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2. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Roberto Lorusso, Maria Elena De Piero, Silvia Mariani, Michele Di Mauro, Thierry Folliguet, Fabio Silvio Taccone, Luigi Camporota, Justyna Swol, Dominik Wiedemann, Mirko Belliato, Lars Mikael Broman, Alain Vuylsteke, Yigal Kassif, Anna Mara Scandroglio, Vito Fanelli, Philippe Gaudard, Stephane Ledot, Julian Barker, Udo Boeken, Sven Maier, Alexander Kersten, Bart Meyns, Matteo Pozzi, Finn M Pedersen, Peter Schellongowski, Kaan Kirali, Nicholas Barrett, Jordi Riera, Thomas Mueller, Jan Belohlavek, Valeria Lo Coco, Iwan C C Van der Horst, Bas C T Van Bussel, Ronny M Schnabel, Thijs Delnoij, Gil Bolotin, Luca Lorini, Martin O Schmiady, David Schibilsky, Mariusz Kowalewski, Luis F Pinto, Pedro E Silva, Igor Kornilov, Aaron Blandino Ortiz, Leen Vercaemst, Simon Finney, Peter P Roeleveld, Matteo Di Nardo, Felix Hennig, Marta Velia Antonini, Mark Davidson, Tim J Jones, Thomas Staudinger, Peter Mair, Juliane Kilo, Christoph Krapf, Kathrin Erbert, Andreas Peer, Nikolaos Bonaros, Florian Kotheletner, Niklas Krenner Mag, Liana Shestakova, Greet Hermans, Dieter Dauwe, Philippe Meersseman, Bernard Stockman, Leda Nobile, Olivier Lhereux, Alexandre Nrasseurs, Jacques Creuter, Daniel De Backer, Simone Giglioli, Gregoire Michiels, Pierre Foulon, Matthias Raes, Inez Rodrigus, Matthias Allegaert, Philippe Jorens, Gerd Debeucklare, Michael Piagnerelli, Patrick Biston, Harlinde Peperstraete, Komeel Vandewiele, Olivier Germay, Dimitri Vandeweghe, Sven Havrin, Marc Bourgeois, Marc-Gilbert Lagny, Genette Alois, Nathalie Lavios, Benoit Misset, Romain Courcelle, Philippe J Timmermans, Alaaddin Yilmaz, Michiel Vantomout, Jerone Lehaen, Ame Jassen, Herbert Guterman, Maarten Strauven, Piet Lormans, Bruno Verhamme, catherine Vandewaeter, Frederik Bonte, Dominique Vionne, Martin Balik, Jan Blàha, Michal Lips, Michal Othal, Filip Bursa, Radim Spacek, Steffen Christensen, Vibeke Jorgensen, Marc Sorensen, Soren A Madsen, Severin Puss, Aleksandr Beljantsev, gabriel Saiydoun, Antonio Fiore, Pascal Colson, Florian Bazalgette, Xavier Capdevila, Sebastien Kollen, Laurent Muller, Jean-Francois Obadia, Pierre-Yves Dubien, Lucrezia Ajrhourh, Pierre G Guinot, Jonathan Zarka, Patricia Besserve, Maximilian V Malfertheiner, Esther Dreier, Birgit Heinze, Payam Akhyari, Artur Lichtenberg, Hug Aubin, Alexander Assman, Diyar Saeed, Holger Thiele, Matthias Baumgaertel, Jan D Schmitto, Natanov Ruslan, Axel Haverich, Matthias Thielmann, Thorsten Brenner, Arjang Ruhpawar, Christoph Benk, Martin Czerny, Dawid L Staudacher, Fridhelm Beyersdorf, Johannes Kalbhenn, Philipp Henn, Aron-Frederik Popov, Torje Iuliu, Ralf Muellenbach, Christian Reyher, Caroline Rolfes, Gosta Lotz, Michael Sonntagbauer, Helen Winkels, Julia Fichte, Robert Stohr, Sebastian Kalverkamp, Christian Karagiannidis, Simone Schafer, Alexei Svetlitchny, Hans-Bernd Hopf, Dominik Jarczak, Heinirich Groesdonk, Magdalena Rommer, Jan Hirsch, Christian Kaehny, Dimitros Soufleris, Georgios Gavriilidis, Kostantinos Pontikis, Magdalini Kyriakopoulou, Anna Kyriakoudi, Serena O'Brien, Ian Conrick-Martin, Edmund Carton, Maged Makhoul, Josef Ben-Ari, Amir Hadash, Alexander Kogan, Reut Kassif Lerner, Anas Abu-Shakra, Moshe Matan, Ahmad Balawona, Erez Kachel, Roman Altshuler, Ori Galante, Lior Fuchs, Yaniv Almog, Yaron S Ishay, Yael Lichter, Amir Gal-oz, Uri Carmi, Asaph Nini, Arie Soroksky, Hagi Dekel, Ziv Rozman, Emad Tayem, Eduard Ilgiyaev, Yuval Hochman, daniel Miltau, Avigal Rapoport, Arieh Eden, Dmitry Kompanietz, Michael Yousif, Miri Golos, Lorenzo Grazioli, Davide Ghitti, Antonio Loforte, Daniela Di Luca, Massimo Baiocchi, Davide Pacini, Antioco Cappai, Paolo Meani, Michele Mondino, Claudio F Russo, Marco Ranucci, Dario Fina, Marco Cotza, Andrea Ballotta, Giovanni Landoni, Pasquale Nardelli, Eygeny V Fominski, Luca Brazzi, Giorgia Montrucchio, Gabriele Sales, Umberto Simonetti, Sergio Livigni, Daniela Silengo, Giulia Arena, Stefania S Sovatzis, Antonella Degani, Mariachiara Riccardi, Elisa Milanesi, Giuseppe Raffa, Gennaro Martucci, Antonio Arcadipane, Giovanna Panarello, Giovanni Chiarini, Sergio Cattaneo, Carmine Puglia, Stefano Benussi, Giuseppe Foti, Marco Giani, Michela Bombino, Maria Cristina Costa, Roberto Rona, Leonello Avalli, Abele Donati, Roberto Carozza, Francesco Gasparri, Andrea Carsetti, Marco Picichè, Anna Marinello, Vinicio Danzi, Anita Zanin, Ignazio Condello, Flavio Fiore, Marco Moscarelli, Giuseppe Nasso, Giuseppe Speziale, Luca Sandrelli, Andrea Montalto, Francesco Musumeci, Alessandro Circelli, Emanuele Russo, Vanni Agnoletti, Ruggero Rociola, Aldo D Milano, Emanuele Pilato, Giuseppe Comentale, Andrea Montisci, Francesco Alessandri, Antonella Tosi, Francesco Pugliese, Giovanni Giordano, Simone Carelli, Domenico L Grieco, Antonio M Dell'Anna, Massimo Antonelli, Enrico Ramoni, Josè Zulueta, Mauro Del Giglio, Sebastiano Petracca, Pietro Bertini, Fabio Guarracino, Luigi De Simone, Paolo M Angeletti, Francesco Forfori, Francesco Taraschi, Veronica N Quintiliani, Robertas Samalavicius, Agne Jankuviene, Nadezda Scupakova, Karolis Urbonas, Juozas Kapturauskas, Gro Soerensen, Piotr Suwalski, Luis Linhares Santos, Ana Marques, Marisa Miranda, Sonia Teixeira, Andrea Salgueiro, Filipe Pereira, Michail Ketskalo, Sergey Tsarenko, Alexandra Shilova, Ivan Afukov, Konstantin Popugaev, Sergei Minin, Daniil Shelukhin, Olga Malceva, Moroz Gleb, Alexander Skopets, Roman Kornelyuk, Alexandr Kulikov, Vadim Okhrimchuk, Alexandr Turchaninov, Maxim Petrushin, Anastasia Sheck, Akhmed Mekulov, Svetlana Ciryateva, Dmitry Urusov, Vojka Gorjup, Alenka Golicnik, Tomaz Goslar, Ricard Ferrer, Maria Martinez-Martinez, Eduard Argudo, Neiser Palmer, Raul De Pablo Sanchez, Lucas Juan Higuera, Lucas Arnau Blasco, Josè A Marquez, Fabrizio Sbraga, Mari Paz Fuset, Pablo Ruiz De Gopegui, Luis M Claraco, Josè A De Ayala, Maranta Peiro, Pilar Ricart, Sergio Martinez, Fernando Chavez, Marc Fabra, elena Sandoval, David Toapanta, Albert Carraminana, Adrian Tellez, Jeysson Ososio, Pablo Milan, Jorge Rodriguez, Garcia Andoni, Carola Gutierrez, Enrique Perez de la Sota, Andrea Eixeres-Esteve, Maria Teresa Garcia-Maellas, Judit Gutierrez-Gutierrez, Rafael Arboleda-Salazar, Patricia Santa Teresa, Alexis Jaspe, Alberto Garrido, Galo Castaneda, Sara Alcantara, Nuria Martinez, Marina Perez, Hector Villanueva, Anxela Vidal Gonzalez, Juan Paez, Arnoldo Santon, Cesar Perez, Marta Lopez, Maria Isabel Rubio Lopez, Antonio Gordillo, Jose Naranjo-Izurieta, Javier Munoz, Immaculada Alcalde, Fernando Onieva, Ricardo Gimeno Costa, Francisco Perez, Isabel Madrid, Monica Gordon, Carlos L Albacete Moreno, Daniel Perez, Nayara Lopez, Domingo Martinenz, Pablo Blanco-Schweizer, Cristina Diez, David Perez, Ana Prieto, Gloria Renedo, Elena Bustamante, Ramon Cicuendez, Rafael Citores, Victoria Boado, Katherine Garcia, Roberto Voces, Monica Domezain, Jose Maria Nunez Martinez, Raimundo Vicente, David Martin, Antonio Andreu, Vanesa Gomez Casal, Ignacio Chico, Eva Maria Menor, Sabela Vara, Jose Gamacho, Helen Perez-Chomon, Francisco Javier Gonzales, Irene Barrero, Luis Martin-Villen, Esperanza Fernandez, Maria Mendoza, Joaquin Navarro, Joaquin Colomina Climent, Alfredo Gonzales-Perez, Guillermo Muniz-Albaceita, Laura Amado, Raquel Rodriguez, Emilio Ruiz, Maria Eiras, Edgars Grins, Rosen Magnus, Mikael Kanetoft, Marcus Eidevald, Pia Watson, Paul R Vogt, Peter Steiger, Tobias Aigner, Alberto Weber, Jurg Grunefelder, Martin Kunz, Martin Grapow, Thierry Aymard, Diana Reser, Gianluca Agus, Jolanda Consiglio, Matthias Haenggi, Jenni Hansjoerg, Manuela Iten, Thomas Doeble, Urs Zenklusen, Xavier Bechtold, Giovanni Faedda, Manuel Iafrate, Amanda Rohjer, Layla Bergamaschi, Jos Maessen, Dinis Reis Miranda, H Endeman, D Gommers, C Meuwese, Jacinta Maas, MJ Van Gijlswijk, RN Van Berg, Dario Candura, Marcel Van der Linden, Merijin Kant, JJ Van der Heijden, Eric Scholten, Nicole Van Belle-van Haren, WK Lagrand, Alexander P Vlaar, Syste De Jong, Basar Cander, Murat Sargin, Murat Ugur, Mehmet A Kaygin, Kathleen Daly, Nicola Agnew, Laura Head, Laura Kelly, Gunawardena Anoma, Clare Russell, Verna Aquino, Ian Scott, Lucy Flemming, Stuart Gillon, Olivia Moore, Elton Gelandt, George Auzinger, Sameer Patel, Robert Loveridge, MUMC+: MA Cardiothoracale Chirurgie (3), CTC, RS: Carim - V04 Surgical intervention, University of Zurich, and Lorusso, Roberto

Subjects
Pulmonary and Respiratory Medicine, 2740 Pulmonary and Respiratory Medicine, 610 Medicine & health, 10023 Institute of Intensive Care Medicine
Abstract

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation.METHODS: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic-from March 1 to Sept 13, 2020-at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing.FINDINGS: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46-60]) were included in the study. Median ECMO duration was 15 days (IQR 8-27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 patients for whom data were available were alive at 6 months. 102 (24%) of 431 patients had returned to full-time work at 6 months, and 57 (13%) of 428 patients had returned to part-time work. At 6 months, respiratory rehabilitation was required in 88 (17%) of 522 patients with available data, and the most common residual symptoms included dyspnoea (185 [35%] of 523 patients) and cardiac (52 [10%] of 514 patients) or neurocognitive (66 [13%] of 512 patients) symptoms.INTERPRETATION: Patient's age, timing of cannulation (FUNDING: None.

Published
2023

3. Determination of selective antegrade perfusion flow rate in aortic arch surgery to restore baseline cerebral near-infrared spectroscopy values: a single-centre observational study

Author

Friess, Jan-Oliver, primary, Beeler, Maurus, additional, Yildiz, Murat, additional, Guensch, Dominik P, additional, Levis, Anja, additional, Gerber, Daniel, additional, Wollborn, Jakob, additional, Jenni, Hansjoerg, additional, Huber, Markus, additional, Schönhoff, Florian, additional, and Erdoes, Gabor, additional

Published
2023
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4. Determination of selective antegrade perfusion flow rate in aortic arch surgery to restore baseline cerebral near-infrared spectroscopy values: a single centre observational study

Author

Friess, Jan-Oliver, Beeler, Maurus, Yildiz, Murat, Guensch, Dominik, Levis, Anja, Gerber, Daniel, Wollborn, Jakob, Jenni, Hansjoerg, Huber, Markus, Schönhoff, Florian, and Erdoes, Gabor

Subjects
610 Medicine & health
Abstract

OBJECTIVE Neuroprotection during aortic arch surgery involves selective antegrade cerebral perfusion. The parameters of cerebral perfusion, e.g. flow rate, are inconsistent across centers and are subject of debate. The aim of this study was to determine the cerebral perfusion flow rate during hypothermic circulatory arrest required to meet preoperative awake baseline regional cerebral oxygen saturation (rSO2). METHODS Patients scheduled for aortic arch surgery with hypothermic circulatory arrest were enrolled in this prospective observational study. After initiation of hypothermic circulatory arrest, bilateral selective antegrade cerebral perfusion was established and cerebral flow rate was continuously increased. The primary endpoint was the difference of cerebral saturation from baseline during cerebral perfusion flow rates of 6 ml/kg/min, 8 ml/kg/min, and 10 ml/kg/min. RESULTS A total of 40 patients were included. During antegrade cerebral perfusion rSO2 was significantly lower than the baseline at 6ml/kg/min (-7.3, 95%-CI: -1.7,-12.9; p=0.0015). In contrast flow rates of 8 and 10 ml/kg/min resulted in rSO2 that did not significantly differ from the baseline (-2; 95%-CI: -4.3,8.3; p>0.99 and 1.8; (95%-CI: -8.5%, 4.8%; p>0.99). Cerebral saturation was significantly more likely to meet baseline values during selective antegrade cerebral perfusion with 8ml/kg/min than at 6ml/kg/min (44.1%; 95%-CI: 27.4%,60.8% vs 11.8%; 95% CI: 0.9%,22.6%; p = 0.0001). CONCLUSION At 8 ml/kg/min cerebral flow rate during selective antegrade cerebral perfusion regional cerebral oximetry baseline values are significantly more likely to be achieved than at 6 ml/kg/min. Further increasing the cerebral flow rate to 10 ml/kg/min does not significantly improve rSO2. CLINICALTRIALS.GOV IDENTIFIER NCT03484104.

Published
2023
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5. 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

Author

Anastasiadis, Kyriakos, primary, Antonitsis, Polychronis, additional, Murkin, John, additional, Serrick, Cyril, additional, Gunaydin, Serdar, additional, El-Essawi, Aschraf, additional, Bennett, Mark, additional, Erdoes, Gabor, additional, Liebold, Andreas, additional, Punjabi, Prakash, additional, Theodoropoulos, Konstantinos C, additional, Kiaii, Bob, additional, Wahba, Alexander, additional, de Somer, Filip, additional, Bauer, Adrian, additional, Kadner, Alexander, additional, van Boven, Wim, additional, Argiriadou, Helena, additional, Deliopoulos, Apostolos, additional, Baker, Robert Α, additional, Breitenbach, Ingo, additional, Ince, Can, additional, Starinieri, Pascal, additional, Jenni, Hansjoerg, additional, Popov, Vadim, additional, Moorjani, Narain, additional, Moscarelli, Marco, additional, Di Eusanio, Marco, additional, Cale, Alex, additional, Shapira, Oz, additional, Baufreton, Christophe, additional, Condello, Ignazio, additional, Merkle, Frank, additional, Stehouwer, Marco, additional, Schmid, Christof, additional, Ranucci, Marco, additional, Angelini, Gianni, additional, and Carrel, Thierry, additional

Published
2022
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6. Initial experience with minimally invasive extracorporeal circulation in coronary artery bypass graft reoperations

Author

Heinisch, Paul Philipp , primary, Mihalj, Maks, additional, Haliguer, Elif, additional, Gahl, Brigitta, additional, Winkler, Bernhard, additional, Venetz, Philipp, additional, Jenni, Hansjoerg, additional, Schober, Patrick, additional, Erdoes, Gabor, additional, Luedi, Markus M., additional, Schefold, Joerg C., additional, Kadner, Alexander, additional, Huber, Christoph, additional, and Carrel, Thierry P., additional

Published
2022
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7. Supplemental Material - 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

Author

Anastasiadis, Kyriakos, Antonitsis, Polychronis, Murkin, John, Serrick, Cyril, Gunaydin, Serdar, El-Essawi, Aschraf, Bennett, Mark, Erdoes, Gabor, Liebold, Andreas, Punjabi, Prakash, Theodoropoulos, Konstantinos C, Kiaii, Bob, Wahba, Alexander, de Somer, Filip, Bauer, Adrian, Kadner, Alexander, van Boven, Wim, Argiriadou, Helena, Deliopoulos, Apostolos, Baker, Robert Α, Breitenbach, Ingo, Ince, Can, Starinieri, Pascal, Jenni, Hansjoerg, Popov, Vadim, Moorjani, Narain, Moscarelli, Marco, Di Eusanio, Marco, Cale, Alex, Shapira, Oz, Baufreton, Christophe, Condello, Ignazio, Merkle, Frank, Stehouwer, Marco, Schmid, Christof, Ranucci, Marco, Angelini, Gianni, and Carrel, Thierry

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemetary Material for 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery by Kyriakos Anastasiadis, Polychronis Antonitsis, John Murkin, Cyril Serrick, Serdar Gunaydin, Aschraf El-Essawi, Mark Bennett, Gabor Erdoes, Andreas Liebold, Prakash Punjabi, Konstantinos C Theodoropoulos, Bob Kiaii, Alexander Wahba, Filip de Somer, Adrian Bauer, Alexander Kadner, Wim van Boven, Helena Argiriadou, Apostolos Deliopoulos, Robert Α Baker, Ingo Breitenbach, Can Ince, Pascal Starinieri, Hansjoerg Jenni, Vadim Popov, Narain Moorjani, Marco Moscarelli, Marco Di Eusanio, Alex Cale, Oz Shapira, Christophe Baufreton, Ignazio Condello, Frank Merkle, Marco Stehouwer, Christof Schmid, Marco Ranucci, Gianni Angelini, Thierry Carrel in Perfusion

Published
2022
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9. Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS)

Author

Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, Carrel, Thierry, Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, and Carrel, Thierry

Abstract

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists.

Published
2021

16. The impact of roller pump‐assisted cardiotomy suction unit on hemolysis.

Author

Jahren, Silje Ekroll, Jenni, Hansjoerg, Roesch, Yannick, Arn, Rafael, Tevaearai, Hendrik, Obrist, Dominik, Carrel, Thierry, and Erdoes, Gabor

Subjects
*HEMOLYSIS & hemolysins, *BLOOD substitutes, *SWINE, *CARDIAC surgery, *ISCHEMIC preconditioning, *CARDIOPULMONARY bypass
Abstract

Hemolysis in cardiac surgery is often related to the contact of blood with air or artificial surfaces. Variations of negative pressure in the suction cannulas may represent an additional factor. Limited data exist on the contribution of a roller pump‐assisted (RPA) cardiotomy suction unit to hemolysis. Elevation of free hemoglobin (fHb) following air suction (AS) or suction tip occlusion (STO) events of a pump‐assisted cardiotomy suction unit was investigated in a mock circuit filled with blood from slaughtered domestic pigs. AS‐associated hemolysis was measured over 240 minutes with 2 minutes of AS occurring every 10 minutes. STO‐associated hemolysis was analyzed over 80‐minute periods: configuration 1 (c1) comprised a cycle of 20 minutes (min) occlusion and 60 minutes RPA flow (20/60 minutes); c2 comprised 20 cycles of 1/3 minutes; c3 comprised 40 cycles of 0.5/1.5 minutes; and c4 comprised 80 cycles of 0.25/0.75 minutes. The AS setup did not lead to significant hemolysis after 2 (P =.97), 3 (P =.40) or 4 (P =.11) hours. The STO setup showed the greatest hemolysis (ΔfHb of 30 mg/dL) in c1 after 20 minutes. ΔfHb was different in c1 from all other configurations at 20 minutes (P <.0001) and 80 minutes (P <.05). Ex vivo generation of large negative pressures by STO events is the main cause of cardiotomy suction‐associated hemolysis. The clinical relevance of this mechanism needs further investigations. [ABSTRACT FROM AUTHOR]

Published
2021
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18. Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS)

Author

Anastasiadis, Kyriakos, primary, Murkin, John, additional, Antonitsis, Polychronis, additional, Bauer, Adrian, additional, Ranucci, Marco, additional, Gygax, Erich, additional, Schaarschmidt, Jan, additional, Fromes, Yves, additional, Philipp, Alois, additional, Eberle, Balthasar, additional, Punjabi, Prakash, additional, Argiriadou, Helena, additional, Kadner, Alexander, additional, Jenni, Hansjoerg, additional, Albrecht, Guenter, additional, van Boven, Wim, additional, Liebold, Andreas, additional, de Somer, Fillip, additional, Hausmann, Harald, additional, Deliopoulos, Apostolos, additional, El-Essawi, Aschraf, additional, Mazzei, Valerio, additional, Biancari, Fausto, additional, Fernandez, Adam, additional, Weerwind, Patrick, additional, Puehler, Thomas, additional, Serrick, Cyril, additional, Waanders, Frans, additional, Gunaydin, Serdar, additional, Ohri, Sunil, additional, Gummert, Jan, additional, Angelini, Gianni, additional, Falk, Volkmar, additional, and Carrel, Thierry, additional

Published
2016
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22. Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS)

Author

Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, Carrel, Thierry, Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, and Carrel, Thierry

Abstract

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists.

23. 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery.

Author

Anastasiadis K, Antonitsis P, Murkin J, Serrick C, Gunaydin S, El-Essawi A, Bennett M, Erdoes G, Liebold A, Punjabi P, Theodoropoulos KC, Kiaii B, Wahba A, de Somer F, Bauer A, Kadner A, van Boven W, Argiriadou H, Deliopoulos A, Baker RΑ, Breitenbach I, Ince C, Starinieri P, Jenni H, Popov V, Moorjani N, Moscarelli M, Di Eusanio M, Cale A, Shapira O, Baufreton C, Condello I, Merkle F, Stehouwer M, Schmid C, Ranucci M, Angelini G, and Carrel T

Subjects
Adult, Humans, Extracorporeal Circulation methods, Perfusion, Minimally Invasive Surgical Procedures methods, Heart, Cardiac Surgical Procedures methods
Abstract

The landmark 2016 Minimal Invasive Extracorporeal Technologies International Society (MiECTiS) position paper promoted the creation of a common language between cardiac surgeons, anesthesiologists and perfusionists which led to the development of a stable framework that paved the way for the advancement of minimal invasive perfusion and related technologies. The current expert consensus document offers an update in areas for which new evidence has emerged. In the light of published literature, modular minimal invasive extracorporeal circulation (MiECC) has been established as a safe and effective perfusion technique that increases biocompatibility and ultimately ensures perfusion safety in all adult cardiac surgical procedures, including re-operations, aortic arch and emergency surgery. Moreover, it was recognized that incorporation of MiECC strategies advances minimal invasive cardiac surgery (MICS) by combining reduced surgical trauma with minimal physiologic derangements. Minimal Invasive Extracorporeal Technologies International Society considers MiECC as a physiologically-based multidisciplinary strategy for performing cardiac surgery that is associated with significant evidence-based clinical benefit that has accrued over the years. Widespread adoption of this technology is thus strongly advocated to obtain additional healthcare benefit while advancing patient care., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Kyriakos Anastasiadis: Consulting agreement with Medtronic. Polychronis Antonitsis: Consulting agreement with Medtronic. Aschraf El-Essawi: Consulting agreement with Medtronic, speaker for Terumo and Edwards. Andreas Liebold: Consulting agreement with Edwards Lifesciences, educational grants from Getinge, LivaNova and Abbott. Bob Kiaii: Consulting agreement with Medtronic, Abbott, and Johnson and Johnson. Adrian Bauer: Advisory board of LivaNova, speaker for Köhler Chemie, advertisement and studies for Medtronic. Wim van Boven: Consulting agreement with Medtronic Helena Argiriadou: Consulting agreement with Medtronic. Hansjoerg Jenni: Consulting agreement with Medtronic. Marco Di Eusanio: Consulting agreement with Medtronic, Corcym and Edwards. Christophe Baufreton: Consulting agreement with Medtronic, Liva-Nova, Nordic Pharma and Cytosorbents. Ignazio Condello: Consulting agreement with Eurosets and Livanova. Marco Ranucci: Advisory Board Member for Medtronic and Livanova. All other authors declared no conflict of interest.

Published
2023
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