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.

What Are the Minimal Criteria of Goal-Directed Perfusion (GDP) in Adult Cardiac Surgery?

February 2, 2024 No Comments

The goal-directed perfusion (GDP) strategy is increasingly adopted in cardiac surgery to maintain optimal perfusion, improving patient outcomes by serving as a quality control tool for monitoring the practice of perfusionists and the use of equipment and disposables. It emphasizes intensive monitoring of respiratory-related parameters, optimal flow, and management of intraoperative parameters to protect end-organ function and enhance surgical outcomes, with the findings advocating for its superiority over traditional perfusion strategies and highlighting the importance of developing protocols within international guidelines.

How to Become a Perfusionist in the United States

January 30, 2024 No Comments

Perfusionists are specialized healthcare professionals trained in operating heart-lung machines during open-heart surgeries and various auxiliary devices. Their education involves diverse pathways, including undergraduate courses in sciences, post-baccalaureate certificates, and master’s degrees, all leading to eligibility for certification and consistent job opportunities across different educational levels.