Cardiovascular System Commons^™

Cyanosis-Associated Coagulopathy In Neonates Undergoing Cardiopulmonary Bypass: A Scoping Review, Lily Crickmar

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2. Structured summary:

A. Background: Patients with cyanotic congenital heart disease exhibit coagulation abnormalities related to chronic hypoxemia, which may increase the risk of bleeding and thrombosis, particularly during cardiopulmonary bypass.

B. Objective: This scoping review mapped the existing literature on coagulation disturbances and perioperative hemostatic outcomes in pediatric patients with cyanotic congenital heart disease.

C. Methods: 14 studies meeting the inclusion criteria were identified through structured database searching. The data were collected and synthesized descriptively due to heterogeneity in study design, patient populations, and coagulation assessment methods.

D. Results: Across studies, cyanotic patient physiology was associated with platelet dysfunction, …

Indicators Of Fontan Circulatory Failure In Pediatric Patients: A Scoping Review Of Early Clinical And Hemodynamic Factors, Marina Mcmahon

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Structured Summary

a. Background/Introduction:

For patients with single ventricle congenital heart disease, the Fontan procedure is the definitive palliative procedure. Although advancements have been made in the surgical technique and management, the Fontan circulation is inefficient and prone to progressive dysfunction. Elevated central venous pressure, non-pulsatile pulmonary blood flow, and reduced cardiac output can lead to many complications, and eventual failure. These conditions can lead to protein losing enteropathy, plastic bronchitis, and hepatic fibrosis which often indicate advanced decline. Though a known problem, there is a lack of standardized criteria to guide optimal intervention timing of Fontan revision prior to …

The Impact Of Normothermic Regional Perfusion Compared With Cold Storage On Warm Ischemia Time In Donation After Circulatory Death Organ Transplantation: A Scoping Review, Chris Turner

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ABSTRACT

2.Structured summary:

Background: Donation after circulatory death (DCD) has expanded the donor pool but introduces an inevitable period of warm ischemia that threatens graft viability. Preservation techniques such as normothermic regional perfusion (NRP) and static cold storage (SCS) aim to minimize this injury and improve transplant outcomes.

Objective: This scoping review identifies and synthesizes published evidence comparing NRP with SCS in DCD organ transplantation, focusing on their respective effects on warm ischemia time, graft function, and early post‑transplant outcomes.

Methods: Following the PRISMA‑ScR framework [23], searches were conducted in MEDLINE, PubMed, Embase, and Scopus for English‑language studies involving DCD …

Pharmacologic Interventions To Reduce Cardiopulmonary Bypass Induced Inflammation In Cardiac Surgery: A Scoping Review, Wyatt Anderson

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ABSTRACT

1. Structured summary

Background

Cardiopulmonary bypass (CPB) is essential in cardiac surgery but can trigger a systemic inflammatory response that contributes to postoperative complications. The scoping review conducted has a purpose to map the existing literature on pharmacologic interventions to mitigate CPB related inflammation. While several interventions demonstrated potential anti-inflammatory effects, findings were inconsistent, and no standardized pharmacologic approach is currently agreed upon.

Methods

This scoping review followed PRISMA-ScR guidelines.Both PubMed, and CINAHL were screened for studies published between 2000 and 2024 that evaluated pharmacologic interventions aimed at reducing CPB related inflammation. After screening and duplicate removal, 10 studies met …

Pharmacological Treatment Options For Vasoplegia Syndrome During And After Cardiopulmonary Bypass: A Scoping Review, Bradley Darby

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ABSTRACT

2: Structured summary

Background

Vasoplegia Syndrome (VS) is a form of distributive shock that is characterized by profound hypotension, low systemic vascular resistance, and high to normal cardiac output during/after cardiopulmonary bypass. VS is associated with increased mortality, morbidity, and length of stay in the intensive care unit.

Objective

The main objectives of this scoping review are to note the available treatment options, characterize potential risk factors, and identify gaps in knowledge for vasoplegia syndrome during and after cardiopulmonary bypass.

Method

This scoping review utilized the Preferred Reporting Items for Systematic reviews and MetaAnalyses extension for Scoping Reviews (PRISMA-ScR) …

Albumin Use In Cardiopulmonary Bypass Pump Prime And Its Association With Postoperative Renal Function And Acute Kidney Injury: A Scoping Review, Hannah Talbot

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ABSTRACT

1.Structured summary:

Background: Cardiopulmonary bypass (CPB) is associated with significant hemodilution, inflammatory activation, and alterations in renal perfusion, all of which may contribute to postoperative acute kidney injury (AKI). Albumin is frequently used as a component of CPB pump prime due to its oncotic properties and potential to mitigate fluid shifts and support intravascular volume. However, the extent to which albumin-containing priming solutions influence postoperative renal outcomes remains unclear.

Objective: This scoping review aimed to map the available literature examining the use of albumin in CPB pump prime and its reported effects on renal function and the incidence …

Clinical Applications Of Topical Platelet-Rich Plasma In Cardiac Surgery: A Scoping Review, Jaron M. Davis

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Background: Postoperative wound complications persist as a significant challenge within adult cardiac surgery. Deep and superficial sternal wound infections, along with complications at saphenous vein harvest sites, are linked to increased morbidity, extended hospital stays, and substantial healthcare expenses. Topical platelet-rich plasma (PRP), commonly known as platelet gel, has been suggested as a biologically active adjunct that may facilitate tissue repair and mitigate postoperative complications. While PRP has garnered attention in surgical practice, the overall scope and consistency of the supporting evidence in cardiac surgery remain ambiguous.

Objective: The purpose of this scoping review is to map and describe the …

Goal-Directed Perfusion Strategies And Postoperative Acute Kidney Injury: A Scoping Review, Austin Davis

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Background: Acute kidney injury (AKI) remains a frequent and clinically important complication following cardiopulmonary bypass (CPB). Goal-directed perfusion (GDP) strategies—most commonly targeting indexed oxygen delivery (DO₂i) and/or other hemodynamic and metabolic parameters—have been proposed to reduce renal injury by improving renal oxygenation and perfusion during CPB.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Review (PRISMA-ScR) compliant scoping review identified 28 adult CPB studies evaluating GDP strategies and postoperative AKI outcomes.

Results: Maintenance of indexed oxygen delivery (DO2i) above critical thresholds and minimizing hemodilution were consistently associated with reduced AKI.

Conclusion: GDP strategies centered on maintaining …

Alternative Anticoagulation Strategies For Heparin-Intolerant Patients Undergoing Cardiopulmonary Bypass: A Scoping Review Of Patient Outcomes, Zachary Nelson

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Background/Introduction: Heparin intolerance, most notably heparin-induced thrombocytopenia (HIT), presents a major clinical challenge during cardiopulmonary bypass (CPB), where systemic anticoagulation is essential for safe circulation through the extracorporeal circuit. While several alternative anticoagulants have been described, there is limited consensus regarding their safety, dosing, and outcomes. The objective of this study was to map existing evidence describing alternative anticoagulation strategies for heparin-intolerant adult patients undergoing CPB and to summarize reported patient outcomes, dosing strategies, and intraoperative management considerations.

Methodology: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) …

What Are The Current Risks For Patients Associated With Technology Related Perfusion Practices: A Scoping Review, Jessica Steel

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Background: Advancements in medical technology, particularly in perfusion practices such as ECMO and heart-lung bypass, have improved patient care but also introduced novel risks. Technological errors—ranging from hardware malfunctions to software failures and AI model inaccuracies—can directly threaten patient safety.

Objective: To identify current trends and risks associated with technology in perfusion practices and synthesize evidence on the frequency, nature, and outcomes of technology-related errors.

Results: Evidence indicates substantial deficiencies in medical devices, predictive models, and health IT systems. AI-based predictive models frequently failed to detect critical health deterioration, missing 66% of injuries in some in-hospital mortality simulations. Adverse events …

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

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1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …