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Perioperative feasibility and post-discharge residual risk in borderline candidates undergoing durable left ventricular assist device implantation: A single-center case series. 边缘性患者接受持久左心室辅助装置植入的围手术期可行性和出院后残留风险:单中心病例系列。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-07 DOI: 10.1177/02676591261496760
Wenfang Zhu, Guiqing Liu, Liangliang Liu, Yuhong Chen, Liang Zhang, Jinpeng Xu
{"title":"Perioperative feasibility and post-discharge residual risk in borderline candidates undergoing durable left ventricular assist device implantation: A single-center case series.","authors":"Wenfang Zhu, Guiqing Liu, Liangliang Liu, Yuhong Chen, Liang Zhang, Jinpeng Xu","doi":"10.1177/02676591261496760","DOIUrl":"https://doi.org/10.1177/02676591261496760","url":null,"abstract":"<p><p>IntroductionSome patients considered for durable left ventricular assist device (LVAD) implantation have borderline features or relative contraindication factors that may lead to deferral or reconsideration of implantation. The relationship between perioperative feasibility and post-discharge residual risk in such patients remains incompletely described.MethodsWe retrospectively reviewed borderline LVAD candidates selected from 30 consecutive adults undergoing durable LVAD implantation between October 2024 and September 2025. Patients were included when major preoperative decision concerns influenced implantation planning. Outcomes were successful implantation with survival to first discharge and post-discharge residual risk-related events.ResultsEleven borderline candidates were included. Median age was 56 years (range, 38-73 years). All patients underwent LVAD implantation and survived to first discharge. Median follow-up duration was 13.0 months (range, 2.1-18.0 months). During follow-up, death occurred in 2 patients, ischemic stroke or intracranial hemorrhage in 4, and gastrointestinal bleeding in 1.ConclusionsBorderline candidacy features did not preclude LVAD implantation or discharge after individualized perioperative handling. However, post-discharge residual risk, especially cerebrovascular vulnerability, anticoagulation exposure, and care-management limitations, remained clinically important. LVAD candidacy should be considered as a longitudinal care pathway rather than a perioperative decision alone.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261496760"},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128694","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 lactate risk score (LRS): Anticipating hyperlactatemia during cardiopulmonary bypass. 乳酸风险评分(LRS):预测体外循环期间的高乳酸血症。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-02-16 DOI: 10.1177/02676591261426843
Ignazio Condello, Michele Dell'Aquila, Serdar Gunaydin, Youssef El Dsouki
{"title":"The lactate risk score (LRS): Anticipating hyperlactatemia during cardiopulmonary bypass.","authors":"Ignazio Condello, Michele Dell'Aquila, Serdar Gunaydin, Youssef El Dsouki","doi":"10.1177/02676591261426843","DOIUrl":"10.1177/02676591261426843","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Hyperlactatemia during cardiopulmonary bypass (CPB) is a marker of inadequate oxygen delivery and correlates with postoperative morbidity and mortality. Although lactate is measured directly via enzymatic sensors, its rise can be anticipated through perfusion, hemodynamic, and metabolic indicators. We reviewed the literature and synthesized a Lactate Risk Score (LRS) weighted by published population data, focusing on adult cardiac surgery procedures performed under mild hypothermia (34-36°C). A Evidence-based Conceptual Review (PubMed, Embase, Scopus, up to September 2025) was conducted using keywords lactate, oxygen delivery, DO&lt;sub&gt;2&lt;/sub&gt;, carbon dioxide production, vasoactive drugs, arterial pressure, glucose, microemboli, cardiopulmonary bypass duration, cardiac surgery. Studies reporting perfusion thresholds linked with lactate levels in adult cardiac surgery were prioritized. Weighting of score components reflected both the strength of association and the population size of published cohorts. Across the literature, indexed oxygen delivery (DO&lt;sub&gt;2&lt;/sub&gt;i) below 260-280 mL/min/m&lt;sup&gt;2&lt;/sup&gt; emerged as the strongest predictor of lactate increase and was assigned +2 points in the score. Similarly, indexed carbon dioxide production greater than 60 mL/min/m&lt;sup&gt;2&lt;/sup&gt; (+2) and a DO&lt;sub&gt;2&lt;/sub&gt;i/VCO&lt;sub&gt;2&lt;/sub&gt;i ratio lower than 5 (+2) were strongly correlated with anaerobic metabolism. An oxygen extraction ratio ≥ 0.35 (+1) and a venous-to-arterial CO&lt;sub&gt;2&lt;/sub&gt; gap ≥ 6 mmHg or a Pv-PaCO&lt;sub&gt;2&lt;/sub&gt;/Ca-CvO&lt;sub&gt;2&lt;/sub&gt; ratio ≥ 1.8 (+1) added further risk information. The cumulative oxygen debt, quantified as the area under the curve of DO&lt;sub&gt;2&lt;/sub&gt; below the critical threshold, was weighted with +2 points, while prolonged CPB duration increased the score according to time: &gt;90 min (+1), &gt;120 min (+2), and &gt;180 min (+3). Hemodynamic instability with mean arterial pressure or arterial line pressure persistently &lt;50 mmHg was considered highly relevant and attributed +2 points, and the requirement for noradrenaline infusion &gt;0.05 µg/kg/min was weighted with +1. Among preoperative factors, advanced age, coronary artery disease, and baseline hemoglobin &lt;8 g/dL were each scored +1. Metabolic stress, reflected by intraoperative glucose increase &gt;180 mg/dL, added +1, and significant gaseous microembolic activity in the arterial line, defined as more than 500 bubbles per hour or emboli &gt;40 µm diameter, contributed +1. Based on this integration, the Lactate Risk Score ranges from 0 to 18 points, with risk stratification defined as low (0-3), intermediate (4-7), and high (≥8) for the development of clinically significant hyperlactatemia (≥4 mmol/L). The Lactate Risk Score integrates preoperative vulnerability (age, coronary artery disease, anemia), perfusion adequacy, cumulative oxygen debt, CPB duration, hemodynamic stability, vasoactive use, metabolic stress, and gaseous microembolic load. Derived from published cardiac surgery cohorts at 34-36","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1125-1133"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208367","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
Hyperthermic Extracorporeal Applied Tumor Therapy (HEATT®) in hospice-eligible cancer patients. 热体外应用肿瘤治疗(HEATT®)在符合临终关怀的癌症患者中的应用。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-01-08 DOI: 10.1177/02676591251413475
Joseph B Zwischenberger, Peyton Mashni, Robert Fischer, Joanne Essa, Sarah Hatchett, Jan Winetz, Roger Vertrees
{"title":"Hyperthermic Extracorporeal Applied Tumor Therapy (HEATT<sup>®</sup>) in hospice-eligible cancer patients.","authors":"Joseph B Zwischenberger, Peyton Mashni, Robert Fischer, Joanne Essa, Sarah Hatchett, Jan Winetz, Roger Vertrees","doi":"10.1177/02676591251413475","DOIUrl":"10.1177/02676591251413475","url":null,"abstract":"<p><p>BackgroundTwo previous clinical studies indicated veno-venous perfusion-induced systemic hyperthermia (VV-PISH), producing elevated temperatures of 42°C, induces cell death, apoptosis, or senescence of responsive cancers. The VV-PISH circuit has been refined and rebranded as Hyperthermic Extracorporeal Applied Tumor Treatment (HEATT<sup>®</sup>).MethodsThe local IRB approved this retrospective chart review. All devices are FDA-approved. The referring physician judged each patient to be hospice-eligible with a median predicted survival of 3 months and maximum predicted survival of 6 months. We evaluated HEATT<sup>®</sup> in hospice-eligible patients (<i>n</i> = 13) with unresponsive, advanced cancer, conducted at a single site, with a select, consistent team of healthcare providers (critical care, anesthesia, perfusionist, interventional radiologist, HEATT<sup>®</sup> consultant). HEATT<sup>®</sup> treatment (42°C for 120 min) was delivered once between June 2021 and April 2022. The referring physician followed patients until documented death. HEATT circuit and criteria were refined to maximize safety.ResultsIn a retrospective chart review of the 13 consecutive patients, 8/13 patients exceeded expected median survival, 6/13 exceeded the 6-months predicted end-of-life, and 5/13 exceeded 12 months. Lessons learned allowed the refinement of inclusion/exclusion criteria of Karnofsky >70, ability to ambulate, and age <80. Likewise, refining the circuitry led to improved standardization of the HEATT<sup>®</sup> perfusion technique and management.ConclusionsThis consecutive series of 13 hospice-eligible patients demonstrated the refinement of HEATT<sup>®</sup>, focusing on perfusion technique and selection criteria. In this small series of physician-referred hospice-eligible patients unresponsive to conventional therapy or other integrative oncology treatments, HEATT<sup>®</sup> demonstrated safety with an increase in the length of survival over median expected in eight of 13 patients, with five of 13 patients living 12 to 18 months, 2-3 times longer than the referring physician expected. These refinements are essential to enable prospective randomized trials of like-patient populations to generate evidence-based medical recommendations.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1215-1222"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935923","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
Sedation practices in adult patients with severe ARDS on extracorporeal respiratory support using VV ECMO - An international survey. VV ECMO体外呼吸支持下严重急性呼吸窘迫综合征(ARDS)成年患者镇静治疗的国际调查
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-01-14 DOI: 10.1177/02676591251415338
Christopher Noel, Adam Green, Abhimanyu Chandel, Joseph Delio, Nitin Puri, Chase Donaldson, Craig Rackley, Steven A Conrad, Peter Rycus, Joseph E Tonna, Akram Zaaqoq, Justyna Swol, Christopher King
{"title":"Sedation practices in adult patients with severe ARDS on extracorporeal respiratory support using VV ECMO - An international survey.","authors":"Christopher Noel, Adam Green, Abhimanyu Chandel, Joseph Delio, Nitin Puri, Chase Donaldson, Craig Rackley, Steven A Conrad, Peter Rycus, Joseph E Tonna, Akram Zaaqoq, Justyna Swol, Christopher King","doi":"10.1177/02676591251415338","DOIUrl":"10.1177/02676591251415338","url":null,"abstract":"<p><p>IntroductionOptimal sedation strategies for patients with respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV ECMO) are not well defined.MethodsPhysicians caring for patients on ECMO in an intensive care unit were invited to complete an international survey about sedation and analgesia practices for adult patients undergoing VV ECMO for severe Acute Respiratory Distress Syndrome (ARDS).ResultsThe survey was completed by 234 physicians, most commonly identifying as critical care (29.9%) and practicing in North America (38.9%). The Richmond Agitation Sedation Scale (88.5%) and Clinical Pain Observation Tool (40.2%) were commonly used for monitoring. Agents of choice were propofol (73.9% prior to ECMO and 56% within 48 h after initiation) and fentanyl (57.3% and 40.2%), with increasing preference for dexmedetomidine after ECMO initiation (14.5% prior to and 25.6% after initiation). Routine neuromuscular blockade use beyond 48 h after cannulation was rare (1.3%). Common strategies to reduce sedatives included sweep gas titration (74.4%) and minimizing nocturnal interventions (63.7%). Most respondents believe antipsychotics also work to this effect (57.3%).ConclusionsSedation strategies for adult ARDS patients receiving VV ECMO seem to be influenced by time from cannulation and patient factors. Future research should focus on identifying optimal sedation strategies and developing a consensus for best practice.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1238-1245"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985711","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}
引用次数: 0
Outcome of del Nido versus St. Thomas cardioplegia solution in adult mitral valve replacement surgery for rheumatic mitral valve disease. del Nido与St. Thomas心脏停搏液在风湿性二尖瓣疾病成人二尖瓣置换术中的疗效
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-02-03 DOI: 10.1177/02676591261423026
Akash Shah, Anil Jain, Himani Pandya, Ronak Raval
{"title":"Outcome of del Nido versus St. Thomas cardioplegia solution in adult mitral valve replacement surgery for rheumatic mitral valve disease.","authors":"Akash Shah, Anil Jain, Himani Pandya, Ronak Raval","doi":"10.1177/02676591261423026","DOIUrl":"10.1177/02676591261423026","url":null,"abstract":"<p><p>BackgroundEffective myocardial protection is essential for successful outcomes in open-heart surgery. Although both del Nido and St. Thomas cardioplegia solutions are widely used, comparative evidence in adult rheumatic mitral valve replacement remains limited. This study aimed to compare their myocardial protective efficacy and clinical outcomes.MethodsA prospective comparative study was conducted between May 2022 and October 2024. Total 50 adult patients undergoing mitral valve replacement-20 with severe mitral regurgitation (MR) and 30 with severe mitral stenosis (MS) were included. Patients were divided into two groups based on cardioplegia type (del Nido or St. Thomas). Intraoperative parameters, postoperative left ventricular ejection fraction (LVEF), troponin I levels, inotropic and ventilatory support, and ICU/hospital stay were analysed.ResultsBaseline characteristics were comparable across groups. The mean number of cardioplegia doses was significantly lower in the del Nido group (1.6 ± 0.5 vs 3.2 ± 0.8; <i>p</i> < 0.001). Postoperative LVEF was better preserved with del Nido cardioplegia (MS: 53.3 ± 7.2% vs 45.3 ± 10.6%; <i>p</i> = 0.023). Troponin I levels at 6, 24, and 48 h were lower in the del Nido group, though not statistically significant. Patients receiving del Nido required less inotropic and ventilatory support, with shorter ICU and hospital stays. One in-hospital death occurred in the del Nido group due to sepsis.ConclusionDel Nido cardioplegia offers comparable or superior myocardial protection to St. Thomas solution in adult mitral valve replacement, with fewer interruptions, reduced dosing, and faster postoperative recovery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1298-1303"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114682","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
Gender differences in one-year unplanned readmissions in atrial fibrillation: Trends from a conflict-stricken country. 房颤一年计划外再入院的性别差异:来自冲突国家的趋势
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2025-12-03 DOI: 10.1177/02676591251407291
Ibrahim Antoun, Alkassem Alkhayer, Alamer Alkhayer, Aref Jalal Eldin, Georgia R Layton, Riyaz Somani, G André Ng, Mustafa Zakkar
{"title":"Gender differences in one-year unplanned readmissions in atrial fibrillation: Trends from a conflict-stricken country.","authors":"Ibrahim Antoun, Alkassem Alkhayer, Alamer Alkhayer, Aref Jalal Eldin, Georgia R Layton, Riyaz Somani, G André Ng, Mustafa Zakkar","doi":"10.1177/02676591251407291","DOIUrl":"10.1177/02676591251407291","url":null,"abstract":"<p><p>IntroductionAtrial fibrillation (AF) is the most common arrhythmia worldwide, yet long-term outcomes in conflict-affected regions are poorly understood. Gender-based disparities in AF outcomes have been reported in high-income countries but remain unexplored in fragile healthcare systems.MethodsWe conducted a retrospective cohort study at Latakia's University Hospital in Latakia, Syria between June/2021-November/2023. Adult patients admitted with primary AF were followed for 1 year to assess unplanned readmissions. Data on unplanned readmissions were defined as non-elective hospitalisations occurring within 1 year after index discharge. These were unscheduled admissions, usually prompted by recurrence of symptoms, acute decompensation, or cardiovascular events. Data were collected from medical records.ResultsOf the included 657 patients (52% male, median age 60 years), 422 (64%) had at least one unplanned readmission within 1 year. Cardiac causes accounted for 67% of readmissions, with recurrent AF responsible for 75% of those. Females had higher all-cause (73% vs 56%) and cardiovascular (53% vs 34%) readmission rates than males (both <i>p</i> < 0.001). On multivariable analysis, independent predictors of readmission included female sex (HR 1.7, 95% CI 1.4-2.0), age ≥60 (HR 3.7, 95% CI 2.9-4.6), diabetes mellites (DM) (HR 1.5, 95% CI 1.2-1.8), and congestive heart failure (CCF) (HR 3.3, 95% CI 2.6-4.6). Females were more likely to have two (44%) or three or more (44%) readmissions than males.ConclusionsOne-year readmissions after AF admission were high, particularly among females. Female gender was an independent risk factor, highlighting the need for gender-sensitive follow-up strategies in resource-limited settings.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1134-1141"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670562","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}
引用次数: 0
Investigating cannula tip angles in pulmonary artery ECMO: A computational study on the potential benefits of angulation for oxygen delivery. 肺动脉ECMO中导管尖端角度的研究:角度对氧气输送的潜在益处的计算研究。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-01-13 DOI: 10.1177/02676591251407293
Eiman Shah, Jan Spillner, Johannes Greven, Annika Schmitz, Andreas Horbach, Yvan Fournier, Mehdi Behbahani
{"title":"Investigating cannula tip angles in pulmonary artery ECMO: A computational study on the potential benefits of angulation for oxygen delivery.","authors":"Eiman Shah, Jan Spillner, Johannes Greven, Annika Schmitz, Andreas Horbach, Yvan Fournier, Mehdi Behbahani","doi":"10.1177/02676591251407293","DOIUrl":"10.1177/02676591251407293","url":null,"abstract":"<p><p>IntroductionPulmonary artery (PA) cannulation is emerging as a method for concurrent cardiac and respiratory failure, but limited data exists on how cannula positioning, particularly cannula tip angle, affects perfusion symmetry. Due to varying pulmonary bifurcation geometry between patients, ensuring even distribution of oxygen-saturated blood becomes critical. This computational fluid dynamics (CFD) study investigated the effects of cannula positioning and angles on oxygen delivery within the PA using 6 different configurations.MethodAn idealized PA geometry based on a CT scan was constructed including the 6 different cannula configurations: two straight (short and long) and four angled (5° and 10° toward either pulmonary branch). Simulations assumed laminar, steady-state flow at 6 L/min total (50% ECMO contribution). Oxygen transport was modeled as a passive scalar with 75% saturation from the heart and 100% from the cannula. Perfusion symmetry was quantified using the absolute difference in mean oxygen saturation (ΔSaO<sub>2</sub>) and partial pressure (ΔpO<sub>2</sub>) between the right (RPA) and left pulmonary arteries (LPA).ResultsCannula positioning and angulation influences oxygen distribution within the PA. Straight-tipped cannulas favored LPA-sided flow due to the natural geometry of the pulmonary artery (ΔSaO<sub>2</sub> = 12.9-15.1%). A 5° RPA directed angulation achieved the most symmetric distribution (ΔSaO<sub>2</sub> = 9.2%, ΔpO<sub>2</sub> = 14.2 mmHg), whereas greater or opposite angulations increased flow asymmetry.ConclusionMinor cannula tip angulation, specifically 5° deflection towards the RPA, enhances bilateral PA oxygenation without increasing ECMO flow, providing a simple yet effective strategy for optimizing pulmonary ECMO perfusion.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1149-1156"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967739","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
Infusion strategy of del Nido cardioplegia for long aortic cross-clamp time in adult cardiac surgery. 成人心脏手术主动脉交叉夹持时间过长的del Nido停搏液输注策略。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2025-12-27 DOI: 10.1177/02676591251412272
Fangrui Wang, Jiechun Huang, Xiaotian Sun, Xianglin Chu, Rongrong Jiang, Yiqing Wang, Liewen Pang, Xiaofeng Chen
{"title":"Infusion strategy of del Nido cardioplegia for long aortic cross-clamp time in adult cardiac surgery.","authors":"Fangrui Wang, Jiechun Huang, Xiaotian Sun, Xianglin Chu, Rongrong Jiang, Yiqing Wang, Liewen Pang, Xiaofeng Chen","doi":"10.1177/02676591251412272","DOIUrl":"10.1177/02676591251412272","url":null,"abstract":"<p><p>BackgroundThe del Nido cardioplegia (DNC) solution has been widely used for myocardial protection in adult cardiac surgery, however, its use remains unclear in cases with long aortic cross-clamp time. Therefore, this study examined postoperative myocardial injury and the use of intraoperative DNC data of patients with cross-clamp time greater than 100 min in the past 4 years to explore a safe and effective infusion strategy for DNC.MethodsData were collected from 129 patients who underwent cardiac surgery between January 2020 and July 2024 using DNC with aortic occlusion time greater than 100 min. This single-center cross-sectional cohort study aimed to review relationship between the postoperative myocardial injury (myocardial markers) and the use of intraoperative DNC data during extracardiac surgery. Potential confounders included patient demographics (age, sex, weight, height), high-risk factors, preoperative cardiac function and surgical factors. Statistical methods were used to analyze the data using SPSS 27.0.ResultsOn average, the patients underwent cardiopulmonary bypass with duration of 193.43 min. Aortic cross-clamp time was 126.19 min, and 2.22 cardioplegia infusions were administered. Most patients (82.9%) received initial infusion and one re-dose, while 17.1% required two or more re-dose. Postoperative myocardial markers were not correlated with patient demographics but were significantly correlated with cardiopulmonary bypass and aortic cross-clamp time. Particularly, time after the second infusion was the best predictor, with a cutoff of 69.5 min by Receiver Operating Characteristic curve. Patients with longer time after the second infusion had higher myocardial markers and required most postoperative vasoactive support.ConclusionsIn adult cardiac surgery with long aortic cross-clamp time, it is recommended to administer a second infusion within 90 min, and avoid exceeding 70 min to give the third infusion. Multiple infusions do not have a significant effect on postoperative myocardial injury.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1198-1206"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846325","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 the Quantra® QPlus sonorheometry with conventional hemostasis laboratory and TEG-5000® parameters. Quantra®QPlus超声测定仪与常规止血实验室和TEG-5000®参数的比较。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2025-12-26 DOI: 10.1177/02676591251412308
Stephan Frédéric, Nicolas Istaces, Linda Lovqvist, Sophie Aunac
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引用次数: 0
Corrigendum to: "A comparison of continuous blood gas monitors during cardiopulmonary bypass LivaNova B-capta, terumo CDI 500, spectrum medical M4". 对“体外循环期间连续血气监测仪的比较”的更正:LivaNova B-capta, terumo CDI 500, spectrum medical M4。
IF 1.3 4区 医学
Perfusion-Uk Pub Date : 2026-10-01 Epub Date: 2026-06-29 DOI: 10.1177/02676591261455188
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引用次数: 0
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