Calculated vs Reality: The CPB Balancing Act

Is Continuous In-Line Blood Gas Monitoring Reliable During Cardiopulmonary Bypass When PaO2 and PaCO2 Are Calculated Rather Than Measured?

March 17, 2026 No Comments

This study evaluates the accuracy of calculated versus measured blood gas values during cardiopulmonary bypass using the Quantum System. In 81 patients, calculated PaO2 was significantly overestimated before calibration and during rewarming, often exceeding acceptable error limits. PaCO2 performed better but drifted with temperature changes. Findings highlight limitations of formula-based monitoring and emphasize the need for calibration and cautious interpretation.

Suction Flow and Reservoir Levels Driving Microemboli During Cardiopulmonary Bypass

The Effect of Surgical Field Suction Flow Rate and Venous Reservoir Levels on Gaseous Microemboli Transmission

March 17, 2026 No Comments

This in vitro study investigated how suction flow rate and venous reservoir level influence gaseous microemboli (GME) during cardiopulmonary bypass. Using a mock CPB circuit with bovine blood, higher suction speeds and lower reservoir levels significantly increased GME transmission. The interaction between these variables was strongest at the venous line, while arterial filtration reduced but did not eliminate emboli.

Global Research Trends and Hotspots in Extracorporeal Membrane Oxygenation for Cardiogenic Shock: A Bibliometric Review and Knowledge Mapping Approach (1990–2024)

March 14, 2026 No Comments

This bibliometric study analyzed global research trends in extracorporeal membrane oxygenation (ECMO) for cardiogenic shock from 1990–2024. Using 701 publications from 55 countries, the authors mapped collaborations, influential institutions, and evolving research themes. Major topics include postcardiotomy shock, extracorporeal cardiopulmonary resuscitation (ECPR), acute myocardial infarction–related shock, and ECMO bridging to transplant. Research focus has shifted toward predictive scoring systems, standardized protocols, and long-term patient outcomes.

Prevalence of Musculoskeletal Disorders Among Perfusion Staff in Germany

March 11, 2026 No Comments

This nationwide cross-sectional study investigated the prevalence of musculoskeletal disorders (MSDs) among perfusionists working in German cardiac centers. Using the Nordic Musculoskeletal Questionnaire, researchers surveyed 287 professionals. Results showed that 86% reported MSD symptoms within the past year, most commonly in the lower back and neck. Increasing age and years of professional experience were associated with higher prevalence, highlighting the need for ergonomic improvements and occupational health strategies.

Precision Life Support: VV ECMO Management in the Modern ICU

Evidence-Based Guidelines for the Use of Extracorporeal Membrane Oxygenation in Australia and New Zealand Using GRADE Methodology Series Part 1: Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) Indications and Management

March 7, 2026 No Comments

This guideline provides evidence-based recommendations for the use of venovenous extracorporeal membrane oxygenation (VV ECMO) in adult patients with severe respiratory failure. Developed using the GRADE methodology by experts across Australia and New Zealand, it evaluates indications for ECMO, management strategies, proning during ECMO, and ventilation approaches. Evidence suggests ECMO improves short-term survival in severe hypoxic respiratory failure but carries significant risks and resource demands.

Goal-Directed Perfusion Monitoring During Cardiopulmonary Bypass

Mini-Compendium on Goal-Directed Perfusion (GDP): Integrating Hemodynamic and Metabolic Determinants of Oxygen Delivery During Cardiopulmonary Bypass

March 5, 2026 No Comments

This narrative review presents a mini-compendium on Goal-Directed Perfusion (GDP), a physiology-based strategy for optimizing cardiopulmonary bypass. GDP integrates oxygen delivery, metabolic indicators, and perfusion pressure to maintain tissue oxygenation and prevent organ injury. Key variables such as DO₂i, O₂ extraction, CO₂ production, and MAP are combined with time-dose models to detect oxygen debt early and personalize perfusion management.

Leveraging the Perfusionist-Surgeon Dyad to Improve the Culture of Safety

February 27, 2026 No Comments

This article describes how a cardiac surgery program at Massachusetts General Hospital transformed its operating room culture by leveraging the unique perfusionist-surgeon relationship. By promoting psychological safety, challenging hierarchical assumptions, and implementing structured guidelines, checklists, and multidisciplinary briefings, the team improved communication, recruitment, teamwork, and resilience. The initiative demonstrates how deliberate cultural change enhances safety and performance.

Intravenous Lidocaine Infusion During Cardiopulmonary Bypass Cardiac Surgery

Evaluation of the Effect of Intravenous Lidocaine on the Systemic Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized Clinical Trial

February 16, 2026 No Comments

This single-center, double-blind randomized clinical trial (LEONARD Trial) evaluates whether intravenous lidocaine reduces systemic inflammation triggered by cardiopulmonary bypass in elective valvular and/or coronary cardiac surgery. Ninety patients will receive lidocaine or placebo, with IL-6 at 6 hours postoperatively as the primary endpoint. Secondary outcomes include inflammatory biomarkers, organ dysfunction, atrial fibrillation, ICU stay, opioid use, and 30-day mortality.

Pediatric Cardiac Patients with Pulmonary Hemorrhage Supported on ECMO: An ELSO Registry Study

March 15, 2025 No Comments

This study examines pediatric cardiac patients with pulmonary hemorrhage (PH) supported on extracorporeal membrane oxygenation (ECMO) using data from the ELSO registry (2011–2020). Analyzing 161 cases, the study identifies high-frequency oscillatory ventilation (HFOV) before ECMO cannulation as a key predictor of survival. The absence of hemorrhagic and renal complications also improved outcomes. Findings suggest that optimized pre-ECMO ventilation strategies may enhance survival rates in these high-risk patients.

Development and Validation of a Checklist for Cardiopulmonary Bypass

March 10, 2025 No Comments

This study focuses on developing and validating a checklist for cardiopulmonary bypass (CPB) to enhance patient safety and reduce adverse events. Using the Delphi method, five expert perfusionists refined an initial 42-item checklist down to 41 crucial elements. The final checklist standardizes CPB procedures, ensuring systematic verification of equipment and protocols. The study highlights the importance of structured guidelines in improving surgical outcomes and preventing errors.