Management of Challenging Cardiopulmonary Bypass Separation

Standard

Management of Challenging Cardiopulmonary Bypass Separation. / Monaco, Fabrizio; Prima, Ambra Licia Di; Kim, Jun Hyun et al.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 34, No. 6, 06.2020, p. 1622-1635.

Research output: Contribution to journal › Review article › peer-review

Harvard

Monaco, F, Prima, ALD, Kim, JH, Plamondon, MJ, Yavorovskiy, A, Likhvantsev, V, Lomivorotov, V, Hajjar, LA, Landoni, G, Riha, H, Farag, AMGA, Gazivoda, G, Silva, FS, Lei, C, Bradic, N, El-Tahan, MR, Bukamal, NAR, Sun, L & Wang, CY 2020, 'Management of Challenging Cardiopulmonary Bypass Separation', Journal of Cardiothoracic and Vascular Anesthesia, vol. 34, no. 6, pp. 1622-1635. https://doi.org/10.1053/j.jvca.2020.02.038

APA

Monaco, F., Prima, A. L. D., Kim, J. H., Plamondon, M. J., Yavorovskiy, A., Likhvantsev, V., Lomivorotov, V., Hajjar, L. A., Landoni, G., Riha, H., Farag, A. M. G. A., Gazivoda, G., Silva, F. S., Lei, C., Bradic, N., El-Tahan, M. R., Bukamal, N. A. R., Sun, L., & Wang, C. Y. (2020). Management of Challenging Cardiopulmonary Bypass Separation. Journal of Cardiothoracic and Vascular Anesthesia, 34(6), 1622-1635. https://doi.org/10.1053/j.jvca.2020.02.038

Vancouver

Monaco F, Prima ALD, Kim JH, Plamondon MJ, Yavorovskiy A, Likhvantsev V et al. Management of Challenging Cardiopulmonary Bypass Separation. Journal of Cardiothoracic and Vascular Anesthesia. 2020 Jun;34(6):1622-1635. Epub 2020 Feb 29. doi: 10.1053/j.jvca.2020.02.038

Author

Monaco, Fabrizio ; Prima, Ambra Licia Di ; Kim, Jun Hyun et al. / Management of Challenging Cardiopulmonary Bypass Separation. In: Journal of Cardiothoracic and Vascular Anesthesia. 2020 ; Vol. 34, No. 6. pp. 1622-1635.

BibTeX

@article{a05b9f6ba2b343d086cd07c65666d73b,

title = "Management of Challenging Cardiopulmonary Bypass Separation",

abstract = "SEPARATION from cardiopulmonary bypass (CPB) after cardiac surgery is a progressive transition from full mechanical circulatory and respiratory support to spontaneous mechanical activity of the lungs and heart. During the separation phase, measurements of cardiac performance with transesophageal echocardiography (TEE) provide the rationale behind the diagnostic and therapeutic decision-making process. In many cases, it is possible to predict a complex separation from CPB, such as when there is known preoperative left or right ventricular dysfunction, bleeding, hypovolemia, vasoplegia, pulmonary hypertension, or owing to technical complications related to the surgery. Prompt diagnosis and therapeutic decisions regarding mechanical or pharmacologic support have to be made within a few minutes. In fact, a complex separation from CPB if not adequately treated leads to a poor outcome in the vast majority of cases. Unfortunately, no specific criteria defining complex separation from CPB and no management guidelines for these patients currently exist. Taking into account the above considerations, the aim of the present review is to describe the most common scenarios associated with a complex CPB separation and to suggest strategies, pharmacologic agents, and para-corporeal mechanical devices that can be adopted to manage patients with complex separation from CPB. The routine management strategies of complex CPB separation of 17 large cardiac centers from 14 countries in 5 continents will also be described.",

keywords = "anesthesia, cardiopulmonary bypass, discontinuation, inotropes, intensive care, separation, ventricular dysfunction, weaning, RANDOMIZED-CONTROLLED-TRIAL, LOW EJECTION FRACTION, PULMONARY-HYPERTENSION, HEART-FAILURE, TRANSESOPHAGEAL ECHOCARDIOGRAPHY, INTRAAORTIC BALLOON PUMP, CARDIOGENIC-SHOCK, LOW CARDIAC-OUTPUT, AMERICAN SOCIETY, SYSTOLIC ANTERIOR MOTION",

author = "Fabrizio Monaco and Prima, {Ambra Licia Di} and Kim, {Jun Hyun} and Plamondon, {Marie Jo} and Andrey Yavorovskiy and Valery Likhvantsev and Vladimir Lomivorotov and Hajjar, {Ludhmila Abrah{\~a}o} and Giovanni Landoni and H. Riha and Farag, {A. M.G.A.} and G. Gazivoda and Silva, {F. S.} and C. Lei and N. Bradic and El-Tahan, {M. R.} and Bukamal, {N. A.R.} and L. Sun and Wang, {C. Y.}",

year = "2020",

month = jun,

doi = "10.1053/j.jvca.2020.02.038",

language = "English",

volume = "34",

pages = "1622--1635",

journal = "Journal of Cardiothoracic and Vascular Anesthesia",

issn = "1053-0770",

publisher = "Elsevier",

number = "6",

}

RIS

TY - JOUR

T1 - Management of Challenging Cardiopulmonary Bypass Separation

AU - Monaco, Fabrizio

AU - Prima, Ambra Licia Di

AU - Kim, Jun Hyun

AU - Plamondon, Marie Jo

AU - Yavorovskiy, Andrey

AU - Likhvantsev, Valery

AU - Lomivorotov, Vladimir

AU - Hajjar, Ludhmila Abrahão

AU - Landoni, Giovanni

AU - Riha, H.

AU - Farag, A. M.G.A.

AU - Gazivoda, G.

AU - Silva, F. S.

AU - Lei, C.

AU - Bradic, N.

AU - El-Tahan, M. R.

AU - Bukamal, N. A.R.

AU - Sun, L.

AU - Wang, C. Y.

PY - 2020/6

Y1 - 2020/6

N2 - SEPARATION from cardiopulmonary bypass (CPB) after cardiac surgery is a progressive transition from full mechanical circulatory and respiratory support to spontaneous mechanical activity of the lungs and heart. During the separation phase, measurements of cardiac performance with transesophageal echocardiography (TEE) provide the rationale behind the diagnostic and therapeutic decision-making process. In many cases, it is possible to predict a complex separation from CPB, such as when there is known preoperative left or right ventricular dysfunction, bleeding, hypovolemia, vasoplegia, pulmonary hypertension, or owing to technical complications related to the surgery. Prompt diagnosis and therapeutic decisions regarding mechanical or pharmacologic support have to be made within a few minutes. In fact, a complex separation from CPB if not adequately treated leads to a poor outcome in the vast majority of cases. Unfortunately, no specific criteria defining complex separation from CPB and no management guidelines for these patients currently exist. Taking into account the above considerations, the aim of the present review is to describe the most common scenarios associated with a complex CPB separation and to suggest strategies, pharmacologic agents, and para-corporeal mechanical devices that can be adopted to manage patients with complex separation from CPB. The routine management strategies of complex CPB separation of 17 large cardiac centers from 14 countries in 5 continents will also be described.

AB - SEPARATION from cardiopulmonary bypass (CPB) after cardiac surgery is a progressive transition from full mechanical circulatory and respiratory support to spontaneous mechanical activity of the lungs and heart. During the separation phase, measurements of cardiac performance with transesophageal echocardiography (TEE) provide the rationale behind the diagnostic and therapeutic decision-making process. In many cases, it is possible to predict a complex separation from CPB, such as when there is known preoperative left or right ventricular dysfunction, bleeding, hypovolemia, vasoplegia, pulmonary hypertension, or owing to technical complications related to the surgery. Prompt diagnosis and therapeutic decisions regarding mechanical or pharmacologic support have to be made within a few minutes. In fact, a complex separation from CPB if not adequately treated leads to a poor outcome in the vast majority of cases. Unfortunately, no specific criteria defining complex separation from CPB and no management guidelines for these patients currently exist. Taking into account the above considerations, the aim of the present review is to describe the most common scenarios associated with a complex CPB separation and to suggest strategies, pharmacologic agents, and para-corporeal mechanical devices that can be adopted to manage patients with complex separation from CPB. The routine management strategies of complex CPB separation of 17 large cardiac centers from 14 countries in 5 continents will also be described.

KW - anesthesia

KW - cardiopulmonary bypass

KW - discontinuation

KW - inotropes

KW - intensive care

KW - separation

KW - ventricular dysfunction

KW - weaning

KW - RANDOMIZED-CONTROLLED-TRIAL

KW - LOW EJECTION FRACTION

KW - PULMONARY-HYPERTENSION

KW - HEART-FAILURE

KW - TRANSESOPHAGEAL ECHOCARDIOGRAPHY

KW - INTRAAORTIC BALLOON PUMP

KW - CARDIOGENIC-SHOCK

KW - LOW CARDIAC-OUTPUT

KW - AMERICAN SOCIETY

KW - SYSTOLIC ANTERIOR MOTION

UR - http://www.scopus.com/inward/record.url?scp=85083062834&partnerID=8YFLogxK

U2 - 10.1053/j.jvca.2020.02.038

DO - 10.1053/j.jvca.2020.02.038

M3 - Review article

C2 - 32276758

AN - SCOPUS:85083062834

VL - 34

SP - 1622

EP - 1635

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 6

ER -

ID: 23985542