Effects, management and optimization of extracorporeal techniques and technologies in contemporary cardiac surgery

The techniques and approaches to extracorporeal circulation have a clinical impact in terms of organ protection, preservation from cerebrovascular damage and cognitive dysfunction. This thesis shows how integrating many aspects related to monitoring the selection of components can impact the post-operative outcome. Even the management of ECMO can be crucial we have introduced observations on the management and preservation of the long-term management of the oxygenator. Management of micro-embolic and embolic activity is crucial in cardiac surgery We have integrated the role of CO2 administration technique for post-operative cognitive disorders (POCD) prevention with the appearance and utility of cardiopulmonary bypass technologies and monitoring in the prevention of micro-embolic activity. The MiECC technique has been studied in detail on the aspects of the pharmacodynamics of Propofol in relation to the content of albumin, hemodilution and contact surface (the metabolic impact on frail patients has been investigated compared to the conventional CPB (and we have evaluated the benefits of the magnetic levitation pump on the reduction of hemolysis on short-term procedures. This thesis integrating the knowledge of cardiopulmonary bypass to the ECMO procedure and vice versa. In the world of research and development of new technologies, the key role of metabolic management is increasingly gaining scientific evidence, and the role of advanced techniques is increasingly crucial in reducing the adverse effects of conventional cardiopulmonary bypass. The holistic approach presented in this thesis represents an evolution of expedients on extracorporeal technologies aimed at the organic preservation of the patient by focusing on various aspects covered in the chapters of the thesis.