In this comprehensive article the author describes the potential harmful effects of peri-operative allogeneic transfusions during cardaic surgery employing the CPB circuit. The author also describes potenital risks of low hematocrits during CPB as would be seen when employing Acute Normovolemic Hemodilution technique for blood conservation.
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Critical Care
January 14, 2015
The authors describe a "huge" increase in ECMO usage for pulmonay failure with a trend, though not statistically significant, towards improved outcomes.
January 14, 2015
This RCT compared daily 200mg or 300mg of FXI-ASO (an antisense oligonucleotide that reduces levels of factor XI) to daily 40mg of enoxaparin in pts undergoing knee replacement surgery. The end point was thromboembolism. FXI-ASO significantly reduced factor XI levels in a dose-response manner. FXI-ASO 200 mg was equivalent to enoxaparin in frequen
January 11, 2015
The CCF group conducted a study of their phlebotomy practices during a 6-month period in 2012. Phlebotomy volumes on each patient were estimated and calculated. Surprisingly, the group found that, on average, cardiac surgery patients lose ~10% of their blood volume due to postoperative phlebotomy alone.
January 10, 2015
The FDA recently approved the fourth new oral anticoagulant, Savaysa for use in non-valvular afib, DVT, and PE. It is another factor Xa inhibitor. Use in non-valvular afib requires renal function assessment prior to prescribing, as the drug is renally excreted. Paradoxically, efficacy may be reduced in patients with better-than-normal renal functi
December 27, 2014
The authors translated 10 common medical phrases into 26 foreign languages and had native speakers of those languages translate those phrases back to English. 42% of the translations were wrong, with the worst accuracy among African and Asian languages.
December 17, 2014
Hemodilution on CPB is a hotly debated topic.
December 3, 2014
Program directors from 6 distinctly different training centers assessed educational costs for CT resident training. Before formal accounting information was explored, the PDs estimated the annual cost per resident to be $250,000. The actual costs per year per resident ranged from $330,000 to $667,000, with a mean of $483,000. Faculty teaching cost
December 1, 2014
This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS). The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy.
November 27, 2014
Abrams and colleagues provide a comprehensive review of the topic of recirculation during VV ECMO. Specifically, the authors discuss the factors contributing to recirculation, how to calculate the extent of recirculation, and what interventions can be applied to correct the issue.