Publications by authors named "Cody C Trowbridge"

The purpose of this study was to describe the development and utilization of a perfusion quality improvement program to reduce perfusion-to-perfusion variability in a large multi-center perfusion practice. Phase I of the study included the establishment of a perfusion database using standard spreadsheet format to serve multiple administrative functions including patient and procedure sequencing, predictive algorithms for yearly caseload, summary statistics, and inter-perfusionist comparison. The database used 236 separate variables, including demographic and clinical procedure-related categories.

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Autologous platelet-gel (APG) is the process of harvesting ones own cells (platelets), concentrating them most often through centrifugation, exposing them to an agonist which induces activation which releases intrinsic substances, and applying them to a target area to accelerate wound healing. APG is attractive because it concentrates a large number of biologically active substances, which are primarily proteins that participate in complex series of mechanisms involved in inflammation and wound healing. It has been used in numerous applications including sports medicine, dermatology, and surgery.

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The administration of recombinant factor VIIa (rFVIIa) is complicated by a wide inter-subject variation in response, a short half-life, evolving indications for use, and the absence of a test that has been shown to correlate with clinical effect. This report describes a method used to titrate rFVIIa to thromboelastography (TEG) parameters in a difficult to manage hemophilic patient with high titer inhibition to factor VIII. The current concepts of monitoring rFVIla administration in hemophiliacs and uncontrolled hemorrhage in cardiac surgery are briefly reviewed.

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Following a total knee replacement surgery, a 51-year-old insulin-dependent patient presented with complications of impaired healing and postoperative trauma to the wound site. The inability of this leg wound to heal placed this patient at risk of amputation. Vacuum-assisted closure therapy was initiated at postoperative day 53; after 100 days of protracted wound history a series of treatments with topical platelet concentrates were added to the vacuum assisted closure therapy and conventional wound care therapy.

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The use of plasmapheresis in cardiac surgery has failed to show an unequivocal benefit. However, the further processing of plasmapheresed blood to obtain a platelet-rich concentrate, termed platelet gel, may reduce patient susceptibility to infection through poorly understood mechanisms related to a combination of platelets, white blood cell content, and expedited wound healing. The purpose of the study was to retrospectively evaluate the incidence wound infections in patients undergoing cardiac surgery.

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Modified ultrafiltration generally is considered a standard of care for treating children undergoing cardiopulmonary bypass for congenital heat surgery. Different methods, incorporating a variety of devices and technologies, have been described. The present report describes a technique of modified ultrafiltration using arterial-venous flow with the Quest Myocardial Protection System (MPS).

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Patients presenting for cardiac surgery with cardiopulmonary bypass (CPB) are more likely to have pre-existing comorbidities, which has resulted in a steady increase in the risk associated with CPB. The resulting challenge has mandated the optimization of perfusion care. The purpose of this study was to retrospectively evaluate the impact of a number of simultaneous, evidence based perfusion care changes on patient outcome.

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