Perfusion-Uk最新文献

{"title":"\"This could be a good thing\".","authors":"Mark Kurusz","doi":"10.1177/02676591241291337","DOIUrl":"10.1177/02676591241291337","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"271-272"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479092","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":"Perfusion education and training in Europe anno 2023.","authors":"Gerdy Debeuckelaere, Christian Klüß, Katja Ruck, Naveen G Nagaraj, Ermin Brajlović, Gunilla Kjellberg, Cristian Talmaciu, Zvonko Lenart, Monika Muraskauskaite, Nemanja Ristić, Camilla Nyeng, Konstantinos Mintzaridis, Emmanuel Devolder, Radoslav Simeonov, Colin Canavan, Stefan Kmetovski, Tamer Sari, Katerina Krumposova, Maria Teresa Mata, Luka Crnković, Jeffrey Muscat, Normunds Sikora, John Campbell, Markku Rantanen, Inês Figueira, Rein Kruusat, Joël Frédéric, Serhii Sudakevych, Ratko Savović, Andrzej Jelonek, San-Mari van Delft- van Deventer, Maria Erminia Macera Mascitelli","doi":"10.1177/02676591241233971","DOIUrl":"10.1177/02676591241233971","url":null,"abstract":"<p><p><i>Background:</i> In the absence of uniform European regulations, there have been many differences in the training of perfusionists across Europe. Furthermore, there has been no uniform or single European accreditation of the profession. One of the objectives of The European Board of Cardiovascular Perfusion (EBCP) is to standardise and monitor training of perfusionists across Europe whilst offering support in accordance with national regulations. This goal is particularly imminent as there have been numerous newly founded National perfusion societies, particularly from Eastern European countries, which are now established members of EBCP.<i>Purpose:</i> In this article, we provide an updated overview or 'snapshot' of current European perfusion training programs that were accessible in 2022. Nationally acquired data refers to 2022 unless stated otherwise. The last overview of Perfusion education in Europe was reported over 15 years ago including 20 countries.<i>Research Design:</i> For this report thirty-two national EBCP delegates plus representatives from Austria were contacted at the beginning of 2023 to complete a pro forma questionnaire about their national perfusion training programmes. The data has been summarized in this article and five additional derived parameters were calculated.<i>Results:</i> We received responses from 31 countries, providing specific national training characteristics which are summarized, listed and benchmarked by country in this article.<i>Conclusion:</i> There have been several national and supranational initiatives towards the recognition of perfusion as a profession in Europe, however so far without success for the majority of countries. For this reason, it remains essential for EBCP, as the only European professional perfusionist body, to define education standards and competencies for perfusionists and to monitor training by accreditation of dedicated perfusion schools across Europe.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"495-512"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974218","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 association between cerebral blood flow variations during on-pump coronary artery bypass grafting surgery and postoperative delirium.","authors":"Caterina Sampaolesi, Erika Casarotta, Giacomo Gresti, Giulia Mariotti, Leonardo Pisani, Diego Veccia, Marco Di Eusanio, Pietro Giorgio Malvindi, Abele Donati, Christopher Maria Münch","doi":"10.1177/02676591241239823","DOIUrl":"10.1177/02676591241239823","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium (POD) has a major impact on patient recovery after cardiac surgery. Although its pathophysiology remains unclear, there could be a correlation between cerebral blood flow (CBF) variations during cardio-pulmonary bypass (CPB) and POD. Our study aimed to evaluate whether variations in on-pump CBF, compared to pre-anesthesia and pre-CPB values, are associated with POD following coronary artery bypass grafting (CABG) surgery.</p><p><strong>Methods: </strong>This prospective observational cohort study included 95 adult patients undergoing elective on-pump CABG surgery. Right middle cerebral artery blood flow velocity (MCAV) was assessed using Transcranial Doppler before anesthesia induction, before CPB and every fifteen minutes during CPB. Pre-anesthesia and pre-CPB values were chosen as baselines. Individual values, measured during CPB, were converted as percentage changes relative to these baselines and named as %MCAV₀ and %MCAV₁, respectively. POD was assessed using the Confusion Assessment Method for ICU (CAM-ICU) during the first 48 post-operative hours and with the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) on the fifth post-surgical day.</p><p><strong>Results: </strong>Overall POD incidence was 17.9%. At 30 minutes of CPB, %MCAV₀ was higher in POD group than in no-POD group (<i>p</i> = .05). %MCAV₀ at 45 minutes of CPB was significantly higher in POD group (87 (±17) %) than in no-POD group (68 (±24) %), <i>p</i> = .04. %MCAV₁ at 30 and 45 minutes of CPB were higher in POD group than in no-POD group, at the limit of statistical significance. We found %MCAV₁ > 100% in POD group, but not in no-POD group.</p><p><strong>Conclusions: </strong>Significant differences in %MCAV₀ became evident after 30 minutes of CPB, whereas differences in %MCAV₁ at 45 minutes of CPB were at limit of statistical significance. In POD group %MCAV₁ was higher than 100% at 30 and 45 minutes of CPB, which is supposed to be a sign of cerebral hyperperfusion. Monitoring CBF during CPB could have prognostic value for POD.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"440-449"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133102","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 effects of tranexamic acid in patients treated with extracorporeal membrane oxygenation after cardiac surgery.","authors":"Wei Chen, Zhongtao Du, Liangshan Wang, Mengjun Wang, Hong Wang, Xiaotong Hou","doi":"10.1177/02676591241242641","DOIUrl":"10.1177/02676591241242641","url":null,"abstract":"<p><strong>Background: </strong>The lysine analog tranexamic acid (TXA) is used as a blood protective drug in cardiac surgery, but efficacy and safety outcomes in patients treated with extracorporeal membrane oxygenation (ECMO) after surgery remain poorly understood.</p><p><strong>Methods: </strong>From January 1, 2017 to December 31, 2022, we retrospectively analyzed patients assisted by ECMO after cardiac surgery and divided them into TXA and control groups depending on whether TXA was used or not. The primary study outcome was red blood cell (RBC) transfusion during ECMO.</p><p><strong>Results: </strong>In total, 321 patients treated with ECMO after cardiac surgery were assessed; 185 patients were eligible for inclusion into to the TXA-intervention group and 136 into to the control group. RBC transfusion during ECMO was 8.0 IU (4.0 IU-14.0 IU) in the TXA group versus 10.0 IU (6.0 IU-16.0 IU) in the control group (<i>p</i> = .034). Median total chest drainage volume after surgery was 1460.0 mL (650.0-2910.0 mL) and 1680.0 mL (900.0-3340.0 mL) in TXA and control groups, respectively (<i>p</i> = .021). Postoperative serum D-dimer levels were significantly lower in the TXA group when compared with the control group; 1.125 µg/mL (0.515-2.176 µg/mL) versus 3.000 µg/mL (1.269-5.862 µg/mL), <i>p</i> < .001. Serious adverse events, including vascular occlusive events, did not differ meaningfully between groups.</p><p><strong>Conclusions: </strong>In patients treated with ECMO after cardiac surgery, TXA infusion modestly but significantly reduced RBC transfusions and chest tube output when compared with the control group.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"475-482"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327306","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":"Negative pressure therapy for ECMO cannula stabilization.","authors":"Jennifer Gauntt, Virginia Kathleen Cox, Vicky Duffy, Matt Deitemyer, Eric Lloyd, Amee Bigelow, Patrick McConnell, Janet Simsic","doi":"10.1177/02676591241236640","DOIUrl":"10.1177/02676591241236640","url":null,"abstract":"<p><p>Cannula stabilization for extracorporeal membrane oxygenation (ECMO) is important for patient mobilization and rehabilitation. Limitations to mobilization on ECMO include staff discomfort and cannula instability. We utilized the technique of negative pressure therapy for ECMO cannula stabilization to improve mobilization. Negative pressure therapy for ECMO cannula stabilization can be utilized safely for a variety of cannulation sites in any patient age from newborns to adults. This wound management strategy may facilitate patient mobilization and rehabilitation therapies in addition to extending cannula site duration.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"343-347"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941097","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 blood conservation protocol on the utilisation of blood and outcome of patients undergoing open heart surgery.","authors":"Vivek Bagaria, Lahari Badragiri, C S Hiremath","doi":"10.1177/02676591241239838","DOIUrl":"10.1177/02676591241239838","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac surgery is fraught with increased consumption of blood and blood products. Various strategies for blood conservation have been described. Our aim was to study the impact of a structured blood conservation protocol (BCP) on the utilization of blood and patient outcome.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected data comparing adult patients undergoing open heart surgery with BCP with those undergoing surgery without BCP. The primary objective was to compare the amount of blood utilized and the hematocrit at discharge. The secondary objective was to compare the parameters of patient outcomes. The level of significance was set at 0.05.</p><p><strong>Results: </strong>The proportion of patients requiring transfusion (19.1% [9/47] vs 58.9% [33/56]; <i>p</i> < 0.001) and the quantity of blood transfused (12 units vs 45 units; <i>p</i> 0.003) in the BCP group was significantly lower. Interestingly, the hematocrit level at discharge was comparable between the groups (30.9 (4.8) versus 31.8 (2.4), p-0.671). The average cost incurred for transfusing blood in the BCP group was ₹ 370.2 as compared to ₹1165.1 in the other (<i>p</i> < 0.001). BCP reduced the odds of overall blood transfusion by 79.8% (OR 0.202 (0.084-0.485); <i>p</i> < 0.001) and intraoperative blood transfusion by 95.3% (OR 0.047 (0.010-0.213); <i>p</i> < 0.001). The morbidity and mortality were comparable between the groups.</p><p><strong>Conclusion: </strong>Implementing a structured blood conservation protocol in patients undergoing open heart surgery significantly reduces the need for blood transfusion. It also has a promising impact on patient recovery after surgery and significant positive cost implications.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"450-459"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140982","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":"Direct aortic cannulation versus femoral arterial cannulation for early outcomes in acute type A aortic dissection: A study-level meta-analysis.","authors":"Yoshiyuki Yamashita, Serge Sicouri, Stephanie Kjelstrom, Georgia Montone, Aleksander Dokollari, Khalid Ridwan, Nicholas Clarke, Roberto Rodriguez, Scott M Goldman, Basel Ramlawi","doi":"10.1177/02676591241241422","DOIUrl":"10.1177/02676591241241422","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of direct aortic cannulation (DAC) versus femoral arterial cannulation (FAC) on clinical outcomes of surgery for acute type A aortic dissection.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched until August 25, 2023, to conduct a meta-analysis. Primary endpoints of the study were operative mortality and postoperative stroke. Secondary endpoints were cardiopulmonary bypass time, myocardial ischemic time, hypothermic circulatory arrest time, temporary neurological dysfunction (TND), combined stroke and TND, re-exploration for bleeding, and need for renal replacement therapy. A random-effect model was used to estimate the pooled effect size, and a leave-one-out method was used for the primary endpoints for sensitivity analysis.</p><p><strong>Results: </strong>15 studies met our eligibility criteria, including a total of 7941 samples. Operative mortality was significantly lower in the DAC group with a pooled odds ratio (OR) of 0.72 [95% confidence interval (CI): 0.61-0.85)]. Incidence of postoperative stroke was also lower in the DAC group with a pooled OR of 0.79 (95% CI: 0.66-0.94). However, after excluding one study with the greatest weight, the difference became nonsignificant. DAC was also associated with a lower incidence of postoperative TND, and re-exploration for bleeding with a pooled OR of 0.52 (95% CI: 0.37-0.73), and 0.60 (95% CI: 0.47-0.77), respectively.</p><p><strong>Conclusions: </strong>This meta-analysis showed that patients who underwent ATAAD repair with DAC had a lower incidence of operative mortality, postoperative stroke, TND, and re-exploration for bleeding compared to those who underwent FAC.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"295-307"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307586","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":"Plasma hyperosmolality during cardiopulmonary bypass is a risk factor for postoperative acute kidney injury: Results from double blind randomised controlled trial.","authors":"Staffan Svenmarker, Helena Claesson Lingehall, Gunnar Malmqvist, Micael Appelblad","doi":"10.1177/02676591241240726","DOIUrl":"10.1177/02676591241240726","url":null,"abstract":"<p><strong>Introduction: </strong>The study objective was to investigate whether a Ringer's acetate based priming solution with addition of Mannitol and sodium concentrate increases the risk of cardiac surgery associated kidney injury (CSA-AKI).</p><p><strong>Methods: </strong>This is a double blind, prospective randomized controlled trial from a single tertiary teaching hospital in Sweden including patients aged ≥65 years (<i>n</i> = 195) admitted for routine cardiac surgery with cardiopulmonary bypass. Patients in the study group received Ringer's acetate 1000 mL + 400 mL Mannitol (60 g) + sodium chloride 40 mL (160 mmol) and heparin 2 mL (10 000 IU) 966 mOsmol (<i>n</i> = 98), while patients in the control group received Ringer's acetate 1400 mL + heparin 2 mL (10 000 IU), 388 mOsmol (<i>n</i> = 97) as pump prime. Acute kidney injury was analysed based on the Kidney Disease Improving Outcomes (KDIGO 1-3) definition.</p><p><strong>Results: </strong>The overall incidence of CSA-AKI (KDIGO stage 1) was 2.6% on day 1 in the ICU and 5.6% on day 3, postoperatively. The serum creatinine level did not show any postoperative intergroup differences, when compared to baseline preoperative values. Six patients in the Ringer and five patients in the Mannitol group developed CSA-AKI (KDIGO 1-3), all with glomerular filtration rates <60 mL/min/1.73 m². These patients showed significantly higher plasma osmolality levels compared to preoperative values. Hyperosmolality together with patient age and the duration of the surgery were independent risk factors for postoperative acute kidney injury (KDIGO 1-3).</p><p><strong>Conclusions: </strong>The use of a hyperosmolar prime solution did not increase the incidence of postoperative CSA-AKI in this study, while high plasma osmolality alone increased the associated risk by 30%. The data suggests further examination of plasma hyperosmolality as a relative risk factor of CSA-AKI.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"466-474"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186114","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":"Blood conservation strategies in complex aortic surgery for a Jehovah's Witness: A case report.","authors":"Hannah Lewis, Joseph Devlin","doi":"10.1177/02676591251324644","DOIUrl":"https://doi.org/10.1177/02676591251324644","url":null,"abstract":"<p><p><i>Introduction</i>: Complex aortic surgery involving Jehovah's Witness patients presents a significant challenge due to their refusal of blood products.<i>Case report</i>: This case report details the management of a 50-year-old female Jehovah's Witness with anaemia and a low body surface area, undergoing an urgent ascending aorta and hemi-arch replacement for a type A dissection. A broad range of blood conservation strategies were utilised in order to preserve haematocrit and clotting factors.<i>Conclusions:</i> This report highlights the importance of careful planning, team collaboration, and the meticulous application of blood conservation techniques in achieving a favourable postoperative outcome.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251324644"},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525080","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":"Quantitative methods to improve bivalirudin dosing in pediatric cardiac ICU patients.","authors":"Lindsey Brinkley, Zasha Vazquez-Colon, Aashay Patel, Matthew S Purlee, Terry Vasilopoulos, Mark S Bleiweis, Jeffrey P Jacobs, Giles J Peek, Helen Moore","doi":"10.1177/02676591251324648","DOIUrl":"https://doi.org/10.1177/02676591251324648","url":null,"abstract":"<p><strong>Background: </strong>A gap in knowledge exists related to optimal bivalirudin dosing in children. The purpose of our analysis is to use quantitative methods and baseline data to quickly predict the optimal therapeutic bivalirudin dose for children.</p><p><strong>Methods: </strong>We developed an internal database of pediatric patients on ECMO or VAD, including baseline patient information, bivalirudin doses, and partial thromboplastin time (PTT) measurements throughout the treatment period. We fit an analysis of covariance (ANCOVA) model to the baseline data to determine the best predictors of therapeutic bivalirudin dose. We used five-fold cross-validation to ensure the model was not overfitting to any specific data subset.</p><p><strong>Results: </strong>The most notable variables that were statistically significant (<i>p</i> < .05) were: the primary use of bivalirudin for heart failure prophylaxis, no complications before bivalirudin administration, other reasons for bivalirudin use, other race (including Asian, pacific islander, and native American), Hispanic or Latinx ethnicity, primary diagnosis of heart failure, and primary diagnosis of myocarditis. To compare our model-predicted dose and the actual starting dose administered to the patients, we looked at how far off each of those was from the therapeutic dose. The mean of absolute differences was 0.28 mg/kg/hr for the administered starting dose and 0.23 mg/kg/hr for the model-predicted dose; therefore, the model results in an improvement of 18% in the difference from the therapeutic dose.</p><p><strong>Conclusion: </strong>Our model provides an initial framework for determining a starting bivalirudin dose that takes into account patient demographic information and baseline admission data.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251324648"},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525081","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}