Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Performance of Hemochron ACT-LR and ACT+ Test Cuvettes in Monitoring Low to Moderate Heparin Concentrations: An In Vitro Study.
According to the manufacturer, the Hemochron ACT-LR cuvette is designated for heparin concentrations of 0 to 2.5 IU/mL, while the optimal concentration range for the ACT+ cartridge is 1 to 6 IU/mL. We hypothesized that at low to moderate heparin concentrations, the ACT-LR is more reliable than the ACT+. ⋯ The performance of ACT+ is equal to that of ACT-LR up to a concentration of 0.5 IU/mL, above which ACT+ is superior to ACT-LR, questioning the rationale for a specific low-range test. However, there is a significant bias between ACT-LR and ACT+ measurements that needs to be considered if switching from one test to the other.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Observational StudyIntroduction of a Vendor-Independent Application for Clinical Generation of Pressure-Volume Loops from Routine Hemodynamic Data: A Methodological Exploration.
In the dynamic perioperative setting, changing fluid states complicate determination of ventricular function. This study evaluated the feasibility of clinical ventricular pressure-volume loop (PVL) construction using routine monitoring (echocardiography and invasive pressure monitoring). An application was developed and tested with biventricular simulated data and right ventricular (RV) clinical data. ⋯ This study introduces a vendor-independent application to generate PVLs from routinely available clinical data. The results highlight the potential application of the pressure-volume framework in cardiovascular research and patient care. A lack of external validation must be taken into account. Further research is warranted to validate the application. The app can be accessed at https://michael-vandenheuvel.shinyapps.io/eMv_Looper/.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Association Between Pulmonary Artery Pulsatility Index and Radial Artery Pulse Pressure and Successful Separation from Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation: A French Single-Center Retrospective Study From 2017 to 2021.
Few reliable tools exist to predict weaning patient outcomes from venoarterial extracorporeal membrane oxygenation (ECMO; VA-ECMO). Pulmonary artery pulse pressure indexed on right atrial pressure (PAPi) reflects the ventricle-pulmonary coupling and may be representative of right ventricular recovery. Radial artery pulse pressure (rPP) may be representative of left ventricular recovery. We intended to explore the usefulness of these indices in the weaning from VA-ECMO. ⋯ Higher PAPi and rPP were predictors of successful weaning from VA-ECMO in this retrospective study.