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See detailEfficacy of the RemoweLL cardiotomy reservoir for fat and leucocyte removal from shed mediastinal blood: a randomized controlled trial.
LAGNY, Marc-Gilbert ULg; GOTHOT, André ULg; HANS, Grégory ULg et al

in Perfusion (2016)

Efficacy of the RemoweLL cardiotomy reservoir for Fat and Leucocyte removal from shed mediastinal blood: a randomized controlled trial. ABSTRACT (176 words) Introduction Re-transfusion of lipid particles ... [more ▼]

Efficacy of the RemoweLL cardiotomy reservoir for Fat and Leucocyte removal from shed mediastinal blood: a randomized controlled trial. ABSTRACT (176 words) Introduction Re-transfusion of lipid particles and activated leucocytes with shed mediastinal blood (SMB) can aggravate cardiopulmonary bypass-associated inflammation and increase the embolic load. This study evaluated the fat and leucocyte removal capacity of the RemoweLL cardiotomy reservoir. Methods Forty-five patients undergoing elective on-pump cardiac surgery were randomly allocated to filtration of SMB using the RemoweLL or the Admiral cardiotomy reservoir. The primary outcome was the drop in leucocytes and lipid particles obtained with the two filters. The effect of the filters on other blood cells and inflammatory mediators such as myeloperoxidase (MPO) was also assessed. Results The RemoweLL cardiotomy filter removed 16.5 % of the leucocytes (P < 0.001) while no significant removal of leucocytes was observed with the Admiral (P = 0.48). The percentage reductions in lipid particles were similar in the two groups (26% vs 23 %, P = 0.2). Both filters similarly affected the level of MPO (P = 0.71). Discussion The RemoweLL filter more effectively removed leucocytes from SMB than the Admiral. It offered no advantage in term of lipid particle clearance. [less ▲]

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See detailPrediction of the post-dilution hematocrit during cardiopulmonary bypass. Are new formulas needed?
ERPICUM, Marie ULg; Dardenne, Nadia ULg; HANS, Grégory ULg et al

in Perfusion (2015)

Objectives: Predicting the post-dilution hematocrit is an important tool to avoid preventable anemia or unnecessary transfusion. Simplified empirical formulas currently used for such a prediction may lead ... [more ▼]

Objectives: Predicting the post-dilution hematocrit is an important tool to avoid preventable anemia or unnecessary transfusion. Simplified empirical formulas currently used for such a prediction may lead to large errors. We aimed to improve the accuracy of these formulas by a better estimation of the dilution volume and the patient circulatory blood volume. Methods: We compared the estimation accuracy of two formulas, using fixed (formula A) versus estimated (formula D) dilution volume and patient circulatory blood volume for 100 cardiac interventions. The difference between predicted and measured HctT1 was considered as “good” if less than 0.5%, “moderate” between 0.5 and 2% and “poor” if higher than 2%. The influence of the body mass index (BMI) on patient blood volume estimation was explored by categorized groups’ comparison. Results: The mean difference between predicted and measured HctT1 differed significantly between formulas A and D. Formula A didn’t differ from HctT1 (p=0.19, IC95% [-0.89-0.18]), but a significant and higher underestimation was observed in the BMI⩽25 group compared to the other BMI groups (p<0.001). Formula D overestimated HctT1 (p<0.001, IC95% [1.01-1.93]) without a difference between the BMI groups. No difference was observed in their overall proportions of good (11 vs 10%), moderate (44 vs 46%) and poor predictions (47 vs 44%) (p=0.117). Conclusions: Formulas used for post-dilution hematocrit prediction lead to major estimation errors and a risk of inadequate transfusion practices. Estimations performed by experienced clinicians could not minimize these biases in all clinical cases as significant errors remain, with potential clinical impact. No estimation formula should be used as a hard tool for transfusing patients, but rather as a guide to predicting the probability of transfusion requirement. [less ▲]

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See detailLeucocytes and lipid particles filtration in suction blood during cardiopulmonary bypass: impact on kidney function evaluated with a monocentric prospective randomized study.
LAGNY, Marc-Gilbert ULg; KOCH, Jean-Noël ULg; BLAFFART, Francine ULg et al

Conference (2015, October 03)

OBJECTIVE: Cardiac surgery may be complicated by acute kidney injury (AKI). Cardiotomy suction during cardiopulmonary bypass (CPB) is deleterious. A few studies have demonstrated that shed mediastinal ... [more ▼]

OBJECTIVE: Cardiac surgery may be complicated by acute kidney injury (AKI). Cardiotomy suction during cardiopulmonary bypass (CPB) is deleterious. A few studies have demonstrated that shed mediastinal blood (SMB) suction during cardiopulmonary bypass (CPB) can increase inflammatory response and lipids emboli. These 2 factors contribute to the development of postoperative AKI. The RemoweLL (RemoweLeucoLipids, Eurosets™, Italy) filter is a recent designed cardiotomy with a multilayer filter for activated leucocytes filtration and a syphon for lipid particles sequestration. The SMB can be collected and filtered in this supplementary cardiotomy added to CPB circuit. The aim of this monocentric prospective study was to compare the specific RemoweLL cardiotomy filtration for suction blood during CPB and a conventional 40 µm filter (Admiral, Eurosets™, Italy). The primary goal was to evaluate the AKI within 48 hours after surgery using the Acute Kidney Injury Network classification (AKIN classification) but also measuring early specific biomarkers of AKI: serum Cystatine C and urinary neutrophil gelatinase-associated lipocalin (NGAL). METHODS: Sixty patients scheduled for elective cardiac surgery (aortic or mitral valvular combined or not with coronary bypass grafting) with a glomerular filtration rate (GFR) > 45mL/min. were randomly into 2 groups for SMB filtration: - Groupe 1 (n=30) with RemoweLL cardiotomy (Leucocytes and lipids filter); - Groupe 2 (n=30) with Admiral cardiotomy (conventional 40 µm filter). All components: venous reservoir, oxygenator and surface treatment were similar in both groups. [less ▲]

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See detailBudd-Chiari syndrome: a case report and review of the literature.
OUHADI, Lorraine ULg; CREEMERS, Etienne ULg; HONORE, Pierre ULg et al

in Revue Médicale de Liège (2015), 70(7-8), 378-383

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See detailAntioxidant capacity and phenolic composition of red wines from various grape varieties : specificity of pinot noir.
degives, Julien; Kevers, Claire ULg; DEFRAIGNE, Jean ULg et al

in Giuseppe Viali (Ed.) 3rd international conference on cellular environmental stressors in biology and medicine : focus on redox reactions (2014, June 25)

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See detailCardiac surgery and acute kidney injury.
LAGNY, Marc-Gilbert ULg; BLAFFART, Francine ULg; KOCH, Jean-Noël ULg et al

Conference given outside the academic context (2013)

Lecture about Cardiac surgery and acute kidney injury. Presentations of results about a retrospective study performed in the University Hospital of Liège and presentations about the protocol of a ... [more ▼]

Lecture about Cardiac surgery and acute kidney injury. Presentations of results about a retrospective study performed in the University Hospital of Liège and presentations about the protocol of a prospective study on the same topic. [less ▲]

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See detailNew Insights Into Aortic Diseases A Report From the Third International Meeting on Aortic Diseases (IMAD3)
KUIVANIEMI, Helena; SakalihasanN, Natzi ULg; LEDERLE, Franck et al

in AORTA (2013), 1

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See detailEpargne sanguine en chirurgie cardiaque : Etude rétrospective des pratiques
ERPICUM, Marie ULg; DEFRAIGNE, Jean ULg; LARBUISSON, Robert ULg

Report (2013)

Cette étude rétrospective s’inscrit dans le cadre des recherches de la thèse de doctorat sur l’épargne sanguine à travers l’itinéraire clinique du patient opéré cardiaque. Son objectif est de dresser un ... [more ▼]

Cette étude rétrospective s’inscrit dans le cadre des recherches de la thèse de doctorat sur l’épargne sanguine à travers l’itinéraire clinique du patient opéré cardiaque. Son objectif est de dresser un état des lieux de la prise en charge des patients opérés cardiaques au CHU de Liège, des pratiques d’épargne sanguine qui y sont employées et de leur impact sur le recours à la transfusion, les durées de séjour et la mortalité. Cet audit devrait permettre de 1) mettre en évidence les éléments pouvant être améliorés dans l’organisation actuelle de la prise en charge de ces patients afin de concourir aux objectifs d’épargne sanguine 2) servir de base à l’élaboration d’un itinéraire clinique du patient opéré cardiaque. [less ▲]

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See detailUtilisation du système CardioPAT® en postopératoire de chirurgie cardiaque
ERPICUM, Marie ULg; FLECHE, Jérôme; SENARD, Marc ULg et al

Report (2013)

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See detailOn the Potential Effect of Increased Dietary Intake of Fruits and Vegetables on Biomarkers of Lipid Peroxidation in Type 2 Diabetes Patients
PINCEMAIL, Joël ULg; PAQUOT, Nicolas ULg; Cillard, J et al

in Journal of Pharmacy & Nutrition Sciences (2013), 3(3),

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See detailSample dilution influences the determination of antioxidant capacity in food. How to minimize it?
Sipel, Arnaud; Kevers, Claire ULg; PINCEMAIL, Joël ULg et al

in Food Analytical Methods (2013), 6(5), 1485-1491

The influence of sample dilution on the measurement of antioxidant capacity was analyzed. To ensure the reproducibility of results it is necessary to realize such scarce investigations. This study focuses ... [more ▼]

The influence of sample dilution on the measurement of antioxidant capacity was analyzed. To ensure the reproducibility of results it is necessary to realize such scarce investigations. This study focuses on different antioxidant capacity assays, commonly used for the analysis of pure substances and food extracts. For all compounds and foods tested in most of the four assays (TEAC, DPPH and ORAC), effects of sample dilution on the measured (and recalculated) antioxidant capacity were observed, differences up to 28% between dilutions. An extrapolation method was proposed to obtain a “real value” thus to minimize the effects of the sample dilution. This extrapolation method is relatively simple, based on a linear regression of 4 or 5 appropriate dilutions of the sample and applicable to the various assays. The use of such a method will improve the consistency of inter-laboratory antioxidant capacity data and thus permit better comparisons. In contrast, there was no dilution problem with FRAP assays. [less ▲]

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See detailMultimodality blood conservation strategy in cardiac surgery with cardiopulmonary bypass: the CHU of Liege experience
ERPICUM, Marie ULg; BLAFFART, Francine ULg; DEFRAIGNE, Jean ULg et al

Poster (2012, November 20)

This study presents the transfusion rates of cardiac surgery patients and describes the in-house strategy of blood conservation applied in a single centre

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See detailPostoperative bleeding and autotransfusion
ERPICUM, Marie ULg; BLAFFART, Francine ULg; DEFRAIGNE, Jean ULg et al

Poster (2012, November 20)

Bleeding in the postoperative period of cardiac surgery is not rare. Mediastinal bleedings could potentially be saved with a cell salvage device. This practice may contribute to decreased allogeneic ... [more ▼]

Bleeding in the postoperative period of cardiac surgery is not rare. Mediastinal bleedings could potentially be saved with a cell salvage device. This practice may contribute to decreased allogeneic transfusion. This study explores the effectiveness of a chest drainage system combined with a cell salvage option during the postoperative period of cardiac surgery in patients at high risk of bleeding [less ▲]

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See detailL'épargne sanguine: un enjeu actuel
ERPICUM, Marie ULg; BLAFFART, Francine ULg; DEFRAIGNE, Jean ULg et al

in Revue Médicale de Liège (2012), 67(11), 593-596

In view of the demographic evolution, the progress of quality requirements and the shortage of donors, a deficiency of blood components is to be feared in the coming years.. This implies the development ... [more ▼]

In view of the demographic evolution, the progress of quality requirements and the shortage of donors, a deficiency of blood components is to be feared in the coming years.. This implies the development of a blood conservation strategy, the revision of transfusion practices and the implementation of preventive measures to limit transfusion requirements. Each department caring for patients at high transfusion risk should assess and rationalize its transfusion practices in a structured multidisciplinary way [less ▲]

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See detailWhat is the potential increase of the heart graft pool by cardiac donation after circulatory death?
NOTERDAEME, Timothée; NELLESSEN, Eric ULg; HANS, Marie-France ULg et al

in Transplantation (2012, November), 94

Background: Heart transplantation remains to date the only definite treatment option for end-stage heart diseases. Currently only heart procured from brain death (DBD) donors are used. Combined with an ... [more ▼]

Background: Heart transplantation remains to date the only definite treatment option for end-stage heart diseases. Currently only heart procured from brain death (DBD) donors are used. Combined with an increasing demand, the constant heart graft shortage leads to an increase of deaths on cardiac transplantation waiting lists. The use of hearts procured after donation after circulatory death (DCD) could help to partly decrease the heart graft shortage. The aim of this study was to evaluate the potential increase of heart graft pool by development of DCD heart transplantation. Methods: The authors retrospectively reviewed their local donor database for the period 2006-2011, and screened the complete controlled DCD donor population for potential heart donors, using the same criteria as for DBD heart transplantation. The acceptable warm ischemic time (WIT) was limited to 30min from life support withdrawal to aortic cannulation. Results: During the analyzed timespan, 177 DBD and 70 DCD were effectively performed. From the 177 DBD, a total of 70 (39.5%) hearts were procured and transplanted locally or in another center. Out of the 70 DCD, 8 (11%) donors fulfilled the criteria for heart graft procurement and had a WIT of less than 30 minutes. During the same period, 82 patients were newly listed for heart transplantation, of which 53 were transplanted, 20 died or were unlisted, and 9 were still awaiting transplantation. Conclusions: Based on our database and a WIT of less than 30min, it could be estimated that 11% of the DCD might be heart graft donors, representing a 11% increase in heart graft procurement, as well as potential reduction of the deaths on the waiting list by 40%. [less ▲]

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See detailMultimodality blood conservation strategy in cardiac surgery with cardiopulmonary bypass : the CHU of Liège experience
ERPICUM, Marie ULg; BLAFFART, Francine ULg; DEFRAIGNE, Jean ULg et al

Poster (2012, September 29)

Introduction: The aim of this study is to analyze the transfusion rates of cardiac surgery patients in a single centre following an in-house strategy of blood conservation. Methods: The data of all adult ... [more ▼]

Introduction: The aim of this study is to analyze the transfusion rates of cardiac surgery patients in a single centre following an in-house strategy of blood conservation. Methods: The data of all adult patients undergoing normothermic cardiac surgery with cardiopulmonary bypass (CPB) over a 1 year period were retrospectively collected (n=491). Management protocols were described. The transfusion rates of allogeneic blood components were recorded: red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PT), as well as the number of units transfused. The timing of transfusion was categorized: during CPB (peroperative period), within the first 48 postoperative hours after wean out CPB (early postoperative period) and during the hospitalisation from surgery until discharge (hospitalisation). The hematocrit values were recorded during CPB, 10 minutes after wean out CPB, after the first 48 postoperative hours and at discharge from hospital. Results: Two hundred and forty-eight patients (50%) received an allogeneic blood component transfusion during hospitalisation. One hundred and twenty-one patients (25%) received RBC during the operative period; the median of units transfused was 2(1-2).The lowest hematocrit value during CPB was 21(19-24) % in median. A cell salvage device was used in each case: the median volume of washed red blood cells transfused was 678(512-891) mL. The median hematocrit value after CPB was 23(21-25) %. One hundred and sixty-five patients (34%) were transfused in the early postoperative period: 27% received RBC, 18% received FFP and 18% received PT. The median of units transfused was 2(1-3) for RBC, 4(2-6) for FFP and 1(1-2) for PT. The median hematocrit value after 48 hours was 32(29-34) % and 32(30-35) % at discharge. Conclusion: The transfusion rates observed in this series are relatively high compared with the literature. Improvements will be made in our practice and protocols management in order to decrease the need of transfusion. This detailed audit of the transfusion practices in our cardiac surgery centre would be helpful to value the effectiveness of further improvements. [less ▲]

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