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https://www.readbyqxmd.com/read/28181301/impact-of-distinct-oxygenators-on-pulsatile-energy-indicators-in-an-adult-cardiopulmonary-bypass-model
#1
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
#2
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...
January 10, 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
#3
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
#4
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
#5
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
#6
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/27735174/cardiovascular-perfusionist
#7
(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
#8
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
https://www.readbyqxmd.com/read/27649636/an-international-survey-the-role-of-specialist-nurses-in-adult-respiratory-extracorporeal-membrane-oxygenation
#9
Kathleen Jr Daly, Luigi Camporota, Nicholas A Barrett
BACKGROUND: The last decade has seen an increase in the number of centres able to provide venovenous extracorporeal membrane oxygenation (VV-ECMO) internationally across different health care systems. To support this growth, a variety of staffing arrangements have been adopted depending on local need and availability of resources, both in terms of manpower and finances to safely meet the complex needs of the patient and circuit management. AIM: The aim of the survey was to describe current staffing arrangements of care provision for adult patients on VV-ECMO, with a focus on understanding the professional roles and responsibilities of staff managing the circuit in order to inform further discussion around different approaches to staffing...
September 21, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27625167/classification-and-surgical-repair-of-injuries-sustained-during-transvenous-lead-extraction
#10
Jamil Bashir, Lynn M Fedoruk, John Ofiesh, Shahzad S Karim, G Frank O Tyers
BACKGROUND: Injuries to cardiac and venous structures during pacemaker and defibrillator lead extraction are serious complications that have been studied poorly. The incidence of these injuries is unknown but likely underestimated. No systematic multicenter review of these injuries or their management has been undertaken. METHODS AND RESULTS: We interrogated our mandatory administrative database for all excimer laser extractions that sustained a cardiac or venous injury in the province of British Columbia...
September 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27523953/practice-characteristics-of-emergency-department-extracorporeal-cardiopulmonary-resuscitation-ecpr-programs-in-the-united-states-the-current-state-of-the-art-of-emergency-department-extracorporeal-membrane-oxygenation-ed-ecmo
#11
Joseph E Tonna, Nicholas J Johnson, John Greenwood, David F Gaieski, Zachary Shinar, Joseph M Bellezo, Lance Becker, Atman P Shah, Scott T Youngquist, Michael P Mallin, James Franklin Fair, Kyle J Gunnerson, Cindy Weng, Stephen McKellar
PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO)...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27490610/cardiopulmonary-bypass-induced-inflammatory-response-pathophysiology-and-treatment
#12
Ronald A Bronicki, Mark Hall
OBJECTIVES: The objectives of this review are to discuss the pathophysiology of the pro-inflammatory response to the cardiopulmonary bypass circuit, the impact of ischemia reperfusion injury on post-operative organ function, the compensatory anti-inflammatory response and the evidence for immune-modulatory strategies and their impact on outcomes. DATA SOURCE: MEDLINE, PubMed. CONCLUSION: Innovations such as the development of more biocompatible surfaces and miniaturized circuits, as well as the increasing expertise of surgeons, anesthesiologists and perfusionists has transformed cardiac surgery and the use of cardiopulmonary bypass into a relatively routine procedure with favorable outcomes...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27465213/comparison-of-isoflurane-and-sevoflurane-in-cardiac-surgery-a-randomized-non-inferiority-comparative-effectiveness-trial
#13
Philip M Jones, Daniel Bainbridge, Michael W A Chu, Philip S Fernandes, Stephanie A Fox, Ivan Iglesias, Bob Kiaii, Ronit Lavi, John M Murkin
PURPOSE: Volatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27397454/anesthetic-challenges-in-minimally-invasive-cardiac-surgery-are-we-moving-in-a-right-direction
#14
REVIEW
Vishwas Malik, Ajay Kumar Jha, Poonam Malhotra Kapoor
Continuously growing patient's demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient's demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27396248/identifying-workflow-disruptions-in-the-cardiovascular-operating-room
#15
T N Cohen, J S Cabrera, O D Sisk, K L Welsh, J H Abernathy, S T Reeves, D A Wiegmann, S A Shappell, A J Boquet
The objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (χ(2) (2, N = 110) = 7.136, p < 0.028) and interruptions (χ(2) (2, N = 427) = 29...
August 2016: Anaesthesia
https://www.readbyqxmd.com/read/27295774/-mitral-valve-repair-with-minimally-invasive-cardiac-surgery-approach-as-routine-practice
#16
Kazuma Okamoto, Mikihiko Kudo, Hideyuki Shimizu
Although minimally invasive cardiac surgery (MICS) via right minithoracotomy is attracting attention as a minimally invasive approach in cardiac surgery, it has not become a standard, routine approach for mitral valve repair. Although it has spread rapidly in Germany (43%) and USA (20.4%), the proportion of MICS in isolated mitral valve repair still comprises only 15.6% of mitral valve repair surgeries in Japan. For safe, assured introduction of MICS as a routine approach under quality control for good surgical and mid- and long-term results, surgeons experienced in mitral valve repair who perform at least 10 mitral valve repairs per year are necessary...
March 2016: Nihon Geka Gakkai Zasshi
https://www.readbyqxmd.com/read/27136246/experience-with-a-new-process-condition-t-for-uncontrolled-donation-after-circulatory-determination-of-death-in-a-university-emergency-department
#17
Michael A DeVita, Clifton W Callaway, Charissa Pacella, Maria Mori Brooks, John Lutz, Susan Stuart
BACKGROUND: In the United States, organ donation after circulatory death (DCD) determination is increasing among those who are removed from life-sustaining therapy but is rare when death is unexpected. We created a program for uncontrolled DCD (uDCD). METHODS: A comprehensive program was created to train personnel to identify and respond quickly to potential donors after unexpected death. The process termed Condition T was implemented in the emergency department (ED) of 2 academic medical centers...
March 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27052063/tricks-tips-and-literature-review-on-the-adapted-vaporize-system-to-deliver-volatile-agents-during-cardiopulmonary-bypass
#18
REVIEW
Caetano Nigro Neto, Francesco De Simone, Luigi Cassara, Carlos Gustavo Dos Santos Silva, Thiago Augusto Azevedo Marãnhao Cardoso, Francesco Carco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: Recently, evidence of cardio-protection and reduction in mortality due to the use of volatile agents during cardiac surgery led to an increase in their use during cardiopulmonary bypass (CPB). These findings seem to be enhanced when the volatile agents are used during all the surgical procedure, including the CPB period. AIMS: Since the administration of volatile agents through CPB can be beneficial to the patients, we decided to review the use of volatile agents vaporized in the CPB circuit and to summarize some tricks and tips of this technique using our 10-year experience of Brazilian and Italian centers with a large volume of cardiac surgeries...
April 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27019882/-gas-microembolism-during-extracorporeal-circulation
#19
L S Lokshin
INTRODUCTION: Over the past 20 years, there are many studies, where great attention is paid to the gas and material embolism as the cause of cognitive impairment in patients undergoing surgery with cardiopulmonary bypass. PURPOSE: To identify the filter capacity of 4 extracorporeal circuits for removing gaseous microemboli in various interventions on the heart and aorta. MATERIAL AND METHODS: Work carried out on 60 patients operated on acquired heart and aorta under cardiopulmonary bypass...
September 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26819269/use-of-minimal-invasive-extracorporeal-circulation-in-cardiac-surgery-principles-definitions-and-potential-benefits-a-position-paper-from-the-minimal-invasive-extra-corporeal-technologies-international-society-miectis
#20
Kyriakos Anastasiadis, John Murkin, Polychronis Antonitsis, Adrian Bauer, Marco Ranucci, Erich Gygax, Jan Schaarschmidt, Yves Fromes, Alois Philipp, Balthasar Eberle, Prakash Punjabi, Helena Argiriadou, Alexander Kadner, Hansjoerg Jenni, Guenter Albrecht, Wim van Boven, Andreas Liebold, Fillip de Somer, Harald Hausmann, Apostolos Deliopoulos, Aschraf El-Essawi, Valerio Mazzei, Fausto Biancari, Adam Fernandez, Patrick Weerwind, Thomas Puehler, Cyril Serrick, Frans Waanders, Serdar Gunaydin, Sunil Ohri, Jan Gummert, Gianni Angelini, Volkmar Falk, Thierry Carrel
Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice...
May 2016: Interactive Cardiovascular and Thoracic Surgery
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