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Perfusion

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https://www.readbyqxmd.com/read/29301460/inert-gas-rebreathing-helpful-tool-in-the-management-of-left-ventricular-assist-device-patients
#1
Nils Reiss, Thomas Schmidt, Stephanie Mommertz, Christina Feldmann, Jan Dieter Schmitto
In patients with left ventricular assist devices (LVAD), exercise capacity is a decisive factor regarding the quality of life. When evaluating exercise capacity, precise information about the total cardiac output generated is crucial. To date, complex measurements using a right-heart catheter were necessary in order to determine total cardiac output. The inert gas rebreathing method facilitates non-invasive, direct and valid measurement of total cardiac output as well as associated parameters, like the difference in arteriovenous oxygen saturation, both at rest and during exercise...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29301459/the-effect-of-ultrafiltration-on-end-cardiopulmonary-bypass-hematocrit-during-cardiac-surgery
#2
Linda Mongero, Alfred Stammers, Eric Tesdahl, Andrew Stasko, Samuel Weinstein
OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on end-CPB hematocrit by cardiac surgical procedure type. METHODS: A review of 73,506 cardiac procedures from a national registry (SCOPE) was conducted between April 2012 and October 2016 at 197 institutions...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29272987/the-practicalities-of-establishing-a-porcine-isolated-heart-model
#3
Warren Pavey, Anthea Raisis, Ben Dunne, Els Van Laeken, Charles Jenkinson, Viji Vincent, Peter Baird, Stuart Prince, Kwok M Ho, Christopher Merry, Ian Gilfillan
BACKGROUND: The isolated heart apparatus is over 100 years old, but remains a useful research tool today. While designs of many large animal systems have been described in the literature, trouble-shooting and refining such a model to yield a stable, workable system has not been previously described. This paper outlines the issues, in tabular form, that our group encountered in developing our own porcine isolated heart rig with the aim of assisting other workers in the field planning similar work...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29258403/a-novel-augmented-venous-drainage-model-of-cardiopulmonary-bypass-for-deep-hypothermic-circulatory-arrest-without-blood-priming
#4
Xuan Jiang, Tianxiang Gu, Yu Liu, Chun Wang, Enyi Shi, Guangwei Zhang
OBJECTIVE: Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are commonly used in cardiac surgery. However, the mortality and morbidity are still high in practice. Developing novel protective stategies and elucidating the underlying mechanisms for the pathophysiological consequences of DHCA have been hampered because of the absence of a satisfactory recovery animal model. The aim of this study was to establish a novel and safe DHCA model without blood priming in rats to study the pathophysiology of potential complications...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29228895/postcardiotomy-refractory-ventricular-fibrillation-rescue-using-veno-arterial-extracorporeal-membrane-oxygenation
#5
Ilya Soynov, Igor Kornilov, Alexey Zubritskiy, Dmitriy Ponomarev, Nataliya Nichay, Artem Gorbatykh, Alexey Voitov, Alexander Karaskov
We present a case of 7-hour ventricular fibrillation with successful use of veno-arterial extracorporeal membrane oxygenation as a bridge to recovery in a 30-year-old patient with grown-up congenital heart disease who underwent pulmonary valve replacement.
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29228894/is-therapeutic-hypothermia-during-neonatal-extracorporeal-membrane-oxygenation-associated-with-intracranial-hemorrhage
#6
Katherine Cashen, Ron W Reeder, Christina Shanti, Heidi J Dalton, J Michael Dean, Kathleen L Meert
INTRODUCTION: The use of therapeutic hypothermia during neonatal extracorporeal membrane oxygenation (ECMO) as a neurologic protective strategy has gained interest among clinicians despite limited data. Our objective is to describe the relationship between the use of therapeutic hypothermia during neonatal ECMO and complications, mortality and functional status among survivors. METHODS: Secondary analysis of data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29224434/percutaneous-intervention-to-correct-central-venous-port-catheter-malposition
#7
Yen-Hsiang Wang, Chieh-Shou Su, Keng-Hao Chang, Chi-Jen Went, Wen-Lieng Lee, Chih-Hung Lai
The use of central venous port access is increasing due to the requirements of multimodal intravenous therapy.1 However, catheter malposition in smaller veins can lead to vein thrombosis, phlebitis and pain. Herein, we report our experience with the use of percutaneous interventions to correct migrated port catheter malposition. Minimally invasive percutaneous interventional correction of malposition could be an alternative to extraction and re-implantation of malpositioned port catheters.
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29199541/impact-of-temperature-on-the-narcotrend-index-during-hypothermic-cardiopulmonary-bypass-in-children-with-sevoflurane-anesthesia
#8
Nils Dennhardt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Alexander Horke, Sebastian Tiedge, Martin Boehne, Robert Sümpelmann
BACKGROUND: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. OBJECTIVE: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29199540/is-the-use-of-hydroxyethyl-starch-as-priming-solution-during-cardiac-surgery-advisable-a-randomized-single-center-trial
#9
Øyvind S Svendsen, Marit Farstad, Arve Mongstad, Rune Haaverstad, Paul Husby, Venny L Kvalheim
INTRODUCTION: The use of cardiopulmonary bypass (CPB) leads to increased fluid filtration and edema. The use of artificial colloids to counteract fluid extravasation during cardiac surgery is controversial. Beneficial effects on global fluid loading, leading to better cardiac performance and hemodynamics, have been claimed. However, renal function and coagulation may be adversely affected, with unfavorable impact on outcome following cardiac surgery. METHODS: Forty patients were randomly allocated to study groups receiving either acetated Ringer's solution (CT group) or hydroxyethyl starch (HES group, Tetraspan®) as CPB priming solution...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29297248/book-review-intraoperative-and-interventional-echocardiography-atlas-of-transesophageal-imaging-oxorn-donald-c-otto-catherine-m-2017-intraoperative-and-interventional-echocardiography-atlas-of-transesophageal-imaging-second-edition-philadelphia-pa-elsevier
#10
https://www.readbyqxmd.com/read/29188749/bleeding-during-veno-venous-ecmo-cannot-reliably-be-predicted-by-rotational-thrombelastometry-rotem%C3%A2
#11
Christina Hellmann, Axel Schmutz, Johannes Kalbhenn
INTRODUCTION: Veno-venous extracorporeal membrane oxygenation (vvECMO) used for respiratory support is associated with clinical bleeding in at least one third of patients. Mechanisms promoting bleeding, like acquired von Willebrand syndrome, cannot be identified by routine coagulation tests. This study was performed to evaluate rotational Thrombelastography (ROTEM™) for specific results predicting bleeding events during vvECMO. METHODS: Five hundred and thirty-four ROTEM™ analyses of 57 patients over 574 days have been evaluated...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29173003/life-threatening-idiopathic-reaction-to-hydrochlorothiazide-treated-with-veno-venous-extracorporeal-membrane-oxygenation
#12
Sean P Kane, Elliott Cohen
Hydrochlorothiazide has been shown to cause rare, but serious non-cardiogenic pulmonary edema. We present a case report of a patient with apparent septic shock and acute respiratory distress syndrome (ARDS) requiring life-sustaining veno-venous extracorporeal membrane oxygenation (VV-ECMO). Upon further review of the literature and the chronology of the patient's presentation, her condition was most likely due to an immune-mediated reaction to hydrochlorothiazide. This represents the first case, to our knowledge, of such a severe reaction to hydrochlorothiazide supported with ECMO therapy...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29172999/left-ventricular-thrombus-formation-in-patients-undergoing-femoral-veno-arterial-extracorporeal-membrane-oxygenation
#13
Carolyn Weber, Antje-Christin Deppe, Anton Sabashnikov, Ingo Slottosch, Elmar Kuhn, Kaveh Eghbalzadeh, Maximilian Scherner, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
INTRODUCTION: Profoundly impaired left ventricular (LV) function in patients undergoing femoral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) can result in intra-cardiac stasis and thrombus formation. There have been several attempts to improve LV unloading in patients with peripheral VA-ECMO, either by improving contractility or by venting the LV. METHODS: Data from all patients who underwent femoral VA-ECMO between 2007 and 2015 due to cardiogenic decompensation were retrospectively analysed regarding intra-cardiac thrombus formation...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29153041/association-of-procalcitonin-values-and-bacterial-infections-in-pediatric-patients-receiving-extracorporeal-membrane-oxygenation
#14
Vi Ean Tan, Wayne S Moore, Arun Chopra, Jeffrey J Cies
OBJECTIVE: There is increasing data in pediatrics demonstrating procalcitonin (PCT) is more sensitive and specific than other biomarkers in the setting of bacterial infections. However, the use of PCT in neonatal and pediatric extracorporeal membrane oxygenation (ECMO) is not well described. Therefore, the purpose of this study was to describe the clinical utility of PCT in determining the absence or presence of bacterial infections in neonatal and pediatric patients on ECMO. METHODS: This was a retrospective electronic medical record (EMR) review of data between January 1, 2010 to June 30, 2016 at a single, free-standing, children 's hospital...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#15
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29125053/twenty-minutes-of-normothermic-cardiac-arrest-in-a-pig-model-the-role-of-short-term-hypothermia-for-neurological-outcome
#16
Katharina Foerster, Christoph Benk, Friedhelm Beyersdorf, Heidi Cristina Schmitz, Karin Wittmann, Itumeleng Taunyane, Claudia Heilmann, Georg Trummer
INTRODUCTION: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named "controlled integrated resuscitation device" (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29108485/minimising-the-risk-of-mycobacterium-chimaera-infection-during-cardiopulmonary-bypass-by-the-removal-of-heater-cooler-units-from-the-operating-room
#17
Thomas A Barker, Uday Dandekar, Nina Fraser, Lincoln Dawkin, Paul Sweeney, Fraser Heron, Jacqui Simmons, Jitendra Parmar
INTRODUCTION: Mycobacterium chimaera ( M. chimaera) is a recently characterised bacterium that can cause life-threatening infections in small numbers of patients who undergo cardiopulmonary bypass during cardiac surgery. The likely mode of transmission is thought to occur through aerosolisation from contaminated water reservoirs. The airborne bacteria then contaminate the surgical field, leading to an infection months or even years later. The preferred practical solution to disrupt the transmission of these airborne bacteria to the patient is to remove the heater-cooler units (HCUs) from the operating room (OR)...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29103365/whole-body-perfusion-strategy-for-aortic-arch-repair-under-moderate-hypothermia
#18
Christopher L Tarola, Katie L Losenno, Jill J Gelinas, Philip M Jones, Philip Fernandes, Stephanie A Fox, Bob Kiaii, Michael W A Chu
INTRODUCTION: Aortic arch reconstruction under moderate hypothermia is commonly performed with antegrade cerebral perfusion (ACP) for brain protection; however, hypothermia alone is often solely relied upon for visceral and lower body protection. We investigated whether the addition of simultaneous lower body perfusion to ACP (whole body perfusion - WBP) may ameliorate the metabolic derangements of moderate hypothermic circulatory arrest (MHCA). METHODS: Between 2008 and 2014, 106 consecutive patients underwent elective or emergent aortic arch surgery with MHCA, with either ACP only (44 patients, 66±12 years, 30% female) or WBP (62 patients, 61±15 years, 31% female)...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29239700/blood-transfusion-devil-and-god-co-existing
#19
Geoff Lockwood
No abstract text is available yet for this article.
January 2018: Perfusion
https://www.readbyqxmd.com/read/29058987/association-between-intraoperative-blood-product-transfusions-and-acute-kidney-injury-following-cardiac-surgery
#20
COMMENT
Ya-Yang Liu, Fu-Shan Xue, Hui-Xian Li, Gui-Zhen Yang
No abstract text is available yet for this article.
January 2018: Perfusion
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