International Perfusion Association

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Category: Safety

Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices

The study examines hospital readmissions in patients with centrifugal-flow left ventricular assist devices (CF-LVADs), highlighting the commonality and impact on patient outcomes. Analyzing data from 204 patients, 67.7% experienced heart failure (HF)/LVAD-related readmissions, mainly due to major bleeding, infection, HF exacerbation, and neurological dysfunction. Using machine learning models, several pre-, intra-, and post-operative factors were identified as predictors of readmission risk, which can guide strategies to improve patient management and outcomes.

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Suction

Advancing Cardiotomy Suction Practices for Coronary Surgery via Multidisciplinary Collaborative Learning

This study focuses on a multidisciplinary quality-improvement intervention to standardize cardiotomy suction practices at the end of cardiopulmonary bypass during coronary artery bypass grafting. Conducted across 32 centers, the initiative showed significant improvements in adherence to recommended practices in Michigan centers compared to non-participating centers, with no adverse effects on clinical outcomes.

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ECMO Hat

Impact of Center Volume on In-Hospital Mortality in Adult Patients with Out-of-Hospital Cardiac Arrest Resuscitated Using Extracorporeal Cardiopulmonary Resuscitation: A Secondary Analysis of the SAVE-J II Study

This secondary analysis of the SAVE-J II study evaluates the correlation between center volume and in-hospital mortality for patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR). Analyzing data from 36 Japanese centers, the study categorizes centers into three groups based on ECPR volume. Findings reveal that high-volume centers (≥21 sessions/year) show a significantly higher survival rate at discharge (33.4%) compared to medium (24.1%) and low-volume (26.8%) centers. Adjusted analysis suggests that patients at high-volume centers are more likely to survive, indicating a positive correlation between center volume and ECPR success.

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Lactic Acidosis

Association Between Lactic Acidosis and Multiple Organ Dysfunction Syndrome After Cardiopulmonary Bypass

The study investigates the link between lactic acidosis and multiple organ dysfunction syndrome (MODS) post-cardiopulmonary bypass (CPB). A post hoc analysis on cardiac surgery patients shows a correlation between lactic acidosis and higher incidences of MODS, with lactic acidosis patients experiencing the worst outcomes. The research suggests the need for intensive monitoring of lactic acidosis post-CPB to mitigate risks and improve patient care.

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Goal Directed

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

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.

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Photo Safety GPT

Simulated Cardiopulmonary Bypass: A High Fidelity Model for Developing and Accessing Clinical Perfusion Skills

The study describes a simulated cardiopulmonary bypass (CPB) model integrated into a mock operative theater, aiming to enhance the training of novice perfusionists. Results from 81 participants indicated high fidelity and effectiveness of the simulation in replicating real CPB scenarios and skills, suggesting its potential for educational use in clinical perfusion training.

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Brian CPB

Post-Operative Delirium and Cognitive Dysfunction in Aged Patients Undergoing Cardiac Surgery: A Randomized Comparison between Two Blood Oxygenators

In a study comparing the new oxygenator system RemoweLL 2 with the conventional Inspire device in elderly patients undergoing cardiopulmonary bypass, RemoweLL 2 showed a trend towards reduced incidence of severe post-operative delirium and lower levels of inflammation biomarkers. The study, assessing cognitive decline and inflammation in 154 patients, suggests that advanced CPB oxygenator technologies may lead to better neurocognitive outcomes in the elderly undergoing cardiac surgery.

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Cardiac Surgery New Year

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2023 Update on Procedure Data and Research

The Society of Thoracic Surgeons Adult Cardiac Surgery Database, which includes data from over nine million procedures, underpins multiple risk models and has been pivotal in shaping health policy and cardiac surgery practices. This annual report updates on the database’s status, introduces new risk models, details current surgical trends, and outlines research and future directions for this extensive clinical resource.

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