scholarly journals Extracorporeal circulation during on‐pump cardiac surgery: an evaluation of the Energy Equivalent Pressure (EEP) index based on waveforms decomposition in harmonics

2021 ◽  
Author(s):  
Agnès Drochon ◽  
Olivier Fouquet ◽  
Christophe Baufreton
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Energy Equivalent

scholarly journals Hemodynamic energy during pulsatile extracorporeal circulation using flexible and rigid arterial tubing: a reassessment

Perfusion ◽  
2018 ◽  
Vol 34 (4) ◽  
pp. 297-302
Author(s):  
Anke Dürr ◽  
Andreas Kunert ◽  
Günter Albrecht ◽  
Andreas Liebold ◽  
Markus Hoenicka
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Pulsatile Flow ◽  
Organ Perfusion ◽  
Pressure Data ◽  
High Compliance ◽  
Energy Equivalent ◽  
Silicone Tubing ◽  
Mock Circulation ◽  
Pulsatile Perfusion

Introduction: Pulsatile extracorporeal circulation may improve organ perfusion during cardiac surgery. Some minimally invasive extracorporeal circulation (MiECC) systems allow pulsatile perfusion. The present study investigated the influence of arterial tubing compliance on hemodynamic energy transfer into the patient. Methods: Aortic models with adult human geometry were perfused in a mock circulation. A MiECC system was connected using either high-compliance silicone tubing or standard kit tubing. Energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) were computed from flow and pressure data. Aortic models with physiological and sub-physiological compliance were tested to assess the influence of the pseudo-patient. Results: Non-pulsatile flow did not generate SHE. SHE during pulsatile flow in the compliant aortic model was significantly higher with kit tubing compared to silicone tubing. Maximum SHE was achieved at 1.6 L/min with kit tubing (7.7% of mean arterial pressure) and with silicone tubing (4.9%). Using the low-compliance aortic model, SHE with kit tubing reached a higher maximum of 14.2% at 1.8 L/min compared to silicone tubing (11.8% at 1.5 L/min). Conclusions: Flexible arterial tubing did not preserve more hemodynamic energy from a pulsatile pump compared to standard kit tubing in a model of adult extracorporeal circulation. The pseudo-patient’s compliance significantly affected the properties of the mock circulation.

Aprotinin But Not ε-Aminocaproic Acid Decreases Interleukin-10 After Cardiac Surgery With Extracorporeal Circulation

Circulation ◽  
2001 ◽  
Vol 104 (suppl 1) ◽  
pp. I-265-I-269 ◽  
Author(s):  
Philip E. Greilich ◽  
Kuniyuki Okada ◽  
Paige Latham ◽  
Ramaswamy Ravi Kumar ◽  
Michael E. Jessen
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Aminocaproic Acid ◽  
Interleukin 10

scholarly journals Thrombelastography and Thrombelastometry

2013 ◽  
Vol 13 (1) ◽  
pp. 14-20
Author(s):  
Lukas Duraj ◽  
J. Stasko ◽  
M. Hasko ◽  
M. Fedor ◽  
P. Chudy ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Early Identification ◽  
Fetal Loss ◽  
Clinical Applications ◽  
Trauma Patients ◽  
Compact Mapping ◽  
Transfusion Requirements ◽  
Increased Risk

Abstract The term thrombelastography / thrombelastometry was used to describe the trace produced from measurement of the viscoelastic changes associated with fibrin polymerization. The result of measurement is a compact mapping of the various stages of haemostasis. One of the first real clinical applications of this method was the haemostatic monitoring of liver transplantation and cardiac surgery using extracorporeal circulation. In trauma patients the thrombelastography /thrombelastometry was proved to predict early transfusion requirements. Another authors suggest thrombelastography /thrombelastometry as a possible tool for early identification of pregnant women at increased risk of fetal loss. This article provides overview on the development of thrombelastography / trombelastometry and its possible use in laboratory of haemostasis.

Minimal invasive extracorporeal circulation preserves platelet function after cardiac surgery: a prospective observational study

Perfusion ◽  
2019 ◽  
Vol 35 (2) ◽  
pp. 138-144
Author(s):  
Helena Argiriadou ◽  
Polychronis Antonitsis ◽  
Anna Gkiouliava ◽  
Evangelia Papapostolou ◽  
Apostolos Deliopoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Correlation Coefficient ◽  
Platelet Function ◽  
Extracorporeal Circulation ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Elective Cardiac Surgery ◽  
Impedance Aggregometry

Introduction: Cardiac surgery on conventional cardiopulmonary bypass induces a combination of thrombocytopenia and platelet dysfunction which is strongly related to postoperative bleeding. Minimal invasive extracorporeal circulation has been shown to preserve coagulation integrity, though effect on platelet function remains unclear. We aimed to prospectively investigate perioperative platelet function in a series of patients undergoing cardiac surgery on minimal invasive extracorporeal circulation using point-of-care testing. Methods: A total of 57 patients undergoing elective cardiac surgery on minimal invasive extracorporeal circulation were prospectively recruited. Anticoagulation strategy was based on individualized heparin management and heparin level–guided protamine titration performed in all patients with a specialized point-of-care device (Hemostasis Management System – HMS Plus; Medtronic, Minneapolis, MN, USA). Platelet function was evaluated with impedance aggregometry using the ROTEM platelet (TEM International GmbH, Munich, Germany). ADPtest and TRAPtest values were assessed before surgery and after cardiopulmonary bypass. Results: ADPtest value was preserved during surgery on minimal invasive extracorporeal circulation (58.2 ± 20 U vs. 53.6 ± 21 U; p = 0.1), while TRAPtest was found significantly increased (90 ± 27 U vs. 103 ± 38 U; p = 0.03). Postoperative ADPtest and TRAPtest values were inversely related to postoperative bleeding (correlation coefficient: −0.29; p = 0.03 for ADPtest and correlation coefficient: −0.28; p = 0.04 for TRAPtest). The preoperative use of P2Y12 inhibitors was identified as the only independent predictor of a low postoperative ADPtest value (OR = 15.3; p = 0.02). Conclusion: Cardiac surgery on minimal invasive extracorporeal circulation is a platelet preservation strategy, which contributes to the beneficial effect of minimal invasive extracorporeal circulation in coagulation integrity.

scholarly journals Initial experiences with a centrifugal-pump based minimal invasive extracorporeal circulation system in pediatric congenital cardiac surgery

2019 ◽  
Vol 11 (S10) ◽  
pp. S1446-S1452
Author(s):  
Alexander Kadner ◽  
Paul Philipp Heinisch ◽  
Maris Bartkevics ◽  
Serena Wyss ◽  
Hans-Joerg Jenni ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Centrifugal Pump ◽  
Extracorporeal Circulation ◽  
Minimal Invasive ◽  
Circulation System ◽  
Congenital Cardiac Surgery

Extracorporeal Circulation in Ewe's Foetus: Towards a Reliable Foetal Cardiac Surgery Protocol a Comparison of two Cases

2000 ◽  
Vol 23 (3) ◽  
pp. 189-198 ◽  
Author(s):  
M. Grigioni ◽  
A. Carotti ◽  
C. Daniele ◽  
G. D'avenio ◽  
U. Morbiducci ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Steady Flow ◽  
Extracorporeal Circulation ◽  
Critical Role ◽  
Systolic Pressure ◽  
Assisted Circulation ◽  
Placental Dysfunction ◽  
Pressure Volume Relationship ◽  
Observation Period

Foetal cardiac surgery is the ultimate goal in the treatment of congenital cardiac malformations. The aim of our research is to elucidate some of the features of the necessarily invasive experimental protocol to be used in an animal model of foetal cardiac surgery. In particular, we assessed the foetal placentar reactivity to prolonged cardiac bypass in steady-flow conditions. Methods Two cases were selected to show the outcome of prolonged (> 30 minutes) extracorporeal circulation (ECC) instituted without oxygenator under steady-flow assistance. Following the instrumentation of the animal (placement of pressure, flow and myocardial fiber length transducers) and the baseline recordings, a 60-minute bypass period was established with an axial turbopump (Hemopump 14 Fr), after systemic heparinisation and artero-venous cannulation. At the end of the circulatory assistance, the cannulae were removed and a 90 minute observation period followed. The cardiac function was assessed by means of indirectly obtained P-V loops. Results Case A showed a marked reduction in the end-systolic pressure-volume relationship (ESPVR) during ECC, corresponding to a rightward shift of the P-V loop, with a gradual recovery after the assisted circulation. On the contrary, case B was subjected to progressive placental dysfunction, as evidenced by haemogasanalytical data. Consequently, the haemodynamic data also outlined a negative outcome, with high ESPVR values after bypass. Conclusions The present study, while confirming the possibility of cardiac intervention in the foetus, underlines the critical role of minimally invasive protocol to limit both foetal stress and placental dysfunction.

Cardiac Surgery with Extracorporeal Circulation in Severe Factor VII Deficiency

1993 ◽  
Vol 23 (1) ◽  
pp. 65-68 ◽  
Author(s):  
A. Ferster ◽  
V. Capouet ◽  
A. Deville ◽  
P. Fondu ◽  
F. Corazza
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Factor Vii ◽  
Factor Vii Deficiency

Pulsatile extracorporeal circulation during on-pump cardiac surgery enhances aortic wall shear stress

2012 ◽  
Vol 45 (1) ◽  
pp. 156-163 ◽  
Author(s):  
Alexander Assmann ◽  
Ali Cemal Benim ◽  
Fethi Gül ◽  
Philipp Lux ◽  
Payam Akhyari ◽  
...  
Keyword(s):  
Shear Stress ◽  
Cardiac Surgery ◽  
Wall Shear Stress ◽  
Extracorporeal Circulation ◽  
Aortic Wall ◽  
Wall Shear
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