Unveiling the Dynamics of Oxygen Delivery Limitation during Veno-Venous ECMO
In their exploration of oxygen delivery mechanisms during veno-venous extracorporeal membrane oxygenation (V-V ECMO), Heymer et al. delve into the intricate process of oxygen transport within the body. They emphasize the critical role played by both convective transport, facilitated by hemoglobin in arterial blood, and diffusion to the mitochondria, the powerhouse of cells. The authors…
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Explores Delayed Kidney Decline After Cardiopulmonary Bypass
A recent pilot study led by Ahmed Zaky and colleagues explored the patterns and predictors of kidney function decline in patients after undergoing cardiopulmonary bypass (CPB). This study responds to the absence of a standardized follow-up protocol for kidney function in CPB patients, aiming to gather preliminary data and identify risk factors for kidney function…
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Techniques for De-Airing in Minimally Invasive and Robotic Heart Surgeries
In minimally invasive and robotic-assisted intracardiac procedures, effective de-airing of the left heart chambers is essential to prevent severe complications such as systemic air embolism, which can cause neurological and myocardial dysfunction. The primary sources of air emboli include air trapped in heart chambers, air entering through surgical openings or devices, and air bubbles formed…
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Landmark Heart Transplant Achieved After 12-Hour Preservation Aboard Commercial Flight
In a groundbreaking achievement, surgeons at Pitié-Salpêtrière Hospital in Paris successfully performed a heart transplant after transporting a donor heart across the Atlantic Ocean. This historic operation took place in January 2024, using a heart from a 48-year-old donor in the French West Indies. The heart was preserved for over 12 hours using ex-vivo hypothermic,…
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Unveiling the Benefits of Awake Management in Veno-venous ECMO Patients.
Felix A. Rottmann and colleagues conducted a comprehensive study investigating the impact of maintaining awake status on patient outcomes, making a significant contribution to understanding patient management during venovenous extracorporeal membrane oxygenation (V-V ECMO). Their research, based on a retrospective analysis of a single-center V-V ECMO cohort, offers valuable insights into the association between sedation…
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Optimal Initiation of Cardiopulmonary Bypass: New Insights on Tissue Oxygenation Kinetics
Heart-lung machine (HLM) initiation during cardiac surgeries is a routine yet critical process. Despite its frequent application, more evidence-based guidelines need to be developed on the best method to start cardiopulmonary bypass (CPB) to prevent cerebral ischemia. Dr. Jan Turra and his team have tackled this issue with a groundbreaking study comparing fast and slow…
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Analyzing Refusal Patterns of Donor Hearts: Insights for Transplantation
In the ever-evolving landscape of organ transplantation, understanding the nuances of donor heart refusal can significantly impact transplantation rates and patient outcomes. A recent study led by Tyler M. Dann, BS, and his team sheds light on the refusal patterns of donor hearts, particularly those procured after circulatory death (DCD), offering valuable insights for the…
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Cognitive Training Shows Promise in Cardiac Surgery Patients
A recent study led by Yu Jiang and colleagues in JAMA Network Open Journal investigates the potential of cognitive training to reduce postoperative delirium, a frequent and severe complication in patients undergoing coronary artery bypass grafting (CABG) surgery. The randomized clinical trial, conducted between April 2022 and May 2023 at three teaching hospitals in southeastern…
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ECPELLA: Enhancing Hemodynamics and Oxygen Delivery in Severe Cardiogenic Shock
A comprehensive simulation study by Hiroki Matsushita and colleagues investigates the impact of ECPELLA—a combination of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the Impella left ventricular assist device—on hemodynamics and global oxygen delivery (DO2) in patients suffering from severe cardiogenic shock (CS) and acute respiratory failure. The study models systemic and pulmonary circulations using a…
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Innovative Use of ECMO and ECLS Devices: A Case Report
In a recent case report authored by Brock Daughtry et al., the innovative utilization of extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) devices is showcased in the management of acute heart failure precipitated by severe mitral regurgitation secondary to COVID-19 pneumonia. The patient was stabilized and underwent open mitral valve replacement through a combination of venoarterial (VA) ECMO…
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Ethical Implications of Discontinuing ECMO in Children with Irreversible Cardiorespiratory Failure
In January 2024, researchers from Harvard Medical School (Department of Pediatrics), Boston Children’s Hospital (Department of Cardiology and Office of Ethics), Children’s Hospital at Westmead Clinical School (Clinical and Population Translational Health), MaineGeneral Medical Center (Department of Pediatrics), Perelman School of Medicine at the University of Pennsylvania (Department of Anesthesiology and Critical Care), and the…
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FDA Advises Healthcare Facilities to Transition Away from Getinge’s Heart Devices Due to Safety Concerns
The U.S. Food and Drug Administration (FDA) has issued a recommendation urging healthcare facilities to discontinue the use of Getinge’s heart devices, including the Cardiohelp system and HLS Sets, as well as the Cardiosave Hybrid and Rescue Intra-Aortic Balloon Pump (IABP) devices. This advisory comes in response to ongoing safety and quality concerns despite multiple…
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