Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Thrombotic Complications Associated With Right Atrial Lines in Neonates and Infants Undergoing Cardiac Surgery. Is Calcium Chloride a Culprit?
To determine if a change from calcium chloride to calcium gluconate infusion resulted in a decreased incidence of atrial thrombi and thrombotic events in neonates undergoing cardiac surgery. ⋯ In this single-center study, a significant decrease in the odds of an atrial catheter-related thrombus when a calcium gluconate infusion is used instead of calcium chloride was shown.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Predictors of Mortality in Venoarterial Extracorporeal Membrane Oxygenation Regardless of Early Left Ventricular Unloading: A National Experience.
The use of an intra-aortic balloon pump (IABP) has been suggested to unload the left ventricle while on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS), leading to possibly improved in-hospital mortality. However, the predictors of mortality on dual mechanical circulatory support have not yet been evaluated, especially in real-world clinical settings. Therefore, a case-control study was conducted to determine the rate of all-cause mortality associated with VA-ECMO use regardless of left ventricular (LV) unloading, and with early LV unloading in the setting of CS, and to identify the predictors of mortality associated with VA-ECMO, with concurrent early LV unloading. ⋯ The mortality rate in CS requiring VA-ECMO, regardless of IABP use, remains high. However, only one predictor (ie, prolonged CPR) was found to increase the likelihood of 30-day mortality with early LV unloading, suggesting that concomitant IABP use might minimize the effect of mortality predictors.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest.
To examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ Levosimendan use in ECPR did not improve survival. Future well-designed randomized trials are warranted to investigate the potential benefit of levosimendan in the ECPR setting.