Publication:
Haematic antegrade repriming to enhance recovery after cardiac surgery from the perfusionist side

dc.contributor.authorBlanco Morillo, Juan
dc.contributor.authorSalmerón Martínez, Diego
dc.contributor.authorArribas Leal, José M.
dc.contributor.authorFarina, Piero
dc.contributor.authorPuis, Luc
dc.contributor.authorSornichero Caballero, Angel J.
dc.contributor.authorCánovas López, Sergio
dc.contributor.departmentCirugía, Pediatría y Obstetricia y Ginecología
dc.date.accessioned2024-07-18T10:47:07Z
dc.date.available2024-07-18T10:47:07Z
dc.date.issued2023-03-24
dc.description© The Author(s). This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/. This document is the Published version of a Published Work that appeared in final form in The Journal of extracorporeal Technology. To access the final edited and published work see https://doi.org/10.1051/ject/2023004
dc.description.abstractNew era of cardiac surgery aims to provide an enhanced postoperative recovery through the implementation of every step of the process. Thus, perfusion strategy should adopt evidence-based measures to reduce the impact of cardiopulmonary bypass (CPB). Hematic Antegrade Repriming (HAR) provides a standardized procedure combining several measures to reduce haemodilutional priming to 300 mL. Once the safety of the procedure in terms of embolic release has been proven, the evaluation of its beneficial effects in terms of transfusion and ICU stay should be assessed to determine if could be considered for inclusion in Enhanced Recovery After Cardiac Surgery (ERACS) programs. Methods: Two retrospective and non-randomized cohorts of high-risk patients, with similar characteristics, were assessed with a propensity score matching model. The treatment group (HG) (n = 225) received the HAR. A historical cohort, exposed to conventional priming with 1350 mL of crystalloid confirmed the control group (CG) (n = 210). Results: Exposure to any transfusion was lower in treated (66.75% vs. 6.88%, p < 0.01). Prolonged mechanical ventilation (>10 h) (26.51% vs. 12.62%; p < 0.01) and extended ICU stay (>2 d) (47.47% vs. 31.19%; p < 0.01) were fewer for treated. HAR did not increase early morbidity and mortality. Related savings varied from 581 to 2741.94 $/patient, depending on if direct or global expenses were considered. Discussion: By reducing the gaseous and crystalloid emboli during CPB initiation, HAR seems to have a beneficial impact on recovery and reduces the overall transfusion until discharge, leading to significant cost savings per process. Due to the preliminary and retrospective nature of the research and its limitations, our findings should be validated by future prospective and randomized studieses
dc.formatapplication/pdfes
dc.format.extent9es
dc.identifier.citationJ Extra Corpor Technol 2023, 55, 30–38
dc.identifier.doihttps://doi.org/10.1051/ject/2023004
dc.identifier.issnPrint: 0022-1058
dc.identifier.issnElectronic: 2969-8960
dc.identifier.urihttp://hdl.handle.net/10201/143195
dc.languageenges
dc.publisherEDP Sciences
dc.relationSin financiación externa a la Universidades
dc.relation.publisherversionhttps://ject.edpsciences.org/articles/ject/full_html/2023/01/JECTJOURNAL-D-22-00028/JECTJOURNAL-D-22-00028.html
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.rightsAtribución 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectCardiopulmonary Bypasses
dc.subjectHematic antegrade repriminges
dc.subjectMinimized extracorporeal circuitses
dc.subjectHaemodilution
dc.subjectBlood conservation
dc.subjectEnhanced recovery after surgery
dc.titleHaematic antegrade repriming to enhance recovery after cardiac surgery from the perfusionist sidees
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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