hydroxocobalamin), vasopressors, and fluid management to mitigate complications and improve survival.

2024 EACTS/EACTAIC/EBCP Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery

February 16, 2025 No Comments

The 2024 EACTS/EACTAIC/EBCP guidelines provide updated, evidence-based recommendations for cardiopulmonary bypass (CPB) in adult cardiac surgery. They cover advancements in perfusion strategies, organ protection, monitoring techniques, and safety measures. Key updates include AI-driven perfusion, enhanced neuromonitoring, and refined protocols for blood management and CPB separation. These guidelines aim to standardize practices, improve outcomes, and ensure patient safety in modern cardiac surgery.

Innovative Balloon-Inflatable Venous Cannula for Enhanced Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery

February 9, 2025 No Comments

This study introduces the Aulus venous cannula, a novel device for minimally invasive cardiac surgery (MICS) designed to improve cardiopulmonary bypass (CPB). The cannula features heparin coating and internal balloons for superior and inferior vena cava occlusion, reducing external manipulation. Preclinical tests, including ex-vivo and large animal studies, demonstrated effective anticoagulation, precise positioning, and favorable safety outcomes, highlighting its potential for clinical use.

Trial of Oxygen Delivery on Cardiopulmonary Bypass and Major Clinical Outcomes

January 18, 2025 No Comments

This study investigates the impact of oxygen delivery (DO2) during cardiopulmonary bypass (CPB) on major clinical outcomes in cardiac surgery patients. Maintaining adequate DO2 during

Traditional vs. Modified Ringer Lactate-Based del Nido Cardioplegia: Impacts on Clinical Outcomes in Coronary Artery Bypass Grafting

December 26, 2024 No Comments

This prospective, randomized, and blinded study compared the impacts of traditional Plasma-Lyte A-based del Nido cardioplegia (PL DN) and a modified Ringer’s lactate-based formulation (LR DN) on clinical outcomes in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Results showed that while both formulations had similar effects on several clinical parameters, PL DN offered superior myocardial protection, as indicated by lower postoperative cardiac enzyme levels and reduced need for epinephrine.

A Technique Avoiding Cardioplegia Delivery Complications: A Case Using Systemic Hyperkalemia Cardiopulmonary Bypass Combined with Circulatory Arrest

December 24, 2024 No Comments

This case study details a novel approach to avoid cardioplegia delivery complications during a high-risk redo mitral valve replacement. The 75-year-old patient, with severe mitral regurgitation and mild aortic regurgitation, underwent minimally invasive surgery using systemic hyperkalemia and circulatory arrest. The method eliminated the need for aortic cross-clamping, achieving effective myocardial protection and an uneventful recovery, despite complex surgical challenges.

Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

December 23, 2024 No Comments

This study addresses the critical issue of oxygenator failure during cardiopulmonary bypass (CPB), a rare but high-risk event. It explores protocols and techniques for addressing oxygenator malfunction, including traditional oxygenator change-outs and alternative approaches like arterial and venous piggyback methods. The authors emphasize the need for institutional preparation, including written protocols and routine emergency drills, and propose a venous piggyback technique as a safer first-line response to improve patient outcomes.

Development of a Professional Advancement Model for Perfusionists

December 22, 2024 No Comments

The article introduces a Professional Advancement Model (PAM) tailored for perfusionists to address high turnover and enhance retention. Drawing from PAM frameworks in other healthcare professions like nursing and advanced practice providers, the author proposes a four-tier system: Perfusionist I through IV. Progression is determined by points earned in categories such as leadership, clinical excellence, education, and service, alongside experience requirements. The PAM offers structured career growth, salary increments, and institutional benefits, serving as a retention strategy and professional growth tool for perfusionists.

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

December 21, 2024 No Comments

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.