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The heart remained a mystery for many years and was considered surgically untouchable. With the use of extracorporeal circulation, there has been a revolution in this area. Due to its mechanical components and interactions with blood, cardiopulmonary bypass (CPB) can cause significant changes in the body. Factors such as contact between artificial...
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Citations
... In addition, there is instruction in the topic of artificial heart systems and the special features of minimized ECC systems. 3,[66][67][68] After the progression of training in the field of adult perfusion, we offer our students from approx. 18 weeks the opportunity to gain an insight into child and infant perfusion [69][70][71][72][73][74][75][76][77] and to create the reports necessary for the ECCP certificate in this area. ...
Background
Increasing regulations and requirements of advisory bodies, in particular the Joint Federal Committee and the Medical Service of the health insurance funds, make it necessary to employ only demonstrably well-trained perfusionists. The minimum requirement for this staff is EBCP certification. Currently there is limited availability of such specialists on the German market. Therefore, the qualification of young people in this area is of central importance. The aim of this paper is to strengthen the training of perfusionists at our centre, to standardise the process and to provide the respective student with a “roadmap” to their internship.
Material & Methods
The structure is based on a rough division of the 24 weeks of internship. This is described in detail in the following and is backed up with the learning objectives for the respective time periods.
Results
At our centre, practical training has been standardized and clear responsibilities have been defined. Furthermore, as a centre of maximum care in the field of cardiac surgery, we can offer students the necessary number of perfusions in just six months to meet the requirements of the ECBP for practical training. According to this concept, 20 perfusionists have been successfully trained in the last 8 years. All of them have passed the exams and have been certified according to EBCP.
Conclusion
The aim of the practical semester is for the student to be in a position at the end of the semester to independently supervise simple cardiac surgery procedures with the aid of the Extra- Corporal Circulation (ECC) and to carry this out in accordance with the currently valid guidelines and directives (1–8) and the departmental procedural instructions based on them. Great emphasis is placed to the students becoming aware of their competence to act, knowing their limits and being able to assess when these limits have been reached and the involvement of experienced colleagues is necessary to ensure patient safety.
... As it is known, different initial cardioplegia solutions may affect clinical outcomes [2,3] . Recently, minimally invasive extracorporeal circulation (MiECC) circuits have also been used in CABG [4] . Was MiECC used in their patient group? ...
... As is known, different initial cardioplegia solutions may affect the PoAF rates and other clinical results 7,8 . Recently, minimally invasive extracorporeal circulation (MiECC) circuits have also been used in CABG operations 9 . Was MiECC used in your patient group? ...
... En cirugía cardiaca es una estrategia que ha demostrado reducir el porcentaje de transfusiones sanguíneas. Un metanálisis en el que se incluyeron 31 ensayos aleatorios con 2i282 pacientes, mostró resultados positivos sobre el efecto del recuperador de sangre en su conservación, concluyendo que el uso intraoperatorio redujo la tasa de exposición a cualquier producto sanguíneo alogénico y glóbulos rojos con resultados estadísticamente significativos (OR 0.63 y p=0.02) y que disminuyó el volumen medio de hemoderivados alogénicos totales transfundidos por paciente y que no hubo diferencia en la mortalidad hospitalaria en pacientes con cirugía cardíaca 15,16 . ...
... Agentes hemostáticos tópicos: los agentes que se emplean para el sellado o compresión anastomótica de heridas, actúan produciendo hemostasia local intentando crear un sello hermético para prevenir el sangrado localizado 16 . Se utilizó el agente hemostático BioGlue® (compuesto de albúmina bovina y glutaraldehído); las moléculas de glutaraldehído se unen covalentemente (reticulan) a las moléculas de albúmina de suero bovino entre sí y estas a las proteínas tisulares en el lugar de la reparación, creando un sello mecánico independiente de la cascada de coagulación 7 . ...
Introducción: las cardiopatías congénitas cada vez son detectadas a edades más tempranas; la mayoría son corregidas quirúrgicamente mediante sutura directa o la colocación de un parche en las márgenes del defecto, al tratarse de cirugías de alto riesgo es necesario el uso de hemoderivados. Caso clínico: paciente de sexo femenino de 9 meses de edad con dificultad para ganancia pondo estatural, fatiga precoz durante la alimentación, soplo sistólico grado III, mediante ecocardiograma es diagnosticada de una comunicación interauricular tipo ostium secundum y comunicación interventricular con repercusión hemodinámica moderada; inicialmente tratada con furosemida y espironolactona sin respuesta favorable, decidiéndose resolución quirúrgica; sus progenitores dadas sus creencias religiosas no aceptaron la posibilidad de transfusiones sanguíneas, por lo que se resuelve realizar cirugía utilizando estrategias para reducir la probabilidad de uso de hemoderivados durante y después de la misma. Conclusión: a pesar de que la cirugía resultó ser exitosa, se plantea el debate sobre la conducta a seguir en situaciones relacionadas con posiciones religiosas y la posibilidad de aplicar tratamientos seguros para los pacientes.
... In your study, perfusion times were found to be significantly higher in the AKI group, but it was not shown as an independent predictor in multiple analysis. Recently, centrifugal perfusion circuits can be used in some patient groups [8]. Which extracorporeal circuits (heparin coated?) do you use as standard in your clinic? ...
