Dynamic filling index: a novel parameter to monitor circulatory filling during minimized extracorporeal bypass.

Objective: To evaluate the dynamic filling index, a novel parameter to monitor changes in venous return and drainable volume, in circulatory assisted patients. Minimized extracorporeal bypass systems lack volume buffering capacity, demanding tight control of drainable volume to maintain bypass flow. Therefore, with patients on minimized bypass quantitative assessment of venous drainable volume is crucial.

Laboratory performance testing of venous cannulae during inlet obstruction.

Venous cannulae undergo continuous improvements to achieve better and safer venous drainage. Several cannula tests have been reported, though cannula performance during inlet obstruction has never been a test criterion. In this study, five different cannulae for proximal venous drainage were tested in a mock circulation that enabled measurement of hydraulic conductance after inlet obstruction by vessel collapse.

An in vitro and in vivo study of the detection and reversal of venous collapse during extracorporeal life support.

The objective of this study was to investigate venous collapse (VC) related to venous drainage during the use of an extracorporeal life support circuit. A mock circulation was built containing a centrifugal pump and a collapsible vena cava model to simulate VC under controlled conditions. Animal experiments were performed for in vivo verification.

Evaluation of a new condensed extra-corporeal circuit for cardiac surgery: a prospective randomized clinical pilot study.

This prospective randomized clinical pilot study was conducted to evaluate a recently introduced reduced volume CPB system that is coated with the biopassive Xcoating. Twenty-two patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB), either with a fully heparin-coated CPB circuit (control, n=11) or with an Xcoating coated condensed extra-corporeal circuit (CondECC, n=11), were included. We examined activation of the complement system (C3bc and C4bc), activation of neutrophils (BPI), the acute phase response (interleukin (IL)-6, and acute phase proteins (LBP, AGP, and CRP)), myocardial tissue injury (troponin T), hemolysis (free hemoglobin (FHb)), and clinical outcome parameters.

Prevention of renal failure in patients undergoing thoracoabdominal aortic aneurysm repair.

Objective: Renal failure is a potential complication after thoracoabdominal aortic aneurysm (TAAA) repair and is a significant risk factor for postoperative mortality. We assessed the results of distal aortic perfusion and continuous volume-controlled and pressure-controlled blood perfusion of the kidneys during TAAA repair in patients with preoperative normal and impaired renal function.

Methods: Surgical repair of TAAA was performed in 279 consecutive patients (type I, n = 90; type II, 117; type III, 42; type IV, 30).

Neurological complications after coronary artery bypass grafting related to the performance of cardiopulmonary bypass.

Study Objectives: Neurologic disorders belong among the most serious complications of cardiac surgery. We tested the hypothesis that combinations of hemodynamic events from apparently normal cardiopulmonary bypass (CPB) procedures are related to the development of postoperative neurologic complications and affect the impact of common clinical risk factors.

Design: Retrospective study.

Thrombin generation during cardiopulmonary bypass: the possible role of retransfusion of blood aspirated from the surgical field.

BACKGROUND: In spite of using heparin-coated extracorporeal circuits, cardiopulmonary bypass (CPB) is still associated with an extensive thrombin generation, which is only partially suppressed by the use of high dosages of heparin. Recent studies have focused on the origins of this thrombotic stimulus and the possible role of retransfused suctioned blood from the thoracic cavities on the activation of the extrinsic coagulation pathway. The present study was designed to find during CPB an association between retransfusion of suctioned blood from the pericardium and pleural space, containing activated factor VIIa and systemic thrombin generation.