Initial experience and outcomes with a hybrid extracorporeal membrane oxygenation and cardiopulmonary bypass circuit for lung transplantation

Year in Review 2023: Noteworthy Literature in Cardiothoracic Transplantation

“…The authors recommend an approach that guides patient’s fluid resuscitation by focusing on assessment of the patient’s macrocirculation and microcirculation, which is achieved by constantly assessing a diverse set of monitors including qualitative pulsatility in arterial waveforms, neurological monitoring, goal-directed fluid therapy driven urine output, assessment of lactate, and point of care testing assessed anticoagulation to minimize blood transfusions. 17,18 The authors describe a low-dose heparin approach, an early angiotensin II vasoplegia strategy, and an enhanced recovery protocol that includes aggressive regional analgesia and intraoperative extubation where feasible. While this manuscript was highly theoretical, it drew upon the best available evidence across many areas of the field combined with expert opinion.…”