Perfusion最新文献

{"title":"Is ultrafiltration volume a predictor of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass?","authors":"Hamid Gerami, Javad Sajedianfard, Bahram Ghasemzadeh, Maryam AnsariLari","doi":"10.1177/02676591241246081","DOIUrl":"https://doi.org/10.1177/02676591241246081","url":null,"abstract":"IntroductionIntraoperative ultrafiltration (UF) is a procedure used during cardiopulmonary bypass (CPB) to reduce haemodilution and prevent excessive blood transfusion. However, the effect of UF volume on acute kidney injury (AKI) is not well established, and the results are conflicting. Additionally, there are no set indications for applying UF during CPB.MethodsThis retrospective study analysed 641 patients who underwent coronary artery bypass graft (CABG) surgery with CPB. Perioperative parameters were extracted from the patients’ records, and the UF volume was recorded. Acute Kidney Injury Network classification was used to define AKI. Univariable and multivariable logistic regression models were used to predict AKI while controlling for confounding factors.ResultsThe study enrolled patients with a mean age of 58.8 ± 11.1 years, 39.2% of whom were female. AKI occurred in 22.5% of patients, with 16.1% (103) experiencing stage I and 6.4% (41) experiencing stage II. The results showed a significant association between UF volume and the risk of developing AKI, with higher UF volumes associated with a higher risk of AKI. In the multivariable analysis, the other predictors of AKI included age, lowest mean arterial pressure (MAP), and red blood cell (RBC) transfusion during CPB.ConclusionThe predictors of postoperative AKI in coronary CABG patients were the volume of UF, age, MAP, and blood transfusion during CPB.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of exercise-based cardiac rehabilitation for patients with left ventricular assist device: A systematic review and meta-analysis","authors":"Yujin Wang, Yawen Wu, Shilin Wei, Sijie Lu, Jianting Zhao, Yanchun Zhang, Xiangyang Wu, Xiaowei Zhang, Yongnan Li","doi":"10.1177/02676591241245876","DOIUrl":"https://doi.org/10.1177/02676591241245876","url":null,"abstract":"PurposeExercise-based cardiac rehabilitation (EBCR) improves functional capacity in heart failure (HF). However, data on the effect of EBCR in patients with advanced HF and left ventricular assist devices (LVADs) are limited. This meta-analysis aimed to evaluate the impact of EBCR on the functional ability of LVAD patients by comparing the corresponding outcome indicators between the EBCR and ST groups.MethodsPubMed, Embase, Clinical Trials, and Cochrane Library databases were searched for studies assessing and comparing the effects of EBCR and standard therapy (ST) in patients following LVAD implantation. Using pre-defined criteria, appropriate studies were identified and selected. Data from selected studies were extracted in a standardized fashion, and a meta-analysis was performed using a fixed-effects model. The protocol was registered on INPLASY (202340073).ResultsIn total, 12 trials involving 477 patients were identified. The mean age of the participants was 52.9 years, and 78.6% were male. The initiation of EBCR varied from LVAD implantation during the index hospitalization to 11 months post-LVAD implantation. The median rehabilitation period ranged from 2 weeks to 18 months. EBCR was associated with improved peak oxygen uptake (VO2) in all trials. Quantitative analysis was performed in six randomized studies involving 214 patients (EBCR: n = 130, ST: n = 84). EBCR was associated with a significantly high peak VO2 (weighted mean difference [WMD] = 1.64 mL/kg/min; 95% confidence interval [CI], 0.20-3.08; p = .03). Similarly, 6-min walk distance (6MWD) showed significantly greater improvement in the EBCR group than in the ST group (WMD = 34.54 m; 95% CI, 12.47-56.42; p = .002) in 266 patients (EBCR, n = 140; ST, n = 126). Heterogeneity was low among the included trials. None of the included studies reported serious adverse events related to EBCR, indicating the safety of EBCR after LVAD implantation.ConclusionThis study demonstrated that EBCR following LVAD implantation is associated with greater improvement in functional capacity compared with ST as reflected by the improved peak VO2 and 6MWD values. Considering the small number of patients in this analysis, further research on the clinical impact of EBCR in LVAD patients is warranted.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden pump stop may cause air release in oxygenators, ‘The Hammer Effect ’: An in vitro evaluation","authors":"Paul van Kaam, Marco Stehouwer","doi":"10.1177/02676591241244961","DOIUrl":"https://doi.org/10.1177/02676591241244961","url":null,"abstract":"BackgroundOxygenators, as used in cardiopulmonary bypass (CPB) circuits, are components with good air removal properties. However, under some conditions the semipermeable characteristics of hollow fibers allow air to accidentally enter the blood side of the CPB circuit. This may occur when a fluid in motion is stopped suddenly by which the rapid change in momentum may cause a relative negative pressure drop, the so-called hammer effect. The hammer effect is not yet described in literature related to CPB. The aim of this in vitro study was to reproduce the hammer effect.MethodsThe in vitro setup consisted of a CPB circuit with a fully occluded roller pump and one of four test oxygenators. The hammer test was performed by a sudden pump stop. The pressure wave was measured and after the test the residual air present in the oxygenator was forced into the arterial line and measured with a bubble detector.ResultsWe showed that a sudden pump stop could lead to the hammer effect, represented as a relative negative pressure drop in the arterial line. This hammer effect resulted in air release through the semipermeable fibers as we showed in two of the four tested brands of oxygenators.ConclusionsWe conclude that the hammer effect may occur before connection of the CPB system to the patient, and this may result in air release into the arterial blood side of the oxygenator. The hammer effect can be caused by clamping of the tubing in combination with a centrifugal pump, or by suddenly stopping the roller pump. With this study we would like to raise awareness of the hammer effect.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safe addition of nitric oxide to the sweep gas of the extracorporeal membrane oxygenation circuit in a pediatric cardiac intensive care unit","authors":"Michael A Brock, Mohammed Ebraheem, Andrew Jaudon, Sukumar Suguna Narasimhulu, Zasha Vazquez-Colon, Joseph Philip, Dalia Lopez-Colon, Jeffrey P Jacobs, Mark S Bleiweis, Giles J Peek","doi":"10.1177/02676591241246079","DOIUrl":"https://doi.org/10.1177/02676591241246079","url":null,"abstract":"Background: Nitric Oxide (NO) is a naturally occurring modulator of inflammation found in the human body. Several studies in the pediatric cardiothoracic surgery literature have demonstrated some beneficial clinical effects when NO is added to the sweep gas of the cardiopulmonary bypass circuit.Purpose: Our primary aim was to determine the safety of incorporating nitric oxide into the oxygenator sweep gas of the extracorporeal membrane oxygenation (ECMO) circuit. Secondarily, we looked at important clinical outcomes, such as survival, blood product utilization, and common complications related to ECMO.Methods: We performed a single center, retrospective review of all patients at our institution who received ECMO between January 1, 2017 and March 31, 2023. We began additing NO to the ECMO sweep gas in 2019.Results: There were no instances of clinically significant methemoglobinemia with the addition of NO to the sweep gas (0% vs 0%, p = 1). The median daily methemoglobin level was higher in those who received NO via the sweep gas when compared to those who did not (1.6 vs 1.1, p = <0.001).Conclusions: The addition of NO to the sweep gas of the ECMO circuit is safe.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Damage-Associated Molecular Patterns in Human Diseases, Volume 3: Antigen-Related Disorders","authors":"Valensa Yosephi, Chyntia Tresna Nastiti","doi":"10.1177/02676591241244970","DOIUrl":"https://doi.org/10.1177/02676591241244970","url":null,"abstract":"","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Globalization of perfusion education: Our profession’s contribution to addressing cardiac surgery inequity worldwide","authors":"Bruce Searles, Robert Groom","doi":"10.1177/02676591241242636","DOIUrl":"https://doi.org/10.1177/02676591241242636","url":null,"abstract":"","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of cardioplegic solution on incidence of acute kidney injury after coronary artery bypass surgery procedure: del Nido cardioplegia versus Histidine-Tryptophan-Ketoglutarate solution: Insight of kidney disease improving global outcomes criteria.","authors":"Lei Wang, QiongYan Dai, Lanxin Hu, Ting-Wei Yang, Xin Chen, XiaoLiang Wang","doi":"10.1177/02676591241244983","DOIUrl":"https://doi.org/10.1177/02676591241244983","url":null,"abstract":"INTRODUCTION\u0000We set out to investigate whether the use of Histidine-Tryptophan-Ketoglutarate (HTK) solution or del Nido cardioplegia is linked to an increased incidence of postoperative acute kidney injury (AKI) in patients undergoing coronary artery bypass surgery (CABG).\u0000\u0000\u0000METHODS\u0000A retrospective study was carried out at our center, with a total of 478 patients included in the analysis. Among them, 268 patients were administered the del Nido solution (DN) while 210 patients received the HTK solution. The primary focus of this study was to assess the occurrence of postoperative AKI and the need for renal replacement therapy (RRT). Multivariable logistic regression was used to examine the relationship between the type of cardioplegia used and adverse kidney outcomes. Additionally, serum levels of sodium, potassium, and ionized calcium were monitored during cardiopulmonary bypass (CPB).\u0000\u0000\u0000RESULTS\u0000The incidence of AKI was significantly higher in the HTK group compared to the DN group [(48/220 (21.81%) vs. 24/186 (12.90%), p = .049], although the rate of RRT did not show a statistically significant difference (9/48, 18.75% vs. 6/24, 25%, p = .538). Multivariate logistic regression analysis revealed that HTK was a significant risk factor for AKI. Furthermore, serum sodium and calcium levels were found to decrease following HTK cardioplegic infusion. Conclusion: Our study provides compelling evidence of the impact of cardioplegic solutions on postoperative AKI rates. It underscores the importance of optimizing cardiac arrest protocols. These findings warrant further prospective investigations into the influence of cardioplegic solutions on electrolyte imbalances and postoperative AKI rates.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"45 14","pages":"2676591241244983"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What the pediatric nurse needs to know about the Impella cardiac assist device","authors":"Giorgia Borrelli, Ilaria Nittolo, Chiara Bochicchio, Laura Trainelli, V. Confalone, Tiziana Satta, Federica Cancani, Richard Kirk, Antonio Amodeo, Matteo Di Nardo","doi":"10.1177/02676591241237761","DOIUrl":"https://doi.org/10.1177/02676591241237761","url":null,"abstract":"Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"178 7","pages":"95S - 106S"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EuroELSO 2024, Author Index.","authors":"","doi":"10.1177/02676591241248245","DOIUrl":"https://doi.org/10.1177/02676591241248245","url":null,"abstract":"","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"106 ","pages":"276S-288S"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation for adult patients undergoing extracorporeal membrane oxygenation.","authors":"M. Polastri, Allaina Eden, J. Swol","doi":"10.1177/02676591231226289","DOIUrl":"https://doi.org/10.1177/02676591231226289","url":null,"abstract":"BACKGROUND AND PURPOSE\u0000Current information on the latest rehabilitative practices is limited, with previous reviews only covering data up to October 2021, and some considering only patients on awake ECMO or with COVID-19. This review aims to present a concise overview of the latest findings on rehabilitation and highlight emerging trends for patients undergoing ECMO support.\u0000\u0000\u0000METHODS\u0000This integrative review was conducted by searching the National Library of Medicine - PubMed database. Two different search strings \"extracorporeal membrane oxygenation\" AND \"rehabilitation\" and \"extracorporeal membrane oxygenation\" AND \"physiotherapy\" were used to search the published literature. Articles that did not describe rehabilitation techniques, editorials, conference proceedings, letters to editor, reviews and research protocols were excluded. Studies conducted on pediatric populations were also excluded. The search process was completed in December 2023.\u0000\u0000\u0000RESULTS\u0000Thirteen articles were included in the final analysis. Eight hundred and thirty-nine patients aged between 27 and 63 years were included; 428 were men (51%). In 31% of the included studies, patients had COVID-19; nevertheless, rehabilitative activities did not differ from non-COVID-19 patients. In most studies, rehabilitation commenced within the first 48-96 h and consisted of progressive exercise and out-of-bed activities such as sitting, standing and walking.\u0000\u0000\u0000CONCLUSION\u0000Current practice focuses on rehabilitative protocols that incorporate exercise routines with progressive intensity, greater emphasis on out-of-bed activities, and a multidisciplinary approach to patient mobilization.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"73 33","pages":"115S-126S"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}