Takeshi Matsumoto, K. Yoshida, Tomotaka Shinohara, E. Miyoshi, T. Ueno
Background: Clinical practice of measuring colloid osmotic pressure (COP) was abandoned after correcting hypoosmolarity did not improve overall patient outcomes. However, the use of albumin and colloidal solutions has contributed to maintaining intraoperative and postoperative fluid balance at lower levels. Reduced perioperative fluid balance is consistently reported to have positive effects on clinical outcomes. Priming solutions for cardiopulmonary bypass typically include colloids; however, the optimal type of priming solution has not yet been determined. Stricter COP management may further improve postoperative courses. To achieve this, the widespread adoption of a measurement method suitable for COP monitoring during cardiopulmonary bypass is required. Methods: A test circuit was made which measured COP using an ultrafiltration membrane method based on the changes in hydrostatic pressure that occurs across a semipermeable membrane. We then compared the measurements obtained using this method with colloidal osmometer measurements. Results: COP measurements were obtained for a total of 100 tests (10 times each for 10 test solutions). The evaluation parameters included simultaneous reproducibility, correlation with colloid osmometer, and measurement time. The results demonstrated high accuracy of the ultrafiltration membrane method, simultaneous reproducibility within 3%, a high positive correlation with the colloid osmometer (correlation coefficient: R2 = 0.99; p < 0.01), and
{"title":"Development of new colloid osmotic pressure measurement method using ultrafiltration membrane during cardiopulmonary bypas","authors":"Takeshi Matsumoto, K. Yoshida, Tomotaka Shinohara, E. Miyoshi, T. Ueno","doi":"10.1051/ject/2023028","DOIUrl":"https://doi.org/10.1051/ject/2023028","url":null,"abstract":"Background: Clinical practice of measuring colloid osmotic pressure (COP) was abandoned after correcting hypoosmolarity did not improve overall patient outcomes. However, the use of albumin and colloidal solutions has contributed to maintaining intraoperative and postoperative fluid balance at lower levels. Reduced perioperative fluid balance is consistently reported to have positive effects on clinical outcomes. Priming solutions for cardiopulmonary bypass typically include colloids; however, the optimal type of priming solution has not yet been determined. Stricter COP management may further improve postoperative courses. To achieve this, the widespread adoption of a measurement method suitable for COP monitoring during cardiopulmonary bypass is required. Methods: A test circuit was made which measured COP using an ultrafiltration membrane method based on the changes in hydrostatic pressure that occurs across a semipermeable membrane. We then compared the measurements obtained using this method with colloidal osmometer measurements. Results: COP measurements were obtained for a total of 100 tests (10 times each for 10 test solutions). The evaluation parameters included simultaneous reproducibility, correlation with colloid osmometer, and measurement time. The results demonstrated high accuracy of the ultrafiltration membrane method, simultaneous reproducibility within 3%, a high positive correlation with the colloid osmometer (correlation coefficient: R2 = 0.99; p < 0.01), and","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127113640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Andersen, M. Appelblad, Urban Wikliund, N. Sundström, S. Svenmarker
Abstract Background: Cerebral blood flow is believed to be relatively constant within an upper and lower blood pressure limit. Different methods are available to monitor cerebral blood flow autoregulation during surgery. This study aims to critically analyze the application of the cerebral oxygenation index (COx), one of the commonly used techniques, using reference to data from a series of clinical registrations. Method: Cerebral blood flow was monitored using near infrared spectroscopy, while cerebral blood pressure was estimated by recordings obtained from either the radial or femoral artery in 10 patients undergoing cardiopulmonary bypass. The association between cerebral blood flow and blood pressure was calculated as a moving continuous correlation coefficient. A Cox index > 0.4 was regarded as a sign of abnormal cerebral autoregulation. Recordings were examined to discuss reliability measures and clinical feasibility of the measurements, followed by interpretation of individual results, identification of possible pitfalls and suggestions of alternative methods. Results and Conclusion: Monitoring of cerebral autoregulation during cardiopulmonary bypass is intriguing and complex. A series of challenges and limitations should be considered before introducing this method into clinical practice.
{"title":"Our initial experience of monitoring the autoregulation of cerebral blood flow during cardiopulmonary bypass","authors":"L. Andersen, M. Appelblad, Urban Wikliund, N. Sundström, S. Svenmarker","doi":"10.1051/ject/2023032","DOIUrl":"https://doi.org/10.1051/ject/2023032","url":null,"abstract":"Abstract\u0000Background: Cerebral blood flow is believed to be relatively constant within an upper and lower blood pressure limit. Different methods are available to monitor cerebral blood flow autoregulation during surgery. This study aims to critically analyze the application of the cerebral oxygenation index (COx), one of the commonly used techniques, using reference to data from a series of clinical registrations.\u0000Method: Cerebral blood flow was monitored using near infrared spectroscopy, while cerebral blood pressure was estimated by recordings obtained from either the radial or femoral artery in 10 patients undergoing cardiopulmonary bypass. The association between cerebral blood flow and blood pressure was calculated as a moving continuous correlation coefficient. A Cox index > 0.4 was regarded as a sign of abnormal cerebral autoregulation. Recordings were examined to discuss reliability measures and clinical feasibility of the measurements, followed by interpretation of individual results, identification of possible pitfalls and suggestions of alternative methods.\u0000Results and Conclusion: Monitoring of cerebral autoregulation during cardiopulmonary bypass is intriguing and complex. A series of challenges and limitations should be considered before introducing this method into clinical practice.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130761726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Soriano, Eduardo Becerra Zapata, Nicolas Maya Trujillo, German Andres Franco Gruntorad
Pediatric in-hospital cardiac arrest (IHCA) has been reported in 1 – 3% of pediatric intensive care unit (ICU) admissions and up to 6% of children admissions in cardiac ICU. In the last 25 years, the survival to hospital discharge after pediatric IHCA has improved from 9% to 13.7% up to 35%. The improvement in outcomes was attributed in part to the apparition of ECMO as a rescue strategy when prolonged conventional CPR cannot restore spontaneous circulation. We report a case of a 4th-month-old patient with a history of ventricular and septal defects, with left to right shunt and enlargement of left heart chambers that underwent surgery for the closure of the atrial and septal defects, and experienced complications that led to the use of ECMO in response to a prolonged cardiac arrest.
{"title":"ECPR for prolonged Pediatric Cardiac Arrest, an outcome without major neurological compromise.","authors":"Laura Soriano, Eduardo Becerra Zapata, Nicolas Maya Trujillo, German Andres Franco Gruntorad","doi":"10.1051/ject/2023019","DOIUrl":"https://doi.org/10.1051/ject/2023019","url":null,"abstract":"Pediatric in-hospital cardiac arrest (IHCA) has been reported in 1 – 3% of pediatric intensive care unit (ICU) admissions and up to 6% of children admissions in cardiac ICU. In the last 25 years, the survival to hospital discharge after pediatric IHCA has improved from 9% to 13.7% up to 35%. The improvement in outcomes was attributed in part to the apparition of ECMO as a rescue strategy when prolonged conventional CPR cannot restore spontaneous circulation. We report a case of a 4th-month-old patient with a history of ventricular and septal defects, with left to right shunt and enlargement of left heart chambers that underwent surgery for the closure of the atrial and septal defects, and experienced complications that led to the use of ECMO in response to a prolonged cardiac arrest.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129726581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Leadership and Mentoring","authors":"Raymond K. Wong","doi":"10.1051/ject/202153237","DOIUrl":"https://doi.org/10.1051/ject/202153237","url":null,"abstract":"","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114756511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hail and Farewell","authors":"R. Groom, D. Fitzgerald, M. Kurusz","doi":"10.1051/ject/202052071","DOIUrl":"https://doi.org/10.1051/ject/202052071","url":null,"abstract":"","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"197 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116147898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This historical vignette describes the career of Joeann Guthrey Taylor Fraser. Her story begins as she cleans animal cages and sweeps floors in the research labs at Jefferson Medical College. As a nursing student at Jefferson she is fascinated by cardiac surgery and accepts the opportunity to learn to operate the heart-lung machine. Esteemed cardiac surgeons, Dr. John H. Gibbon, Jr. and Dr. John Y. Templeton III guide her to become one of the first perfusionists in the United States.
这幅历史插图描述了Joeann guthriy Taylor Fraser的职业生涯。她的故事开始于她在杰斐逊医学院的研究实验室里打扫动物笼子和扫地。作为杰斐逊大学的一名护理专业学生，她对心脏手术非常着迷，并接受了学习操作心肺机的机会。尊敬的心脏外科医生，Dr. John H. Gibbon, Jr.和Dr. John Y. Templeton III引导她成为美国第一批灌注师之一。
{"title":"Joeann Guthrey Taylor Fraser: Trailblazing Nurse in a New Profession","authors":"M. A. Rowland, Rn Joanne P. Formicola","doi":"10.1051/ject/201850199","DOIUrl":"https://doi.org/10.1051/ject/201850199","url":null,"abstract":"This historical vignette describes the career of Joeann Guthrey Taylor Fraser. Her story begins as she cleans animal cages and sweeps floors in the research labs at Jefferson Medical College. As a nursing student at Jefferson she is fascinated by cardiac surgery and accepts the opportunity to learn to operate the heart-lung machine. Esteemed cardiac surgeons, Dr. John H. Gibbon, Jr. and Dr. John Y. Templeton III guide her to become one of the first perfusionists in the United States.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121798504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From the Editor","authors":"J. Wegner","doi":"10.1051/ject/201850003","DOIUrl":"https://doi.org/10.1051/ject/201850003","url":null,"abstract":"","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129327136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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