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Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A Randomized Controlled Trial

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dc.contributor.authorBlanco-Morillo, J
dc.contributor.authorMorillo-Cuadrado, DV
dc.contributor.authorPuis, L
dc.contributor.authorVerdú-Verdú, A
dc.contributor.authorMartínez-Molina, M
dc.contributor.authorTormos-Ruiz, E
dc.contributor.authorSornichero-Caballero, A
dc.contributor.authorFarina, P
dc.contributor.authorCánovas-López, S
dc.contributor.authorSalmerón Martínez, Diego
dc.contributor.authorArribas Leal, José María
dc.contributor.authorRamírez, Pablo (Ramírez Romero)
dc.contributor.departmentCiencias Sociosanitarias
dc.date.accessioned2024-01-12T12:43:49Z
dc.date.available2024-01-12T12:43:49Z
dc.date.issued2023-03
dc.description© 2023 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity SocietyThis document is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. This document is the published version of a published work that appeared in final form in ASAIO Journal. To access the final edited and published work see https://doi.org/10.1097/MAT.0000000000001776es
dc.description.abstractParticulate and gaseous microemboli (GME) are side effects of cardiac surgery that interfere with postoperative recovery by causing endothelial dysfunction and vascular blockages. GME sources during surgery are multiple, and cardiopulmonary bypass (CPB) is contributory to this embolic load. Hematic antegrade repriming (HAR) is a novel procedure that combines the benefits of repriming techniques with additional measures, by following a standardized procedure to provide a reproducible hemodilution of 300 ml. To clarify the safety of HAR in terms of embolic load delivery, a prospective and controlled study was conducted, by applying Doppler probes to the extracorporeal circuit, to determine the number and volume of GME released during CPB. A sample of 115 patients (n = 115) was considered for assessment. Both groups were managed under strict normothermia, and similar clinical conditions and protocols, receiving the same open and minimized circuit. Significant differences in GME volume delivery (control group [CG] = 0.28 ml vs. HAR = 0.08 ml; p = 0.004) and high embolic volume exposure (>1 ml) were found between the groups (CG = 30.36% vs. HAR = 4.26%; p = 0.001). The application of HAR did not represent an additional embolic risk and provided a four-fold reduction in the embolic volume delivered to the patient (coefficient, 0.24; 95% CI, 0.08-0.72; p = 0.01), which appears to enhance GME clearance of the oxygenator before CPB initiation.es
dc.formatapplication/pdfes
dc.format.extent8es
dc.identifier.citationASAIO Journal 69(3):p 324-331, March 2023
dc.identifier.doihttps://doi.org/10.1097/MAT.0000000000001776
dc.identifier.issnElectronic: 1538-943X
dc.identifier.issnPrint: 1058-2916
dc.identifier.urihttp://hdl.handle.net/10201/137236
dc.languageenges
dc.publisherLippincott Williams & Wilkinses
dc.relationSin financiación externa a la Universidades
dc.relation.publisherversionhttps://journals.lww.com/asaiojournal/fulltext/2023/03000/hematic_antegrade_repriming_reduces_emboli_on.14.aspxes
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.titleHematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A Randomized Controlled Triales
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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relation.isAuthorOfPublication6f0a63f6-2a3c-4171-9c1b-c17801916e6e
relation.isAuthorOfPublicatione64e013c-bc8c-4eae-ad1e-9bd89655a6d0
relation.isAuthorOfPublication.latestForDiscoveryeb66f6d0-47c9-4f9b-bc79-04137a6b2d59
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