Perfusion-Uk最新文献

{"title":"Body adiposity index and other indexes of body composition in predicting cardiovascular disease in the Chinese population: A Cohort study.","authors":"Wen-Shu Luo, Yi Ding, Zhi-Rong Guo","doi":"10.1177/02676591241300973","DOIUrl":"10.1177/02676591241300973","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare the ability of four obesity indicators, including waist circumference (WC), body mass index (BMI), body adiposity index (BAI), and waist-to-height ratio (WHtR) on prediction for incident cardiovascular disease (CVD) in Chinese Han population.</p><p><strong>Methods: </strong>We analyzed data from a prospective population cohort of 3598 participants aged 35 to 74 years from Jiangsu China. The logistic regression model was used to analyze the association between four obesity indicators and CVD risk. The ROC curve was used to assess and compare the diagnostic performance of four obesity indicators.</p><p><strong>Results: </strong>During 8 years (median 6.3 years) of follow-up time, 82 CVD endpoints were collected during follow up (36 men and 46 women). After adjustment for age, smoking status, alcohol consumption and family history of CVD, in men, WC, BMI, and BAI were associated with triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and hypertension. In women, WC, BMI and WHtR were associated with TG, HDL-C, hyperglycemia and hypertension, BAI was only associated with HDL-C, hyperglycemia, and hypertension. ROC curve analysis indicated that BAI have the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese males. WHtR has the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese females.</p><p><strong>Conclusions: </strong>CVD risk was more consistently correlated with BAI in Chinese men and more consistently correlated with WHtR and WC in Chinese women.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241300973"},"PeriodicalIF":1.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631447","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":"Efficacy and safety of percutaneous post-closure technique during the decannulation for veno-arterial extracorporeal membrane oxygenation.","authors":"Junchu Wei, Andong Lu, Chenliang Pan, Liangshan Wang, Juan Ma, Nan Bai, Kang Dong, Jing Zhao, Ming Bai","doi":"10.1177/02676591241300946","DOIUrl":"https://doi.org/10.1177/02676591241300946","url":null,"abstract":"<p><strong>Background: </strong>In recent years, during the decannulation process for veno-arterial extracorporeal membrane oxygenation (VA-ECMO), methods for suturing the femoral artery have included the pre- and post-closure techniques. The safety and efficacy of the pre-closure technique are widely recognised; however, reports on the post-closure technique are scarce. This study aimed to evaluate the safety and efficacy of the post-closure technique using ProGlide (Abbott Healthcare, Green Oaks, IL, USA) device during VA-ECMO decannulation.</p><p><strong>Methods: </strong>We reviewed 170 patients who underwent VA-ECMO between January 2021 and June 2023. All patients had their femoral artery puncture sites closed using the post-closure technique upon decannulation. The success rate of this technique and incidence of lower limb complications were recorded and analysed.</p><p><strong>Result: </strong>Technical success was achieved in 157 (92.4%) patients. Sixteen patients (9.4%) experienced lower limb-related complications, including 8 (4.7%) with lower limb arterial thrombosis and 11 (6.5%) with pseudo-aneurysms. Among all lower limb-related complications, four patients (2.4%) required interventional procedures. This study included 170 patients: 80 in the 'S' (15-16 F) group and 90 in the 'M' (17-19 F) group. In the univariate analysis of different arterial cannula sizes for in-hospital lower limb-related complications, the differences were not statistically significant (<i>p</i> > 0.05). The multivariate logistic model indicated that, compared to the S (15-16 F) group, the M (17-19 F) group was not associated with an increased rate of in-hospital lower limb-related complications.</p><p><strong>Conclusions: </strong>The suture-mediated closure of the femoral artery during VA-ECMO decannulation is a promising therapeutic strategy.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241300946"},"PeriodicalIF":1.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639931","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":"Initial experience with pump controlled retrograde trial-off (PCRTO) veno-arterial extra corporeal membrane oxygenation in children.","authors":"Anuradha P Menon, Janine C Koh, Siew Yan Teng, Tanee Chan, Masakazu Nakao","doi":"10.1177/02676591241300955","DOIUrl":"https://doi.org/10.1177/02676591241300955","url":null,"abstract":"<p><p>Pump Controlled Retrograde Trial Off (PCRTO) is a relatively new technique in trialing-off Veno-Arterial Extra Corporeal Membrane Oxygenation (VA-ECMO). Literature on the use of PCRTO in children remains scarce. We describe our centre's initial experience with PCRTO in a neonate and an older child and review its potential advantages and disadvantages compared to traditional weaning methods. More research and shared best practices are required in children to facilitate wider adoption of this technique.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241300955"},"PeriodicalIF":1.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631543","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":"Extended use of axillary impella 5.5 as a bridge to post-infarct ventricular septal defect repair.","authors":"Vasiliki Gregory, Ariadne Zias, Ameesh Isath, David Spielvoge, Suguru Ohira","doi":"10.1177/02676591241300951","DOIUrl":"https://doi.org/10.1177/02676591241300951","url":null,"abstract":"<p><p>Post-infarct ventricular septal defect (VSD) carries high mortality. Since emergent repair of post-infarct VSD is challenging, hemodynamic stabilization utilizing temporary mechanical circulatory support crucially provides time to delay intervention and allows necessary scar tissue formation which improves the fragility of myocardium and leads to a definitive repair. To date, there remains no standard for achieving hemodynamic stability, including usage and mode of temporary mechanical circulatory support. We describe a patient with acute post-infarct VSD in cardiogenic shock successfully supported with Impella 5.5 for 67 days as a bridge to surgical repair and coronary artery bypass grafting.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241300951"},"PeriodicalIF":1.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631541","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":"Postoperative bleeding outcome of fresh frozen plasma prime in pediatric cardiac surgery: A systematic review & meta-analysis.","authors":"Dian Kesumarini, Yunita Widyastuti, Cindy Elfira Boom, Andrea Laurentius, Lucia Kris Dinarti","doi":"10.1177/02676591241298822","DOIUrl":"https://doi.org/10.1177/02676591241298822","url":null,"abstract":"<p><strong>Introduction: </strong>Bleeding after cardiac surgeries holds risk of mortality and morbidity in pediatrics. This systematic review aimed to evaluate postoperative blood loss and blood transfusion requirements for pediatric patients undergoing cardiac surgery with fresh frozen plasma (FFP) priming.</p><p><strong>Methods: </strong>In 2024, the search reviewed four databases on randomized trials (RCTs) examining the impact of FFP prime intervention on 24-h postoperative blood loss and transfusion requirements in pediatric cardiac surgeries. The journals were appraised using <i>Grading of Recommendation Assessment, Development, and Evaluation</i> checklists, and random effects models estimated the effect size with a 95% confidence interval. Significance and study heterogeneity were indicated by <i>p</i>-values and I².</p><p><strong>Results: </strong>Of the screened 2070 articles, one high-quality and four moderate-quality RCTs involving 354 children were identified. No significant reduction in 24-h mean postoperative blood loss was found following FFP priming (mean difference MD: -0.78, 95% CI [-3.3 to 1.75], <i>p</i> = .55) in general pediatric cardiac surgeries. However, subgroup analysis showed significant decrease in blood loss for younger children (<7 months) or those with lower body weight (<6 kg). There was no significant difference between groups in FFP (MD: -0.19, 95% CI [-0.42 to 0.05], <i>p</i> = .13) or red blood cell transfusion (MD: -0.25, 95% CI [-0.51 to 0.02], <i>p</i> = .07).</p><p><strong>Conclusion: </strong>Administering FFP as prime fluid in cardiac surgery did not reduce postoperative bleeding in general pediatric patients, but younger children (<7 months) and those with lower weight (<6 kg) were the subjects who benefited from the FFP priming before surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241298822"},"PeriodicalIF":1.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607151","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":"An investigation into the contributing factors to survival of ARDS patients supported by veno-venous ECMO.","authors":"Gavin Majithia-Beet, Roozbeh Naemi, Richard Issitt","doi":"10.1177/02676591241297048","DOIUrl":"https://doi.org/10.1177/02676591241297048","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify characteristics associated with survival during and post Extra Corporeal Membrane Oxygenation (ECMO) therapy, in patients with acute respiratory distress syndrome (ARDS) during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A retrospective observational study on 94 consecutive patients with confirmed COVID-19 induced ARDS supported by ECMO was carried out 49/94 (52.7%) patients survived to hospital discharge.</p><p><strong>Results: </strong>Non-survivors were found to have significantly (<i>p</i> < .05) higher: Pre-ECMO International normalized ratios (INR), carbon dioxide partial pressure (<i>p</i>CO₂), Acute Kidney Injury (AKI) scores and blood urea levels. Also, lower pre-ECMO peak inspiratory pressures (PIP), mean arterial pressure, saturation of arterial oxygen (SaO₂), blood bicarbonate levels (HCO3), blood Ph and fewer trials off ECMO with shorter combined trial off times. Patients that did not survive were more likely to have renal impairment and have received peri-ECMO haemofiltration. Poor prognosis was significantly associated with: receiving pre-ECMO nitric oxide (HR = 3.047, CI = 1.247-7.447, <i>p</i> = .015), renal impairment (HR = 3.023, CI = 1.586-5.763, <i>p</i> < .001), AKI of 2 (HR = 3.611, CI = 1.382-9.441, <i>p</i> = .009) or 3 (HR = 3.275, CI = 1.235-8.685, <i>p</i> = .017), peri-ECMO haemofiltration (HR = 2.412, CI = 1.310-4.442, <i>p</i> = .005) and the ABO blood group B (HR = 3.103, CI = 1.335-7.212, <i>p</i> = .008). pre-ECMO high CO₂ (HR = 1.134, CI = 1.031-1.248, <i>p</i> = .010), blood lactate (HR = 1.350, CI = 1.156-1.576, <i>p</i> < .001), INR (HR = 2.571, CI = 1.438-4.598, <i>p</i>=<0.001) and lower blood Ph (HR = 0.023, CI = 0.002-0.210, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Commonly used mortality scores may not be of use in a COVID-19 cohort of ECMO patients. The initiation of ECMO needs to be implemented prior to metabolic derangements, renal and fulminant respiratory failure.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241297048"},"PeriodicalIF":1.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589832","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":"Interaction of azithromycin and methylprednisolone with ex-vivo extracorporeal membrane oxygenation circuits (ECMO).","authors":"Andrew Chevalier, Autumn McKnite, Aviva Whelan, Carina Imburgia, Joseph E Rower, Kevin M Watt, Danielle J Green","doi":"10.1177/02676591241297401","DOIUrl":"https://doi.org/10.1177/02676591241297401","url":null,"abstract":"<p><strong>Background: </strong>Azithromycin and methylprednisolone are two medications that are commonly used in patients who require ECMO support. Unfortunately, ECMO support can decrease drug concentrations through adsorption to circuit components. Such interactions have not been well described for either azithromycin or methylprednisolone. This study determined the extraction of these medications by ECMO circuits in an <i>ex-vivo</i> system.</p><p><strong>Methods: </strong>Medications were administered to closed-loop, blood-primed ECMO circuits to attain target therapeutic concentrations. Drug concentration remaining in the circuit was measured over 6 h. The difference in medication recovery was compared between the ECMO circuits and controls using two-sample t-tests.</p><p><strong>Results: </strong>Concentrations of azithromycin and methylprednisolone remained constant in control experiments over time, indicating medication stability in blood. There was no statistical difference in percent recovery after 6 h between control experiments and the ECMO circuits for either azithromycin (<i>p</i> = .32) or methylprednisolone (<i>p</i> = .17).</p><p><strong>Discussion: </strong>Azithromycin and methylprednisolone did not significantly interact with <i>ex-vivo</i> ECMO circuits. While these studies do not account for all <i>in-vivo</i> pharmacokinetic changes that may occur as a result of ECMO and critical illness, they suggest that standard dosing may be adequate to achieve therapeutic concentrations of azithromycin and methylprednisolone.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241297401"},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584758","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":"Cardiopulmonary bypass of acute type A aortic dissection during pregnancy at the 20th gestational week with maternal and foetal survival: A case report.","authors":"Ling Wang, Jie Yi, Fang-Fang Qin, Cai-Xia Liu, Liu Huang","doi":"10.1177/02676591241297319","DOIUrl":"https://doi.org/10.1177/02676591241297319","url":null,"abstract":"<p><strong>Background: </strong>Type A acute aortic dissection, an aggressive and highly fatal disease, is particularly common among pregnant women and foetuses. This disease often occurs during the third trimester of pregnancy and the postpartum period.</p><p><strong>Case report: </strong>This case involves a female who was 20 weeks pregnant with type A acute aortic dissection. While maintaining pregnancy, the patient underwent Bentall surgery and Sun's procedure. The duration of circulatory arrest was a brief 4 min. The patient fully recovered 40 days after surgery and remained pregnant post-discharge. At the 38th gestational week, she delivered a healthy male infant via caesarean section.</p><p><strong>Clinical discussion: </strong>Gestational morbidity can have a serious impact on the safety of mothers and children. Currently, the shortest time reported for hypothermic circulatory arrest is 5 min. In this case, the lower body circulatory arrest was controlled to approximately 4 min during cardiopulmonary bypass while simultaneously safeguarding both individuals. Ideal strategies for cardiopulmonary bypass to reduce foetal risk include shorter cardiopulmonary bypass times, higher flow rates, and higher perfusion pressures. A reduction in the duration of hypothermic circulatory arrest further increases foetal survival rates.</p><p><strong>Conclusions: </strong>The development of a rational cardiopulmonary bypass plan should be tailored to the physiological characteristics of the pregnant woman to ensure the safety of both the pregnant woman and the foetus, reduce complications, and improve the success rate of the operation.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241297319"},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584756","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":"The safety of cell saver washing all shed mediastinal blood before re-transfusing it to the patient.","authors":"Sara Scicluna, Magnus Dencker, Henrik Bjursten","doi":"10.1177/02676591241297545","DOIUrl":"https://doi.org/10.1177/02676591241297545","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiotomy suction blood is used in cardiopulmonary bypass (CPB) surgery to maintain blood volume in the CPB system, although it is known to contain micro emboli, cytokines and free plasma hemoglobin. Our aim was to investigate whether cell saver washing the cardiotomy suction blood before re-transfusing it is safe.</p><p><strong>Methods: </strong>This is a retrospective study of 1671 elective coronary artery bypass patients, 209 of whom had their pericardial blood processed in a cell saver (Ce-S group). PS matching was performed with patients who had their pericardial blood returned back to the CPB-system by the cardiotomy suction (Ca-S group). Perioperative transfusion requirements, surgical outcome, postoperative lab data and mortality were then compared.</p><p><strong>Results: </strong>There were no differences in baseline characteristics or EuroSCORE between the groups. The number of patients requiring transfusions did not differ, but the patients in the Ca-S group received more platelets (0.34 ± 1.0 vs 0.16 ± 0.7 units, <i>p</i> = .03) than in the Ce-S group. CRP (c-reactive protein) levels at day 2 and 4 were higher in the Ca-S group (174.8 ± 67.2 and 148.9 ± 74.3 mg/L vs 160.1 ± 64.6 and 125.9 ± 67.2 mg/L, <i>p</i> = .03, <i>p</i> = .002) and so were ASAT (aspartate aminotransferase) levels (0.97 ± 0.8 vs 0.81 ± 0.6 μkat/L, <i>p</i> = .03). Mortality, postoperative ventilation time, stroke, mediastinal infections and length of stay in the ICU were the same in both groups.</p><p><strong>Conclusions: </strong>In this retrospective study of patients undergoing elective CABG surgery, washing the cardiotomy suction blood before re-transfusion was not associated with higher risk of allogenic blood transfusion, postoperative stroke, mediastinal infections, or 30- and 365-days mortality.</p><p><strong>Clinical registration number: </strong>LU EPN 2016/4.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241297545"},"PeriodicalIF":1.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570268","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":"Surgery for a giant atherosclerotic left main trifurcation saccular coronary artery aneurysm.","authors":"Mehmet Cahit Saricaoglu, Yusuf Corbacioglu, Salih Anil Boga, Serenay Deniz, Irem Dincer, Ahmet Ruchan Akar","doi":"10.1177/02676591241296714","DOIUrl":"https://doi.org/10.1177/02676591241296714","url":null,"abstract":"<p><p>Aneurysms of the left main coronary artery are rare clinical entities with an incidence of 0.1%. We herein report a case of left main trifurcation aneurysm in a 57-year-old woman whose coronary angiography demonstrated a giant saccular aneurysm of trifurcation of the left main coronary artery, measuring 32 × 21 mm with tight post-aneurysmal stenosis in the intermediate artery. The patient underwent coronary artery bypass grafting following the resection of CAA and reconstruction with saphenous vein roof-plasty, which ensured the preservation of the native coronary vasculature. At the 6-month follow-up, she remained asymptomatic and preserved preoperative left ventricular function.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591241296714"},"PeriodicalIF":1.1,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570262","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}