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The Potential Benefits of S100B in Cardiac Surgery Brain Monitoring

In January 2022, researchers from d’Annunzio University (Neonatal Intensive Care Unit), Biago and C. Arrigo (Department of Maternal, Fetal, and Neonatal Medicine), Maastricht University (Department of Pediatrics and Neonatology), and IRCCS San Donato Milanese Hospital (Department of Pediatric Cardiac Surgery) discussed the use of protein S100B to predict short and long-term adverse neurological outcomes in adult and pediatric patients undergoing cardiac surgery. The complete manuscript by Giuseppe Lapergola, Alessandro Graziosi, Ebe D’Adamo, Patrizia Brindisino, Mariangela Ferrari, Anna Romanelli, Mariachiara Strozzi, Roberta Libener, Danilo A. W. Gavilanes, Antonio Maconi, Angela Satriano, Alessandro Varrica, and Diego Gazzolo is available in Clinical Chemistry and Laboratory Medicine. Detailed below is a summary of their article.

Congenital heart disease (CHD) accounts for 28% of all significant congenital anomalies and consists of malformations in the anatomy of the heart and/or great arteries during fetal development. Of those born with CHD, 30% are critical cases requiring surgical correction within the first year of life to prevent death. However, 50% of survivors suffer from neurocognitive developmental damage.


Optimizing PO2 During Peripheral Veno-Arterial ECMO

In July 2022, researchers from Centre Hospitalier Universitair de Besancon (Service de Reanimation medicale), Centre Hospitalier Universitaire de Dijon (Service d’Anesthesie-Reanimation Chirurgicale), APHP Sorbonne Universite Hopital Pitie-Salpetriere (Service de Medecine Intensive Reanimation), Centre Hospitalier Universitaire de Besancon (Service d’Anesthesie-Reanimation Chirurgicale and Service de Chirurgie Cardiaque), Maastricht University Medical Centre (Cardio-Thoracic Surgery Department), Centre Hospitalier Universitaire de Nancy Brabois (Service de Medicine Intensive Reanimation), School of Public Health and Preventive Medicine (Department of Epidemiology), and University of Franche Comte (Research Unity EA 3920 and SFR FED 4232) summarized the evidence and rationale supporting the PO2 target recommendation of 150 mmHg during peripheral Veno-Artierial ECMO. The complete manuscript by Hadrien Winiszewski, Pierre-Gregoire Guinot, Matthieu Schmidt, Guillaume Besch, Gael Piton, Andrea Perrotti, Roberto Lorusso, Antoine Kimmoun, and Gilles Capellier is available in Critical Care. Detailed below is a summary of their review.


Reviewing The Evolution of Simulation-Based Training to Create a Safer Future

In June 2022, researchers from the Rutgers School of Health Professions, Department of Interdisciplinary Studies, looked at the history of simulation-based training and reviewed its current applications with the goal of providing a foundation for future developments and expanded use. The complete manuscript by Jared Bienstock and Albert Heuer can be found in Medicine. A summary is detailed below.

Simulation-based training (SBT) enhances safety and quality in many industries, although it is vastly underutilized within the healthcare field despite being used for centuries. One-tenth of all patients worldwide are harmed while receiving hospital care in high-income countries, and 50% of these instances are preventable with proper SBT application.


A Review of Impella as An Unloading Strategy During VA-ECMO

In December 2021, researchers from Harefield Hospital, Department of Cardiology, and Imperial College, Cardiovascular Sciences, investigated the safety and efficacy of Impella for LV unloading during ECMO in patients experiencing a cardiogenic shock. The full manuscript by Francesca Fiorelli and Vasileios Panoulas can be found in Reviews in Cardiovascular Medicine. In addition, a summary of the systemic review and meta-analysis is detailed below.

Cardiogenic shock (CS) is a significant cause of in-hospital mortality from acute myocardial infarction. For those with refractory CS, Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) is often used for circulatory support, and it can help maintain peripheral perfusion and restore end-organ function. However, despite these benefits, VA-ECMO also increases left ventricular (LV) afterload, which can further damage the myocardium.


Current Guidelines for Cardiopulmonary Resuscitation

In August 2022, Adult Congenital Heart Disease researchers at Southampton University Hospital summarized current guidelines on cardiopulmonary resuscitation as provided by the Resuscitation Council UK. The complete summary by Panagiota Mitropoulou and Samantha Fitzsimmons can be found in Medicine. Their key points are detailed below.

Cardiac arrest occurs when cardiac activity suddenly stops, causing the affected individual to become unresponsive and display no signs of normal breathing or circulation. Cardiac arrest is a life-threatening condition requiring immediate corrective measures, such as cardiopulmonary resuscitation (CPR).

Mitropoulou et al. summarized the guidelines for CPR, with critical findings regarding hospital training, ethical guidelines, and the impact of the COVID-19 pandemic.


Obstacles Surrounding the Expansion of TAVR Use

In July 2022, researchers from the University Medical Center Schleswig-Holstein (Departments of Cardiovascular Surgery, Internal Medicine III (Cardiology, Angiology, and Critical Care), and Radiology and Neuroradiology), German Centre for Cardiovascular Research, Centre for Heart Lung Innovation & Providence Research, Centre for Cardiovascular Innovation, Centre for Heart Valve Innovation, Centre for Heart Lung Innovation, St. Paul’s Hospital (Department of Radiology), and Copenhagen University Hospital discuss the current data surrounding TAVR and the obstacles remaining for its expansion. The complete manuscript by Xiling Zhang, Thomas Puehler, Derk Frank, Janarthanan Sathananthan, Stephanie Seller, David Meier, Marcus Both, Philipp Blanke, Hatim Seoudy, Mohammed Saad, Oliver J. Muller, Lars Sondergaard, and Georg Liutter can be found in the Journal of Cardiovascular Development and Disease. A summary of the review article is detailed below.

Aortic valve stenosis (AS) due to degeneration is one of the most common valvular diseases, with an incidence that increases with age. Over one-third of those with AS are considered high risk for surgical aortic valve replacement (SAVR). In these patients, transcatheter aortic valve replacement (TAVR) is an alternative treatment option that is non-inferior to SAVR in many randomized trials and intermediate-risk patients. Current clinical trials for TAVR focus on determining if it can extend its use to younger patients or those at low risk; however, some challenges with TAVR remain.


A Review of Anticoagulant Options for Pediatric Patients on ECMO

In July 2022, researchers from Columbia University Medical Center (Department of Pediatrics), Children’s Hospital of Michigan (Division of Hematology), and Erasmus Medical Center University Medical Center Sophia Children’s Hospital (Department of Pediatric Hematology and Oncology) reviewed the use of unfractionated heparin (UFH) and direct thrombin inhibitors (DTIs) in pediatric patients with extracorporeal membrane oxygenation (ECMO) therapy. The complete manuscript by Cindy Neunert, Meera Chitlur, and Cornelia Heleen van Ommen can be found in Frontiers in Medicine. In addition, a summary of the review is included below.

Pediatric patients with life-threatening respiratory or cardiac failure are often put on ECMO, accounting for 20.1% of all ECMO runs. However, thrombotic complications occur in up to 37.5% of pediatric patients, and despite technological improvements, hemostatic complications, including thrombosis and bleeding, are still essential contributors to mortality and morbidity.


Outcomes for Left Ventricular Assist Device Usage with End-Stage Renal Disease

In April 2022, researchers from Queens Hospital Center (Internal Medicine), Icahn School of Medicine at Mount Sinai (Internal Medicine), Kettering Medical Center (Internal Medicine), Rawal Institute of Health Services (Medicine), Weill Cornell Medicine (Cardiology/Medicine), and Queens Hospital Center (Cardiology) examined the outcomes of end-stage renal disease (ESRD) patients requiring a left ventricular assist device (LVAD) as destination therapy (DT) or bridge to transplant (BTT). The complete manuscript by Sofia Lakhdar, Mahmoud Nassar, Chandan Buttar, Laura M. Guzman Perez, Shahzad Akbar, Anoosh Zafar, and Most Munira can be found in Cureus. The summary of their systematic review is detailed below.

The standard of care for patients with end-stage heart failure is heart transplantation, although there is a significant lack of donor's hearts compared to the number of recipients in need. For these patients awaiting transplantation requiring destination therapy (DT) or bridge to transplant (BTT), left ventricular assist devices (LVADs) are commonly used. However, renal dysfunction has been associated with a reduced survival rate after implantation of LVAD, especially in those with ESRD at the time of implantation.


Determining the Metabolites Removed by CRRT

In November 2022, researchers from the First and Second Affiliated Hospital of Harbin Medical University (Department of Intensive Care Medicine) completed a prospective study screening differential metabolic markers in AKI patients before and after CRRT to determine which are removed. The complete study by Yue Li, Wenhua Liu, Kaijiang Yu, Hongliang Wang, and Changsong Wang can be found in Critical Care. A summary of their research is detailed below.

Continuous renal replacement therapy (CRRT) is used on patients with acute kidney injury (AKI) to stimulate standard glomeruli filtration, which results in the removal of water and solute. CRRT filters out solutes that weigh less than 50,000 daltons, which can include trace elements such as glucose, K+, and Na+. Since these elements are needed in the body and are not desired to be filtered out, they are often supplemented in patients receiving CRRT. However, there has yet to be any experimental research regarding the loss of organic matter through CRRT, including if any is lost, how much is lost, and how this loss may affect the body.


Current Data on Minimalist TAVR Care Pathways and Future Research Directions

In June 2022, researchers from Emory University School of Medicine, Division of Cardiology, Department of Internal Medicine, and Division of Cardiothoracic Surgery summarized current data for a minimalist TAVR approach and what future studies need to focus on to optimize TAVR care. The full manuscript by Mariem A. Sawan, Avery E. Calhoun, Kendra J. Grubb, and Chandan M. Devireddy can be found in Current Cardiology Reports. Their review is summarized below.

Since its first application in 2002, transcatheter aortic valve replacement (TAVR) has become a central component in treating aortic stenosis. As TAVR continues to be a preferred treatment option for patients with aortic stenosis, there is an advancement in the "minimalist approach," which places a significant emphasis on early discharge.