Perfusion-Uk最新文献

{"title":"Outcomes of acute type A aortic dissection repair in patients under the age of 75 versus 75 and older.","authors":"Reyna Jones, Sarah Yousef, James A Brown, Derek Serna-Gallegos, Danial Ahmad, Jianhui Zhu, Kathirvel Subramaniam, Rama Joshi, Theresa Gelzinis, Julie Phillippi, Pyongsoo Yoon, Johannes Bonatti, David Kaczorowski, Danny Chu, Ibrahim Sultan","doi":"10.1177/02676591241313170","DOIUrl":"https://doi.org/10.1177/02676591241313170","url":null,"abstract":"<p><strong>Objective: </strong>Elderly patients are less likely to undergo surgery for an acute type A aortic dissection (ATAAD). This study aims to understand the risks of surgical treatment in patients 75 and older.</p><p><strong>Methods: </strong>This was a retrospective study using an institutional database of patients who underwent ATAAD repair from 2007 to 2021. Outcomes were compared between patients <75 and patients <math><mrow><mo>≥</mo></mrow></math> 75. Logistic regression was performed for operative mortality, and Cox regression was performed for long-term mortality.</p><p><strong>Results: </strong>A total of 601 patients underwent surgery for ATAAD, 112 (18.6%) of whom were ≥75. Patients ≥75 were significantly more likely to undergo hemiarch replacement (vs total arch replacement) and concomitant CABG. Operative mortality was 16.1% in patients ≥75 versus 10.2% in those <75 (<i>p</i> = 0.078). On multivariable logistic regression, age ≥75 was not significantly associated with operative mortality (<i>p</i> = 0.068). Effect of age on long-term mortality was time-dependent: on Cox regression, being 75 or older and within one-year post-discharge was significantly associated with an increased hazard of death (time-dependent HR 4.56; 95% CI, 2.31-9.06; <i>p</i> < 0.001), while age was not associated with an increased hazard of death after the first postoperative year (<i>p</i> = 0.779).</p><p><strong>Conclusion: </strong>Despite reduced survival during the first postoperative year among patients 75 years and older, operative mortality and late survival were similar across each group. By implication, age alone should not be a deterrent to operative intervention in ATAAD patients, even though further investigation is needed to determine opportunities for improving survival during the first postoperative year after ATAAD repair.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241313170"},"PeriodicalIF":1.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of clinico-metabolic profiles between St Thomas and del Nido cardioplegia solutions: A pilot study.","authors":"Amit Rastogi, Prabhat Tewari, Shantanu Pande, Rimjhim Trivedi, Surendra Kumar Agarwal, Durgesh Dubey, Dinesh Kumar","doi":"10.1177/02676591241311726","DOIUrl":"https://doi.org/10.1177/02676591241311726","url":null,"abstract":"<p><strong>Introduction: </strong>Cardioplegia (CP) is integral to myocardial protection during cardiac surgery. Two standard cardioplegic solutions viz. Del Nido solution (DNS) and St Thomas solution (STS) are widely used in cardiac surgeries. The DNS is a single-dose CP that offers superior myocardial protection in adults, and studies have claimed myocardial injury in STS patients. The elevated circulatory level of citric acid cycle intermediate, succinate is a metabolic hallmark of ischemia. Its rapid oxidation after reperfusion causes ischemia-reperfusion (IR) injury through mitochondrial reactive oxygen species production. Succinate has been identified as an early marker of IR injury through blood plasma/serum-based clinical metabolomics studies. The primary objective of the study was metabolomic profiling of succinate from the coronary sinus and venous blood.</p><p><strong>Methods: </strong>Two blood samples each were obtained from coronary sinus (CS) & venous reservoir from patients before the application of aortic cross-clamp and after the release of aortic cross-clamp from 22 patients divided into two groups. The blood-serum metabolic profiles were measured by 800 MHz NMR spectrometer and compared using univariate statistical analysis methods. The study also compared the two groups' cardiopulmonary bypass variables and left ventricle functions.</p><p><strong>Result: </strong>DNS leads to increased serum levels of succinate in the coronary sinus blood after the reperfusion compared to STS. The results of our study are consistent with a previous study that found DNS administration (90 minutes) increases the inflammatory response in the myocardium.</p><p><strong>Conclusion: </strong>NMR-based serum metabolomics revealed significantly increased circulatory succinate in coronary sinus blood of patients administered with DNS cardioplegia in comparison to STS cardioplegia. URL- https://ctri.nic.in/Clinicaltrials/login.php.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241311726"},"PeriodicalIF":1.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unfractionated heparin monitoring by anti-factor Xa versus activated partial thromboplastin time strategies during venoarterial extracorporeal life support.","authors":"Iris Feng, Tanner R Powley, Christine G Yang, Paul A Kurlansky, Lauren D Sutherland, Jonathan M Hastie, Yuji Kaku, Justin A Fried, Koji Takeda","doi":"10.1177/02676591241309500","DOIUrl":"https://doi.org/10.1177/02676591241309500","url":null,"abstract":"<p><strong>Introduction: </strong>No clear guidelines exist for unfractionated heparin (UFH) monitoring in adult patients on veno-arterial extracorporeal life support (VA-ECLS) for refractory cardiogenic shock. In this study, we sought to compare outcomes between anti-factor Xa (FXa) and activated partial thromboplastin time (aPTT) strategies for UFH monitoring during VA-ECLS.</p><p><strong>Methods: </strong>This is a single-center, retrospective review of VA-ECLS patients who received UFH in the cardiothoracic intensive care unit between July 2019 and November 2023. Standard protocol for UFH titration was aPTT goal of 45-60 sec (<i>n</i> = 52) before September 2021, then transitioned to FXa goal of 0.1-0.2 U/mL (<i>n</i> = 50) thereafter. Inverse probability of treatment weighting was used to balance baseline differences between cohorts.</p><p><strong>Results: </strong>In adjusted analyses, 89.3% of FXa patients and 76.0% of aPTT patients achieved goal range for their respective assay. Total UFH duration (4.0 vs 4.0 days, <i>p</i> = .239) and maximum weight-adjusted UFH dose (9.3 vs 9.4 U/hr/kg, <i>p</i> = .823) remained comparable between adjusted FXa and aPTT cohorts. Moreover, in-hospital mortality (50.3% vs 33.9%, <i>p</i> = .133), major bleeding events (20.6% vs 11.2%, <i>p</i> = .292), and thromboembolic events (30.1% vs 30.1%, <i>p</i> = .998) were not significantly different. Extracorporeal circuit thrombosis and cannula site bleeding were the most frequent events in both groups. Multivariate logistic regression found the FXa strategy was not a significant risk factor for the composite outcome of major bleeding or thromboembolism (OR [95% CI]: 1.539 [0.575, 4.116], <i>p</i> = .393).</p><p><strong>Conclusions: </strong>In adult VA-ECLS patients at our institution, bleeding and thromboembolic complications occurred at a similar rate regardless of which UFH monitoring strategy was utilized. Further studies in larger and more institutionally diverse cohorts are warranted.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241309500"},"PeriodicalIF":1.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance and discordance of anticoagulation assays in children supported by ECMO: The truth is out there.","authors":"Carlos A Carmona, Jesse Bain, Oliver Karam","doi":"10.1177/02676591241309841","DOIUrl":"https://doi.org/10.1177/02676591241309841","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membrane oxygenation (ECMO) provides critical support to patients in severe cardiac and respiratory failure, but it requires anticoagulation to prevent complications like bleeding and thrombosis. Heparin, the primary anticoagulant utilized, is monitored by activated partial thromboplastin time (aPTT) and anti-Factor Xa (AntiXa) levels. Discordance between the two assays complicates its titration and the impact on patient outcomes is not well-established. This study examines the prevalence of discordance, its impact on heparin dosing, and the association of bleeding, thrombosis, ICU-free days, and mortality in pediatric ECMO patients.</p><p><strong>Methods: </strong>This secondary analysis of the Bleeding and Thrombosis on Extracorporeal Membrane Oxygenation study consisted of 511 patients under 19 years. Demographics, laboratory results, ECMO indications, daily heparin doses, and clinical outcomes were collected. Discordance was categorized as major or minor, and adjustments to heparin dosing were analyzed for appropriateness based on normal ranges of aPTT and AntiXa. Logistic regression models assessed the impact of heparin titration strategies on bleeding, clotting, ICU-free days, and mortality.</p><p><strong>Results: </strong>Major discordance occurred on 17.5% of days with high aPTT and low AntiXa being most common. Titrating heparin based on AntiXa in scenarios of discordance was associated with an 11% lower incidence of bleeding compared to aPTT (<i>p</i> = .02). Higher proportion of concordance was independently associated with increased bleeding and/or clotting, but not significantly affect ICU-free days or mortality.</p><p><strong>Conclusion: </strong>Discordance is common in pediatric ECMO patients. AntiXa-guided heparin titration, notably during discordant periods, is associated with fewer bleeding and clotting events. This emphasizes the need for improved anticoagulation protocols since discordance does not demonstrate worse ICU-free days or mortality.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241309841"},"PeriodicalIF":1.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application comparison of paediatric myocardial protection procedures in arterial switch surgery.","authors":"Frank Münch, Matthias Kohl, Nicola Kwapil, Oliver Dewald, Michela Cuomo, Ariawan Purbojo","doi":"10.1177/02676591241309842","DOIUrl":"https://doi.org/10.1177/02676591241309842","url":null,"abstract":"<p><strong>Background: </strong>Reliable myocardial protection is essential for a good outcome after arterial switch operation.</p><p><strong>Patients and methods: </strong>We evaluated 56 neonates with arterial switch operation in this retrospective study. Three types of cardioplegia were used: antegrade Custodiol® (CCC) <i>n</i> = 22, antegrade Custodiol® plus paediatric microplegia (mix) <i>n</i> = 14, and antegrade plus retrograde intermittently paediatric microplegia (blood) <i>n</i> = 20. We evaluated the extent of myocardial injury using troponin I, Creatine kinase (CK), CK-MB (CK in myocardial cells) and vasoactive inotrope score (VIS), immediately- and the first postoperative day, as well as outcome parameters. A statistical analysis was conducted using multiple linear regression, with adjustments made for the RACHS score and ischemia time, at a significance level of 5%.</p><p><strong>Results: </strong>Preoperative data were comparable between the three groups. Aortic cross clamp time was significantly different between the three groups (CCC: 115 ± 26 min: mix: 162 ± 35 min: blood: 153 ± 31 min). We found significantly lower troponin I release in the blood group 14 ng/mL [CI95 10; 18] versus CCC group 36 ng/mL [CI95 27; 48] and versus mix group 27 ng/mL [CI95 19; 38]; troponin I 24 h blood group 8 ng/mL [CI95 6; 11] versus CCC group 14 ng/mL [CI95 10; 19]. No significant differences were found in CK, CK-MB, VIS, as well as in outcome parameters 30-day mortality, ventilation time, hospital stay or ECMO implantation.</p><p><strong>Conclusions: </strong>Intermittent paediatric microplegia led to a significantly lower release of troponin I, despite significantly longer ischemia times than after application of Custodiol®. Paediatric microplegia can be safely performed in neonates and also offers the advantage of miniaturization of the Cardiopulmonary bypass setup.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241309842"},"PeriodicalIF":1.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous coronary saccular aneurysm exclusion.","authors":"Stephen Maharaj, Amanda-Marie Mc Carthy, Jose Martinez, Risshi Rampersad, Gianni Angelini","doi":"10.1177/02676591241308985","DOIUrl":"https://doi.org/10.1177/02676591241308985","url":null,"abstract":"<p><p>Coronary artery aneurysms are a relatively uncommon finding during coronary angiography and can present certain challenges in terms of treatment options. This may be due to unclear underlying mechanisms and varying presentations, as well as a lack of large-scale outcome data. In this case report we present the successful use of percutaneous coronary intervention (PCI) in treating a 43-year-old male patient who presented with acute myocardial infarction and was discovered during angiography to have a saccular coronary aneurysm.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241308985"},"PeriodicalIF":1.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery model for minimally invasive central cannulation, cardiopulmonary bypass, and cardioplegic arrest in quadrupeds.","authors":"Matthew D Johnson, Lise Tchouta, Brianna L Spencer, Mark W Langley, Kristopher A Urrea, John M Toomasian, Joseph B Niman, Robert H Bartlett, Alvaro Rojas-Peña, Daniel H Drake","doi":"10.1177/02676591241309824","DOIUrl":"https://doi.org/10.1177/02676591241309824","url":null,"abstract":"<p><p><i>Objectives:</i> Sternotomy is rarely performed for veterinary therapeutic or recovery models in quadrupeds because of difficulties with breathing, ambulation, and pain control. Central cannulation for cardiopulmonary bypass (CPB) is infrequent and typically performed through full thoracotomies. Experienced clinical surgeons and perfusionists should provide guidance for new therapeutic interventions and translational research. We sought to develop, validate, and detail a contemporary model for minimally-invasive central cannulation, CPB, and cardioplegic arrest. <i>Methods:</i> After induction of anesthesia and sterile preparation, a right second-interspace parasternal mini-thoracotomy was performed, the ascending aorta was cannulated using Seldinger technique, and a cardioplegia needle was placed. A dual-stage cannula was introduced through the right atrial appendage and CPB commenced. The aorta was clamped and Buckberg 4:1 induction cardioplegia was administered. Arrest was maintained for 30 minutes. CPB was discontinued after 2 hours and the great vessels were decannulated. Hemostasis was achieved and the wound was closed. Initial recovery was accomplished in intensive care with subsequent transfer to the vivarium.<i>Results:</i> Ten consecutive Yorkshire swine (45 ± 5 kg) were minimally invasively placed on CPB including cardioplegic arrest using central cannulation through a right parasternal mini-thoracotomy. There was no operative or late mortality. Morbidity appeared minimal. Planned euthanasia and scheduled necropsy were performed to exclude clinically-occult major complications. None were identified. Following initial supervision, veterinary and resident surgeons completed the procedures autonomously with excellent results.<i>Conclusion:</i> The described protocols should facilitate safe veterinary cardiac surgical care and humane translational research.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241309824"},"PeriodicalIF":1.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas.","authors":"Dengzhi Wei, Xiaoxu Wang, Haiying Tian, Xu Li, Daokang Xiang, Yizhu Shu","doi":"10.1177/02676591241307572","DOIUrl":"https://doi.org/10.1177/02676591241307572","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus on the dose of heparin to be used intraoperatively in cardiac myxomas, so the goal of this study was to look into the differences in the clinical effects on the perioperative period of patients with cardiac myxomas when different doses of heparin were used intraoperatively.</p><p><strong>Methods and analysis: </strong>70 patients who had cardiac myxomas excision via cardiopulmonary bypass between January 2024 and July 2024. The 70 patients were separated into two groups based on the heparin dose administered prior to cardiopulmonary bypass heparinization. 42 patients in group A had a dose of ≤400 U/kg, while 28 patients in group B received a dose of >400 U/kg.</p><p><strong>Result: </strong>PT, INR, and APTT were significantly prolonged in patients with cardiac myxomas in group A in the postoperative period 24 h after surgery, which was statistically significant (<i>P</i> < .05) compared with that in group B. Intraoperative heparin dose appeared to influence changes in coagulation at 24 h postoperatively, but was mainly dominated by APTT. Also, heparinized doses showed a weak positive correlation with 24-h postoperative drainage volume. In addition, the dimension of the cardiac myxomas appeared to have some correlation with the patient's preoperative APTT and age.</p><p><strong>Conclusion: </strong>When patients with cardiac myxomas were heparinized intraoperatively with varying doses of heparin, the enhancement of coagulation in the 24 h after surgery was more pronounced in the group given higher doses of heparin, and endogenous coagulation pathways were activated much more than exogenous coagulation pathways in the 24 h after surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241307572"},"PeriodicalIF":1.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring quality information for patients tool to assess patient information on CABG websites: Systemic search and evaluation.","authors":"Chun Wai Tai, Lam Wing Kwan, Jeremy Chan, Gianni D Angelini","doi":"10.1177/02676591241303842","DOIUrl":"https://doi.org/10.1177/02676591241303842","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass surgery (CABG) is the most common cardiac surgical procedure worldwide. The Internet is often the first place for patients to obtain medical information and may influence their health-seeking behaviour. This study aimed to assess the quality of online CABG information for patients.</p><p><strong>Methods: </strong>A review was conducted on the available CABG information online using four search terms in Google: \"coronary artery bypass grafting\", \"CABG\", \"bypass surgery\", and \"coronary surgery\". Websites on the first three pages of each search term were assessed by two independent assessors using the Ensuring Quality Information for Patients (EQIP) tool (score 0-36).</p><p><strong>Results: </strong>71 websites in total were eligible for the evaluation. Most websites originated from the USA and the UK (35% for both). The median EQIP score was 16.5. Most websites used everyday language (94%) in short sentences (83%). More than half (60%) of the websites addressed qualitative complications and risks of surgery. Only 1/3 of the websites described treatment alternatives, precautions before surgery, and warning signs after surgery. Only about 1/10 of websites could address quality-of-life issues and resolution of complications.</p><p><strong>Conclusion: </strong>Most online sites concerning CABG scores were low in EQIP tool assessment in terms of quality and readability with insufficient sources. Minimal information is provided regarding the quantitative risks and complications. Enhancement of the credibility and informativeness of websites is needed to reduce patients' anxiety about surgical procedures and help with treatment options for coronary artery disease. Education and investigation on the consistency of high-quality websites may help patient identify high quality medical information.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241303842"},"PeriodicalIF":1.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoadsorption during cardiopulmonary bypass to absorb plasma-free hemoglobin in patients with acute type a aortic dissection: A randomized controlled trial.","authors":"Yu Bao, XiaoJun Wang, YunFeng Zi, Xu Qian, YongBo Li, ShuXi Li, Zhao Wang","doi":"10.1177/02676591241305276","DOIUrl":"https://doi.org/10.1177/02676591241305276","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the effect of hemoadsorption (HA) on plasma-free hemoglobin (pfHb) levels during cardiopulmonary bypass (CPB) and the clinical outcomes in patients with acute type A aortic dissection (ATAAD).</p><p><strong>Methods: </strong>In this single-center randomized trial, patients were assigned to either a group using the HA380 device or a control group without it. The primary outcome was changes in pfHb levels during CPB and within the first 48 hours after surgery. The study concentrated on comparing compared the data between the two groups using analysis of variance for repeated measures. Concurrently, both correlation and linear regression analyses were employed to identify the factors influencing pfHb levels.</p><p><strong>Results: </strong>The mean pfHb concentration was lower in the HA380 group than in the control group,but there were no significant differences between the two groups (<i>F</i> = 2.883, 95% confidence interval CI: -0.006 to 0.072, <i>p</i> = .093) using a repeated measures analysis of covariance model. Linear regression analysis identified body mass index (BMI) as the primary factor influencing the adsorption effect (<i>B</i> = 0.01, 95% CI: 0.36-1.24, <i>p</i> = .001). Additionally, the major postoperative complications within the first 48 hours did not show significant differences between the groups, including acute kidney injury (AKI) (25% HA380 group vs 36% control group, <i>p</i> = .261) and postoperative liver dysfunction (PLD) (5% HA380 group vs 16% control group, <i>p</i> = .106).</p><p><strong>Conclusion: </strong>The use of the HA380 device in CPB during cardiac operations may contribute to reduced pfHb levels. However, the difference was statistically non-significant because pfHb adsorption was notably influenced by the patient's BMI. Consequently, BMI should be considered when deploying HA380 in prolonged CPB procedures, including ATADD repair. Enhancing either the number of devices or the duration of HA in patients with overweight or obesity may potentially improve postoperative clinical outcomes.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241305276"},"PeriodicalIF":1.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}