Perfusion-Uk最新文献

{"title":"Impact of left common carotid cannula design on flow distribution and cerebral perfusion pressure during bilateral selective antegrade cerebral perfusion: An experimental and computational study.","authors":"Petter Holmlund, Julia Servin, Axel Vikström, Martha Johannesdottir, Laleh Zarrinkoob, Jan Hellström, Micael Appelblad","doi":"10.1177/02676591261489044","DOIUrl":"https://doi.org/10.1177/02676591261489044","url":null,"abstract":"<p><p>BackgroundIn aortic arch surgery, bilateral selective antegrade cerebral perfusion (bSACP) maintains cerebral blood flow during circulatory arrest. bSACP is often delivered using a single pump with a Y-connector, dividing the flow. Current practice has veered towards perfusion of the left common carotid artery by cannula and the right subclavian artery by a vascular graft. Flow distribution may therefore depend on left-sided cannula resistance, particularly in patients with limited collateral circulation. We investigated how cannula design influences perfusion pressure and flow distribution during bSACP.MethodsFour clinically available carotid perfusion cannulas were characterized using bench measurements (40-200 mL/min) and computational fluid dynamics (CFD). The resulting resistance models were integrated into patient-specific CFD models of the cerebral circulation in three patients with varying collateral capacity. Both flow- and pressure-targeted perfusion strategies were simulated.ResultsBench testing demonstrated a 3-4-fold difference in flow resistance between the lowest- and highest-resistance cannulas, which was accurately reproduced in CFD simulations. Importantly, resistance did not correlate with nominal French size. In the patient-specific CFD models, increasing left side cannula resistance roughly doubled the pressure laterality (7-9 to 14-23 mmHg) and halved the left side inflow (135-160 to 70-100 mL/min) for the cannulas tested. Effects were most pronounced in patients with limited collateral circulation. Sensitivity analyses confirmed robustness across physiological and geometric perturbations.ConclusionsCannula resistance does not correlate with nominal French size. Cannula design may influence cerebral perfusion pressure and flow distribution during bSACP and may warrant increased attention.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489044"},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002437","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":"Successful management of acute respiratory distress syndrome secondary to type A aortic dissection using venovenous oxygenation: A case report.","authors":"Kazuhisa Hamada, Tomoaki Fujii","doi":"10.1177/02676591261489055","DOIUrl":"https://doi.org/10.1177/02676591261489055","url":null,"abstract":"<p><p>IntroductionType A aortic dissection (AD) rarely coexists with acute respiratory distress syndrome (ARDS). Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is avoided owing to bleeding and dissection progression concerns.Case ReportA 49-year-old man presented with sudden onset of chest pain and dyspnea. Computed tomography findings did not indicate rupture or malperfusion in Type A AD. He developed severe ARDS refractory to lung-protective ventilation and recruitment maneuvers. VV-ECMO was initiated with nafamostat anticoagulation, with temporary continuous hemodiafiltration for fluid balance. Oxygenation improved, allowing ECMO removal on Day 14. After tracheostomy, he was discharged from the ICU on Day 49 and mechanically ventilated without AD progression.DiscussionVV-ECMO can stabilize gas exchange without exacerbating AD in select patients with ARDS when perioperative risk outweighs the immediate risk of rupture or organ malperfusion.ConclusionVV-ECMO may be considered for ARDS complicated AD when the bleeding risk is mitigated by regional anticoagulation.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489055"},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978636","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":"Propensity-matched on-pump versus off-pump isolated left internal mammary artery to left anterior descending coronary artery bypass grafting analysis.","authors":"Marcus Taylor, Jasleen Nagi, Antony Walker, David Rose, Mohamad N Bittar","doi":"10.1177/02676591261489064","DOIUrl":"https://doi.org/10.1177/02676591261489064","url":null,"abstract":"<p><p>IntroductionIsolated surgical revascularisation of the left anterior descending (LAD) coronary artery using the left internal mammary artery (LIMA) can be performed either with or without the use of cardiopulmonary bypass and is often performed by surgeons who do not otherwise routinely perform off-pump (OPCAB) surgery, despite evidence suggesting outcomes after off-pump surgery correlate with surgeon experience. We aimed to review short and long-term outcomes after isolated LIMA to LAD.MethodsSingle-centre retrospective review of all consecutive patients undergoing first-time isolated in-situ LIMA to LAD between 1997 and 2024 via median sternotomy. Primary outcomes were in-hospital mortality and overall survival. Secondary outcomes were post-operative length of stay (PLOS) and post-operative complications. Propensity score matching (PSM) was performed to produce two matched groups.Results662 patients were included (median follow-up time 84 months [29-154]). Off-pump surgery was performed in 58.2% (<i>n</i> = 385). In-hospital mortality was 0.9% (<i>n</i> = 6). PSM produced 275 matched pairs. Rates of post-operative stroke and blood transfusion were significantly lower in the OPCAB group, but in-hospital mortality (off-pump 0.8% vs on-pump 1.1%, <i>p</i> = 0.684) and overall survival (log-rank analysis <i>p</i> = 0.127) were similar between groups. The hazard ratio for OPCAB was 1.309 (95% confidence intervals 0.925-1.854, <i>p</i> = 0.127). Surgeon experience was not significantly associated with outcomes.ConclusionsIn this cohort, both off-pump and on-pump surgery emerged as safe treatment options for isolated LIMA to LAD surgery. Whilst OPCAB was associated with fewer complications, all other outcomes were comparable. Additional long-term studies extending beyond ten years are required to ensure these findings remain valid.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489064"},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983992","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":"Repair of recurrent aortic coarctation after the Norwood procedure without external aortic clamping.","authors":"Tsutomu Hataoka, Yoshikiyo Matsunaga, Toru Okamura","doi":"10.1177/02676591261489771","DOIUrl":"https://doi.org/10.1177/02676591261489771","url":null,"abstract":"<p><p>IntroductionAortic arch repair following the Norwood operation remains challenging because of dense adhesions and the risk of phrenic or recurrent nerve injury. We present a novel approach employing descending aortic antegrade perfusion using a balloon catheter to minimize the extent of dissection.Case ReportA 2-year-old male with hypoplastic left heart syndrome and post-Norwood operation underwent aortic arch repair. A balloon catheter was inserted through the aortic arch for simultaneous descending aortic occlusion and distal antegrade perfusion. This eliminated the need for external clamping. The procedure was successful with no nerve paralysis.DiscussionThis technique reduces the dissection area, mitigating nerve injury risks. Furthermore, it ensures continuous lower body antegrade perfusion, protecting visceral organs independent of deep hypothermia.ConclusionSimultaneous descending aortic occlusion and antegrade perfusion using a balloon catheter represents a safe, feasible strategy for complex arch repair, potentially reducing morbidity in high-risk single-ventricle patients.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489771"},"PeriodicalIF":1.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972192","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":"Minimally invasive versus conventional extracorporeal circulation in cardiac surgery: A meta-analysis of 41 randomized controlled trials.","authors":"Karam R Motawea, Mai Saad Ahmed, Mohamed Khalil, Momen Ibrahim, Yomna Abdelkader, Marc Pelletier, Mohammad El Diasty, Yakov Elgudin, Joseph F Sabik, Yasir Abu-Omar","doi":"10.1177/02676591261488596","DOIUrl":"https://doi.org/10.1177/02676591261488596","url":null,"abstract":"<p><p>ObjectiveWe aimed to compare postoperative clinical outcomes between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) in patients undergoing cardiac surgery.MethodsWe performed a meta-analysis of randomized controlled trials comparing MiECC and CECC in adult cardiac surgery. A literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane library databases from inception to July 2026 to identify relevant studies. Primary outcomes included mortality, myocardial infarction, atrial fibrillation, stroke, acute kidney injury, delirium, transfusion requirements, ICU length of stay, ventilation duration, and hospital length of stay.ResultsForty-one RCTs with a total of 5215 patients (2652 in MiECC group, and 2563 in CECC group) were included. MiECC was associated with decreased myocardial infarction (RR = 0.50, 95% CI [0.34, 0.73], <i>p</i>-value = 0.0004), atrial fibrillation (RR = 0.82, 95% CI [0.72, 0.93], <i>p</i>-value = 0.002), stroke (RR = 0.50, 95% CI [0.27, 0.93], <i>p</i>-value = 0.03), delirium (RR = 0.42, 95% CI [0.24, 0.73], <i>p</i>-value = 0.002), chest tube drainage (RR = -123.27, 95% CI [-165.41, -81.13], <i>p</i>-value <0.00001), units of transfused RBC (MD = -0.67, 95% CI [-0.84, 0.49], <i>p</i>-value <0.00001), ICU length of stay (MD = -0.99, 95% CI [-1.42, 0.56], <i>p</i>-value <0.00001), hospital length of stay (MD = -0.61, 95% CI [-1.09, -0.12], <i>p</i>-value = 0.01) and ventilation duration (MD = -2.71, 95% CI [-3.72, -1.69], <i>p</i>-value <0.00001) compared to CECC. However, no significant differences were observed between both groups in terms of mortality, transient ischemic attack, acute kidney injury, reoperation for bleeding, and platelet transfusions.ConclusionMiECC may provide myocardial and neurological protection, better hemostasis, and faster early postoperative recovery compared to CECC, supporting its adoption as a preferred perfusion strategy in cardiac surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261488596"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931548","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":"Experiences of surgeons and perfusionists using del Nido cardioplegia in paediatric cardiac surgery: A qualitative sub-study of the DESTINY trial.","authors":"Kirsty L Wilson, Fiona E Holmes, Nigel E Drury","doi":"10.1177/02676591261485078","DOIUrl":"https://doi.org/10.1177/02676591261485078","url":null,"abstract":"<p><p>Introductiondel Nido cardioplegia had not been commercially available in the United Kingdom prior to the DESTINY trial, a multi-centre individually randomised controlled trial to evaluate whether del Nido or St Thomas' blood cardioplegia provides better myocardial protection in children of all ages. In this sub-study, we explored the experiences of surgeons and perfusionists using del Nido in the trial, to support implementation of del Nido in the United Kingdom and identify any practical or safety concerns.MethodsWe conducted qualitative, semi-structured interviews with surgeons and perfusionists who had completed at least three cases with del Nido cardioplegia in the trial. Interviews were conducted face-to-face or via Zoom, digitally audio-recorded, transcribed, and analysed using a hybrid thematic approach, according to the Consolidated Framework for Implementation Research domains. Trial registration: ISRCTN13638147, registered July 2021.ResultsTwelve participants were interviewed, six surgeons and six perfusionists from all four paediatric cardiac surgical centres participating in the trial. Four key themes emerged: (1) attitudes towards the use of del Nido cardioplegia; (2) practical aspects of delivering del Nido cardioplegia; (3) blood conservation techniques; and (4) adopting del Nido cardioplegia into routine clinical use beyond the trial.ConclusionsSurgeons and perfusionists reported that they found del Nido cardioplegia to have practical benefits over St Thomas' blood cardioplegia but felt that further research on the optimal cooling temperature, blood conservation, and dosing for paediatric use are required to support the development of a best practice guideline and guide national implementation beyond the trial.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485078"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946060","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":"Minimally invasive approach versus median sternotomy in patients undergoing surgery for mitral valve infective endocarditis, a meta-analysis.","authors":"Karam R Motawea, Michael Blackledge, Abed M Al-Sheikh, Mohammad El Diasty, Yakov Elgudin, Joseph F Sabik, Yasir Abu-Omar","doi":"10.1177/02676591261488628","DOIUrl":"https://doi.org/10.1177/02676591261488628","url":null,"abstract":"<p><p>ObjectiveWe aimed to compare early and late postoperative clinical outcomes between minimally invasive surgery (MIS) and full sternotomy (FS) in patients with mitral valve (MV) infective endocarditis (IE).MethodsThis meta-analysis was conducted in compliance with the PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched for any randomized control trials or cohort studies that compared MIS versus FS in surgery for mitral valve infective endocarditis.ResultsFour cohort studies with 466 patients (137 in MIS group and 329 in FS group), were included in our study. Pooled analysis showed no significant difference between MIS and FS in terms of in-hospital/30-day mortality (RR = 0.71, 95% CI [0.31-1.60], <i>p</i>-value = 0.40), stroke (RR = 0.63, 95% CI [0.16-2.46], <i>p</i>-value = 0.50), atrial fibrillation (RR = 0.89, 95% CI [0.57-1.40], <i>p</i>-value = 0.62), acute kidney injury/renal failure (RR = 0.51, 95% CI [0.22-1.16], <i>p</i>-value = 0.11), multi-organ failure (RR = 0.94, 95% CI [0.33-2.70], <i>p</i>-value = 0.90), and readmission rates (RR = 0.75, 95% CI [0.39-1.45], <i>p</i>-value = 0.39). However, our study showed a statistically significant association between MIS and lower risk of postoperative sepsis (RR = 0.17, 95% CI [0.03-0.84], <i>p</i>-value = 0.03), fewer blood transfusions (RR = 0.63, 95% CI [0.48-0.84], <i>p</i>-value = 0.001), and shorter length of ICU stay (RR = -1.57, 95% CI [-2.16, -0.97], <i>p</i>-value <0.00001) compared to FS. The pooled effect estimate showed no significant difference between both groups in terms of need for reoperation, permanent pacemaker implantation, survival up to 2.5 years, and IE recurrence up to 3.5 years.ConclusionsOur findings suggest that MIS may be a safe and cost-effective alternative for FS in patients undergoing surgery for mitral valve infective endocarditis. Surgical approach should be tailored to the patient's clinical risk profile, the extent of endocarditis, and the team's experience, to ensure optimal clinical outcomes.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261488628"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931532","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 efficacy of leukocyte removal by blood filters in autologous cell salvage.","authors":"Mark Alm, Natasha Bush, Alisa Maznytsya, Mary Dooley, Laura Dell'aiera, Stuart A McCluskey, Mark Vallelonga","doi":"10.1177/02676591261485073","DOIUrl":"https://doi.org/10.1177/02676591261485073","url":null,"abstract":"<p><p>BackgroundAutotransfusion devices concentrate white blood cells (WBCs) within the washed product that may lead to undesirable clinical effects when reinfused to the patient. This quality improvement project evaluated the leukocyte removal efficacy of three types of salvaged blood filters in autologous cell salvage.MethodsUsing a prospective observational cohort approach, we evaluated microaggregate, lipid-reducing, and leukocyte-reducing salvaged blood filters in adult patients undergoing surgery with autologous cell salvage. Filters were evaluated one after another, with samples of processed autologous blood collected prior to filtration and again after 30 mL had passed through each type of filter to allow for direct comparison of each filter's effects on WBC concentrations.ResultsSalvaged blood samples were collected from 35 patients. Median pre-filtration WBC count was 9.8 [6.8-13.3] × 10⁹/L, being reduced to 9.3 [6.6-12.6] × 10⁹/L after microaggregate filtration (1.7 [-0.6-4.6]% removal), 0.8 [0.5-2.5] × 10⁹/L after lipid filtration (89.7 [83.3-93.9]% removal), and 0.0 [0.0-0.0] × 10⁹/L after leukocyte filtration (100 [100-100]% removal). The microaggregate filter achieved significantly less WBC reduction than both the leukocyte-reducing filter (<i>p</i> < 0.0001) and lipid-reducing filter (<i>p</i> < 0.0001). There was no significant difference observed between the leukocyte-reducing and lipid-reducing filters (<i>p</i> = 0.3124).ConclusionsLeukocyte- and lipid-reducing filters were effective at reducing WBCs from processed autologous blood by nearly 10-fold, while microaggregate filters were significantly less effective at removing leukocytes. Use of leukocyte- or lipid-reducing filters minimizes the number of activated WBCs reinfused to the patient during autologous cell salvage.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485073"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946056","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":"Hypotension during cardioplegia: a cardiac depressor reflex?","authors":"Michael W Vespe, Marc E Stone","doi":"10.1177/02676591261485080","DOIUrl":"https://doi.org/10.1177/02676591261485080","url":null,"abstract":"<p><p>Profound, transient hypotension refractory to α₁-agonists and increased bypass flow during cardioplegia administration (intermittent vasoplegia) is a well-recognized yet unexplained phenomenon in cardiac surgery. Retrograde cardioplegia has been shown to cause profound hypotension with greater frequency than antegrade administration despite identical formulations, ischemic intervals, and perfusion parameters. It seems plausible that the link between cardioplegia administration to the arrested heart and the intermittent vasoplegic systemic response may result from a vagally mediated cardiac depressor reflex.Electrophysiologic and histologic studies have identified multiple vagal receptors within the ventricular myocardium and coronary vasculature that, when stimulated, produce a centrally mediated and prolonged withdrawal of efferent sympathetic activity to the systemic vasculature. During antegrade cardioplegia, hypotension most likely arises from activation of left ventricular chemoreceptors terminating in the inferoposterior wall. These afferents respond to endogenous mediators of ischemia and reperfusion such as bradykinin and prostaglandins.In contrast, the depressor reflex observed during retrograde cardioplegia likely arises from vagal afferent ventricular mechanoreceptors. In the arrested, decompressed heart, only 20-33% of retrograde cardioplegia traverses the capillaries, while the remainder is shunted through the Thebesian system. The resulting surge in coronary venous pressure causes distension that is easily transmitted to the surrounding interstitial space, creating the mechanical effects of grossly elevated end-diastolic pressure and pathological myocardial stretch despite the absence of true ventricular filling and wall tension.If the intermittent vasoplegic response to cardioplegia is viewed within the mechanistic framework of a vagally mediated depressor reflex, the optimal intervention to mitigate prolonged hypotension may not be stronger vasopressors (e.g., norepinephrine or vasopressin), but rather the inclusion of lidocaine in the microplegia additive. Lidocaine is known to markedly attenuate reflex vasodepressor responses through the blockade of sodium channels in nerve fibers.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485080"},"PeriodicalIF":1.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907864","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":"Association between rewarming rate during cardiopulmonary bypass and postoperative delirium in patients receiving olanzapine after cardiac surgery: A retrospective cohort study.","authors":"Dan Dan Xu, Shuang Xu, XinYu Zhu, Lei Wang, Yun Wang, Jie Shi","doi":"10.1177/02676591261487331","DOIUrl":"https://doi.org/10.1177/02676591261487331","url":null,"abstract":"<p><p>BackgroundThe relationship between rewarming rate during cardiopulmonary bypass (CPB) and postoperative delirium (POD) in cardiac surgery remains unclear. This retrospective study aimed to evaluate whether rapid rewarming is associated with an increased risk of POD.MethodsA total of 548 adult cardiac surgery patients (January 2021-December 2023) were enrolled. POD was identified through medical record review based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)criteria or documented delirium symptoms combined with olanzapine use (serving as a surrogate marker). Rewarming rate was defined as the average temperature increase per minute from the lowest nasopharyngeal temperature during CPB to 36.5°C, calculated as (36.5°C - lowest temperature)/rewarming time (min). Multivariable logistic regression and ROC analysis were performed.ResultsRewarming rate was significantly higher in the POD group (<i>n</i> = 300) than the non-POD group (<i>n</i> = 248) (0.095 ± 0.044 vs 0.072 ± 0.034°C/min, <i>p</i> < 0.001). Olanzapine dosage (18.5 ± 8.2 mg vs 0 mg) and duration (4.2 ± 2.1 days vs 0 days) in the POD group showed significant positive correlations with rewarming rate (r = 0.887 and r = 0.814, respectively, both <i>p</i> < 0.01). Rewarming rate (OR = 1.782), red blood cell transfusion (OR = 1.456), CPB duration (OR = 1.023), and mean CVP (OR = 1.156) were identified as independent risk factors for POD (all <i>p</i> < 0.05). The predictive model achieved an AUC of 0.775 (95% CI: 0.736-0.814).ConclusionsRapid rewarming during CPB is associated with increased POD risk and may be a modifiable perioperative factor. Prospective studies with standardized POD screening are warranted to validate these findings.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261487331"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892751","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}