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Pilar Anton-Martin, Vinai Modem, Donna Taylor, Donald Potter, Cindy Darnell-Bowens
INTRODUCTION: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. METHOD: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. RESULTS: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO...
October 10, 2016: Perfusion
Richard A Jonas
No abstract text is available yet for this article.
October 5, 2016: Perfusion
Craig M McRobb, Richard J Ing, D Scott Lawson, James Jaggers, Mark Twite
Modified ultrafiltration (MUF) is a technique which is commonly used immediately post-cardiopulmonary bypass (CPB) for open heart surgery in children. There are many advantages of MUF, but there are also a number of less reported disadvantages. At our institution, after considering all of the available data, a decision was made to no longer perform MUF. The primary motivation being the simplified and miniaturized CPB circuit would reduce hemodilution, decrease our likelihood of reaching our transfusion trigger during CPB and, potentially, improve safety...
October 5, 2016: Perfusion
Ashok Padukone, Ahmed K Sayeed, Nandor Marczin, Diana García Sáez, Bartlomiej Zych, Prashant N Mohite, Mohamed Zeriouh, Robert D Smith, Andre R Simon, Anton Sabashnikov, Aron-Frederik Popov
Spontaneous left main coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death, constituting less than 1% of all epicardial coronary artery dissections. It is often fatal and is mostly recognized at post-mortem examination in young victims of sudden death. More than 70% of the reported cases occurred in women, particularly during pregnancy and the peripartum period and those on oral contraceptives. The clinical presentation is highly variable and prognosis varies widely, depending predominantly on the speed of diagnosis...
September 13, 2016: Perfusion
Drahomira Holmannova, Martina Kolackova, Jiri Mandak, Pavel Kunes, Zdenka Holubcova, Tomas Holubec, Jan Krejsek
OBJECTIVE: Cardiac surgery is known to trigger a systemic inflammatory response. While the use of conventional cardiopulmonary bypass (CPB) results in profound inflammation, modified mini-CPB is considered less harmful. We evaluated the impact of cardiac surgery on the expression of CD162, CD166, CD195 molecules and their association with the type of CPB used. METHODS AND RESULTS: Twenty-four patients were enrolled in our study. Twelve of them were operated using conventional CPB while the other twelve patients underwent surgery with mini-CPB...
September 13, 2016: Perfusion
Katherine Cashen, Roland L Chu, Justin Klein, Peter T Rycus, John M Costello
INTRODUCTION: Pediatric patients with hemophagocytic lymphohistiocytosis (HLH) may develop refractory respiratory or cardiac failure that warrants consideration for extracorporeal membrane oxygenation (ECMO) support. The purposes of this study were to describe the use and outcomes of ECMO in pediatric HLH patients, to identify risk factors for hospital mortality and to compare their ECMO use and outcomes to the ECMO population as a whole. METHODS: Pediatric patients (⩽ 18 years) with a diagnosis of HLH in the Extracorporeal Life Support Organization (ELSO) Registry were included...
September 13, 2016: Perfusion
Giangiuseppe Cappabianca, Claudio Roscitano, Samuele Bichi, Antonio Cricco, Matteo Parrinello, Cesare Beghi, Giovanni Albano, Giampiero Esposito
The Frozen Elephant Trunk (FET) can be adopted in selected type A acute aortic dissections (TAAAD). During FET, a prolonged distal circulatory arrest exposes the spine and visceral organs to potential ischemic injuries. Antegrade distal aortic perfusion (ADAP) could minimize this risk: we describe the technical aspects of the simultaneous use of antegrade cerebral perfusion (ACP) and ADAP achieving a "Whole Body Perfusion" (WBP) during FET.
September 9, 2016: Perfusion
Carole Hamilton, Denise Marin, Frank Weinbrenner, Branka Engelhardt, Dow Rosenzweig, Ulrich Beck, Pavel Borisov, Stephen Hohe
BACKGROUND: There is no acceptable method of testing oxygen transfer performance in membrane oxygenators quickly and easily during cardiopulmonary bypass. Pre-clinical testing of oxygenators is performed under controlled situations in the laboratory, correlating oxygen transfer to blood flow using 100% oxygen. This laboratory method cannot be used clinically as oxygen transfer values vary significantly at each blood flow and the FiO2 is not kept at 1. Therefore, a formula was developed which corrects the existing FiO2 to attain a PaO2 of 150 mmHg: the corrected FiO2 at 150 mmHg...
September 5, 2016: Perfusion
Craig A Robertson, Terence Gourlay
BACKGROUND: HemoSep(®) is a commercial ultrafiltration and haemoconcentration device for the concentration of residual bypass blood following surgery. This technology is capable of reducing blood loss in cardiac and other types of "clean site" procedures, including paediatric surgery. Clinical feedback suggested that the device would be enhanced by including a sensor technology capable of discerning the concentration level of the processed blood product. We sought to develop a novel sensor that can, using light absorption, give an accurate estimate of packed cell volume (PCV)...
September 2, 2016: Perfusion
Jerome Rambaud, Pierre L Léger, Ludovic Porlier, Michelle Larroquet, Herve Raffin, Charlotte Pierron, Herve Walti, Ricardo Carbajal
Refractory severe hemodynamic or respiratory failure may require extracorporeal membrane oxygenation (ECMO). Since some patients are too sick to be transported safely to a referral ECMO center on conventional transportation, mobile ECMO transport teams have been developed. The experiences of some ECMO transport teams have already been reported, including air and international transport. We report the first French pediatric international ECMO transport by aircraft. This case shows that a long distance intervention of the pediatric ECMO transport team is feasible, even in an international setting...
September 1, 2016: Perfusion
Marco C Stehouwer, Kristina R Legg, Roel de Vroege, Johannes C Kelder, Erik Hofman, Bastian A de Mol, Peter Bruins
Gaseous microemboli (GME) may originate from the extracorporeal circuit and enter the arterial circulation of the patient. GME are thought to contribute to cerebral deficit and to adverse outcome after cardiac surgery. The arterial filter is a specially designed component for removing both gaseous and solid microemboli. Integration of an arterial filter with an oxygenator is a contemporary concept, reducing both prime volume and foreign surface area. This study aims to determine the air-handling properties of four contemporary oxygenator devices with an integrated arterial filter...
August 11, 2016: Perfusion
Samantha Wills, Paul Forrest
Haemolysis, thrombosis and haemorrhage are well-documented complications of extracorporeal membrane oxygenation. This case report outlines an unusual case of haemolysis, thought secondary to a large mobile thrombus in the inferior vena cava.
August 9, 2016: Perfusion
Leonidas V Athanasopoulos, Marco Moscarelli, Giuseppe Speziale, Prakash P Punjabi, Thanos Athanasiou
This review focused on whether subvalvular techniques are more effective than isolated restrictive annuloplasty in addressing ischemic mitral regurgitation (MR). Searching identified 445 papers and, following a selection process, we ended up with 10 articles. Two were propensity-matched studies, four retrospective and four prospective, non-randomized studies. The end points of interest were late recurrence of MR, other early echocardiographic outcomes of mitral function and early mortality. All studies focusing on echocardiographic measurements showed improved results in the groups where subvalvular repair techniques were used...
July 28, 2016: Perfusion
Nicola Vistarini, Eric Laliberté, Philippe Beauchamp, Ismail Bouhout, Yoan Lamarche, Raymond Cartier, Michel Carrier, Louis Perrault, Denis Bouchard, Ismaïl El-Hamamsy, Michel Pellerin, Philippe Demers
The purpose of this study is to report our experience with del Nido cardioplegia (DNC) in the setting of minimally invasive aortic valve surgery. Forty-six consecutive patients underwent minimally invasive aortic valve replacement (AVR) through a "J" ministernotomy: twenty-five patients received the DNC (Group 1) and 21 patients received standard blood cardioplegia (SBC) (Group 2). The rate of ventricular fibrillation at unclamping was significantly lower in the DNC group (12% vs 52%, p=0.004), as well as postoperative creatinine kinase-MB (CK-MB) values (11...
July 28, 2016: Perfusion
Yousif Ahmad, Prakash P Punjabi
No abstract text is available yet for this article.
October 2016: Perfusion
Syarul Haziq Mohd Shah, Prakash P Punjabi
No abstract text is available yet for this article.
October 2016: Perfusion
Mark Kurusz
No abstract text is available yet for this article.
October 2016: Perfusion
Marc-Gilbert Lagny, Andre Gothot, Gregory A Hans, Jean-Noël Koch, Francine Blaffart, Dominique Hella, Anne-Françoise Donneau, Laurence Roediger, Christelle Lecut, Joël Pincemaïl, Jean-Paul Cheramy-Bien, Jean-Olivier Defraigne
INTRODUCTION: Re-transfusion of lipid particles and activated leucocytes with shed mediastinal blood (SMB) can aggravate cardiopulmonary bypass-associated inflammation and increase the embolic load. This study evaluated the fat and leucocyte removal capacity of the RemoweLL cardiotomy reservoir. METHODS: Forty-five patients undergoing elective on-pump cardiac surgery were randomly allocated to filtration of SMB using the RemoweLL or the Admiral cardiotomy reservoir...
October 2016: Perfusion
Liang Chen, Lin Lv, Cun Long, Song Lou
OBJECTIVE: To investigate whether human serum albumin coating before cardiopulmonary bypass (CPB) could improve platelet function and hemostasis and mitigate the inflammatory response among patients receiving aortic arch replacement with deep hypothermic circulatory arrest (DHCA). METHODS: Sixty patients were included and randomized into two groups: the Control Group (CG, receiving 40 g human albumin 5 minutes after the initiation of CPB) and the Study Group (SG, circulating the prime with 40 g albumin for 5 minutes before CPB)...
October 2016: Perfusion
Rimantas Benetis, Paulius Orda, Jolanta Justina Vaškelytė, Vytenis Ivanauskas, Eglė Ereminienė, Povilas Jakuška, Loreta Jankauskienė
OBJECTIVE: To evaluate late outcomes after posterior mitral valve (MV) annulus double-suture annuloplasty for degenerative (non-ischaemic) MV insufficiency. DESIGN: Between 2005 and 2011, 138 patients underwent MV repair using posterior MV double-suture annuloplasty and an additional 105 patients underwent tricuspid valve repair. The study protocol included operative mortality, reoperation rate and reasons, as well as echocardiographic parameters at pre- and postoperative and follow-up periods (2-9 years)...
October 2016: Perfusion
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