Perfusion-Uk最新文献

{"title":"Intraoperative iatrogenic type B aortic dissection. Temporary perfusion pause, immediate restoration and final solution.","authors":"Dionysios Pavlopoulos, Vasilis Kollias, Ioannis Toumpoulis, Kostas Antonopoulos, Christos Verikokos, Dimitrios Angouras","doi":"10.1177/02676591251314762","DOIUrl":"10.1177/02676591251314762","url":null,"abstract":"<p><p>We present the case of a 74-year-old female patient with a 50 mm ascending aortic aneurysm who underwent ascending aorta replacement. During routine open heart surgery, suboptimal flow in the cardiopulmonary bypass circuit, led to the discovery of a type B aortic dissection with substantial flow in the false lumen. Conservative management was chosen, focusing on blood pressure control in the ICU. Despite an initial uneventful recovery the patient developed malperfusion syndrome prompting consideration of endovascular repair. Following a temporary improvement, malperfusion symptoms recurred, leading to a successful endovascular repair, with complete thrombosis of the false lumen.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1714-1716"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014940","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":"Evaluation of the impact of extracorporeal membrane oxygenation (ECMO) oxygenator shunt flow on neonatal hemolysis: An in vitro study.","authors":"Christopher Nemeh, Caleb Varner, Nicholas Schmoke, Elon Trager, Yeu Sanz Wu, Michael Brewer, Caitlin Cain-Trivette, Nikki Aw, Richard O Francis, Diana Vargas Chaves, Eva W Cheung, William Middlesworth","doi":"10.1177/02676591251322000","DOIUrl":"10.1177/02676591251322000","url":null,"abstract":"<p><p>IntroductionExtracorporeal membrane oxygenation (ECMO) is utilized in critically ill neonates with severe cardiopulmonary failure. Hemolysis is a potential complication and is associated with significantly increased morbidity and mortality. The etiology of hemolysis in neonates is multifactorial, including shear forces generated by the ECMO pump, higher flow resistance from smaller tubing and smaller cannulas, the oxygenator, and other patient factors. Centrifugal pumps and oxygenators commonly have shunts with partially occluding clamps to regulate blood flow. We hypothesized that these clamps are significant contributors to hemolysis.MethodAn in vitro study was conducted with three identical ECMO circuits containing an integrated polymethylpentene (PMP) oxygenator and centrifugal pump (Cardiohelp HLS 5.0) and 1/4″ arteriovenous (AV) loop tubing. The circuits were primed with equal components, including expired ABO-compatible packed red blood cells (pRBCs), 25% albumin, 5% albumin, sodium bicarbonate, heparin, and calcium chloride. Circuit A had a completely occluded shunt. Circuit B had a partially occluded shunt, allowing 500 mL/min of shunt flow back to the oxygenator. Circuit C had a fully open shunt, generating 1000 mL/min of shunt flow back to the oxygenator. Plasma-free hemoglobin values were measured serially over 5 days.ResultsBaseline plasma-free hemoglobin levels were equal in all three circuits. Circuit C had the greatest increase in plasma-free hemoglobin daily (26.3 mg/dL/day) compared to Circuit A and Circuit B, which were 14.1 mg/dL/day and 12.9 mg/dL/day, respectively.ConclusionsOur data suggests that partially occluding clamps are not a significant contributor to hemolysis; rather, increased flow through the oxygenator significantly increased the rate of hemolysis in neonatal ECMO circuits.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1646-1652"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442593","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":"10.1177/02676591241311726","url":null,"abstract":"<p><p>IntroductionCardioplegia (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.MethodsTwo 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.ResultDNS 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.ConclusionNMR-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":"1585-1591"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","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":"Developing active learning activities for didactic perfusion courses.","authors":"Catherine Kim, Ronald Gerrits","doi":"10.1177/02676591251314930","DOIUrl":"10.1177/02676591251314930","url":null,"abstract":"<p><p>BackgroundIn the world of academia, traditional lecturing has been the most common pedagogical approach for centuries. However, it can create an environment for students to be passive learners in the classroom. Alternatively, active learning is a pedagogical approach intended to encourage students to engage with content in manners which have been associated with improved exam performance, final course grades, clinical reasoning skills, and critical thinking skills. Given that perfusion is inherently a profession where didactic information must be applied in practice, the implementation of active learning in didactic courses is worth considering. Although active learning is practiced in perfusion education through participation in simulations and clinical rotations, there are no easily identifiable active learning resources available to supplement didactic perfusion courses. In response, written active learning activities were specifically designed for didactic perfusion courses.MethodsThe activities were designed based on the format for guided inquiry worksheets, the incorporation of the learning cycle, and the implementation of process oriented guided inquiry learning (POGIL) strategies. Key concepts were identified, learning objectives were specified, and models (figures or tables of data) were created as targets of engagement and analysis. Following each model, questions and prompts are given to guide students through identifying, understanding, and exploring the concepts incorporated in the activity as well as opportunities to apply the newly gained knowledge and understanding.ResultsTen active learning activities have been developed based on the methods summarized above.ConclusionWhile the purposes of this paper are to inform the perfusion community of active learning and to share guidelines on how to create active learning activities for didactic perfusion courses, the goals of the activities are to provide examples to perfusion educators and to guide students in understanding basic perfusion concepts in a clinically relevant manner. It is recommended that perfusion students complete these activities alongside their didactic perfusion courses.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1559-1566"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034731","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":"Replacement of extended aortic arch aneurysm using partial sternotomy under beating heart and continuous cardiac perfusion.","authors":"Judith Clauss, Christoph Vogel, Bence S Bucsky, Stefan Klotz","doi":"10.1177/02676591251313977","DOIUrl":"10.1177/02676591251313977","url":null,"abstract":"<p><p>We report the case of a 72-year-old male patient who presented with a progressive aortic arch aneurysm. To reduce surgical trauma, we planned the procedure using an upper partial sternotomy with continuous cardiac perfusion and moderate hypothermia. Two vents were inserted to provide sufficient relief to the heart during perfusion. The heart was perfused continuously under flow and pressure control. To treat the aneurysm, a Vascutec™ Thoraflex Hybrid prosthesis was implanted. Despite the minimally invasive approach of partial sternotomy and beating heart combined with moderate hypothermia, the procedure was performed safely, quickly and without complications. The operation required precise pre-planning of the anatomy, outstanding surgical expertise and excellent interdisciplinary cooperation with the anaesthetist and clinical perfusionist.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1704-1707"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980474","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":"Del Nido versus conventional blood cardioplegia in tetralogy of fallot repair: A systematic review and meta-analysis of randomized controlled trials.","authors":"Leo Noanh Consoli, Ilias Georgios Koziakas, Meletios Kanakis","doi":"10.1177/02676591241312380","DOIUrl":"10.1177/02676591241312380","url":null,"abstract":"<p><p>ObjectivesCompare outcomes of Del Nido (DN) versus conventional blood cardioplegia (BC) in the surgical repair of Tetralogy of Fallot (ToF).MethodsMedical databases were searched to identify relevant clinical trials. Meta-analysis was conducted for primary (cardiopulmonary bypass [CPB] and aortic cross-clamp [ACC] times, hospital and intensive care unit [ICU] length of stay [LOS], mechanical ventilation time) and secondary (adverse events, lactate levels, volume of additional cardioplegia) endpoints. Analysis was conducted for DN versus conventional blood cardioplegia, and we performed sensitivity analysis with leave one-out analysis for the primary outcome.Results4 randomized controlled trials were included (<i>n</i> = 275). Mean differences (MD) with 95% confidence intervals (CI) were calculated with a random-effects model. Groups had similar CPB (MD -5.76 minutes; [-23.32 to 11.80]; <i>p</i> = 0.52) and ACC (MD 3.06 minutes; [-13.64 to 7.52]; <i>p</i> = 0.57) times, ICU (MD -6.42 hours; [-25.62 to 12.78]; <i>p</i> = 0.51) LOS and additional cardioplegia volume (MD -195.18 mL; [-434.19 to 43.82]; <i>p</i> = 0.11). The DN group had shorter hospital LOS (MD -0.81 days; [-1.25 to -0.36]; <i>p</i> = 0.0003) and time under mechanical ventilation (MD -4.57 hours; [-8.73 to -0.42]; <i>p</i> = 0.03). There was no difference in mortality.ConclusionsDN cardioplegia has similar clinical outcomes and operative times compared to conventional blood cardioplegia in ToF surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1535-1545"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933261","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":"Trauma-related psychopathologies after extracorporeal membrane oxygenation support: A systematic review and meta-analysis.","authors":"Ashley Demory, Elizabeth Broden, Lucile Equey, Melissa C Funaro, Mona Sharifi, Ilan Harpaz-Rotem, Chani Traube, Oliver Karam","doi":"10.1177/02676591251317919","DOIUrl":"10.1177/02676591251317919","url":null,"abstract":"<p><p>Extracorporeal Membrane Oxygenation (ECMO) use is associated with substantial psychiatric morbidity in patients and their families. This systematic review and meta-analysis quantifies the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression among ECMO survivors and their families. Included studies enrolled patients on ECMO or their families and reported at least one trauma-related psychopathology. Of 1767 screened studies, 55 were included (5146 participants): 50 in adult ECMO survivors, one in pediatric ECMO survivors, and four in families of ECMO patients (two adult, two pediatric.). The pooled prevalence of PTSD was 19% in adult ECMO survivors, 20% in pediatric ECMO survivors, 25% in families of adult ECMO patients, and 21% in families of pediatric ECMO patients. The pooled prevalence of anxiety was 30% in adult ECMO survivors, 8% in pediatric ECMO survivors, 67% in families of adult ECMO patients, and 46% in families of pediatric ECMO patients. The pooled prevalence of depression was 24% in adult ECMO survivors, 8% in pediatric ECMO survivors, 50% in families of adult ECMO patients, and 32% in families of pediatric ECMO patients. This meta-analysis demonstrates a high prevalence of trauma-related psychopathologies surrounding ECMO use, highlighting the need for interventions to improve post-ECMO outcomes.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1546-1558"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069029","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":"Effect of del Nido cardioplegia in patients with reduced left ventricular ejection fraction: A meta-analysis.","authors":"Yoshiyuki Yamashita, Massimo Baudo, Dimitrios E Magouliotis, Francesco Cabrucci, Serge Sicouri, Basel Ramlawi","doi":"10.1177/02676591251315037","DOIUrl":"10.1177/02676591251315037","url":null,"abstract":"<p><p>PurposeResearch on the safety and efficacy of del Nido cardioplegia in adult patients with reduced left ventricular ejection fraction (LVEF) is limited. We evaluated the effect of del Nido cardioplegia on early outcomes of cardiac surgery in this cohort.MethodsPubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched through August 2024 to conduct a meta-analysis comparing del Nido to other cardioplegia in adult patients with reduced LVEF (≤50%). Primary endpoint was early mortality, and secondary endpoints included morbidities, aortic cross-clamp time and postoperative LVEF before discharge. A random-effect model was used to estimate the pooled effect size.ResultsSeven studies met our eligibility criteria, including three propensity score-matched studies with a total of 1160 patients. Conventional blood cardioplegia was used exclusively as a control solution in the included studies. The incidence of early mortality was similar between the del Nido and control groups, with a pooled odds ratio of 0.94 [95% confidence interval: 0.52; 1.71] (<i>p</i> = .822). Postoperative stroke (<i>p</i> = .680), renal failure (<i>p</i> = .832), atrial fibrillation (<i>p</i> = .412), and aortic cross-clamp time (<i>p</i> = .153) were also comparable between the two groups. Postoperative LVEF was significantly higher in the del Nido group compared to the control group, with a standardized mean difference of 0.52 [95% confidence interval: 0.07; 0.96] (<i>p</i> = .034).ConclusionsIn adult patients with reduced LVEF undergoing cardiac surgery, del Nido cardioplegia provides comparable mortality and morbidity rates compared to conventional blood cardioplegic solutions, with the potential to offer protective effects on myocardial function.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1612-1621"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967125","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":"10.1177/02676591241309842","url":null,"abstract":"<p><p>BackgroundReliable myocardial protection is essential for a good outcome after arterial switch operation.Patients and MethodsWe 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%.ResultsPreoperative 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.ConclusionsIntermittent 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":"1567-1574"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450243/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of changes in thrombocyte indices, on-on-pump time on prognosis in open heart surgery.","authors":"Elnaz Hatamighoushchi, Ayşem Kaya, Evin Ademoğlu","doi":"10.1177/02676591251316436","DOIUrl":"10.1177/02676591251316436","url":null,"abstract":"<p><p>Extracorporeal perfusion systems utilized in open-heart surgeries with cardiopulmonary bypass can affect multiple body systems. The primary adverse effects of Extracorporeal Perfusion Systems (EPS) on the hematological system include postoperative bleeding and coagulation issues. The aim of this study is to evaluate the effects of on-pump time and cross-clamp duration on total platelet count (PLT) and platelet indices in open-heart surgeries performed using cardiopulmonary bypass. This evaluation is achieved by comparing PLT, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) before and after surgery. For this study, the laboratory results of a total of 392 patients who underwent open-heart surgery with cardiopulmonary bypass at the Department of Cardiovascular Surgery, Istanbul University Cerrahpaşa Institute of Cardiology, between 2017 and 2018 were retrospectively analyzed. The stepwise multiple linear regression model, in which postoperative PLT was the dependent variable and other parameters were independent variables, revealed that the main determinants of the significant change in postoperative PLT were the duration of device use, along with preoperative PLT and PDW. Our results indicate that on-pump time, along with preoperative PLT and PDW values, is the primary determinants of changes in PLT and PCT in open-heart surgeries with cardiopulmonary bypass. Considering the patient's preoperative platelet count and PDW values in such surgeries may be useful in preventing postoperative adverse events.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1622-1632"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025359","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}