Perfusion-Uk最新文献

{"title":"Salvage extracorporeal membrane oxygenation in severe pulmonary haemorrhage: A single-center retrospective observational study.","authors":"Maximilian Leitner, Jeannine L Kühnle, Torben M Rixecker, Kai Borchardt, Egzona Sulollari, Robert Bals, Philipp M Lepper, Vitalie Mazuru","doi":"10.1177/02676591251376517","DOIUrl":"10.1177/02676591251376517","url":null,"abstract":"<p><p>IntroductionExtracorporeal membrane oxygenation (ECMO) has emerged as a treatment option for respiratory failure. Evidence supports use of ECMO for severe ARDS. Diffuse alveolar haemorrhage (DAH) involves diffuse bleeding in the alveolar tissue, typically due to autoimmune or coagulatory disturbances. The accumulation of blood in the alveoli impairs gas exchange and creates a functional right-to-left shunt, leading to hypoxaemia. While ECMO is effective in managing severe ARDS, its role and outcomes in patients with severe DAH are not well documented.MethodsWe performed a retrospective analysis of all patients with diffuse alveolar haemorrhage receiving ECMO support at the Saarland University Medical center from 03/2012 to 02/2025.ResultsFrom an electronic database, 15 Patients with DAH receiving ECMO support were identified. Patients with critical hypoxia due to pulmonary haemorrhage were included. The median PaO2/FiO2 right before ECMO-canulation was 53 (41.43; 56.42). Flexible bronchoscopy identified diffuse bleeding as the main cause of respiratory insufficiency. All included patients (mean age 39.9 ± 19.4 years; nine male) received primary veno-venous (V-V) ECMO. The median duration of ECMO-therapy was 15 (9.31; 25.69) days. The mean blood flow was 3.89 L/min (±1.06) with a sweep gas flow of 3.34 L/min (±2.37 L/min) in the first five ECMO-days. Anticoagulation strategy was determined according to clinical presentation. In two patients, no anticoagulation was administered due to fulminant bleeding. The remaining patients received unfractionated heparin at an average dose of 7.43 IE/kg/h (±3.46 IE/kg/h). Median aPTT of the anticoagulated patients was 39.49 s (±11.76). ECMO was successfully removed following respiratory stabilization in 10 patients. Among the 15 patients in total, 5 (33.33%) died.ConclusionFor patients with critical, refractoy pulmonary bleeding, V-V ECMO is a bridge to recovery option.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"988-994"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070952","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":"From pump technicians to academic perfusionists: The evolution of the perfusionist profession in Türkiye.","authors":"Reşat Dikme","doi":"10.1177/02676591251380664","DOIUrl":"10.1177/02676591251380664","url":null,"abstract":"<p><p>The perfusionist profession is a vital healthcare field responsible for managing devices that temporarily maintain a patient's circulation and respiration outside the body. In Türkiye, the perfusionist profession has evolved significantly over the past decade-from a technician-based role known colloquially as \"pump operator\" and learned through a master-apprentice model-into a recognized and professional discipline.In recent years, the perfusionist profession has gained academic identity and now plays a critical role in extracorporeal circulation procedures. This article provides a detailed analysis of the historical development, educational and legal evolution, and the professionalization process of the perfusionist profession in Türkiye.Moreover, by highlighting the roles of organizations such as the European Board of Cardiovascular Perfusion (EBCP) and the American Board of Cardiovascular Perfusion (ABCP), the study offers a comparative evaluation of the structure, education, and standards in Türkiye with those in Europe and the United States of America (USA).Based on national regulations, international guidelines, and an extensive review of the literature, this study presents a descriptive analysis that aims to determine where the perfusionist profession in Türkiye stands in the context of global standards. The process, spanning from the 1960s to the present, reflects the transformation of the profession from a technical \"pump operator\" role into a well-established academic discipline.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"974-987"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076460","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":"Towards goal-directed perfusion - Part II: Temperature dependence of Q₁₀, oxygen-demand dependence on age and weight, further clinical insights.","authors":"Mansour T A Sharabiani, Alireza S Mahani, Richard W Issitt, Yadav Srinivasan, Alex Bottle, Serban Stoica","doi":"10.1177/02676591251385838","DOIUrl":"10.1177/02676591251385838","url":null,"abstract":"<p><p>BackgroundGoal-directed perfusion (GDP) during cardiopulmonary bypass (CPB) seeks to match oxygen delivery with patient-specific metabolic demand, yet determinants of oxygen demand and dynamics of oxygen extraction ratio (OER) are not well characterised in paediatric populations. Building on our GARIX (Global AutoRegressive Integrated model with eXogenous variables and an equilibrium force) model from Part 1, we analysed minute-level intraoperative data to derive clinical insights.MethodsGARIX integrates autoregressive memory, exogenous clinical variables (cardiac index, haemoglobin, arterial oxygen saturation, temperature), and an equilibrium component defining indexed oxygen demand (tVO₂i) as a function of age, weight, and temperature. We applied GARIX to 20,443 minutes of data from 293 paediatric CPB procedures to study: (1) age- and weight-related variation in oxygen demand; (2) temperature dependence of demand, estimating local and interval Q₁₀; (3) age-stratified OER responses to haemoglobin and other variables; and (4) time evolution of the mismatch between oxygen consumption and demand after step changes in oxygen delivery.ResultstVO₂i followed a non-monotonic pattern, rising from birth to ∼3 years and declining thereafter. Metabolic demand decreased nonlinearly with temperature, with a 17% reduction from 37°C to 32°C and 39% further reduction to 27°C. Local Q₁₀ ranged from ∼1.3 near normothermia to ∼3.8 in deep hypothermia. OER responsiveness to haemoglobin was blunted in neonates and infants compared with older children. Simulations revealed transient over- and under-oxygenation following step changes in oxygen delivery due to lags in OER adaptation.ConclusionsWe identify risks of over- and under-oxygenation during CPB despite normal OER readings, challenge the use of fixed targets and constant Q₁₀, and highlight age- and weight-dependent dynamics. These findings support individualised, time-aware perfusion strategies and lay the groundwork for model-guided decision support and control.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"947-956"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356638","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":"Evaluation of water loss during extracorporeal membrane oxygenation.","authors":"Yuki Nakamura, Yoshimasa Shimamoto, Katsunori Tachibana, Koichi Umimoto","doi":"10.1177/02676591251395575","DOIUrl":"10.1177/02676591251395575","url":null,"abstract":"<p><p>IntroductionExtracorporeal membrane oxygenation (ECMO) can cause blood water loss due to insensible perspiration via oxygenators and plasma leakage. The accurate quantification of water loss is crucial for maintaining fluid balance in patients on ECMO. Although several studies have experimentally investigated water loss in ECMO, the factors influencing this loss and the methods for measuring plasma leakage-related water loss remain uninvestigated.MethodsIn this study, we incorporated a fluid replacement set into a closed circuit and examined the effects of circulating fluid temperature, oxygenator pressure, and gas flow rate on insensible water loss via an oxygenator. Furthermore, we measured water loss due to plasma leakage by circulating pure water and a solution with a lower surface tension than that of healthy human plasma in the same circuit.ResultsOur findings revealed that insensible water loss from the oxygenator was significantly influenced by the circulating fluid temperature and gas flow rate, but was not affected by the oxygenator pressure. Additionally, the difference in water loss between pure water and the low-surface-tension solution accurately represented the water loss due to plasma leakage.ConclusionsWater loss from the oxygenator depends on the temperature and gas flow, and plasma leakage can be quantified by accounting for the insensible loss in a closed-loop system.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"879-885"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446307","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":"Goal-directed perfusion during cardiopulmonary bypass: Physiological rationale, clinical evidence, and critical appraisal.","authors":"Hiroshi Mukaida, Yuki Minami","doi":"10.1177/02676591261446139","DOIUrl":"10.1177/02676591261446139","url":null,"abstract":"<p><p>ObjectivesCardiopulmonary bypass (CPB) is essential to cardiac surgery but is associated with organ injury from non-physiological perfusion. Goal-directed perfusion (GDP) has emerged as a physiology-based strategy to optimize intraoperative perfusion by targeting specific hemodynamic and metabolic parameters, particularly oxygen delivery (DO₂). This review critically appraises the evidence supporting GDP during CPB, emphasizing comparative strategies, clinical outcomes, and limitations.MethodsA narrative review of the literature was conducted, incorporating evidence from randomized controlled trials, observational studies, meta-analyses, and international guidelines addressing perfusion strategies during CPB. This review included studies evaluating DO₂-guided, pressure-guided, and oxygen-metabolic-indicator-guided approaches, focusing on target definitions, outcome measures, and patient populations.ResultsRandomized and observational studies have consistently demonstrated that maintaining adequate DO₂ levels during CPB is associated with a reduced incidence of cardiac surgery-associated acute kidney injury (CSA-AKI), leading to the guideline endorsement of DO₂-guided perfusion. In contrast, evidence on neurological outcomes, length of stay, and mortality remains limited and inconsistent. Pressure-guided and venous-oxygen-saturation- or oxygen-metabolic-indicator-guided strategies provide complementary physiologic information but have not independently demonstrated superiority in randomized trials. Substantial heterogeneity has been reported in perfusion targets, outcome definitions, patient risk profiles, and potential trade-offs, including increased transfusion exposure and implementation complexity.ConclusionsCurrent evidence supports DO₂-guided perfusion as an effective strategy to reduce CSA-AKI during CPB, although its impact on broader clinical outcomes remains uncertain. Future studies should focus on individualized perfusion targets that account for patient-specific risk, metabolic demand, temperature, and autoregulatory capacity, rather than universal thresholds.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"837-849"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730547","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":"Levels of hypothermia and clinical outcomes in acute type a aortic dissection surgery with circulatory arrest and antegrade cerebral perfusion: A systematic review and meta-analysis.","authors":"Erik Braatz, Magnus Dalén, Christian Olsson, Malin Stenman","doi":"10.1177/02676591261460650","DOIUrl":"10.1177/02676591261460650","url":null,"abstract":"<p><p>ObjectivesIn acute type A aortic dissection (ATAAD) surgery requiring hypothermic circulatory arrest (HCA), substantial variation persists in cooling strategies, and the optimal target temperature before circulatory arrest remains debated. The objective of this study was to evaluate clinical outcomes associated with different hypothermia strategies in ATAAD surgery performed under HCA with antegrade cerebral perfusion (ACP).MethodsThis review followed PRISMA guidelines and a registered PROSPERO protocol. Comprehensive database searches identified comparative studies of hypothermia levels during ATAAD repair with ACP. After screening and quality assessment, data were extracted for meta-analysis using random-effects modeling, evaluating mortality, postoperative stroke, and the need of postoperative dialysis.ResultsThe search yielded 11 eligible studies comprising 5996 patients. Most were observational and assessed mild-moderate temperature strategies. Meta-analysis showed reduced mortality and dialysis with warmer hypothermia, while the rates of postoperative stroke were similar. Heterogeneity was low except for postoperative dialysis, and publication bias was minimal to moderate across outcomes.ConclusionAcross all evaluated outcomes, deeper hypothermia did not demonstrate superiority over warmer strategies regarding in-hospital mortality, postoperative stroke, or acute kidney failure requiring dialysis. A definitive optimal temperature threshold for ATAAD surgery requiring HCA and ACP remains to be established.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"803-813"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228995","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":"International survey on ECMO candidacy and exclusion criteria for infants with congenital diaphragmatic hernia.","authors":"M Yang, B Yoder, M T Harting, J Daniel, C J Fernandes, B Gray, S H Gowda, J Ibrahim, K Lichtsinn, B Mahmood, A Makkar, F Miquel-Verges, P Thakkar, N Rintoul, R Rodriguez, B Thomas, R DiGeronimo, N Carr","doi":"10.1177/02676591261452054","DOIUrl":"https://doi.org/10.1177/02676591261452054","url":null,"abstract":"<p><p>IntroductionSevere congenital diaphragmatic hernia (CDH) is associated with significant morbidity and mortality. Pre/post-natal risk factors guide decisions on extracorporeal membrane oxygenation (ECMO) intervention. We aimed to describe variations in ECMO decision-making for neonatal CDH.MethodsWe distributed a practice-based survey (October 2023) to assess institutional ECMO guidelines for neonatal CDH. Respondents included neonatal/pediatric intensivists, surgeons, and ECMO coordinators. We used descriptive statistics for analysis.ResultsFormal CDH management guidelines were reported by 60 (77%) from 82 respondents across 12 countries. The most common exclusion criteria were prematurity (73%), low birthweight (72%), and aneuploidy (58%). Pre-existing neurological complications, single ventricle palliation heart disease, and genetics-related poor neurodevelopmental prognosis were the most cited exclusion criteria independent of CDH severity.ConclusionSignificant practice variation exists in the exclusion criteria for ECMO in neonatal CDH. There remains an opportunity for a more unified approach regarding ECMO use in infants with severe CDH.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261452054"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876368","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 immunomodulatory effect of continuous ultrafiltration during pediatric cardiac surgery.","authors":"Joel David Bierer, Roger Stanzel, Mark Henderson, John Sapp, Pantelis Andreou, Jean S Marshall, David Horne","doi":"10.1177/02676591251374252","DOIUrl":"10.1177/02676591251374252","url":null,"abstract":"<p><p>BackgroundCardiopulmonary bypass is associated with systemic inflammation during pediatric cardiac surgery and features elevated systemic concentrations of complement, cytokines and chemokines. The objective of this study is to quantify the immunologic efficacy of ultrafiltration (UF) used continuously throughout CPB.MethodsPediatric patients were enrolled in a single-arm prospective clinical study (NCT05154864) and received standard cardiac operations, CPB and subzero-balance ultrafiltration (SBUF) with an effluent extraction rate of 30 mL/kg/hr and conventional ultrafiltration (CUF). Paired arterial and UF effluent samples were taken at regular intervals during CPB and the concentration of 33 inflammatory mediators were measured. An exploratory counterfactual analysis assessed whether UF removed a significant amount of mediator mass using area under the curve (AUC), generalized linear mixed-effects models (GLMEM), and median fold change [95% CI] comparisons between observed data (UF) and reconstructed counterfactual data (no UF).ResultsForty consecutive eligible consenting patients participated; the majority were male (58%), age of 7.3 (1.7 - 39.0) months and weight of 6.7 (4.6 - 14.9) kg. All patients received UF therapy with effluent extraction of 155 (100 - 185) ml/kg during CPB. C3a, C5a, TNF, IL-1α, IL-1β, IL-1Ra, IL-2, IL-6, IL-10, CCL2, CCL3, CCL4, CXCL1, CXCL2, CXCL8, ET1, GM-CSF and TRAIL were detected in the UF effluent. In the counterfactual analysis, only C3a was significantly extracted by UF using AUC (<i>p</i> = 3.5 × 10^-12), GLMEM (<i>p</i> = 2.3 × 10^-87), and median fold change [95% CI] as C3a showed a decrease of -0.2 [-0.3 to 0] relative to CPB initiation, in the observed data, compared to the counterfactual with a median fold increase of 4.3 [3.1 - 5.3].ConclusionsUltrafiltration during pediatric CPB extracts cytokines and chemokines continuously throughout CPB with relatively low effectiveness. In an exploratory counterfactual analysis, C3a was the only inflammatory mediator meaningfully removed from the circulation by UF.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1018-1032"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976550","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":"Inflammatory prognostic index predicts late mortality after surgical aortic valve replacement.","authors":"Batuhan Yazıcı, Mustafa Can Kaplan, Zinar Apaydın, Alkım Ateşli Yazıcı, Barış Timur, İsa Can, Tural Muradlı, Alper Selim Kocaoğlu","doi":"10.1177/02676591251375717","DOIUrl":"10.1177/02676591251375717","url":null,"abstract":"<p><p>ObjectiveThis study aimed to investigate the prognostic value of the preoperative Inflammatory Prognostic Index (IPI) in predicting late mortality in patients undergoing isolated surgical aortic valve replacement (AVR).MethodsA retrospective, single-center cohort of 400 patients who underwent elective, isolated surgical AVR between 2015 and 2023 was analyzed. The IPI was calculated using the formula: C-reactive protein (CRP) × neutrophil-to-lymphocyte ratio (NLR) / albumin. Patients were stratified into low- and high-IPI groups based on an optimal cut-off value of 0.2588 determined via ROC analysis. Clinical characteristics, operative data, and outcomes were compared. Cox proportional hazards regression was used to identify independent predictors of late mortality.ResultsPatients with high IPI scores (≥0.2588) had significantly increased late mortality compared to those with low IPI (<0.2588) (10.3% vs 2.3%, <i>p</i> < .001). High IPI was associated with elevated CRP and neutrophils, and reduced albumin and lymphocytes. In univariate analysis, age, bioprosthesis use, and high IPI were significantly associated with late mortality. However, in multivariate analysis, only high IPI remained an independent predictor (HR = 3.405, 95% CI: 1.289-8.996, <i>p</i> = .013). Kaplan-Meier survival analysis confirmed lower long-term survival in the high-IPI group (<i>log-rank p</i> < .001).ConclusionPreoperative IPI is a simple, accessible, and independent predictor of late mortality after surgical AVR. Integrating IPI into preoperative risk assessment may improve long-term prognostic stratification and guide perioperative management.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"995-1003"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976627","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":"Neuromonitoring and neuroprotection during neonatal aortic arch surgery: A United Kingdom and Ireland survey.","authors":"William M McDevitt, Indie Bilkhoo, Edmund Carver, Timothy J Jones, Stefano Seri, Barney R Scholefield, Nigel E Drury","doi":"10.1177/02676591251384585","DOIUrl":"10.1177/02676591251384585","url":null,"abstract":"<p><p>IntroductionNeonatal aortic arch surgery is associated with neurological morbidity of varying severity which is detected and potentially limited through neuroprotective strategies. We conducted a survey of healthcare professionals at all neonatal cardiac surgery centres in the United Kingdom and Ireland to determine current intraoperative neuromonitoring and neuroprotection practice.MethodsAn online cross-sectional survey was sent to congenital cardiac surgeons, cardiac anaesthetists, clinical perfusion scientists, and clinical neurophysiology professionals in all 12 level 1 paediatric cardiac surgical centres. Information was sought on their current clinical practice in neonates undergoing aortic arch surgery, including pharmacological management, cardiopulmonary bypass, acid-base and blood pressure management, neuromonitoring, and hypothermic circulatory arrest, and the feasibility and willingness to participate in a future clinical trial of neuroprotective strategies in these patients.ResultsWe received 55 (34%) responses, including representatives of all four clinical disciplines in 9 (75%) centres. Cooling to a nasopharyngeal temperature of 18°C before hypothermic circulatory arrest, selective antegrade cerebral perfusion, and near-infrared spectroscopy (NIRS) monitoring are common practice, whereas pharmacology, acid-base management, blood pressure and flow parameters, and NIRS-based interventions vary. In 7 (58%) centres, respondents from all four disciplines were willing to consider participation in a future clinical trial on neuroprotection.ConclusionsAspects of intraoperative neuroprotection and neuromonitoring are common across centres, although key areas of practice differ between practitioners and institutions. Most respondents were willing to participate in a future multi-centre clinical trial, which suggests clinical equipoise in the optimal strategy to protect the neonatal brain during aortic arch surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"957-965"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309776","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}