Perfusion-Uk最新文献

{"title":"Postoperative hemoglobin changes following ultrafiltration in cardiac patients.","authors":"Ethan Forsberg, Douglas Smego, Kirk Bingham, Christopher Blaylock","doi":"10.1177/02676591251344852","DOIUrl":"https://doi.org/10.1177/02676591251344852","url":null,"abstract":"<p><p>IntroductionThis retrospective study investigated the relationship between differing thresholds of Conventional Ultrafiltration (CUF) and postoperative hemoglobin (HGB) in cardiac surgery cases involving cardiopulmonary bypass.MethodsThe study utilized EPIC and STS data for patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). It included three groups: those without CUF (<i>n</i> = 106), low CUF (volume <20 mL/kg; <i>n</i> = 33), and high CUF (volume ≥20 mL/kg); <i>n</i> = 18). HGB levels were assessed at the following points: Pre-operative, end-bypass, first hour in the ICU, discharge, and 30 days post-procedure. Total intravenous fluid administration at 72 hours postoperatively was also evaluated.ResultsThere was no significant difference between the three groups in HGB pre-operatively, end-bypass, or during the first hour in the ICU. At discharge, the non-CUF group had significantly higher HGB levels than the high CUF group (<i>p</i> = 0.028), and HGB in the low CUF group was not significantly different from the high CUF (<i>p</i> = 0.102) group. At 30 days, HGB in the low CUF group was significantly higher than those with high CUF (<i>p</i> = 0.022). Additionally, HGB levels in the non-CUF group were not significantly different than those with high CUF (0.078). Surprisingly, there was no difference in total IV fluid volume administered at 72 hours post-op (<i>p</i> = 0.181) between any of the groups.ConclusionsLow CUF is superior to no CUF, and high CUF in the preservation of hemoglobin levels - even at 30 days. Additionally, CUF of any volume was not associated with increased IV fluid resuscitation postoperatively.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251344852"},"PeriodicalIF":1.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175506","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":"Changes in cardiopulmonary exercise testing variables after surgery for primary mitral regurgitation.","authors":"Jonathan Afoke, Simon Gibbs, Sunthar Kanaganayagam, Domenico Bruno, Luke Howard, Prakash Punjabi","doi":"10.1177/02676591251346035","DOIUrl":"https://doi.org/10.1177/02676591251346035","url":null,"abstract":"<p><p>AimsDescribe differences in changes in cardiopulmonary exercise testing after surgery for severe primary mitral regurgitation between class I and class II indications for surgery. Methods Prospective observational study of patients who underwent transthoracic echocardiogram and cardiopulmonary exercise testing pre-operatively and six months after surgery. Results Forty three of the fifty patients recruited between February 2017 and October 2018 were included in per protocol analysis. Seven patients were excluded-two patients did not meet inclusion criteria after further investigation, two patients were unable to perform pre-operative cardiopulmonary exercise testing, two patients had post-operative mortality, one patient declined post-operative cardiopulmonary exercise testing. Median age was 64 years and 15 patients (34.9%) were female. Thirty five patients had impaired post-operative functional capacity defined as post-operative left ventricular ejection fraction on echocardiogram <50% and/or post-operative percentage predicted peak VO2 ≤ 84%). In patients with class I indication for surgery (n = 30), there was no significant change post-operatively in ppVO2 (81 (69-88) % vs. 79 (60-87) %, p = 0.09). In patients with class II indication for surgery (n = 13), there was a significant fall post-operatively in ppVO2 (82 (79-92) % vs. (74 (68-86) %, p < 0.01). In the univariate analysis, pre-operative ppVO2 ≤ 84% (p < 0.01) was a predictor for impaired post-operative functional capacity. Conclusions Patients with class I indication have persistently abnormal exercise performance six months after surgery. Patients with class II indication for surgery have worse exercise performance parameters six months after surgery. Pre-operative ppVO2 ≤84% is an independent predictor of impaired post-operative functional capacity at six months.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251346035"},"PeriodicalIF":1.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163553","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":"Extracorporeal membrane oxygenation for systemic lupus erythematosus: An ELSO registry analysis.","authors":"Maria Pereira, Danielle Guffey, Katherine Doane, Eyal Muscal, Carla Levin, Peter Rycus, Marc Anders, Andrea Ontaneda","doi":"10.1177/02676591251346069","DOIUrl":"https://doi.org/10.1177/02676591251346069","url":null,"abstract":"<p><p>The success of extracorporeal membrane oxygenation (ECMO) in treating Systemic Lupus Erythematosus (SLE) and the risk factors associated with mortality remain uncertain. <i>Methods:</i> We describe the survival outcomes at discharge of the largest SLE cohort on ECMO support. We performed a retrospective cohort study of the Extracorporeal Life Support Organization registry database from 2012 to 2022. Pediatric and adult survivor groups were analyzed using descriptive statistics for the primary study outcome of survival to hospital discharge. Risk predictors for survival were determined by logistic regression.<i>Results:</i> We included 48 children and 368 adults with SLE. Overall, 198 patients (54%) survived to hospital discharge, with a survival of 52% and 47% of pediatric and adult patients, respectively.<i>Conclusion:</i> We conclude that ECMO can be considered a life supporting strategy in pediatric and adult SLE patients.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251346069"},"PeriodicalIF":1.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152561","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":"No benefit of adding mannitol to cardiopulmonary bypass priming solution assessing cystatin C. A randomized clinical trial.","authors":"Andreas Sköld, Alain Dardashti, Sandra Lindstedt, Snejana Hyllén","doi":"10.1177/02676591251344857","DOIUrl":"https://doi.org/10.1177/02676591251344857","url":null,"abstract":"<p><p>IntroductionThere is no recommendation regarding the optimal prime solution for the cardiopulmonary bypass circuit in adult cardiac surgery. Despite the lack of scientific evidence, mannitol has frequently been added to the prime solution with intention to prevent acute kidney injury. The aim of this study was to investigate the impact of mannitol in cardiopulmonary bypass circuit prime in patients with preoperative renal dysfunction.MethodsThis prospective, randomized, double-blind study included 70 patients, who underwent coronary artery bypass grafting. One group received 1200 mL of a prime based on Ringer's acetate (<i>n</i> = 35), and the other a prime consisting of 1000 mL Ringer's acetate and 200 mL mannitol (<i>n</i> = 35). Primary endpoint were levels of Cystatin C, a renal function biomarker. Changes in renal-related parameters, electrolytes, osmolality and acid-base status were monitored.ResultsThe median cystatin C on day four in the mannitol group were 1.6 mg/L (IQR 1.4-2.0 mg/L) and 1,8 mg/L (IQR 1.5-2.1 mg/L) in the Ringer's acetate group at the same time. Using mixed model analysis, no differences in cystatin C (<i>p</i> = 0.442), creatinine (<i>p</i> = 0.203), estimated glomerular filtration rate (<i>p</i> = 0.264) and urea (<i>p</i> = 0.141) could be detected between the groups. The mannitol group showed a more pronounced reduction in sodium levels after cardiopulmonary bypass circuit commencement compared to the Ringer's acetate group <i>p</i> < 0.001.ConclusionsIn patients with preoperative renal dysfunction, the addition of mannitol in the prime solution did not show any renoprotective effect measured by cystatin C compared to a cardiopulmonary bypass circuit prime based on Ringer's acetate. This study was reported to ClinicalTrials.org, id: NCT03302286. Effects of Extra Corporeal Circuit Prime on Electrolytes Balance and Clinical Outcome Following Cardiac Surgery https://clinicaltrials.gov/study/NCT03302286?id=NCT03302286&rank=1.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251344857"},"PeriodicalIF":1.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136550","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":"Association between venous to arterial carbon dioxide tension gap and clinical outcome in cardiac surgery patients: A systematic review and meta-analysis.","authors":"Dan Lin, Hongying Luo, Feng Long, Meng-Han Liu, Yan Zhang, Ting Liu, Rong-Hua Zhou","doi":"10.1177/02676591251344858","DOIUrl":"https://doi.org/10.1177/02676591251344858","url":null,"abstract":"<p><p>BackgroundCardiac surgery is associated with increased risk of major adverse outcomes. Venous to arterial carbon dioxide tension gap (<i>Pv-aCO</i>_<i>2</i> gap) showed significant prognostic value of non-cardiac surgery, while their prognostic value after cardiopulmonary bypass (CPB) remains controversial.MethodsWe conducted a systematic research of PubMed, MEDLINE, EMBASE and Web of science electronic database and ClinicalTrials.gov to analysis the association between high <i>Pv-aCO</i>_<i>2</i> gap and adverse outcomes in adult cardiac surgery patients. Random effect model was used to pool data.ResultsEight studies (<i>n</i> = 2136 patients) were enrolled. High <i>Pv-aCO</i>_<i>2</i> gap was mainly defined as <i>Pv-aCO</i>_<i>2</i> ≥ 6-8 mmHg. In cardiac surgery, high <i>Pv-aCO</i>_<i>2</i> gap was not associated with increased hospital mortality (odds ratio, 0.63; 95% CI, 0.17-2.32; <i>p</i> = 0.49)), but was related with higher ICU mortality (odds ratio, 5.27; 95% CI, 2.31-12.00; <i>p</i> < 0.001), higher incidence of major complications (<i>p < 0.05</i>), longer ICU length of stay (<i>p</i> = 0.03) and prolonged ventilation time in the ICU (<i>p</i> < 0.001). Moreover, high <i>Pv-aCO</i>_<i>2</i> gap was linked to postoperative lower cardiac index (<i>p < 0</i>.01) and lower <i>ScvO</i>_<i>2</i> (<i>p</i> < 0.001). Interesting, high <i>Pv-aCO</i>_<i>2</i> gap was not associated with increased postoperative lactate level and longer hospital length of stay.ConclusionAn elevated <i>Pv-aCO</i>_<i>2</i> gap seems to be associated with adverse outcomes in very short time and indicates tissue hypoperfusion rather than tissue hypoxia. Therefore, interventions aiming at normalizing <i>Pv-aCO</i>_<i>2</i> gap may potentially improve clinical outcomes, while further validation is required.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251344858"},"PeriodicalIF":1.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129438","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":"Crescent plication of the aortic sinuses of Valsalva.","authors":"Mazin Ai Sarsam, Georgios T Karapanagiotidis, Ioannis Dimarakis","doi":"10.1177/02676591251345710","DOIUrl":"https://doi.org/10.1177/02676591251345710","url":null,"abstract":"<p><p>ObjectiveThe study objective was to describe our experience of performing the relatively simple technique of crescent plication of one or more sinus of Valsalva in various clinical scenarios as an alternative to root replacement and to assess the mid to long term results.MethodsFrom 2006 to 2016 17 patients underwent crescent plication of one or more aortic sinuses in association with other procedures 12 had trileaflet aortic valve (group one) four had bicuspid aortic valve (group two) in addition there was a single patient with Marfan syndrome who presented with acute type A aortic dissection.ResultsCrescent plication resulted in a moderate reduction in root diameter that has remained stable over the study period apart from the Marfan patient who unsurprisingly showed modest root dilation over time.ConclusionsCrescent plication is a relatively simple procedure that reduced root diameter and appears to be stable over time in all but the syndromic patient and can be a viable alternative in situations where full root replacement is judged hazardous.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251345710"},"PeriodicalIF":1.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129441","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":"Complex cardiac and orthopedic surgery in a 14-year-old with DiGeorge syndrome from a Jehovah's Witness household: A blood conservation approach.","authors":"Maria E Hoyos, Mario A O'Connor, Brian Kaufman, Cynthia Keene, Madeline Loftin, Hugo R Martinez, Charles D Fraser, Erin Gottlieb","doi":"10.1177/02676591251340940","DOIUrl":"https://doi.org/10.1177/02676591251340940","url":null,"abstract":"<p><p>This case report discusses the management of a 15-year-old Jehovah's Witness (JW) with DiGeorge syndrome, complex congenital heart disease (CHD), and severe neuromuscular scoliosis requiring major orthopedic surgery. Refusal of blood transfusions required preoperative optimization and advanced blood conservation strategies. The patient underwent multiple cardiac surgeries and spinal fusion. This case emphasizes multidisciplinary coordination and blood management strategies for surgical cases with religious restrictions.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340940"},"PeriodicalIF":1.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129439","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":"Influence of concomitant mitral valve intervention on clinical outcomes during atrial myxoma surgery.","authors":"Demir Cetintas, Mustafa Selcuk Atasoy, Ahmet Yuksel, Hakan Guven, Ufuk Turan Kursat Korkmaz, Iris Irem Kan, Yusuf Velioglu, Ayhan Muduroglu, Serdar Badem, Ali Onder Kilic, Gencehan Kumtepe, Mustafa Aldemir, Erhan Renan Ucaroglu, Murat Bicer","doi":"10.1177/02676591251345727","DOIUrl":"https://doi.org/10.1177/02676591251345727","url":null,"abstract":"<p><p>IntroductionThe aim of this study was to examine whether concomitant mitral valve intervention affected the clinical outcomes in patients undergoing atrial myxoma surgery.Materials and MethodsWe included a total of 97 patients who underwent surgery for atrial myxoma between February 1990 and July 2024 in this study. Among them, 19 patients underwent concomitant mitral valve intervention and these patients comprised the mitral valve group while remaining 78 patients comprised the myxoma-alone group. Preoperative clinical characteristics, operative data, postoperative outcomes and complications of the patients were retrospectively reviewed, and compared between the groups.ResultsThere were no significant differences between the groups in terms of preoperative basic demographic and clinical characteristics, except for the mean diameter of mass and frequency of atrial fibrillation. In the postoperative period, only new-onset atrial fibrillation rate was significantly greater in the mitral valve group than in the myxoma-alone group. In terms of other postoperative outcomes and complications, no significant differences were found between the groups and both groups were statistically similar. During the postoperative period, no valve-related adverse event occurred in patients undergoing mitral valve replacement. In eight of nine patients undergoing mitral valve repair for moderate or severe mitral regurgitation, absent or mild mitral regurgitation was observed. In one patient undergoing mitral valve repair for severe mitral regurgitation, the regurgitation regressed to moderate and this patient was followed asymptomatically with medical treatment.ConclusionOur study demonstrated that concomitant mitral valve intervention did not significantly affect the clinical outcomes in patients undergoing atrial myxoma surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251345727"},"PeriodicalIF":1.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112540","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":"\"Delta pressure, AKI and cardiopulmonary bypass. Other factors to keep in mind\".","authors":"Guillermo Lema","doi":"10.1177/02676591251341700","DOIUrl":"https://doi.org/10.1177/02676591251341700","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251341700"},"PeriodicalIF":1.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121267","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":"Does the venous cannulation method affect gaseous embolic load to the patient during extracorporeal circulation?","authors":"Petronella Torild, Anna Corderfeldt Keiller, Tor Damén","doi":"10.1177/02676591251344859","DOIUrl":"https://doi.org/10.1177/02676591251344859","url":null,"abstract":"<p><p>IntroductionCardiopulmonary bypass (CPB) is essential for cardiac surgery but poses risks, including gaseous micro emboli (GME). While the incidence of stroke-a common clinical consequence of embolism-ranges from 1-5% in cardiac surgery, prevalence of GME during CPB remain poorly understood.ObjectivesTo quantitatively compare GME incidence in the arterial line between cavoatrial and bicaval cannulation during open-heart surgery. Secondary exploratory objectives include evaluating the impact of venous reservoir volume on GME, and the correlation between GME in the venous and arterial lines.MethodsThis single center randomized controlled trial was conducted at Sahlgrenska University Hospital, Sweden. Patients ≥18 years undergoing planned aortic valve repair/replacement with cavoatrial cannulation, or mitral valve repair/replacement with bicaval cannulation, with or without coronary artery revascularization, were screened for eligibility. Patients were further randomized to either venous reservoir volume of ≥300 mL (control) or 200-300mL (intervention). GME detection was performed using GAMPT BCC300 with probes positioned at multiple locations within the CPB circuit.Results39 patients were included. No significant differences in GME quantity in the arterial line were observed between the cannulation methods (count p=.444; volume p=967). Similarly, no significant differences were found based on venous reservoir volume (count p=.074; volume p=.166). Furthermore, no significant correlation was observed between GME in venous line entering the arterial line (count p-value=492; volume p-value=.750). The CPB circuit effectively removed 99.14% of GME, with no adverse events reported.ConclusionNo significant differences were found in arterial GME count or volume between cavoatrial and bicaval cannulation during CPB. These findings underscore the importance of the bypass circuit's air-handling capacity, as well as the role of modern oxygenators and arterial line filters in effectively minimizing the passage of GME. Trial Registration:ClinicalTrials.gov Identifier: NCT05820828URL: https://clinicaltrials.gov/ct2/show/NCT05820828.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251344859"},"PeriodicalIF":1.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112538","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}