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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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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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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Heart Function

A Modified Intraventricular Balloon Method for Functional Assessment of Hearts From Donation After Circulatory Death

This study evaluates a modified intraventricular balloon method for functional assessment of hearts from donation after circulatory death. By using a saline-filled balloon in the left atrium, the study measures left ventricular pressure during reperfusion in juvenile pigs. Results show significant correlations between contractility and relaxation parameters measured by the modified method and those in working mode. This technique offers a mitral valve-sparing option for early heart viability assessment during ex-vivo heart perfusion.

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CPB Time

The Impact of Cardiopulmonary Bypass Time on the Sequential Organ Failure Assessment Score After Cardiac Surgery

This study investigates the effect of cardiopulmonary bypass (CPB) time on postoperative Sequential Organ Failure Assessment (SOFA) scores. The analysis of data from 1,032 patients reveals that longer CPB times correlate with higher SOFA scores, particularly affecting cardiovascular and renal functions. Prolonged CPB times (>200 minutes) are associated with an increased likelihood of severe dysfunction, emphasizing the predictive power of CPB duration on postoperative organ health.

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Infection 1

Nosocomial Infections After Pediatric Congenital Heart Disease Surgery: Data from National Center for Cardiovascular Diseases in China

This study evaluates nosocomial infections in pediatric patients post-cardiac surgery, analyzing data from the National Center for Cardiovascular Diseases in China. Out of 4776 patients, the nosocomial infection rate was 2.1%, with multidrug-resistant organisms (MDROs) found in 36 patients. Pneumonia and sepsis were the most common infections, with pneumonia showing an incidence density of 7.2/1000 patient-days. MDRO infections were associated with significantly longer intensive care unit stays compared to non-MDRO infections. The results highlight the impact of MDRO infections on surgical outcomes and the importance of infection prevention and control measures.

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Myocardial Protection

Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass

This study investigates the effects of dexmedetomidine (Dex) pretreatment in patients undergoing cardiac valve replacement under cardiopulmonary bypass. In the Dex group, the time to the first rescue dose of propofol was longer, and the total propofol dosage was less than in the control group. Additionally, the Dex group showed reduced cardiac injury markers and inflammation, requiring less mechanical ventilation time than the control group. The findings suggest that Dex pretreatment offers myocardial protection and optimizes postoperative outcomes.

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Goal Directed Perfusion

Intraoperative Goal-Directed Perfusion in Cardiac Surgery with Cardiopulmonary Bypass: The Roles of Delivery Oxygen Index and Cardiac Index

This study explores the efficacy of intraoperative Goal-Directed Perfusion (GDP) in reducing postoperative complications, ICU, and hospital stay durations in cardiac surgery using cardiopulmonary bypass. By monitoring and optimizing oxygen delivery and cardiac index, GDP significantly lowered ICU stays and hospital lengths of stay, although it did not significantly affect mortality rates.

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