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Perfusion

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https://www.readbyqxmd.com/read/28090817/coronary-or-ventricular-rupture-after-blunt-chest-trauma-a-clinical-dilemma
#1
Anton Sabashnikov, Guido Michels, Javid Fatullayev, Kaveh Eghbalzadeh, Mohamed Zeriouh, Stephan Baldus, Jens Wippermann, Thorsten Wahlers, Navid Madershahian
Cardiac rupture (CR) is one of the most serious and life-threatening complications of blunt chest trauma (BCT) usually associated with high mortality. Moreover, its diagnosis and treatment strategies may be extremely challenging for clinicians due to various anatomical localisations of the tear. Whereas most injuries fall under the category of right atrial ruptures, left ventricular lesions represent a rare type of this injury, with greater mortality, particularly in cases of multi-chamber injuries. However, not only cardiac chamber or great vessel ruptures may occur as a result of BCT; a growing number of reports also describe BCT-induced isolated coronary artery injuries, including ruptures...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#2
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/28043204/safety-of-gelatin-solutions-for-the-priming-of-cardiopulmonary-bypass-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#3
Idris Ghijselings, Dirk Himpe, Steffen Rex
This systematic review and meta-analysis was conducted to evaluate the safety of gelatin versus hydroxyethyl starches (HES) and crystalloids when used for cardiopulmonary bypass (CPB)-priming in cardiac surgery. MEDLINE (Pubmed), Embase and CENTRAL were searched. We included only randomized, controlled trials comparing CPB-priming with gelatin with either crystalloids or HES-solutions of the newest generation. The primary endpoint was the blood loss during the first 24 hours. Secondary outcomes included perioperative transfusion requirements, postoperative kidney function, postoperative ventilation times and length of stay on the intensive care unit...
December 1, 2016: Perfusion
https://www.readbyqxmd.com/read/27913766/myocardial-cytochrome-oxidase-activity-increases-with-age-and-hypoxemia-in-patients-with-congenital-heart-disease
#4
Michael Onwugbufor, Richard J Levy, David Zurakowski, Richard A Jonas, Pranava Sinha
BACKGROUND: Myocardial tolerance to ischemia is influenced by age and preoperative cyanosis through unknown mechanisms and significantly affects postoperative outcomes. Cytochrome c oxidase (CcOx), the terminal enzyme of the mitochondrial electron transport chain, may play a role in the susceptibility to ischemic-reperfusion (IR) injury. Our study aimed at investigating changes in human myocardial CcOx activity based on age and preoperative oxygen saturation to understand its role in transition from neonatal to mature myocardium and hypoxic conditions...
December 1, 2016: Perfusion
https://www.readbyqxmd.com/read/27881700/veno-venous-ecmo-as-a-safe-bridge-to-recovery-in-a-patient-with-severe-peripartum-cardiomyopathy-learning-from-errors
#5
Christopher Ull, Thomas Armin Schildhauer, Justus T Strauch, Andreas Mügge, Justyna Swol
Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child...
November 23, 2016: Perfusion
https://www.readbyqxmd.com/read/27881701/externally-visible-thrombus-partially-predicts-internal-thrombus-deposition-in-extracorporeal-membrane-oxygenators
#6
Charles F Evans, Tieluo Li, Vikas Mishra, Diana L Pratt, Isa S K Mohammed, Zachary N Kon, Bartley P Griffith
AIM: We sought to quantify the location and volume of thrombus in used hollow-fiber membrane oxygenators and correlate the volume of thrombus with patient demographics, flow characteristics and anticoagulation parameters. METHODS: Hollow-fiber membrane oxygenators (Quadrox D, Maquet, Rastatt, Germany) were collected after clinical use in ECMO circuits and divided into sections. Each section was digitally imaged and analyzed using ImageJ software. The location and total volume (cm(3)) of thrombus was calculated for different sections...
November 22, 2016: Perfusion
https://www.readbyqxmd.com/read/27872272/oxygenator-failure-in-acute-myeloid-leukaemia-a-case-report
#7
Chinmay Patvardhan, Kamen Valchanov
Extracorporeal membrane oxygenation (ECMO) therapy can be used to rescue patients who develop respiratory failure with acute myeloid leukaemia. We describe a unique case of rapid failure of an oxygenator on ECMO, secondary to high leukocyte count and cell lysis in an adult patient with acute myeloid leukaemia.
November 20, 2016: Perfusion
https://www.readbyqxmd.com/read/27856841/hemolysis-generation-from-a-novel-linear-positive-displacement-blood-pump-for-cardiopulmonary-bypass-on-a-six-kilogram-piglet-a-preliminary-report
#8
D Scott Lawson, Derek Eilers, Suzanne Osorio Lujan, Maria Bortot, James Jaggers
BACKGROUND: Current blood pumps used for cardiopulmonary bypass generally fall into two different pump design categories; non-occlusive centrifugal pumps and occlusive, positive-displacement roller pumps. The amount of foreign surface area of extracorporeal circuits correlates with post-operative morbidity due to systemic inflammation, leading to a push for technology that reduces the amount of foreign surfaces. Current roller pumps are bulky and the tubing forms an arc in the pumping chamber (raceway), positioning the inlet 360 degrees from the outlet, making it very difficult to place the pump closer to the patient and to efficiently reduce tubing length...
November 16, 2016: Perfusion
https://www.readbyqxmd.com/read/27852958/pentraxin-3-and-other-inflammatory-biomarkers-related-to-atrial-fibrillation-in-cardiac-surgery
#9
Zdenka Holubcova, Pavel Kunes, Jiri Mandak, Dana Vlaskova, Martina Kolackova, Drahomira Holmannova, Ctirad Andrys, Jan Krejsek, Tomas Holubec
OBJECTIVES: The aim was to evaluate the association between perioperative inflammatory biomarkers and atrial fibrillation (AF) in cardiac surgical patients. METHODS: Forty-two patients undergoing cardiac surgery were divided into three groups according to the occurrence of AF: Group A (n = 22) - patients with no AF, Group B (n = 11) - patients with new onset AF postoperatively and Group C (n = 9) - patients with preoperative history of atrial fibrillation. The serum levels of PTX3, CRP, TLR2, IL-8, IL-18, sFas, MMP-7 and MMP-8 were measured at the following time points: before surgery, immediately and 6 h after surgery and on the 1(st), 3(rd) and 7(th) postoperative days (POD)...
November 15, 2016: Perfusion
https://www.readbyqxmd.com/read/27837164/evaluation-of-a-pharmacy-managed-heparin-protocol-for-extracorporeal-membrane-oxygenation-patients
#10
Kalliopi Fitousis, Robin Klasek, Phillip E Mason, Faisal Masud
INTRODUCTION: Unfractionated heparin is the preferred anticoagulant in extracorporeal membrane oxygenation (ECMO) patients. However, there is a lack of consensus on its titration and monitoring. The objective of this study was to describe the efficacy and safety of a pharmacy managed heparin protocol utilizing activated partial thromboplastin time (aPTT) in comparison to our standard physician-managed activated clotting time (ACT)-based anticoagulation in ECMO patients. METHODS: Patients administered a heparin drip while on ECMO were included in the study...
November 10, 2016: Perfusion
https://www.readbyqxmd.com/read/27815558/in-vitro-effects-of-an-extracorporeal-membrane-oxygenation-circuit-on-the-sequestration-of-%C3%AF%C2%B5-aminocaproic-acid
#11
Deborah Wagner, Miguel Caraballo, John Waldvogel, Yuki Peterson, Duxin Sun
OBJECTIVE: To assess the in vitro effects of drug sequestration in extracorporeal membrane oxygenation (ECMO) on ϵ-aminocaproic acid (EACA) concentrations. METHODS AND DESIGN: This in vitro study will determine changes in EACA concentration over time in ECMO circuits. A pediatric dose of 2,500 mg was administered to whole expired blood in the simulated pediatric ECMO circuit. Blood samples were collected at 0, 30, 60, 360 and 1440-minute intervals after initial administration equilibration from three different sites of the circuit: pre-oxygenator (PRE), post-oxygenator (POST) and PVC tubing (PVC) to determine the predominant site of drug loss...
November 3, 2016: Perfusion
https://www.readbyqxmd.com/read/27815557/whole-body-perfusion-for-hybrid-aortic-arch-repair-evolution-of-selective-regional-perfusion-with-a-modified-extracorporeal-circuit
#12
Philip Fernandes, Graham Walsh, Stephanie Walsh, Michael O'Neil, Jill Gelinas, Michael W A Chu
BACKGROUND: Patients undergoing hybrid aortic arch reconstruction require careful protection of vital organs. We believe that whole body perfusion with tailored dual circuitry may help to achieve optimal patient outcomes. METHODS: Our circuit has evolved from a secondary circuit utilizing a cardioplegia delivery device for lower body perfusion to a dual-oxygenator circuit. This allows individually controlled regional perfusion with ease of switching from secondary to primary circuit for total body flow...
November 3, 2016: Perfusion
https://www.readbyqxmd.com/read/27872271/effects-of-a-change-in-entry-to-practice-criteria-for-cardiovascular-perfusion-in-canada-results-of-a-national-survey
#13
Dean Belway, Diem T T Tran, Fraser D Rubens
INTRODUCTION: Years of experience and level of education are two important determinants of a clinician's expertise. While entry-to-practice criteria for admission to perfusion training in Canada changed from clinical experience-based criteria to education-based criteria in 2006, the effects of these changes have not been studied. OBJECTIVE: To determine the academic and clinical backgrounds of perfusionists in Canada, ascertain perceptions about the adequacy of training and evaluate the effects of the changes on the composition of the perfusion community of Canada...
November 1, 2016: Perfusion
https://www.readbyqxmd.com/read/27864477/is-visceral-flow-during-intra-aortic-balloon-pumping-size-or-volume-dependent
#14
Sandro Gelsomino, Pieter W J Lozekoot, Monique M J de Jong, Fabiana Lucà, Orlando Parise, Francesco Matteucci, Mario Romano, Abdullrazak Hossien, Mark La Meir, Niccolò Marchionni, Jos G Maessen, Roberto Lorusso
AIM: We evaluated the influence of intra-aortic balloon size and volume on mesenteric and renal flows. METHODS: Thirty healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion. Then, they were randomly assigned to the following five groups of animals, with six animals in each group: no intra-aortic balloon pump (IABP), a short 35-mL IABP, a short 40-mL IABP, a long 35-mL IABP and a long 40-mL IABP...
November 1, 2016: Perfusion
https://www.readbyqxmd.com/read/27799498/hemodynamic-changes-in-patients-with-extracorporeal-membrane-oxygenation-ecmo-demonstrated-by-contrast-enhanced-ct-examinations-implications-for-image-acquisition-technique
#15
Lukas Lambert, Tomas Grus, Martin Balik, Jaromir Fichtl, Jan Kavan, Jan Belohlavek
Extracorporeal membrane oxygenation (ECMO) is an established tool for respiratory and circulatory support. In computed tomography, altered hemodynamics in ECMO patients requires special considerations and handling in contrast injection and its timing. In this article, we demonstrate changes in hemodynamics in ECMO patients captured on contrast-enhanced CT examinations and pitfalls in strategies for contrast injection in relation to the ECMO flow, cardiac function and the placement of ECMO cannulas. Contrast-enhanced CT of patients with ECMO requires prior knowledge of the ECMO cannulas, central venous lines, changes of hemodynamics induced by low cardiac output and the influence of adjustment of ECMO on blood flow in order to optimize injection of the contrast material and timing of the scan...
October 30, 2016: Perfusion
https://www.readbyqxmd.com/read/27794072/off-pump-left-ventricular-assist-device-exchange-via-re-do-left-mini-thoracotomy-with-original-outflow-graft-preservation
#16
Jessika Iwanski, Phat L Tran, Catherine Jerman, Richard Smith, Toshinobu Kazui, Zain Khalpey
Complications associated with long-term left ventricular assist device (LVAD) use may require pump exchange due to device thrombosis or thromboembolism. Minimally invasive off-pump procedures represent an advantageous alternative to standard full sternotomy exchanges and those performed with the use of cardiopulmonary bypass. By mitigating surgical invasion and trauma to the central chest, the potential for post-operative bleeding, transfusions and complications can be reduced. This case report describes the successful off-pump exchange of a HeartWare LVAD via left re-do-thoracotomy with the re-use of the original outflow graft...
October 27, 2016: Perfusion
https://www.readbyqxmd.com/read/27789847/acidosis-induced-by-carbon-dioxide-insufflation-decreases-heparin-potency-a-risk-factor-for-thrombus-formation
#17
Karin A M Gorter, Marco C Stehouwer, Bart P Van Putte, Eline A Vlot, Rolf T Urbanus
BACKGROUND: Since the introduction of CO2 insufflation during open heart surgery in our hospital, we incidentally observed thrombus formation in the dissected heart, in the pericardium and in the cardiotomy reservoir of the cardiopulmonary bypass system. Furthermore, we measured very high levels of pCO2, causing severe acidosis, in stagnant blood in the pericardium and cardiotomy reservoir. OBJECTIVES: In this in vitro study, we assessed the influence of acidosis and hypothermia on heparin potency and thrombin formation...
October 26, 2016: Perfusion
https://www.readbyqxmd.com/read/28042764/certainty-in-a-time-of-uncertainty-the-science-of-paradox
#18
Jonathan Afoke, Prakash P Punjabi
No abstract text is available yet for this article.
January 2017: Perfusion
https://www.readbyqxmd.com/read/27451053/the-impact-of-a-focused-vascular-lower-limb-arterial-duplex-f-vlad-scan-in-management-decisions-for-acute-limb-ischaemia
#19
Pasha Normahani, Mohammed Aslam, Nigel J Standfield, Usman Jaffer
OBJECTIVE: To establish the diagnostic accuracy of a 'focused vascular lower limb arterial duplex scan (F-VLAD)' developed to facilitate rapid decision-making for acute limb ischaemia (ALI). METHODS: Ten cases of ALI were identified from our patient database; clinical details, history and examination findings were extracted from the clinical notes. Original 'full' duplex ultrasound (DUS) pictorial reports were 're-formatted' to include only anatomical segments included in the 'F-VLAD' scan...
January 2017: Perfusion
https://www.readbyqxmd.com/read/27451052/del-nido-cardioplegia-in-low-risk-adults-undergoing-first-time-coronary-artery-bypass-surgery
#20
Gustavo E Guajardo Salinas, Roger Nutt, Gerardo Rodriguez-Araujo
OBJECTIVES: Single-dose del Nido cardioplegia has been used in the pediatric population for many years. Only a small amount of data exists about its use in adult cardiac surgery. We sought to compare the outcomes of all patients undergoing coronary artery bypass, using our 4:1 blood cardioplegia versus single-dose 1:4 del Nido cardioplegia, at our institution. METHODS: Data were retrospectively reviewed from all patients during 2 consecutive years (2013-2014). We switched our cardioplegia protocol from 4:1 blood cardioplegia to exclusively 1:4 single-dose del Nido cardioplegia in early 2014...
January 2017: Perfusion
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