Vincent F. Olshove

Evaluation of air handling in a new generation neonatal oxygenator with integral arterial filter

Prime volume of the cardiopulmonary bypass circuit may lead to significant hemodilution and the potential need for blood products for all patients, but may be more critical in the pediatric and, specifically, the neonatal patient. We report on the first use of the Terumo® CAPIOX® FX05 (Baby-FX™) oxygenator with integral arterial filter, prime volume 43 ml, evaluating performance and air-handling of six Baby-FX™ versus thirteen Baby-RX™ oxygenators. The Terumo Baby-FX™ primes and performs as easily as the Baby-RX™ series. A significant prime component in the neonatal CPB circuit can be the arterial line filter (ALF). Removal of the ALF may lead to significant reduction in prime volume, decreased exposure to foreign surfaces with subsequent reduction in inflammation, and potential elimination or reduction in blood product exposures.

Cerebral saturations trend with mixed venous saturations in patients undergoing extracorporeal life support

Cerebral saturation (SCO2) monitors are noninvasive tools that continuously measure saturations in the cerebral cortex, a predominately venous bed. The purpose of this study was to see if a trend existed between measurements of SCO2 and mixed venous saturation values (SVO2) for patients on extracorporeal life support (ECLS). Six patients required ECLS for cardiac failure after congenital cardiac surgery, and one patient required ECLS for pulmonary failure. Patients were divided into two groups, those without systemic/pulmonary venous mixing (n=3, Group I) and those with mixing due to an intraatrial shunt or left ventricular vent (n=4, Group II). The age of patients was 0.49-0.5 years (mean9-SD), weight was 5.29-2.3 kg, and time on ECLS was 8.39-4.8 days. No significant abnormalities were seen on head imaging. A total of 786 paired data points were collected. Mean values were different; however, there was a significant trend between SCO2 and SVO2 for the entire sample (R2=0.66, p B-0.001). Cerebral saturation trends follow mixed venous trends and, therefore, may be helpful in combination with other physical and laboratory findings in the care of the critically ill child.

1232: OPERATING ROOM HUDDLE IMPROVED GOAL ALIGNMENT AND ACHIEVEMENT IN PEDIATRIC CARDIAC SURGERY PATIENTS

Crit Care Med 2016 • Volume 44 • Number 12 (Suppl.) than 8 mg/dL. This represented an absolute improvement of 14% towards goal. Conclusions: At baseline, 35% of PICU patients were transfused for hemoglobin less than 7 mg/dL. Within two months post-intervention, nearly half of patients were transfused for a hemoglobin level less than 7 mg/dL. We recommend restrictive transfusion thresholds with an awareness campaign strategy, which could reduce unnecessary transfusions and lead to resource and cost savings.