Perfusion-Uk最新文献

Examining the role of thromboelastography in patients with COVID-19. 探讨血栓弹性成像在COVID-19患者中的作用。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-14 DOI: 10.1177/02676591251340967

Alexander L Chen, Matthew Robbins, Sean Masters, Elizabeth Boudiab, Daniel Finn, Emanuela Peshel, Gregory Thomas, Diane Studzinski, Steven Truscott, Courtney Watterworth, Nathan Novotny, Felicia Ivascu, Anthony Iacco

{"title":"Examining the role of thromboelastography in patients with COVID-19.","authors":"Alexander L Chen, Matthew Robbins, Sean Masters, Elizabeth Boudiab, Daniel Finn, Emanuela Peshel, Gregory Thomas, Diane Studzinski, Steven Truscott, Courtney Watterworth, Nathan Novotny, Felicia Ivascu, Anthony Iacco","doi":"10.1177/02676591251340967","DOIUrl":"https://doi.org/10.1177/02676591251340967","url":null,"abstract":"BackgroundCOVID-19 causes a severe respiratory distress syndrome. Systemic inflammation and hypercoagulability are common. These findings are often evaluated with non-specific markers, including CRP, D-dimer, and fibrinogen. We sought to evaluate thromboelastography (TEG) to better understand this complex coagulopathy.MethodsWe conducted a prospective observational study analyzing TEG results in hospitalized patients with COVID-19. TEG was performed on admission and at pre-set intervals. Based on the TEG findings, patients were deemed \"hypercoagulable\" or \"not hypercoagulable.\" Clinical outcomes were recorded.Results88 patients were evaluated. 78/88 (89%) were hypercoagulable. 10% of the hypercoagulable group (8/78) died compared to none in the non-hypercoagulable group (0/10), with thrombotic events occurring in 9% (8/88), a higher requirement for O2 support in 19% (17/88), and prolonged length of stay exceeding 4 days for 74% (65/88). No statistical significant differences were observed between the groups for any of the four adverse events. Patients with complete fibrinolysis shutdown (Ly30 = 0) had more thrombotic events than those with Ly30 > 0 (30% vs 0%, p = .03).ConclusionPatients with COVID-19 are often hypercoagulable based upon specific TEG parameters. While many TEG parameters are not associated with adverse outcomes, complete fibrinolysis shutdown is associated with an increased risk of thrombotic events. Further studies are warranted to assess the utility of TEG in this population.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340967"},"PeriodicalIF":1.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057033","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}

引用次数: 0

Del Nido cardioplegia in adult cardiac surgery: A narrative review. 成人心脏手术中的德尔尼多心脏骤停：一个叙述性的回顾。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-09 DOI: 10.1177/02676591251340970

Ishaq Ibrahim Najmuddin, P Sainath, Vaibhav Krishna Pillai

{"title":"Del Nido cardioplegia in adult cardiac surgery: A narrative review.","authors":"Ishaq Ibrahim Najmuddin, P Sainath, Vaibhav Krishna Pillai","doi":"10.1177/02676591251340970","DOIUrl":"https://doi.org/10.1177/02676591251340970","url":null,"abstract":"Myocardial protection during cardiac surgery is crucial for preventing ischemia-reperfusion injury and preserving myocardial function. Cardioplegia, a solution used to induce electromechanical cardiac arrest, is the fundamental method for myocardial protection during on-pump procedures. Del Nido cardioplegia, developed in the 1990s, has gained increasing popularity in adult cardiac surgeries over the past two decades. Del Nido cardioplegia is a crystalloid-based solution used to achieve depolarized arrest. Its mechanism of action also involves preventing intracellular calcium overload, a key driver of reperfusion injury. Numerous studies have evaluated the safety and efficacy of del Nido cardioplegia in adult cardiac surgeries, including coronary artery bypass grafting and valve procedures. Compared to standard blood cardioplegia, del Nido cardioplegia has demonstrated reduced hemodilution, transfusion requirements and shorter cardiopulmonary bypass times due to its extended arrest duration. Many studies have reported lower levels of myocardial injury biomarkers and improved myocardial functional recovery with del Nido cardioplegia. It has also been associated with reduced defibrillation requirements, which is attributable to the antiarrhythmic effects of lidocaine. While some studies have reported no significant differences in outcomes between del Nido cardioplegia and blood cardioplegia, others have favored del Nido cardioplegia in terms of myocardial protection, postoperative cardiac function, and perioperative morbidity. The choice between cardioplegia solutions remains subjective and dependent on surgeon preference and institutional practices. However, del Nido cardioplegia has emerged as an acceptable alternative to traditional cardioplegia, offering potential advantages in adult cardiac surgeries.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340970"},"PeriodicalIF":1.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022531","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}

引用次数: 0

The value of cerebral and somatic near-infrared spectroscopy within an integrated tissue perfusion monitoring strategy in cardiac surgery: A prospective pilot study. 脑和躯体近红外光谱在心脏外科综合组织灌注监测策略中的价值：一项前瞻性先导研究。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-08 DOI: 10.1177/02676591251340942

Polychronis Antonitsis, Helena Argiriadou, Anna Gkiouliava, Apostolos Deliopoulos, Stylianos Mimikos, Sotiria Gilou, Despoina Sarridou, Christos Voucharas, Georgios Karapanagiotidis, Kyriakos Anastasiadis

{"title":"The value of cerebral and somatic near-infrared spectroscopy within an integrated tissue perfusion monitoring strategy in cardiac surgery: A prospective pilot study.","authors":"Polychronis Antonitsis, Helena Argiriadou, Anna Gkiouliava, Apostolos Deliopoulos, Stylianos Mimikos, Sotiria Gilou, Despoina Sarridou, Christos Voucharas, Georgios Karapanagiotidis, Kyriakos Anastasiadis","doi":"10.1177/02676591251340942","DOIUrl":"https://doi.org/10.1177/02676591251340942","url":null,"abstract":"IntroductionWe sought to evaluate cerebral and somatic oximetry in an integrated tissue perfusion monitoring strategy.MethodThirty adult patients undergoing full-spectrum cardiac surgery with Minimal Invasive Extracorporeal Circulation (MiECC) were recruited. We simultaneously assessed the adequacy of tissue perfusion with near-infrared spectroscopy (NIRS) for cerebral and tissue oximetry, cerebral autoregulation monitoring (COx), sublingual microcirculation with video microscopy and real-time in-line metabolic monitoring during cardiopulmonary bypass. The primary endpoint of the study was to evaluate the diagnostic accuracy of NIRS cerebral desaturation in predicting a global perfusion-related adverse clinical event.ResultsCerebral oximetry showed the higher positive and negative predicting values (50% and 67%, respectively) in detecting a tissue perfusion-related adverse outcome. Somatic oximetry was related to higher values compared to cerebral (p < .001) and followed a different trend. ROC analysis calculated a cutoff value of 22 for right-sided cerebral desaturation and 32 for cumulative left- and right-sided desaturation as a sensitive predictor of hyperlactemia. Microcirculatory parameters were impaired after induction of anesthesia, while they were preserved during cardiopulmonary bypass.ConclusionsNIRS cerebral oximetry represents a useful tissue perfusion monitoring tool. An AUC cutoff value of 22 for a single hemisphere and 32 bilaterally correlate with hyperlactemia and may serve as alarm for prompt action.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340942"},"PeriodicalIF":1.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004500","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}

引用次数: 0

Leveraging pediatric veno-arterial extra corporeal membrane oxygenation parameters to identify early risk factors for mortality. 利用小儿静脉-动脉体外膜氧合参数来确定死亡的早期危险因素。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-07 DOI: 10.1177/02676591251340933

Bennett Weinerman, Soon Bin Kwon, Tammam Alalqum, Daniel Nametz, Murad Megjhani, Eunice Clark, Caleb Varner, Eva W Cheung, Soojin Park

{"title":"Leveraging pediatric veno-arterial extra corporeal membrane oxygenation parameters to identify early risk factors for mortality.","authors":"Bennett Weinerman, Soon Bin Kwon, Tammam Alalqum, Daniel Nametz, Murad Megjhani, Eunice Clark, Caleb Varner, Eva W Cheung, Soojin Park","doi":"10.1177/02676591251340933","DOIUrl":"https://doi.org/10.1177/02676591251340933","url":null,"abstract":"ObjectivePediatric Veno-Arterial Extra Corporeal Membrane Oxygenation (VA ECMO) can be a lifesaving technology; however, it is associated with high mortality. A successful VA ECMO course requires attention to multiple aspects of patient care; yet often overlooked are ECMO flow parameters. Early, potentially modifiable, risk factors associated with patient mortality should be scrutinized in patients requiring VA ECMO.MethodRetrospective single center experience of pediatric patients requiring VA ECMO from January 2021 to October 2023. Laboratory and ECMO flow parameters were extracted from the patients record and analyzed. Risk factors were analyzed using a Cox proportion hazard regression, and a multivariate regression.Main ResultsThere were 45 patients studied. Overall survival was 51%. Upon uncorrected analysis there were no significant differences between the patients who survived and those who died during their hospital admission. Utilizing a Cox proportion hazard regression, platelet count, fibrinogen level, and creatinine level normalized to age within the first 24 hours of a patients ECMO course were significant risk factors for hospital mortality. We did not find that ECMO flow parameters were significantly associated with mortality within the first 24 hours.SignificanceAlthough we did not find a significant difference among ECMO flow parameters in this study, this work highlights that granular ECMO flow data can be incorporated to risk analysis profiles and potential modeling in pediatric VA ECMO. This study demonstrated that when controlling for ECMO flow parameters, kidney dysfunction and clotting regulation are associated with pediatric VA ECMO mortality.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340933"},"PeriodicalIF":1.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055777","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}

引用次数: 0

Comparison of two different autotransfusion devices: An ex-vivo study. 两种不同自体输血装置的比较：一项离体研究。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-07 DOI: 10.1177/02676591251340938

San-Mari van Delft-van Deventer, Marco C Stehouwer, Wim van Oeveren

{"title":"Comparison of two different autotransfusion devices: An ex-vivo study.","authors":"San-Mari van Delft-van Deventer, Marco C Stehouwer, Wim van Oeveren","doi":"10.1177/02676591251340938","DOIUrl":"https://doi.org/10.1177/02676591251340938","url":null,"abstract":"IntroductionDuring surgery, blood is recovered from the surgical field and the autotransfusion device separates and washes the red blood cells (RBC's) after which these can be retransfused to the patient. Autotransfusion devices differ strongly in separation method and washing settings, which may lead to different RBC recovery rates and removal rates of contaminants. The objective of this study was to compare the autoLog IQTM (Medtronic) and the Xtra® (LivaNova) in terms of RBC recovery, quality of the processed blood and processing time.MethodsHuman blood was heparinised and processed with both autotransfusion devices according to their standard protocols. Blood samples were taken from the collection reservoir and from the transfusion bag and analyzed for cell count, heparin removal and cell injury.ResultsThe RBC recovery rates for both devices was 93%. Heparin was almost completely removed in both devices with >99.9%. The autoLog IQTM showed significantly better removal of platelets (autoLog IQ vs Xtra; 86.1 ± 2.7 and 78.6 ± 4.4%, p = 0.01) and of leukocytes (autoLog IQ vs Xtra; 39.6 ± 2.7 and 13.4 ± 5.7%, p < 0.001). No other significant differences were observed in removal rates. The volume of RBC concentrated per minute was faster for the Xtra® (autoLog IQ vs Xtra, 21 ± 3 and 27 ± 2 mL RBC/min, p = 0.007).ConclusionsIn this study both the autoLog IQTM and the Xtra® showed similar RBC recovery rates of 93% and almost all heparin was eliminated. The washing quality of the autoLog IQTM device appears to be better, with better removal of platelets and leukocytes. Although both the autoLog IQTM and the Xtra® devices use very different separation techniques and washing protocols, the difference in processing speed and various markers for cell damage in the end product seems trivial.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251340938"},"PeriodicalIF":1.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042122","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}

引用次数: 0

The effects of del Nido cardioplegia combined with dexmedetomidine on cardiac surgery with cardiopulmonary bypass. 德尔尼多停搏联合右美托咪定对体外循环心脏手术的影响。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-04 DOI: 10.1177/02676591251340971

Xiuli Jiang, Xiaoyu Zhou, Lei Yao, Lu Li, Tianyu Gu

引用次数: 0

Mitral bioprosthesis early dysfunction treated with transapical valvuloplasty during V-A ECMO. 在 V-A ECMO 期间通过经心尖瓣膜成形术治疗二尖瓣生物假体早期功能障碍。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-01 Epub Date: 2024-06-17 DOI: 10.1177/02676591241260860

Antonio D'Errico Ramirez, Vito Giovanni Ruggieri

引用次数: 0

Application of targeted nursing intervention in patients undergoing synchronous carotid endarterectomy and coronary artery bypass grafting. 在同步进行颈动脉内膜切除术和冠状动脉旁路移植术的患者中应用针对性护理干预。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-01 Epub Date: 2024-08-12 DOI: 10.1177/02676591241271995

Xiumei Chen, Lipeng Zhang, Fan Zhang, Xuemei Li, Hui Li

{"title":"Application of targeted nursing intervention in patients undergoing synchronous carotid endarterectomy and coronary artery bypass grafting.","authors":"Xiumei Chen, Lipeng Zhang, Fan Zhang, Xuemei Li, Hui Li","doi":"10.1177/02676591241271995","DOIUrl":"10.1177/02676591241271995","url":null,"abstract":"ObjectivesTo investigate the effect of targeted nursing intervention on the short-term prognosis of patients with coronary heart disease and carotid artery stenosis undergoing synchronous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA).MethodsA total of 58 patients who received OPCABG + CEA from February 2018 to May 2021 at the Beijing Anzhen Hospital were selected as the study subjects. They were randomly divided into two groups, with 29 patients in each group. The control group received routine postoperative nursing care, while the observation group received targeted nursing intervention in addition to the routine care. The incidence of postoperative stroke and the length of postoperative stay were observed.ResultsThere were no statistically significant differences in baseline data between the two groups. Postoperative acute stroke occurred in 2 cases (6.9%) in the control group and 0 cases in the observation group, although this difference was not statistically significant. The median postoperative hospital stay was 13 days in the control group, with the earliest discharge at 10 days. In the observation group, the median postoperative hospital stay was 10 days, with the earliest discharge on the 8th day. This difference was statistically significant.ConclusionsTargeted nursing intervention can improve the short-term prognosis of patients with coronary heart disease and carotid artery stenosis undergoing OPCABG + CEA, and it can also shorten the length of postoperative hospital stay.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1057-1061"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972189","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}

引用次数: 0

Perioperative risks associated with administration of andexanet alfa during emergency cardiac surgery with circulatory arrest. 在循环骤停的紧急心脏手术中使用安赛蜜α的围手术期风险。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-01 Epub Date: 2024-07-25 DOI: 10.1177/02676591241268395

Ajami Gikandi, Jean M Connors, Christoph G Nabzdyk, Marco A Zenati

引用次数: 0

EXCOR membrane motion analyzer (EMMA) to quantify and assess hemodynamic performance of the EXCOR pediatric heart assist device. EXCOR 膜运动分析仪（EMMA），用于量化和评估 EXCOR 儿科心脏辅助装置的血液动力学性能。

IF 1.1 4区医学

Perfusion-Uk Pub Date : 2025-05-01 Epub Date: 2024-07-21 DOI: 10.1177/02676591241265052

Rachel Hillner, Luke Perry, Natalie Hill, Aditya V Badheka, Venkat Keshav Chivukula

{"title":"EXCOR membrane motion analyzer (EMMA) to quantify and assess hemodynamic performance of the EXCOR pediatric heart assist device.","authors":"Rachel Hillner, Luke Perry, Natalie Hill, Aditya V Badheka, Venkat Keshav Chivukula","doi":"10.1177/02676591241265052","DOIUrl":"10.1177/02676591241265052","url":null,"abstract":"BackgroundPediatric heart failure is associated with high mortality rates and is a current clinical burden. There is only one FDA approved pediatric VAD, Berlin Heart EXCOR, for treatment. Thrombo-embolic complications are a significant clinical challenge, which can lead to devastating complications such as stroke and impair efficient EXCOR function. Currently, clinicians perform largely qualitative periodic assessment of EXCOR operation by observing the motion of a rapidly moving membrane, which can be prone to human error and can lead to missing out on crucial information.MethodsIn this study, we design and implement a quantitative early warning system for accurate and quantitative assessment of the EXCOR membrane, named EXCOR Membrane Motion Analyzer (EMMA). Using a combination of image analysis, computer vision and custom designed algorithm, we perform rigorous frame by frame analysis of EXCOR membrane video data. We developed specialized metrics to identify relative smoothness between successive peaks, time between peaks and overall smoothness indicators to quantify and compare between multiple cases.ResultsOur results demonstrate that EMMA can successfully identify the motion and wrinkles on each video frame and quantify the smoothness and identify the phases of each cardiac cycle. Moreover, EMMA can obtain the smoothness of each frame and the temporal evolution of membrane smoothness across all image frames for the video sequence.ConclusionsEMMA allows for a fast, accurate, quantitative assessment to be completed and reduces user error. This enables EMMA to be used effectively as an early warning system to rapidly identify device abnormalities.","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"898-906"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735506","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}

引用次数: 0