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Article ; Online: Extracorporeal membrane oxygenation from last resort to indispensable tool in the treatment of respiratory and/or circulatory failure.

De Somer, Filip / Swol, Justyna

2024 Volume 39, Issue 1_suppl, Page(s) 3S–4S

MeSH term(s)	Extracorporeal Membrane Oxygenation/methods ; Humans ; Respiratory Insufficiency/therapy ; Shock/therapy
Language	English
Publishing date	2024-04-07
Publishing country	England
Document type	Editorial
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591231226292
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Article ; Online: Adverse renal effects associated with cardiopulmonary bypass.

Milne, Benjamin / Gilbey, Tom / De Somer, Filip / Kunst, Gudrun

Perfusion

2023 Volume 39, Issue 3, Page(s) 452–468

Abstract: Cardiac surgery on cardiopulmonary bypass (CPB) is associated with postoperative renal dysfunction, one of the most common complications of this surgical cohort. Acute kidney injury (AKI) is associated with increased short-term morbidity and mortality ... ...

Abstract	Cardiac surgery on cardiopulmonary bypass (CPB) is associated with postoperative renal dysfunction, one of the most common complications of this surgical cohort. Acute kidney injury (AKI) is associated with increased short-term morbidity and mortality and has been the focus of much research. There is increasing recognition of the role of AKI as the key pathophysiological state leading to the disease entities acute and chronic kidney disease (AKD and CKD). In this narrative review, we will consider the epidemiology of renal dysfunction after cardiac surgery on CPB and the clinical manifestations across the spectrum of disease. We will discuss the transition between different states of injury and dysfunction, and, importantly, the relevance to clinicians. The specific facets of kidney injury on extracorporeal circulation will be described and the current evidence evaluated for the use of perfusion-based techniques to reduce the incidence and mitigate the complications of renal dysfunction after cardiac surgery.
MeSH term(s)	Humans ; Cardiopulmonary Bypass/adverse effects ; Postoperative Complications/etiology ; Cardiac Surgical Procedures/adverse effects ; Acute Kidney Injury ; Kidney ; Risk Factors ; Retrospective Studies
Language	English
Publishing date	2023-02-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591231157055
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Article ; Online: Protamine dosing in cardiac surgery.

Vandenheuvel, Michael / Vandewiele, Korneel / De Somer, Filip / Wouters, Patrick F

Perfusion

2023 Volume 39, Issue 3, Page(s) 645–646

MeSH term(s)	Humans ; Protamines/therapeutic use ; Cardiac Surgical Procedures ; Anticoagulants ; Heparin ; Heparin Antagonists ; Cardiopulmonary Bypass
Chemical Substances	Protamines ; Anticoagulants ; Heparin (9005-49-6) ; Heparin Antagonists
Language	English
Publishing date	2023-01-25
Publishing country	England
Document type	Letter
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591231154116
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Article ; Online: The evolving role of the modern perfusionist: insights from transesophageal echocardiography.

Bouchez, Stefaan / De Somer, Filip

Perfusion

2020 Volume 36, Issue 3, Page(s) 222–232

Abstract: Transesophageal echocardiography is a relatively non-invasive, mobile, safe imaging technique that is ideal for providing real-time information on cardiac anatomy and function during heart surgery. The technology has evolved from two-dimensional to real- ... ...

Abstract	Transesophageal echocardiography is a relatively non-invasive, mobile, safe imaging technique that is ideal for providing real-time information on cardiac anatomy and function during heart surgery. The technology has evolved from two-dimensional to real-time three-dimensional imaging during cardiac procedures, which has significantly benefited preoperative planning, intraoperative guidance, evaluation, and postoperative follow-up. Transesophageal echocardiography may serve the clinical perfusionist by providing imaging guidance for identifying potential problems before cardiopulmonary bypass, guiding the proper placement of cannulas, monitoring cardiac performance on cardiopulmonary bypass, and providing useful feedback during weaning from cardiopulmonary bypass. Although the perfusionist should be able to understand all echocardiographic images and measurements in depth, perfusion-related echocardiographic information can or should be used to optimize the clinical practice of the modern perfusionist. Vice versa, whenever the perfusionist suspects a problem, the surgical team including the sonographer should verify this "clinical treat" by echocardiography whenever possible.
MeSH term(s)	Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Echocardiography ; Echocardiography, Transesophageal ; Humans ; Monitoring, Intraoperative
Language	English
Publishing date	2020-07-30
Publishing country	England
Document type	Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/0267659120944094
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Article ; Online: A novel methodology for low-range heparin detection: A single-centre prospective diagnostic study.

Vandenheuvel, Michael / Vandewiele, Korneel / Van Gompel, Carla / De Kesel, Pieter M / Wyffels, Piet / De Somer, Filip / Devreese, Katrien M J / Wouters, Patrick F

European journal of anaesthesiology

2022 Volume 40, Issue 1, Page(s) 57–60

MeSH term(s)	Humans ; Heparin/adverse effects ; Prospective Studies
Chemical Substances	Heparin (9005-49-6)
Language	English
Publishing date	2022-12-07
Publishing country	England
Document type	Journal Article
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0000000000001747
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Article ; Online: Enzymatic Deglycation of Damaged Skin by Means of Combined Treatment of Fructosamine-3-Kinase and Fructosyl-Amino Acid Oxidase.

De Decker, Ignace / Notebaert, Margo / Speeckaert, Marijn M / Claes, Karel E Y / Blondeel, Phillip / Van Aken, Elisabeth / Van Dorpe, Jo / De Somer, Filip / Heintz, Margaux / Monstrey, Stan / Delanghe, Joris R

International journal of molecular sciences

2023 Volume 24, Issue 10

Abstract: The consensus in aging is that inflammation, cellular senescence, free radicals, and epigenetics are contributing factors. Skin glycation through advanced glycation end products (AGEs) has a crucial role in aging. Additionally, it has been suggested that ...

Abstract	The consensus in aging is that inflammation, cellular senescence, free radicals, and epigenetics are contributing factors. Skin glycation through advanced glycation end products (AGEs) has a crucial role in aging. Additionally, it has been suggested that their presence in scars leads to elasticity loss. This manuscript reports fructosamine-3-kinase (FN3K) and fructosyl-amino acid oxidase (FAOD) in counteracting skin glycation by AGEs. Skin specimens were obtained (n = 19) and incubated with glycolaldehyde (GA) for AGE induction. FN3K and FAOD were used as monotherapy or combination therapy. Negative and positive controls were treated with phosphate-buffered saline and aminoguanidine, respectively. Autofluorescence (AF) was used to measure deglycation. An excised hypertrophic scar tissue (HTS) (n = 1) was treated. Changes in chemical bonds and elasticity were evaluated using mid-infrared spectroscopy (MIR) and skin elongation, respectively. Specimens treated with FN3K and FAOD in monotherapy achieved an average decrease of 31% and 33% in AF values, respectively. When treatments were combined, a decrease of 43% was achieved. The positive control decreased by 28%, whilst the negative control showed no difference. Elongation testing of HTS showed a significant elasticity improvement after FN3K treatment. ATR-IR spectra demonstrated differences in chemical bounds pre- versus post-treatment. FN3K and FAOD can achieve deglycation and the effects are most optimal when combined in one treatment.
MeSH term(s)	Phosphotransferases (Alcohol Group Acceptor) ; Glycation End Products, Advanced ; Amino Acids ; Oxidoreductases
Chemical Substances	fructosamine-3-kinase (EC 2.7.1.-) ; Phosphotransferases (Alcohol Group Acceptor) (EC 2.7.1.-) ; Glycation End Products, Advanced ; Amino Acids ; Oxidoreductases (EC 1.-)
Language	English
Publishing date	2023-05-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24108981
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Article ; Online: Effect of aortic stiffness versus stenosis on ventriculo-arterial interaction in an experimental model of coarctation repair.

Panzer, Joseph / De Somer, Filip / Segers, Patrick / De Wolf, Daniel / Bove, Thierry

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2020 Volume 58, Issue 6, Page(s) 1206–1215

Abstract: Objectives: The aim of this study was to investigate the effect of short- versus long-segment aortic stiffness and stenosis on ventriculo-arterial interaction in a porcine model of coarctation repair.: Methods: Short-long aortic stiffness was created ...

Abstract	Objectives: The aim of this study was to investigate the effect of short- versus long-segment aortic stiffness and stenosis on ventriculo-arterial interaction in a porcine model of coarctation repair. Methods: Short-long aortic stiffness was created by transection/suture [coarctation (CoA) suture, n = 6] and stenting (stent, n = 5) of the proximal descending aorta. Short-long aortic stenosis was achieved by wrapping a prosthetic graft around the aorta to 1/3-circumference reduction, over a segment length of 1 cm (CoA suture stenosis, n = 5) and 4.5 cm (stent stenosis, n = 6). After 3 months, aortic pressure-flow haemodynamics, aortic distensibility by intravascular ultrasound and left ventricular performance by pressure-volume loops were compared to a Sham group (n = 5) at baseline and during dobutamine administration. Results: The aortic impedance increased with 30.3 (12.6%) and 41.3 (20.9%) (P < 0.001) in CoA stenosis and stent stenosis during inotropic response. Impaired haemodynamic aortic compliance was associated with lower aortic distensibility by intravascular ultrasound, specifically in long-segment stenosis. The ventriculo-arterial coupling was disturbed in both groups with stenosis, with blunted contractile response [Sham 140.3 (19.8%), CoA suture 101.3 (14.5%), CoA suture stenosis 75.0 (8.4%), stent 115.5 (12.7%), stent stenosis 55.1 (14.6%), P < 0.001] and increased myocardial stiffness during dobutamine in the long-segment aortic stenosis group [Sham -26.0 (12.9%), CoA suture -27.5 (15.9%), CoA stenosis -9.5 (8.6%), stent -23.4 (4.8%), stent stenosis 19.9 (23.1%), P < 0.001]. Conclusions: This animal study on the sequelae of coarctation repair demonstrated that aortic stiffness had little effect on aortic pressure-flow characteristics in the absence of stenosis. However, the negative chronic effect of stenosis on aortic haemodynamics-especially a longer segment-leads to the rapid impairment of ventriculo-arterial interaction, which is accentuated by inotropy. Therefore, therapeutical management needs to focus on improving aortic remodelling after coarctation repair, preferably by minimizing residual stenosis, even at the cost of inducing aortic stiffness.
MeSH term(s)	Animals ; Aorta ; Aortic Coarctation/surgery ; Constriction, Pathologic ; Models, Theoretical ; Swine ; Vascular Stiffness
Language	English
Publishing date	2020-08-20
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezaa241
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Article ; Online: Neurologic complications after cardiopulmonary bypass - A narrative review.

Gilbey, Tom / Milne, Benjamin / de Somer, Filip / Kunst, Gudrun

Perfusion

2022 Volume 38, Issue 8, Page(s) 1545–1559

Abstract: Neurologic complications, associated with cardiac surgery and cardiopulmonary bypass (CPB) in adults, are common and can be devastating in some cases. This comprehensive review will not only consider the broad categories of stroke and neurocognitive ... ...

Abstract	Neurologic complications, associated with cardiac surgery and cardiopulmonary bypass (CPB) in adults, are common and can be devastating in some cases. This comprehensive review will not only consider the broad categories of stroke and neurocognitive dysfunction, but it also summarises other neurological complications associated with CPB, and it provides an update about risks, prevention and treatment. Where appropriate, we consider the impact of off-pump techniques upon our understanding of the contribution of CPB to adverse outcomes.
MeSH term(s)	Adult ; Humans ; Cardiopulmonary Bypass/adverse effects ; Cardiopulmonary Bypass/methods ; Nervous System Diseases/etiology ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/methods ; Stroke/etiology ; Postoperative Complications/etiology
Language	English
Publishing date	2022-08-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591221119312
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Article ; Online: Cardiac surgery-Associated acute kidney injury - A narrative review.

Rasmussen, Sebastian Buhl / Boyko, Yuliya / Ranucci, Marco / de Somer, Filip / Ravn, Hanne Berg

Perfusion

2023 , Page(s) 2676591231211503

Abstract: Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) is a serious complication seen in approximately 20-30% of cardiac surgery patients. The underlying pathophysiology is complex, often involving both patient- and procedure related risk factors. In ... ...

Abstract	Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) is a serious complication seen in approximately 20-30% of cardiac surgery patients. The underlying pathophysiology is complex, often involving both patient- and procedure related risk factors. In contrast to AKI occurring after other types of major surgery, the use of cardiopulmonary bypass comprises both additional advantages and challenges, including non-pulsatile flow, targeted blood flow and pressure as well as the ability to manipulate central venous pressure (congestion). With an increasing focus on the impact of CSA-AKI on both short and long-term mortality, early identification and management of high-risk patients for CSA-AKI has evolved. The present narrative review gives an up-to-date summary on definition, diagnosis, underlying pathophysiology, monitoring and implications of CSA-AKI, including potential preventive interventions. The review will provide the reader with an in-depth understanding of how to identify, support and provide a more personalized and tailored perioperative management to avoid development of CSA-AKI.
Language	English
Publishing date	2023-10-31
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591231211503
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Article ; Online: Comparison of coagulation monitoring using ROTEM and Sonoclot devices in cardiac surgery: a single-center prospective observational study.

Vandenheuvel, Michael / VAN Gompel, Carla / Vandewiele, Korneel / DE Kesel, Pieter M / Wyffels, Piet / DE Somer, Filip / Devreese, Katrien M / Wouters, Patrick F

Minerva anestesiologica

2022 Volume 88, Issue 9, Page(s) 680–689

Abstract: Background: Viscoelastic tests (VETs) are recommended during cardiac surgery to monitor coagulation status and guide transfusion. We compared the results of two VETs, the Sonoclot Analyzer and the ROTEM Sigma. Agreement between viscoelastic tests' ... ...

Abstract	Background: Viscoelastic tests (VETs) are recommended during cardiac surgery to monitor coagulation status and guide transfusion. We compared the results of two VETs, the Sonoclot Analyzer and the ROTEM Sigma. Agreement between viscoelastic tests' subdiagnoses and overall diagnosis severity was assessed. Correlations with conventional coagulation tests (CCT) and the discriminatory potential of numerical VET outputs for transfusion thresholds was determined. Methods: Single-center, prospective observational study in a tertiary academic center. In fifty adult patients undergoing elective cardiac surgery, parallel Sonoclot, ROTEM and CCT analysis was performed before heparin, or after protamine or coagulation product administration. All patients completed the study, resulting in 139 data points. Results: Agreement on the severity of coagulation disorders was acceptable (83%), but poor (27%) on the differentiation of the underlying causes. Correlations between ROTEM parameters and CCT were good (postprotamine: FIBTEM A5 (r Conclusions: ROTEM and Sonoclot accord well on the detection of severity of coagulation dysfunction, but not on the diagnosis of the underlying cause. ROTEM correlated more closely with CCT then Sonoclot. We propose a testing strategy that could lead to a cost-effective approach to the bleeding cardiac surgery patient.
MeSH term(s)	Adult ; Blood Coagulation ; Blood Coagulation Tests ; Cardiac Surgical Procedures/methods ; Fibrinogen ; Humans ; Thrombelastography/methods
Chemical Substances	Fibrinogen (9001-32-5)
Language	English
Publishing date	2022-03-22
Publishing country	Italy
Document type	Journal Article ; Observational Study
ZDB-ID	123584-9
ISSN	1827-1596 ; 0026-4717 ; 0375-9393
ISSN (online)	1827-1596
ISSN	0026-4717 ; 0375-9393
DOI	10.23736/S0375-9393.22.16119-5
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