Perfusion Techniques for an 800 g Premature Neonate Undergoing Arterial Switch Procedure for Transposition of the Great Arteries

March 20, 2024 No Comments

This article highlights the groundbreaking success in utilizing cardiopulmonary bypass (CPB) techniques for congenital heart surgery in premature neonates weighing less than 1000 g. Focusing on a case of a 28-week-old, 800 g neonate with transposition of the great arteries, the study discusses the challenges and innovations in perfusion techniques. Miniaturization of the CPB circuit, careful management of patient-to-circuit ratios, pharmacological distribution volumes, pressure gradients, and meticulous physiological environment control were key to mitigating risks such as volume shifts, electrolyte imbalance, and intracranial hemorrhage. This report underscores the feasibility and critical adjustments needed for successful CPB in extremely low birth weight neonates.

Prospective Randomized Double-Blind Study to Evaluate the Superiority of Vasopressin Versus Norepinephrine in the Management of Patients at Renal Risk Undergoing Cardiac Surgery with Cardiopulmonary Bypass (NOVACC Trial)

March 20, 2024 No Comments

The NOVACC trial, a multicentre, randomized, double-blind study, evaluates vasopressin against norepinephrine for patients at renal risk during cardiac surgery with cardiopulmonary bypass. Targeting the reduction of cardiac surgery-associated acute kidney injury (CS-AKI) and its associated morbidity and healthcare costs, the study is based on preliminary findings suggesting vasopressin’s potential to lower CS-AKI incidence and post-operative atrial fibrillation. With the primary endpoint being the occurrence of acute kidney injury and death, and secondary endpoints including a range of post-operative complications and medico-economic costs, the trial aims to demonstrate vasopressin’s effectiveness in reducing CS-AKI, mortality, and medical expenses.

Mean Arterial Pressure (MAP) Trial: Study Protocol for a Multicentre, Randomized, Controlled Trial to Compare Three Different Strategies of Mean Arterial Pressure Management during Cardiopulmonary Bypass

March 20, 2024 No Comments

The MAP Trial is a pioneering multicentre, randomized, controlled study comparing three strategies for managing mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) in heart surgery. It challenges the traditional “standard MAP” of 50-60 mmHg by introducing a “high MAP” (70-80 mmHg) and a “patient-tailored MAP” approach, aiming to optimize organ perfusion. The study’s primary goal is to identify the most effective MAP management technique by measuring serum lactate peaks as indicators of tissue hypoxia. Secondary outcomes include intraoperative oxygenation parameters and major postoperative complications, contributing to enhanced cardiac surgery results.

Fostering Open Communication in Perfusion and Cardiothoracic Surgery: A Critical Call to Action

March 17, 2024 No Comments

The article emphasizes the importance of open communication within the perfusion and cardiothoracic surgery community to improve patient safety and outcomes. It advocates for all team members, including nurses, anesthesiologists, and perfusionists, to actively share insights and concerns. A culture that encourages speaking up without fear of repercussions, coupled with the use of debriefs, root cause analyses, and data management systems, is essential for continuous improvement. The adoption of the WHO surgical safety checklist and a strong speak-up culture are highlighted as crucial steps for elevating perfusion care standards and enhancing patient care.

Exploring Online International Health Professions Education: A Mixed Methods Review

March 17, 2024 No Comments

This study investigates the feasibility and early outcomes of online international health professions education, specifically in Cardiovascular Perfusion. Using mixed methods, the research identified barriers, facilitators, and initial results of implementing an online Extracorporeal Science (ECS) program compared to traditional in-person training. Qualitative analysis highlighted primary and subthemes leading to targeted interventions in the ECS program design. Quantitative data showed no significant difference in student performance and satisfaction between online and traditional cohorts, indicating that online international education in health professions can achieve outcomes comparable to conventional methods.

Beating Heart Transplant Procedures Using Organs From Donors With Circulatory Death

March 12, 2024 No Comments

This study evaluates the safety and efficacy of the beating heart method for heart transplantation using donors deceased after circulatory death (DCD). Conducted on 10 male patients with end-stage heart failure, it found 100% survival without the need for postoperative extracorporeal membrane oxygenation (ECMO). This method, which potentially reduces ischemia reperfusion injury, suggests a promising approach to DCD heart transplantation that may lower the incidence of primary graft dysfunction. The findings are significant for institutions considering the use of DCD donors for heart transplants.

Perfusion Education and Training in Europe Anno 2023

March 5, 2024 No Comments

This article reviews the current state of perfusion education and training across Europe, highlighting the lack of uniform European regulations and accreditation. The European Board of Cardiovascular Perfusion (EBCP) aims to standardize training in line with national regulations. Data from 31 countries reveals diverse training practices. The EBCP’s efforts to define educational standards and competencies for perfusionists and to accredit dedicated schools are crucial for the profession’s recognition in Europe.

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery

February 14, 2024 No Comments

This retrospective study at the National Cardiovascular Center Harapan Kita analyzed 1056 on-pump CABG procedures from January 2019 to December 2022, finding that high preoperative systemic immune-inflammation index (SII) values were significantly associated with poor perioperative outcomes. Patients with an SII value ≥528.715 × 103/mm3 experienced longer surgery and cardiopulmonary bypass times, prolonged mechanical ventilation, ICU and hospital stays, and an increased risk of postoperative complications such as atrial fibrillation, cardiac arrest, acute myocardial infarction, and mortality. The study underscores the importance of preoperative SII values as predictors of morbidity and mortality in on-pump CABG surgery

Effects of Albumin and Crystalloid Priming Strategies on Red Blood Cell Transfusions in On-pump Cardiac Surgery: A Network Meta-analysis

February 8, 2024 No Comments

This network meta-analysis evaluates the impact of albumin and crystalloid priming strategies on red blood cell transfusion requirements in on-pump cardiac surgery. The study reviewed 830 studies and included 10 in the final analysis. The findings suggest that crystalloid priming may significantly decrease total perioperative red blood cell transfusions compared to albumin. However, the difference in postoperative transfusions was not statistically significant. Both direct comparisons and network meta-analysis indicate that albumin priming results in higher transfusion rates, suggesting a reconsideration of its use in cardiac surgery for optimal blood management.

Vacuum Assisted and Gravitational Venous Drainage in Aortic Valve Surgery: A Propensity-Match Study

February 6, 2024 No Comments

This study compared the early outcomes of isolated aortic valve replacement using Vacuum Assisted Venous Drainage (VAVD) and Gravity Venous Drainage (GVD). Data from 521 patients were analyzed through propensity match analysis, resulting in two cohorts of 129 patients each. The findings suggest that the use of VAVD is not associated with increased risks of postoperative complications or in-hospital mortality compared to GVD, with similar or better outcomes in certain aspects such as acute kidney injury. The study highlights the safety and efficacy of VAVD in cardiac surgery.

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Perfusion Techniques for an 800 g Premature Neonate Undergoing Arterial Switch Procedure for Transposition of the Great Arteries

Prospective Randomized Double-Blind Study to Evaluate the Superiority of Vasopressin Versus Norepinephrine in the Management of Patients at Renal Risk Undergoing Cardiac Surgery with Cardiopulmonary Bypass (NOVACC Trial)

Mean Arterial Pressure (MAP) Trial: Study Protocol for a Multicentre, Randomized, Controlled Trial to Compare Three Different Strategies of Mean Arterial Pressure Management during Cardiopulmonary Bypass

Fostering Open Communication in Perfusion and Cardiothoracic Surgery: A Critical Call to Action

Exploring Online International Health Professions Education: A Mixed Methods Review

Beating Heart Transplant Procedures Using Organs From Donors With Circulatory Death

Perfusion Education and Training in Europe Anno 2023

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery

Effects of Albumin and Crystalloid Priming Strategies on Red Blood Cell Transfusions in On-pump Cardiac Surgery: A Network Meta-analysis

Vacuum Assisted and Gravitational Venous Drainage in Aortic Valve Surgery: A Propensity-Match Study

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