A questionnaire was administered to determine the blinding success.
Results: Modified ultrafiltration resulted in a removal of 1000 +/- 251 mL of fluid and a reduction in the pump balance (1025 +/- 807 vs 1804 +/- 838; P < .001) with an increase in hemoglobin immediately after intervention (increase of 7.7 +/- 8.8 g/L in modified ultrafiltration vs 3.8 +/- 5.1 g/L in sham; P – .04). Introduction or increase in dose of vasopressors was more frequent in the modified ultrafiltration group (52% vs 28%; P = .048). Differences in
red cell transfusion rates between groups did not reach statistical significance (P = .59). Blinding was successful for the anesthetist (blinding index 0.13 [95% confidence interval, selleck 0.11-0.38] and the intensivist (blinding index, 0.09 [95% confidence interval, 0.14-0.31]) but not for the surgeon (blinding index, 0.24 [95% confidence interval, 0.05-0.42]). The compliance rate for the transfusion protocol was greater than 90%.
Conclusions: Modified ultrafiltration was effective for hemoconcentration
after cardiopulmonary bypass in patients of low body weight, but it is associated with an increased need NU7441 molecular weight for vasopressor support. The anesthetist and intensivist were successfully blinded to the intervention. (J Thorac Cardiovasc Surg 2010; 139: 701-6)”
“Objective: We developed and tested a clinical simulation program in the principles and conduct of cardiopulmonary bypass with the aim of improving confidence and proficiency in this critical aspect of cardiac surgical care.
Methods: Fifteen residents from 6 resident-training programs who reported no prior cardiopulmonary bypass observation or simulation-based perfusion experience participated in a cardiopulmonary bypass course involving both didactic lectures and hands-on simulation. A computer-controlled hydraulic model of the human circulation was
used in a specifically designed ifoxetine multidisciplinary simulation center environment to give the participants hands-on training with both basic operations and specific perfusion crisis scenarios. Pretraining and posttraining assessments concerning confidence, knowledge, and applications with regard to cardiopulmonary bypass were administered and compared.
Results: Likert scale scores on confidence-related items increased significantly (P <. 001), from 59% +/- 16% to 92% +/- 8%. Pretraining versus posttraining scores (72% +/- 14%) on similar cognitive items were not significantly different (P = .3636). Scores on similar open-ended application items before and after training improved from 62% +/- 25% to 85 +/- 10% (P < .0001). All subjects agreed that simulation-based cardiopulmonary bypass training was superior to classroom-and clinic-based education and that the scenarios enhanced their learning experience.