Perfusion
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Historically, perioperative hemoglobin monitoring has relied on calculated saturation, using blood gas devices that measure plasma hematocrit (Hct). Co-oximetry, which measures total hemoglobin (tHb), yields a more comprehensive assessment of hemodilution. The purpose of this study was to examine the association of tHb measurement by co-oximetry and Hct, using conductivity with red blood cell (RBC) transfusion, length of stay (LOS) and inpatient costs in patients having major cardiac surgery. ⋯ tHb monitoring during cardiovascular surgery could offer a significant reduction in RBC transfusion, length of stay and hospital cost compared to Hct monitoring.
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Case Reports
Scedosporium apiospermum infection: lethal complication after extracorporeal cardiopulmonary resuscitation.
In recent years, the development of extracorporeal membrane oxygenation (ECMO) technology has led to its extensive use in clinical practice. In particular, ECMO can play an important role in cardiopulmonary resuscitation (CPR). ⋯ However, it is important to be aware of the possibility of infection-related complications. Here, we report on a patient who suffered a cardiac arrest in hospital and was rescued with ECMO, but who subsequently developed an infection with Scedosporium apiospermum.
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The use of cardiopulmonary bypass is associated with a risk of neurocognitive deficit caused by gaseous microemboli. Flushing the empty bypass circuit with carbon dioxide, which is more soluble than air, may reduce the amount of gaseous microemboli in the priming solution before the initiating of cardiopulmonary bypass. ⋯ Flushing the bypass circuits with carbon dioxide before priming significantly decreased the number of gaseous microemboli in the priming solution.