Multicenter International Survey on Cardiopulmonary Bypass Perfusion Practices in Adult Cardiac Surgery

Akhtar, Murtaza; Gautel, Livia; Ломиворотов, В. В.; Neto, Caetano Nigro; Vives, Marc; El-Tahan, Mohamed R.; Marczin, Nándor; Landoni, Giovanni; Rex, Steffen; Kunst, Gudrun

doi:10.1053/j.jvca.2020.08.043

Cited by 16 publications

(7 citation statements)

References 32 publications

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“…Table 8 lists the first five articles in each of the last 3 years, which were ranked by the harmonic mean (H) of three different structural variation variables, namely ΔM, ΔCLw, and C KL (Chen, 2012 ). The five highly ranked articles in 2021 focused on the pathophysiologic mechanisms of PNDs, such as anesthetic regimen, cerebral perfusion pressure management, cerebral oximetry monitoring and so on (Akhtar et al, 2021 ; Evered and Goldstein, 2021 ; Pisano et al, 2021 ; Snyder et al, 2021 ; Zugni et al, 2021 ). In 2019 and 2020, there were two valuable articles providing evidence-based recommendations on perioperative delirium care and prevention (White et al, 2019 ; Hughes et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A Bibliometric and Visual Analysis

2022

Front. Aging Neurosci.

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BackgroundIdentifying useful markers is essential for diagnosis and prevention of perioperative neurocognitive disorders (PNDs). Here, we attempt to understand the research basis and status, potential hotspots and trends of predictive markers associated with PNDs after cardiac surgery via bibliometric analysis.MethodsA total of 4,609 original research articles and reviews that cited 290 articles between 2001 and 2021 were obtained from the Web of Science Core Collection (WoSCC) as the data source. We used the software CiteSpace to generate and analyze visual networks of bibliographic information, including published years and journals, collaborating institutions, co-cited references, and co-occurring keywords.ResultsThe number of annual and cumulative publications from 2001 to 2021 has been increasing on the whole. The Harvard Medical School was a very prolific and important institution in this field. The journal of Ann Thorac Surg (IF 4.33) had the most publications, while New Engl J Med was the most cited journal. Neuron-specific enolase (NSE), S100b and kynurenic acid (KYNA) were frequently discussed as possible markers of PNDs in many references. Cardiopulmonary bypass (CPB) was a keyword with high frequency (430) and sigma (6.26), and inflammation was the most recent burst keyword.ConclusionPotential markers of PNDs has received growing attention across various disciplines for many years. The research basis mainly focuses on three classic biomarkers of S100b, NSE, and KYNA. The most active frontiers are the inflammation-related biomarkers (e.g., inflammatory cells, cytokines, or mediators) and surgery-related monitoring parameters (e.g., perfusion, oxygen saturation, and the depth of anesthesia).

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Section: Resultsmentioning

confidence: 99%

Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A Bibliometric and Visual Analysis

2022

Front. Aging Neurosci.

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“…However, the types of surgery were heterogeneous, and most patients underwent surgery under cardiopulmonary bypass; only 18 (5.3%) patients underwent OPCAB. Considering that most clinicians do not perform mechanical ventilation during cardiopulmonary bypass, [ 17 ] the impact of a high V T on the risk of AKI may be more pronounced in patients undergoing off-pump cardiac surgery where mechanical ventilation is performed throughout surgery without interruption.…”

Section: Discussionmentioning

confidence: 99%

“…While most patients do not undergo mechanical ventilation during cardiopulmonary bypass, [ 17 ] mechanical ventilation is performed throughout off-pump cardiac surgery without interruption. It can be inferred that the impact of intraoperative V T may be more prominent in off-pump cardiac surgery; therefore, we hypothesized that a high intraoperative V T would increase the risk of AKI after off-pump cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

Relationship between intraoperative tidal volume and acute kidney injury following off-pump coronary artery bypass grafting: A retrospective observational study

Bae

Lee

et al. 2022

Medicine

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The effect of intraoperative tidal volume (V T ) on clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) has not been studied. The aim of this study was to assess the relationship between intraoperative tidal volume (V T ) and acute kidney injury (AKI ) after OPCAB. A total of 1049 patients who underwent OPCAB between January 2009 and December 2018 were analyzed. Patients were divided into high (>8 ml/kg) and low V T (≤8 ml/kg) groups (intraoperative median V T standardized to predicted body weight). The data were fitted using a multivariable logistic regression model. Subgroup analyses were performed according to age, sex, comorbidities, preoperative laboratory variables, operative profiles, and Cleveland score. The risk of AKI was not significantly higher in the high than the low V T group (OR: 1.15, 95% CI: 0.80-1.66; P = .459); however, subgroup analyses revealed that a high V T may increase the risk of AKI in males, patients aged < 70 years, with chronic kidney disease, a left ventricular ejection fraction < 35%, or a long duration of surgery. High intraoperative V T s were not associated with an increased risk of AKI after OPCAB. Nonetheless, it may increase the risk of AKI in certain subgroups, such as younger age, male sex, reduced renal and cardiac function, and a long surgery time.

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“…A recent survey of cardiac anesthesiologists revealed that 27% routinely use cerebral oximetry monitoring, increasing to 59% in aortic arch surgery, which may reflect a paucity of high-quality evidence. 89 Detractors of NIRS-based interventions may point to findings, such as the inability for UT-NIRS to identify absent cerebral circulation in adults with brain death. 23 However, there appears to be enough evidence to suggest that a low preoperative value is associated with POD, and there is reasonable agreement that cerebral desaturation intraoperatively is associated with both POD and POCD.…”

Section: Conclusion-nirs Monitoringmentioning

confidence: 99%

Neuromonitoring and Neurocognitive Outcomes in Cardiac Surgery: A Narrative Review

Milne

Gilbey

Gautel

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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Neurocognitive dysfunction after cardiac surgery can present with diverse clinical phenotypes, which include postoperative delirium, postoperative cognitive dysfunction, and stroke, and it presents a significant healthcare burden for both patients and providers. Neurologic monitoring during cardiac surgery includes several modalities assessing cerebral perfusion and oxygenation (near-infrared spectroscopy, transcranial Doppler and jugular venous bulb saturation monitoring) and those that measure cerebral function (processed and unprocessed electroencephalogram), reflecting an absence of a single, definitive neuromonitor. This narrative review briefly describes the technologic basis of these neuromonitoring modalities, before exploring their use in clinical practice, both as tools to predict neurocognitive dysfunction, and with a bundle of interventions designed to optimize cerebral oxygen supply, with the aim of reducing postoperative delirium and cognitive dysfunction following cardiac surgery.

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Multicenter International Survey on Cardiopulmonary Bypass Perfusion Practices in Adult Cardiac Surgery

Cited by 16 publications

References 32 publications

Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A Bibliometric and Visual Analysis

Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A Bibliometric and Visual Analysis

Relationship between intraoperative tidal volume and acute kidney injury following off-pump coronary artery bypass grafting: A retrospective observational study

Neuromonitoring and Neurocognitive Outcomes in Cardiac Surgery: A Narrative Review

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