The journal of extra-corporeal technology最新文献

{"title":"An update on AI in Academic Publishing.","authors":"Raymond K Wong","doi":"10.1051/ject/2026023","DOIUrl":"10.1051/ject/2026023","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 2","pages":"100-101"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cybersecurity as it relates to perfusion.","authors":"Kara Lung","doi":"10.1051/ject/2025064","DOIUrl":"10.1051/ject/2025064","url":null,"abstract":"<p><p>Perfusionists must maintain strong digital security habits, know the inherent risks of devices in use, and have a healthy respect for the consequences of a security breach at a hospital. While perfusion has largely been able to operate without much interaction with cybersecurity experts, the relentless advancement of the digital age means that perfusionists cannot remain oblivious to the intersection of their devices and hospital digital security. This article provides a historical overview of healthcare cybersecurity with specific recommendations for perfusion teams looking to ensure best practices for protected health information (PHI). Critical recommendations include keeping physical copies of downtime procedures, routine practice of downtime procedures, discussion with the hospital information technology (IT) team to confirm perfusion-based asset lists, and the creation of an American Society of Extracorporeal Technology (AmSECT) standard or guideline regarding attention to cybersecurity.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"3-18"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of plasmapheresis during cardiopulmonary bypass in a pediatric heart transplant of a patient with Failing Fontan Physiology: first case in Argentina.","authors":"Matias Jorge Martinez, Ignacio Berra, Javier Cornelis, Juan Costilla, Fernando Zamora, Pablo Garcia Delucis","doi":"10.1051/ject/2025053","DOIUrl":"10.1051/ject/2025053","url":null,"abstract":"<p><strong>Background: </strong>A 17-year-old male patient diagnosed with a single ventricle, in a failed Fontan stage, was evaluated prior to heart transplantation. The patient had a panel-reactive antibody (PRA) for human leucocyte antigen (HLA) I of 18% and for HLA II of 37%, so the decision was made to administer three doses of immunoglobulin while waiting for a donor heart.</p><p><strong>Methods: </strong>Once extracorporeal circulation was initiated, the apheresis machine extracted blood from the patient's venous drainage and returned it to the oxygenator reservoir. A total of 8278 mL of blood was processed, and 4224 mL of plasma was extracted. For replacement, 1341 mL of fresh frozen plasma and 2700 mL of 5% albumin were used. 75 mL of citrate-dextrose acid (CDA) was used as an anticoagulant. The procedure lasted 135 min.</p><p><strong>Results: </strong>On the tenth postoperative day, the PRA for HLA I and II was 0%. On the thirtieth postoperative day, a catheterization with endomyocardial biopsy showed no evidence of immunological rejection. An echocardiogram showed good function of the heart graft. One year later, a catheterization with endomyocardial biopsy showed no signs of humoral rejection. The patient is currently in the third-year post-transplant and continues to show no signs of rejection in their progression.</p><p><strong>Conclusion: </strong>Plasmapheresis during cardiopulmonary bypass is a reproducible, safe, and effective technique. It may be indicated for sensitized patients on the heart transplant waiting list.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and pathophysiology of gastrointestinal bleeding during mechanical circulatory support: A retrospective analysis using machine learning algorithms.","authors":"Kelsey Gore, Dean Linder, Juan Jose Martinez Duque, Junxi Wang, Connor Rudnicki, Adrian Alexis Ruiz, Shaun Yockelson, Bobby Nossaman","doi":"10.1051/ject/2025061","DOIUrl":"10.1051/ject/2025061","url":null,"abstract":"<p><strong>Background: </strong>End-organ hypoperfusion from cardiopulmonary shock may require mechanical circulatory support (MCS). However, patients receiving MCS risk the development of hemorrhagic complications, including gastrointestinal bleeding (GI). Examining potential risk factors for these complications improves clinical understanding. The purpose of this investigation was to study the risk for GI bleeding in MCS patients.</p><p><strong>Methods: </strong>Following IRB approval, patient characteristics, previously reported comorbidities, and the incidence of GI bleeding were reviewed from January 2017 to October 2023. Clinical variables underwent machine learning with autovalidation. Support vector machine modeling provided the best performance among the ensemble models tested.</p><p><strong>Results: </strong>In this study of 156 patients who underwent 284 MCS procedures, the incidence of GI bleeding was 6.0% CI 3.3-10.4%. Following machine learning, patients with insulin-dependent diabetes were associated with GI bleeding. The Receiver Operating Characteristic (ROC) curve demonstrated an area under the curve (AUC) of 0.85 with a misclassification rate of 7.5%. The relative risk of the need for major transfusion (>2 packed red blood cell units/episode) was 1.7 CI 1.1-2.5. The majority (87%), but not all, of these patients received unfractionated heparin therapy. Finally, hospital length of stay was increased in patients with GI bleeding.</p><p><strong>Conclusion: </strong>Insulin-dependent diabetes was associated with increased risk for GI bleeding during MCS, and these patients more often required major transfusions. Further evaluation of continuous anticoagulation therapy is warranted. Knowledge derived from this analytical study may guide the development of institutional protocols to improve care in this patient population.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"39-42"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiating cardiopulmonary bypass using a dry venous line: implications and analysis.","authors":"Tristan Benedict, Robert Brownlee, Christopher Foley, Nathan Hoyer, Laura Dell'Aiera, Mary Dooley, Dave Fitzgerald","doi":"10.1051/ject/2025034","DOIUrl":"10.1051/ject/2025034","url":null,"abstract":"<p><strong>Background: </strong>Autologous priming of the cardiopulmonary bypass (CPB) circuit is a critical technique for reducing hemodilution during cardiac surgery. Vacuum-assisted venous drainage (VAVD) offers access to an alternative method using a dry venous line, aiming to reduce hemodilution associated with crystalloid priming.</p><p><strong>Methods: </strong>This study investigates the impact of initiating CPB with a dry venous line on gaseous microemboli (GME) production, compared to a traditional primed venous line in an adult CPB circuit. Using a controlled experimental setup with an oxygenator featuring an integrated arterial filter, we examined GME counts and sizes throughout the circuit under varying VAVD pressures and initiation techniques.</p><p><strong>Results: </strong>Results show that higher VAVD pressures and the immediate initiation of CPB correlate with increased GME production post-oxygenator. Statistical analysis reveals significant differences in GME counts and sizes between control and experimental groups.</p><p><strong>Conclusion: </strong>The statistical differences in GME size and count observed between initiation types and pressures emphasize the importance of optimal CPB initiation strategies to minimize GME transmission. These findings underscore the need for further research to refine CPB techniques and enhance patient safety in cardiac surgery.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of the effect of slow and rapid initiation of cardiopulmonary pump on tissue oxygenation index and ischemic complications.","authors":"Mostafa Bagherinasab, Sahar Rezaei, Ali Reza Moradi, Ali Jabbari, Amin Noori, Zachary Archer, Nathaniel H Darban","doi":"10.1051/ject/2025050","DOIUrl":"10.1051/ject/2025050","url":null,"abstract":"<p><strong>Introduction: </strong>Although the use of the heart-lung machine (HLM) is routine in cardiac operating theaters, there is still a lack of evidence-based guidelines concerning the optimal speed to reach full flow during initiation to reduce critical episodes of cerebral ischemia. Therefore, we have designed a study to compare two distinct initiation times for the commencement of cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>We conducted a randomized, monocentric, double-blind, prospective study to assess the impact of two different CPB initiation speeds - rapid initiation at 30 s and slow initiation at 180 s - on cerebral tissue oxygenation (TOI via NIRS), arterial oxygen pressure, hematocrit (HCT) variation, and the incidence of postoperative delirium. The target flow rate was set at 2.4 L/min/m², with adjustments made according to the patient's body surface area.</p><p><strong>Results: </strong>The absolute values of the tissue oxygenation index (TOI) and HCT showed no differences between the study during the first 180 s following commencement of CPB. Patients in the fast group exhibited significantly lower arterial oxygen pressure at the initiation of the (P < 0.05). Additionally, patients in the fast group experienced a higher incidence of delirium in the second and third days following surgery. While clinically relevant, the elevated incidence of delirium fell short of being statistically significant, with post-operative days 2 and 3 having P-values of 0.06 and 0.08, respectively.</p><p><strong>Conclusion: </strong>The results of this study indicate that, despite the absence of a significant difference in TOI between the study groups, patients in the slow group exhibited a not statistically significant trend for a lower incidence of delirium, as defined by CAMICU-7, in comparison to those in the fast group.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for determining first-attempt success on the American Board of Cardiovascular Perfusion Certification Exams for graduates of a master's level perfusion education program.","authors":"Amber M Palmer","doi":"10.1051/ject/2025062","DOIUrl":"10.1051/ject/2025062","url":null,"abstract":"<p><strong>Background: </strong>As demand for perfusionists grows due to increased cardiac procedures and retirements, improving first-time pass rates is essential to addressing workforce shortages. This quantitative study analyzed academic, demographic, and clinical variables as predictors of success on the American Board of Cardiovascular Perfusion (ABCP) exam.</p><p><strong>Materials and methods: </strong>Data were collected from 103 students enrolled in the master's-level Carlow University-University of Pittsburgh Medical Center (UPMC) Cardiovascular Perfusion program between 2017 and 2022 (IRB #02232024-1). Student-level variables included undergraduate GPA, grades in prerequisite courses, clinical experience hours, and admission status (graduate vs. undergraduate). Associations between these variables and first-time ABCP exam success were examined.</p><p><strong>Results: </strong>Logistic regression analysis revealed that higher performance in Introduction to Cardiac Perfusion (B = 1.002, p = .008) and Hematology (B = .636, p = .028) significantly predicted first-time success on the ABCP exam. Admission as an undergraduate student was also a significant predictor (p = .004). However, neither the number of clinical experience hours nor the student's cohort year showed statistical significance (p > .05).</p><p><strong>Conclusion: </strong>Academic performance in key foundational courses and student background (such as admission status) were significantly associated with first-time ABCP exam success. In contrast, the amount of clinical experience did not demonstrate a meaningful impact on pass rates. Further research should utilize a richer dataset that captures a more comprehensive view of perfusion program curricula, including detailed clinical training components. This would help clarify how specific educational experiences contribute to ABCP exam success and overall program outcomes.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"95-99"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheoesophageal fistula repair with veno-venous extracorporeal support and Montgomery T-tube: a case report.","authors":"José Luis Che Morales, Gary Kosai Vargas Mendoza","doi":"10.1051/ject/2025055","DOIUrl":"10.1051/ject/2025055","url":null,"abstract":"<p><p>Tracheoesophageal fistulas (TEFs) are a major surgical challenge requiring a meticulous approach. This case report describes the successful surgical treatment of a 50 mm TEF extending from the upper third of the trachea to 40 mm above the main carina in a young female patient. The chosen strategy involved an extensive transcervical approach, utilization of Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO), and placement of a Montgomery T-tube. The use of ECMO allowed surgical manipulation of mediastinal structures in apnea, ensured adequate gas exchange in the absence of mechanical ventilation, and enhanced comfort during postoperative splinting of the involved structures. The integration of the Montgomery T-tube provided stable airway management postoperatively, particularly advantageous in the context of impaired neurological status precluding early extubation. This combined surgical approach, involving VV-ECMO and Montgomery T-tube, offers a novel, safe, and effective alternative for managing complex TEFs and is recommended for consideration in similar challenging clinical scenarios.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of early hyperoxia on outcomes during neonatal and pediatric veno-arterial extracorporeal life support★.","authors":"Ashish Saini, Rebecca Shamah, Joshua Qian, Kasey Keane-Lerner, Paola Rodriguez Morales, Pranay Nayi, Adithi Shyam, Joel Davis, Mohan John, Heather Viamonte, Assad G Beshish","doi":"10.1051/ject/2025057","DOIUrl":"10.1051/ject/2025057","url":null,"abstract":"<p><strong>Background: </strong>Hyperoxia induces oxidative stress and can exacerbate inflammatory response to Veno-Arterial Extracorporeal Life Support (VA-ECLS). This study aimed to evaluate the association between hyperoxia during VA-ECLS and morbidity, complications, and in-hospital mortality.</p><p><strong>Methods: </strong>This study included pediatric patients who received VA-ECLS between 2014 and 2019. Hyperoxia severity was categorized as mild (PaO₂: 101-200 mmHg), moderate (PaO₂: 201-300 mmHg), and severe (PaO₂ > 300 mmHg. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included a composite measure of cardiovascular or renal complications, AKI, and change in Functional Status.</p><p><strong>Results: </strong>Among 229 patients supported on VA-ECLS runs, 73.4% involved neonates. Median age and weight of the entire cohort were 2.5 months (IQR 0.3, 19.0), and 4.4 kg (IQR 3.2, 10.7), respectively. Cardiac indications accounted for 48.9% of cases. Hyperoxia occurred in 79% of patients and was more common in those requiring ECLS for cardiac indications. The overall in-hospital mortality rate was 45%, increasing to 64% in the severe hyperoxia cohort (p = 0.23). Severe hyperoxia was significantly associated with the composite outcome of cardiovascular or renal complications but not in-hospital mortality in multivariable analysis. No association was found between hyperoxia, AKI, and adverse functional outcomes.</p><p><strong>Conclusions: </strong>Standardized PaO₂ targets to minimize hyperoxia may improve outcomes for patients supported on VA-ECLS.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The never-ending process of adaptation.","authors":"Luc Puis","doi":"10.1051/ject/2026005","DOIUrl":"10.1051/ject/2026005","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"58 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}