Abstract:The blood remaining in the oxygenator and the circuit after cardiopulmonary bypass(CPB)is named as"residual circuit blood"or"circuit blood".The volume of residual circuit blood ranges following an adult CPB procedure is approximately 400-1200 mL.In most medical centers,this blood is typically collected into sterile infusion bags and directly retransfused to the patient.However,the management may also bring the risks such as infection,hemolysis,bleeding,and organ injury which may be due to bacterial contamination,erythrocyte damage,clot formation,and leukocyte activation during storage in the bag.To mitigate the risks,clinical strategies including using blood bags compatible with CPB connectors and containing red cell preservation solution,with concurrent protamine infusion to neutralize heparin ex vivo prior to patient administration,and/or processing the blood via centrifugation washing or leukocyte filtration before reinfusion.This review summarizes the risks associated with the retransfusion of residual circuit blood and the corresponding processing methods,aiming to assist clinicians in enhancing blood conservation efficacy.The goal is to concurrently reduce both allogeneic blood transfusion requirements and the risks inherent in retransfusing residual circuit blood.

Abstract:Objective To analyze the changes in intraoperative lactate levels in pediatric heart transplant patients and their impact on prognosis.Methods We retrospectively collected clinical data of pediatric heart transplant patients in the Department of Cardiac Surgery,Guangdong Provincial People's Hospital,from January 2018 to December 2023.Patients were divided into the survival group(n=39)and the death group(n=5)according to their status at discharge.Demographic characteristics,laboratory indicators,surgical parameters,and postoperative hospital stay were compared between the two groups.Repeated-measures ANOVA and group-based trajectory modeling(GBTM)were used to assess the effect of intraoperative lactate patterns on prognosis.Results A total of 44 children undergoing heart transplantation were included,of whom 5(11.36%)died after surgery and before discharge.Repeated measures ANOVA showed that lactate levels changed over time(F=10.424,P<0.001),with significant differences between groups(F=79.588,P<0.001),but the interaction between group and time was not statistically significant(F=1.354,P=0.234).GBTM identified two intraoperative lactate trajectories:high-level rapid increase and low-level slow increase.Patients with the low-level slow increase trajectory had a significantly lower risk of death than those with the high-level rapid increase trajectory,HR=0.588,P=0.034.Conclusion Pediatric heart transplant patients with a high-level rapid increase in intraoperative lactate had a worse prognosis.Early identification of high-risk lactate trajectories may help improve patient management and guide treatment strategies.

Abstract:Objective To investigate the surgical effect of totally thoracoscopic surgery for atrial septal defect(ASD).Methods A total of 104 ASD patients who underwent ASD repair at our hospital between July 2022 to July 2023 were enrolled and divided into two groups based on the surgical approach:the endoscopic group(Group A,n=52)and the traditional thora-cotomy group(Group B,n=52).Parameters compared included cardiopulmonary bypass(CPB)time,aortic cross-clamp time,24 hours thoracic drainage volume,ventilator support time,ICU stay time,postoperative hospital stay,total hospitalization cost,blood salvaged volume,incidence of complications,rate of re-sternotomy for bleeding,rate of spontaneous sinus rhythm resump-tion,and follow-up results.Results All patients successfully underwent ASD repair ASD repair combined with tricuspid val-vuloplasty,or ASD repair combined with patent foramen ovale closure.Spontaneous resumption of sinus rhythm occurred after aortic unclamping in all patients across both groups.No severe complications were observed,all patients were discharged cured,and no re-sternotomy for bleeding was required.In group A,no procedures required extended incisions or conversion to median sternotomy.However,two patients in group A had residual leakage of about 2mm and were discharged for observation without treatment.There was no statistical difference in the general preoperative data between the two groups(P>0.05).Compared with the conventional thoracotomy group,the endoscopic group demonstrated significantly longer CPB and aortic cross-clamp time,higher hospitalization costs,significantly less 24h drainage flow volume,and a shorter postoperative hospital stay(P<0.05).There was no significant difference between the two groups in postoperative ventilator support time,ICU time,blood salvaged volume,rate of rethoracotomy for bleeding rate of spontaneous rhythm resumption,or incidence of complications(P>0.05).Conclusion Totally complete thoracoscopic ASD surgery is safe and feasible,offering advantages such as minimal invasiveness and faster postoperative recovery.

Abstract:Objective To compare the myocardial protective effects of Custodiol HTK(histidine-tryptophan-ketogluta-rate)cardioplegia and blood cardioplegia(BCP)when administered in totally thoracoscopic valve surgery.Methods Clinical data of 101 patients who underwent totally thoracoscopic valve surgery at Guangdong Provincial People's Hospital from January 2021 to December 2021 were retrospectively analyzed.Patients were divided into two groups according to the cardioplegia they adopted during operation,including group HTK(n=32)and group BCP(n=69).Postoperative outcomes represented by myocardial enzyme levels involving creatine kinase MB isotype(CK-MB)and cardiac troponin T(cTnT),left ventricular ejection fraction(LVEF),vasoactive-inotropic score(VIS),myocardial infarction(MI)and spontaneous return to sinus rhythm were compared between the two groups.Results 69 and 32 patients adopted blood cardioplegic and HTK solutions,respectively.The levels of CK-MB and cTnT at<24 h,24～48 h and>48 h after surgery,postoperative LVEF,VIS and incidence of MI were similar be-tween the two groups(P>0.05),but HTK administration was associated with a lower possibility of spontaneous return to sinus rhythm(P=0.018).Additionally,increased aortic cross-clamp time(every 10 minutes)was associated with a higher risk of MI(P=0.002)while increased total volume was associated with a lower risk of MI(P=0.029).Conclusion Delivery of HTK solu-tion offered equivalent myocardial protection to the blood cardioplegia in patients undergoing totally thoracoscopic valve surgery.Timely increased perfusion effectively reduced the incidence of early postoperative myocardial infarction following thoracoscop-ic surgery.

Abstract:Objective To explore the risk factors for 30-day mortality after heart valve surgery in patients complicated with preoperative cerebral infarction.Methods From January 1st,2010 to July 31st,2022,435 consecutive patients complicated with preoperative cerebral infarction,who underwent heart valve surgery in our center,were enrolled retrospectively.Univariable and multivariable logistic analyses were performed to identify predictors of 30-day mortality.Results 30-day mortality was 8.51%overall among the 435 patients.Multivariable logistic analysis showed that preoperative chronic lung disease(OR=9.184,95%CI:2.132-39.560,P=0.003),higher BMI(OR=1.147,95%CI:1.017-1.294,P=0.026)and lower endogenous creatinine clearance rate(OR=0.977,95%CI:0.955-0.999,P=0.037)were independent risk factors.Conclusion Preoperative chronic lung disease,higher BMI and lower endogenous creatinine clearance rate were independent risk factors for 30-day mortality in patients complicated with preoperative cerebral infarction,who underwent heart valve surgery.

Abstract:Extracorporeal circulation(ECC)is a vital life support technology in cardiac surgery.However,the contact between circuit materials and blood can trigger coagulation cascades,leading to issues such as thrombosis—a pressing clinical challenge that requires urgent resolution.In recent years,multiple gaseous signaling molecules have been reported to play crucial roles in anticoagulation:Nitric oxide(NO)inhibits platelet activation via the cyclic guanosine monophosphate(cGMP)-protein kinase G(PKG)signaling axis and regulates vascular thrombosis through S-nitrosylation of protein disulfide isomerase(PDI);Carbon monoxide(CO)suppresses platelet activation through both cGMP-dependent and cGMP-independent pathways;while hydrogen sulfide(H2S)exerts anticoagulant effects through mediating sulfhydryl(S-sulfhydration)modification and multi-target regulation of platelets,vascular endothelial cells,and the coagulation cascade.Coating ECC circuit surfaces with gaseous signal-ing molecules represents a cutting-edge strategy to enhance their biocompatibility and anticoagulant efficacy.Current research in this field primarily focuses on integrating NO,CO,and H2S onto device surfaces through diverse coating material designs.How-ever,achieving sustained,stable,and controllable release of these gas signaling molecules remains a major challenge.This review summarizes the anticoagulation mechanisms and recent advances in coating materials incorporating NO,CO,and H2S,providing insights for the development of novel anticoagulation strategies based on gaseous signaling molecules.It also discusses the exist-ing challenges and future clinical translation prospects of gaseous signaling molecule-based anticoagulant coating technologies.

Abstract:Objective Heart transplantation is an effective treatment for patients with end-stage heart failure.This article mainly explores perioperative clinical outcomes after heart transplantation and the risk factors related to postoperative mortality.Methods A retrospective analysis was conducted on the clinical data of patients who underwent heart transplantation in the Department of Cardiovascular Surgery,the First Affiliated Hospital of Naval Medical University from January 2018 to January 2024.Patients were divided into survival and non-survival groups based on in-hospital mortality.Preoperative characteristics,intraoperative data,and postoperative outcomes were compared between the two groups,and multivariate Firth logistic regression was used to analyze the risk factors related to early in-hospital death after surgery.Results A total of 170 patients were included in this study,including 132 males(77.65%).The main preoperative disease etiology was dilated cardiomyopathy(80.58%).There were 23 in-hospital deaths,yielding an early mortality rate of 13.5%.The causes of death included 10 cases of graft dysfunction,9 cases of multiple organ dysfunction,and 4 cases of sepsis.Compared with the survival group,the non-survival group had significantly lower preoperative platelet count and higher preoperative pulmonary artery pressure.No statistically significant differences were observed in intraoperative parameters between the groups.Analysis of postoperative outcomes showed that the non-survival group had a significantly higher rate of receiving mechanical circulatory support(including IABP,ECMO,ECMO+IABP)(35%vs.9.5%,P=0.003),and a higher incidence of pulmonary infection(21.7%vs.3.4%,P=0.005).Multivariate Firth regression analysis found that elevated preoperative mean pulmonary artery pressure was an independent risk factor for in-hospital death after heart transplantation.Conclusion The perioperative mortality rate of heart transplantation remains relatively high.High preoperative pulmonary artery pressure is an independent risk factor for early in-hospital mortality after heart transplantation.

Abstract:The perfusionist training system in Canada is characterized by high standardization and specialization with rig-orous criteria governing admission requirements,curriculum design,and certification.This article systematically introduces the education and training model,national certification system,employment environment and working patterns for perfusionists in Canada.Furthermore,in light of industry trends,it explores new opportunities and challenges facing the profession in areas such as artificial cardiopulmonary technology,prolonged extracorporeal support and interdisciplinary collaboration,aiming to provide a reference for domestic counterparts.

Abstract:As a core management strategy in type A aortic dissection surgery,moderate hypothermic circulatory arrest has made its clinical value and optimization strategies the focus of research in recent years.This paper provides a comprehensive review of the application of moderate hypothermic circulatory arrest in Stanford Type A aortic dissection,covering fundamental theories,epidemiology,clinical practice,and future developments.It elaborates in detail on the pathology of Stanford Type A aor-tic dissection and the physiological effects of moderate hypothermic circulatory arrest.The article conducts an in-depth analysis of the epidemiological characteristics of this disease,diagnostic techniques,as well as the perioperative management of moderate hypothermic circulatory arrest,its impact on postoperative complications,and clinical outcomes.It also explores comparisons with other intraoperative protective techniques and controversies surrounding the safety and efficacy of moderate hypothermic circulatory arrest.Furthermore,the paper discusses future advancements in moderate hypothermic circulatory arrest technology and innovative developments in the treatment of Stanford Type A aortic dissection.By synthesizing numerous studies,this paper offers a comprehensive reference for clinical practice and research in this field.

Abstract:Objective To investigate the effects of venous-arterial membrane oxygenation(V-A ECMO)on left ventric-ular hemodynamics in a sheep model of cardiogenic shock induced by acute myocardial infarction.Methods Six healthy adult male Small-tailed Han sheep were included to establish an ischemic shock model,followed by V-A ECMO support.Pressure-vol-ume loop(PV-Loop)and echocardiography techniques were employed to dynamically monitor key hemodynamic parameters,in-cluding left ventricular preload,afterload,and cardiac function,during the baseline period,shock period,and V-A ECMO support period.Results All six experimental sheep were successfully modeled,survived with V-A ECMO support,and completed the entire experimental procedure.Pressure-volume loop(PV-Loop)data showed that stroke work(SW),cardiac output(CO),and stroke volume(SV)significantly decreased compared to the shock period(P<0.001).No significant difference was observed in ejection fraction(EF)compared to the shock period.Volumetric parameters,including maximum volume(Vmax),minimum vol-ume(Vmin),end-systolic volume(Ves),and end-diastolic volume(Ved),all significantly decreased(P<0.001).Among pressure parameters,maximum pressure(Pmax)and developed pressure(Pdev)showed a decreasing trend(P<0.05),while no statistical differences were found in minimum pressure(Pmin),mean pressure(Pmean),end-systolic pressure(Pes),or end-diastolic pres-sure(Ped).Echocardiography data revealed that left atrial volume(LAV)significantly decreased compared to the shock period(P=0.020).Left ventricular end-systolic volume(LVESV)also markedly decreased(P=0.041).Left ventricular ejection fraction(LVEF)remained at a relatively low level(35.5%)without significant improvement compared to the shock period.The maximum aortic valve velocity(AV Vmax)exhibited a decreasing trend during the V-A ECMO support period.Myocardial strain parameters showed no significant differences between the V-A ECMO support and shock periods.Strain bull's-eye plots indicat-ed partial recovery of segmental strain values,suggesting a potential early trend of regional functional recovery.Conclusion In a V-A ECMO supported acute cardiogenic shock model,V-A ECMO effectively reduced left ventricular volume load(Vmax,Vmin,Ves,Ved)and alleviated ventricular dilation,while also decreasing myocardial oxygen demand by reducing cardiac work(SW,CO,SV).The decline in certain pressure parameters(Pmax,Pdev)suggests a possible reduction in wall stress,creating favorable conditions for myocardial recovery.Although overall cardiac function did not show significant improvement in the short term,partial recovery trends were observed in certain myocardial segments,demonstrating the therapeutic potential of V-A ECMO support.

Abstract:Venoarterial extracorporeal membrane oxygenation(V-A ECMO)has become increasingly prevalent in the provision of cardiopulmonary support for patients with cardiogenic shock.However,while improving systemic perfusion,V-A ECMO concurrently elevates left ventricular afterload,leading to ventricular distension and subsequently triggering a spectrum of adverse events.Despite the existence of numerous left ventricular unloading strategies designed to mitigate these risks,optimal management during V-A ECMO remains undefined due to a paucity of high-level randomized evidence.This review methodically analyses the therapeutic efficacy of these interventions and provides a concise summary of recent research advances.

Abstract:Extracorporeal circulation(ECC)is a widely used technique in cardiac surgery to replace cardiopulmonary function during surgery,but the process is often associated with various complications,such as ischemia-reperfusion injury,in-flammatory reactions,and hemodynamic disturbances.In recent years,adenosine has been recognized as a potential myocardial preservation agent in ECC due to its unique pharmacological effects.The purpose of this article is to systematically review the mechanism of adenosine in ECC,the current status of domestic and international research and the future research direction,and to provide a reference basis for the clinical application of adenosine in ECC.

Abstract:Objective To identify short-term prognostic factors in patients with acute myocardial infarction compli-cated by cardiogenic shock(AMI-CS)receiving venoarterial extracorporeal membrane oxygenation(V-A ECMO)support,and to develop an early risk prediction model to guide clinical decision-making and individualized management strategies.Methods A total of 112 AMI-CS patients who received V-A ECMO support at our center from January 2021 to December 2024 were retrospectively enrolled.Demographic data,laboratory findings,organ function scores,mechanical circulatory sup-port status,and clinical outcomes were collected.The primary endpoint was 28-day all-cause mortality.Univariate and mul-tivariate logistic regression analyses were performed to identify independent predictors of 28-day mortality.A composite risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curve analysis.Results Among the 112 patients enrolled,71.43%were male(80/112),and the mean age was 62.8±9.4 years.The 28-day mortality rate was 58.93%(66/112),and the successful weaning rate from ECMO was 41.07%(46/112).Compared with survivors,non-survivors had significantly higher baseline lactate levels(6.18±2.21 vs.4.03±1.65 mmol/L,P<0.001),serum creatinine(135.7±44.6 vs.104.2±38.1 μmol/L,P=0.002),NT-proBNP levels(15 836.3±7 642.5 vs.10 128.5±6 284.7 ng/L,P=0.009),and SOFA scores(10.6±3.1 vs.8.4±2.6,P<0.001),along with a lower rate of intra-aortic balloon pump(IABP)use(43.94%vs.67.39%,P=0.018).Multivariate logistic regression revealed that elevated lactate(OR=1.412,95%CI:1.136-1.755,P=0.002),higher NT-proBNP(OR=1.302,95%CI:1.071-1.684,P=0.003),increased SOFA score(OR=1.239,95%CI:1.045-1.470,P=0.014),and absence of IABP support(OR=2.231,95%CI:1.057-4.708,P=0.035)were independent predictors of 28-day mortality.ROC curve analysis demonstrated that lactate,NT-proBNP,and SOFA score yielded AUCs of 0.772,0.704,and 0.756,respective-ly.The combined prediction model showed improved discriminative performance,with an AUC of 0.842(95%CI:0.763-0.921),sensitivity of 85.5%,and specificity of 80.4%.Conclusion AMI-CS patients supported by V-A ECMO have a high short-term mortality.Baseline lactate,NT-proBNP,SOFA score,and IABP use are important prognostic indicators.A multifactorial predic-tion model based on these variables demonstrates good discriminatory power and may aid in early risk stratification and individu-alized clinical decision-making.

Abstract:Objective To investigate the risk factors associated with hypoproteinemia after cardiac valve replacement with cardiopulmonary bypass(CPB),and to establish a predictive model using receiver operating characteristic(ROC)curve analysis.Methods A total of 250 patients undergoing cardiac valve replacement under CPB in our hospital were enrolled.According to serum albumin(ALB)levels within 48 hours postoperatively,patients were divided into a hypoproteinemia group(n=65)and a non-hypoproteinemia group(n=185).Multivariate logistic regression was used to analyze risk factors,and ROC curve was applied to evaluate predictive performance and construct a predictive model.Results Multivariate logistic regression analysis revealed that advanced age(OR=1.037),female(OR=2.147),fatty liver disease(OR=4.402),prolonged lengthy CPB time(OR=1.016),extended postoperative cannulation(OR=1.182),pulmonary infection(OR=6.552),and gastrointestinal im-pairment(OR=3.957)were independent risk factors for hypoproteinemia following CPB cardiac valve replacement(P<0.05).ROC curve analysis demonstrated that the combined predictive model achieved an area under the curve(AUC)of 0.850(95%CI of 0.791-0.909),with a sensitivity of 0.846,and specificity of 0.762,indicating high predictive value.Conclusion Advanced age,female,fatty liver disease,prolonged CPB time,extended postoperative catheterization time,pulmonary infection and gas-trointestinal dysfunction are significant risk factors for hypoproteinemia after CPB cardiac valve replacement.

Abstract:Extracorporeal membrane oxygenation(ECMO)serves as an essential life-support intervention for critically ill patients.Despite its life-saving potential,ECMO is associated with a considerable incidence of hemorrhagic and thrombotic complications,which significantly compromise patient prognosis.Consequently,the accurate assessment of bleeding risk and precise management of anticoagulation and transfusion therapy have emerged as paramount clinical priorities.Viscoelastic hemostatic assay(VHA),which provides a dynamic,real-time profile of the hemostatic process,is being increasingly integrated into the anticoagulation management of ECMO patients due to its rapidity and comprehensive nature.This review systematically evaluates the correlation between VHA and conventional laboratory assays in the context of bleeding and anticoagulation monitoring,and critically appraises the evolving role of VHA in guiding ECMO anticoagulation.Focusing on clinical studies from the past 10 years,this review comprehensively evaluates the current applications and future directions of this technology in clinical practice,with the aim of providing a theoretical basis and practical guidance for anticoagulation management and transfusion strategies in ECMO patients.

Abstract:Objective To investigate the early weaning success rate of veno-arterial extracorporeal membrane oxygenation(V-A ECMO)in patients with severe cardiogenic shock(CS)and to identify relevant clinical and laboratory risk factors,aiming to provide evi-dence for timely weaning decisions and individualized management.Methods This retrospective study included 83 patients with severe CS who received V-A ECMO support at our hospital between January 2023 and December 2024.All patients met the inclusion criteria.According to whether ECMO was successfully weaned within 7 days after initiation,patients were divided into an early weaning success group(n=34)and a failure group(n=49).Data collected included demographic information,comorbidities,SOFA score,laboratory pa-rameters before ECMO and at 24 hours post-initiation(lactate,troponin I,NT-proBNP,D-dimer,platelet count,etc.),echocardiographic parameters(LVEF,LVOT VTI),ECMO-related parameters(pump speed,flow rate),additional support(IABP,CRRT),and ECMO-related complications(bleeding,infection,limb ischemia,etc.).Group comparisons were performed using t-tests,Mann-Whitney U tests,and χ2 tests.Multivariate logistic regression was used to identify independent predictors of early weaning success,and model performance was assessed using receiver operating characteristic(ROC)curves.Results The early weaning success rate among patients receiving V-A ECMO was 40.96%(34/83).Univariate analysis revealed that compared to the failure group,the success group had significantly lower pre-ECMO lactate levels(3.74±1.19 mmol/L vs.6.21±2.05 mmol/L,P<0.001),significantly higher lactate clearance 24-hour post-ini-tiation(61.35%±12.28%vs.38.67%±11.46%,P<0.001),higher LVEF(37.82%±5.41%vs.29.47%±6.33%,P<0.001),greater LVOT VTI(14.26±3.51 cm vs.10.72±2.86 cm,P<0.001),higher platelet count(132.58±37.92×109/L vs.95.46±29.13×109/L,P=0.003),and higher urine output(876.41±265.32 mL/d vs.523.17±218.49 mL/d,P=0.008),while D-dimer levels were significant-ly lower in the success group(2.64±0.85 mg/L vs.4.13±1.26 mg/L,P=0.002).Multivariate logistic regression identified pre-ECMO lactate level(OR=1.92,95%CI:1.31-2.85,P=0.001),lactate clearance rate(OR=0.76,95%CI:0.65-0.89,P<0.001),LVEF(OR=0.81,95%CI:0.70-0.94,P=0.005),and D-dimer level(OR=1.48,95%CI:1.11-1.97,P=0.009)as independent risk factors for early weaning failure.The ROC curve demonstrated strong predictive performance of the model,with an AUC of 0.871(95%CI:0.793-0.934),sensitivity of 85.29%,and specificity of 82.35%.Conclusion The early weaning success rate for patients with severe CS supported by V-A ECMO remains relatively low at approximately 40.96%.Elevated lactate and D-dimer levels,along with reduced lactate clearance and impaired cardiac function(as indicated by LVEF),are significantly associated with early weaning failure.Comprehensive and dynamic evaluation of metabolic status and cardiac function is essential to optimize weaning timing,improve clinical outcomes,and reduce complications in patients receiving ECMO support.

Abstract:Cardiac surgery,particularly that involving cardiopulmonary bypass(CPB),increases the risk of coagulation dysfunction.Traditional treatment approaches typically rely on the administration of fresh frozen plasma(FFP)to correct co-agulation abnormalities.In recent years,research on prothrombin complex concentrate(PCC)as an alternative to FFP has been steadily increasing.Studies have demonstrated that PCC offers certain advantages over FFP in reducing blood loss and transfu-sion requirements,while maintaining an overall favorable safety profile.However,PCC still exhibits certain limitations,and the data in special patient populations remain uncertain.Therefore,this review comprehensively examines the application of PCC in cardiac surgery,aiming to provide evidence and references for clinical treatment strategies.

Abstract:Objective This study aims to establish an in vitro testing method to evaluate the degree of blood cell damage caused by extracorporeal membrane oxygenation(ECMO)kits during use,in order to facilitate preclinical research and product performance assessment.Methods A test circuit was constructed under simulated clinical conditions,and evaluation indicators were established based on relevant standards and guidelines,including free hemoglobin(FHb),index of hemolysis(IH),platelet decline rate,and leukocyte decline rate.The ECMO kit was used to operate this test method,with samples collected at 0 h,0.5 h,3 h,and 6 h during the test.Results An experimental method for testing blood cell damage induced by ECMO kits was estab-lished,with the HI as an evaluation indicator for blood cell damage.Calculation formulas for the increase in free hemoglobin,and the decline rates of platelets and leukocytes were developed.The established method was applied to test the ECMO kit,which showed an increase in free hemoglobin levels and a decrease in platelet and leukocyte counts during the testing process.Specif-ically,the increase in free hemoglobin was 44～80 mg/(L·h),the platelet decline rate was 1.7%/h～27.8%/h,and the leukocyte decline rate was 1.5%/h～16.3%/h.Conclusion The in vitro testing method established in this study provides a scientific tool for evaluating overall blood cell damage caused by ECMO kits,improving the accuracy of test results and supporting the preclin-ical assessment of product safety and efficacy.

Abstract:Surface coating on cadiopulmonary bypass(CPB)consumables significantly reduces reactions such as throm-bosis,inflammation and hemolysis by improving the interaction between material and blood.However,they also raise concerns about long-term safety and associated risks.This article primarily elaborates on key aspects for the preclinical evaluation of surface coatings on CPB consumables,focusing on product description,raw material control,toxicology research,performance evaluation and production process,Corresponding evaluation methodologies for relevant properties are discussed.The aim is to enhance the scientific comprehensiveness of both the development and evaluation of these coatings,thereby reducing the clinical risks posed by coatings in related products.