Interdisciplinary cardiovascular and thoracic surgery · 2026
Blood-Based Versus Crystalloid Cardiopulmonary Bypass Priming in Left Ventricular Assist Device Surgery: Impact on End-Organ Function and Survival.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bonni Sophie, Zayat Rashad, Ramnath Natasja W M, Hatam Nima, Tewarie Lachmandath, Moza Ajay, Sales Marjolijn C
Аннотация
OBJECTIVES: Cardiopulmonary bypass (CPB) priming may influence haemodilution, bleeding, and end-organ injury during HeartMate 3 (HM3) implantation, but evidence in contemporary left ventricular assist device (LVAD) surgery is limited.
METHODS: We retrospectively analysed 92 HM3 implantations (2015-2025) by priming strategy (blood-based [FFP + RBC], n = 36; crystalloid, n = 56). The primary end-point was postoperative right heart failure (RHF; Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS]). Multivariable regression and propensity score-based inverse probability of treatment weighting (IPTW) sensitivity analyses were performed.
RESULTS: Baseline characteristics were balanced between groups, with comparable age (blood-based: 58 [49.5-66.0]; crystalloid: 62 [55.8-68.2]; P = .069) and female sex (blood-based: n = 3/36 [8.3%]; crystalloid: n = 8/56 [14.3%]; P = .518). Right heart failure was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 17/56 [30.4%]; P = .012; adjusted OR 0.23 [95% confidence interval (CI) 0.06-0.86]; P = .030). Dialysis was lower unadjusted (blood-based: n = 4/36 [11.1%]; crystalloid: n = 18/56 [32.1%]; P = .021), with a directionally lower adjusted estimate (OR 0.30 [95% CI, 0.09-1.01]; P = .053). Delirium was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 16/56 [28.6%]; P = .019; adjusted OR 0.22 [95% CI, 0.06-0.84]; P = .027). Survival did not differ significantly (log-rank P = .055; adjusted HR 0.59 [95% CI, 0.27-1.32]; P = .201). IPTW analyses showed lower delirium (OR 0.23 [95% CI, 0.06-0.84]) and an attenuated RHF association (OR 0.35 [95% CI, 0.10-1.23]).
CONCLUSIONS: Blood-based CPB priming was associated with lower RHF and delirium, and directionally lower dialysis rates, after HM3 implantation. Survival estimates were not statistically significant. Findings require prospective validation.
CLINICAL REGISTRATION NUMBER: Ethics Committee of the Medical Faculty of RWTH Aachen (EK 25-154).
METHODS: We retrospectively analysed 92 HM3 implantations (2015-2025) by priming strategy (blood-based [FFP + RBC], n = 36; crystalloid, n = 56). The primary end-point was postoperative right heart failure (RHF; Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS]). Multivariable regression and propensity score-based inverse probability of treatment weighting (IPTW) sensitivity analyses were performed.
RESULTS: Baseline characteristics were balanced between groups, with comparable age (blood-based: 58 [49.5-66.0]; crystalloid: 62 [55.8-68.2]; P = .069) and female sex (blood-based: n = 3/36 [8.3%]; crystalloid: n = 8/56 [14.3%]; P = .518). Right heart failure was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 17/56 [30.4%]; P = .012; adjusted OR 0.23 [95% confidence interval (CI) 0.06-0.86]; P = .030). Dialysis was lower unadjusted (blood-based: n = 4/36 [11.1%]; crystalloid: n = 18/56 [32.1%]; P = .021), with a directionally lower adjusted estimate (OR 0.30 [95% CI, 0.09-1.01]; P = .053). Delirium was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 16/56 [28.6%]; P = .019; adjusted OR 0.22 [95% CI, 0.06-0.84]; P = .027). Survival did not differ significantly (log-rank P = .055; adjusted HR 0.59 [95% CI, 0.27-1.32]; P = .201). IPTW analyses showed lower delirium (OR 0.23 [95% CI, 0.06-0.84]) and an attenuated RHF association (OR 0.35 [95% CI, 0.10-1.23]).
CONCLUSIONS: Blood-based CPB priming was associated with lower RHF and delirium, and directionally lower dialysis rates, after HM3 implantation. Survival estimates were not statistically significant. Findings require prospective validation.
CLINICAL REGISTRATION NUMBER: Ethics Committee of the Medical Faculty of RWTH Aachen (EK 25-154).