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https://www.readbyqxmd.com/read/29049743/additional-veno-venous-gas-exchange-as-a-problem-solving-strategy-for-an-oxygenator-not-transferring-oxygen-in-paediatric-cardiopulmonary-bypass
#1
Wolfgang Boettcher, Nicodème Sinzobahamvya, Frank Dehmel, Andreas Matschke, Andre Iben, Mi-Young Cho, Mathias Redlin, Joachim Photiadis
OBJECTIVES: Oxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described. METHODS: A supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure. RESULTS: On 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator ( n  = 4) and Capiox FX15 ( n  = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#2
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28985692/comprehensive-blood-conservation-program-in-a-new-congenital-cardiac-surgical-program-allows-bloodless-surgery-for-the-jehovah-witness-and-a-reduction-for-all-patients
#3
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28979043/heparin-effects-upon-the-glycocalyx-and-endothelial-cells
#4
REVIEW
Bruce D Spiess
Unfractionated heparin (UFH) is the most widely used injectable medication in the United States. UFH is a poly-dispersed, relatively impure combination of many polysaccharides known as a glycosaminoglycan. It is used as the primary anticoagulant for heart surgery as well as for active treatment of deep venous thrombosis, vascular thrombosis, stroke, and many other potentially catastrophic clotting syndromes. Many perfusionists and cardiac team members know little of the biology of UFH other than its use for cardiopulmonary bypass...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28979037/a-2015-2016-survey-of-american-board-of-cardiovascular-perfusion-certified-clinical-perfusionists-perfusion-profile-and-clinical-trends
#5
Casey Turnage, Edward DeLaney, Bradley Kulat, Ann Guercio, David Palmer, Carol Ann Rosenberg, Kyle Spear, David Boyne, Charles Johnson, William Riley
To document the current perfusion workforce status and to anticipate the future demands of an ever-changing perfusion workplace environment, a valid survey is needed to help guide the future of the perfusion workforce. The American Board of Cardiovascular Perfusion (ABCP) sponsored a survey of Certified Clinical Perfusionist (CCP) demographic and clinical trends that was linked electronically to the 2015-2016 ABCP online recertification process. Of 3,875 eligible CCP's, 3,056 (78.9%) responded to the survey...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28970635/basics-of-cardiopulmonary-bypass
#6
REVIEW
Manjula Sarkar, Vishal Prabhu
Cardiopulmonary bypass (CPB) provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB. However, it also has its share of complications and strategies to reduce these complications are the area of the current research.
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28887932/issues-in-the-intensive-care-unit-for-patients-with-extracorporeal-membrane-oxygenation
#7
REVIEW
Hitoshi Hirose, Harrison T Pitcher, Michael Baram, Nicholas C Cavarocchi
The care of patients on extracorporeal corporeal oxygenation support takes a coordinated effort among the team of nurses, midlevel providers, perfusionists, respiratory therapists, pharmacists, and physicians. Attention on the details of the circuitry and its interactions with the patient, the resolution of the disease process and the ongoing plan of care, and unique issues in the intensive care unit are crucial for success.
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28832794/coronary-perfusion-pressure-during-antegrade-cardioplegia-in-on-pump-cabg-patients
#8
Jackson Brandão Lopes, Carlos Cezar Monteiro Dos Santos
Objective: The aim of this study was to investigate whether aortic tension estimated by palpation and cardioplegia infusion line pressure provide results equivalent to those obtained with direct aortic intraluminal pressure measurement. Methods: Sixty consecutive patients who underwent coronary artery bypass graft surgeries with extracorporeal circulation were analyzed. Sanguineous cardioplegic solution in a ratio of 4:1 was administered using a triple lumen antegrade cannula...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#9
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28820030/epidemiology-of-cardiovascular-disease-in-the-united-states-implications-for-the-perfusion-profession-a-2017-update
#10
Joseph J Sistino, David C Fitzgerald
INTRODUCTION: By analyzing epidemiological trends in cardiovascular disease (CVD), key stakeholders can make informed decisions on the future of disease burden and treatment. Accordingly, the cardiovascular perfusion community would benefit from data that would help predict future professional resource utilization. METHODS: In 2003, the changes in the number of hospital discharges for CVD from 1990 to 2000 were published, based on data from the National Center for Health Statistics (NCHS)...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28566014/assessing-the-culture-of-safety-in-cardiovascular-perfusion-attitudes-and-perceptions
#11
Chad Lawson, Megan Predella, Allison Rowden, Jamie Goldstein, Joseph J Sistino, David C Fitzgerald
INTRODUCTION: The Hospital Survey on Patient Safety Culture was developed by the Agency for Healthcare Research and Quality (AHRQ) to assess the culture of safety in hospitals. The purpose of this study was to identify specific domains of perfusion that are indicators of a high quality culture of safety. METHODS: Perfusionists were recruited to participate in the survey through email invitation through Perflist, Perfmail and LinkedIn. The survey consisted of 37 questions across six safety domains...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#12
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28181301/impact-of-distinct-oxygenators-on-pulsatile-energy-indicators-in-an-adult-cardiopulmonary-bypass-model
#13
Lonneke M Griep, Laurentius J M van Barneveld, Antoine P Simons, Christa Boer, Patrick W Weerwind
The quantification of pulse energy during cardiopulmonary bypass (CPB) post-oxygenator is required prior to the evaluation of the possible beneficial effects of pulsatile flow on patient outcome. We therefore, evaluated the impact of three distinctive oxygenators on the energy indicators energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) in an adult CPB model under both pulsatile and laminar flow conditions. The pre- and post-oxygenator pressure and flow were measured at room temperature using a 40% glycerin-water mixture at flow rates of 1, 2, 3, 4, 5, and 6 L/min...
February 2017: Artificial Organs
https://www.readbyqxmd.com/read/28077509/the-basic-approach-a-single-centre-experience-with-a-cost-reducing-model-for-paediatric-cardiac-extracorporeal-membrane-oxygenation
#14
Massimo A Padalino, Chiara Tessari, Alvise Guariento, Anna C Frigo, Vladimiro L Vida, Andrea Marcolongo, Fabio Zanella, Michael J Harvey, Ravi R Thiagarajan, Giovanni Stellin
Objectives: Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. Methods: We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014...
April 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27994260/a-case-of-successful-thromboelastographic-guided-resuscitation-after-postpartum-hemorrhage-and-cardiac-arrest
#15
M Hurwich, D Zimmer, E Guerra, E Evans, T Shire, M Abernathy, J T Shreve, G R Kolettis, M T McCurdy, F J Castellino, M Walsh
Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG)...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994258/results-of-the-2015-perfusionist-salary-study
#16
Doreen M Lewis, Steven Dove, Ralph E Jordan
Presently, there exists no published valid and reliable salary study of clinical perfusionists. The objective of the 2015 Perfusionist Salary Study was to gather verifiable employee information to determine current compensation market rates (salary averages) of clinical perfusionists working in the United States. A salary survey was conducted between April 2015 and March 2016. The survey required perfusionists to answer questions about work volume, scheduling, and employer-paid compensation including benefits...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27925235/quantification-of-operational-learning-in-minimal-invasive-extracorporeal-circulation
#17
Kyriakos Anastasiadis, Polychronis Antonitsis, Christos Asteriou, Helena Argiriadou, Apostolos Deliopoulos, Dimitrios Konstantinou, Vassilios Grosomanidis, Paschalis Tossios
Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB)...
December 7, 2016: Artificial Organs
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
#18
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...
May 2017: Perfusion
https://www.readbyqxmd.com/read/27735174/cardiovascular-perfusionist
#19
(no author information available yet)
No abstract text is available yet for this article.
April 2016: Clinical Privilege White Paper
https://www.readbyqxmd.com/read/27729702/blood-conservation-a-team-sport
#20
REVIEW
Donald S Likosky, Timothy A Dickinson, Theron A Paugh
Cardiac surgery accounts for between 15% and 20% of all blood product utilization in the United States. A body of literature suggests that patients who are exposed to even small quantities of blood have an increased risk of morbidity and mortality, even after adjusting for pre-operative risk. Despite this body of literature supporting a restrictive blood management strategy, wide variability in transfusion rates exist across institutions. Recent blood management guidelines have shed light on a number of potentially promising blood management strategies, including acute normovolemic hemodilution (ANH) and retrograde autologous priming (RAP)...
September 2016: Journal of Extra-corporeal Technology
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