International Journal of Artificial Organs

BACKGROUND: Maintenance hemodialysis (MHD) patients are often admitted to the hospital for severe morbidities. Prolonged intermittent renal replacement therapy (PIRRT) is required during the hospital staying. There are controversial opinions on the use of arteriovenous fistula (AVF) as vascular access for PIRRT in MHD patients. METHODS: Patients with AVF who accepted PIRRT in our center between January 2014 and June 2021 were retrospectively screened. AVF dysfunction and patient mortality were assessed as endpoints...

BACKGROUND: Cardiac functions and support modes of left ventricular assist device (LVAD) will influence the pump inner flow field and blood damage potential. METHODS: Computational fluid dynamics (CFD) method and lumped-parameter-model (LPM) were applied to investigate the impacts of cardiac functions under full (9000 rpm) and partial (8000 rpm) support modes in an axial pump. RESULTS: The constitution of hemolysis index (<mml:math xmlns:mml="https://www...

The hemoconcentration effect for middle weight solutes in hemodialysis is corrected by oversimplified methods based on hematocrit changes or distribution volume variations. Here we implemented a variable volume dual pool kinetic model targeted at obtaining a precise correction factor equation for extracellularly distributed solutes based on relevant kinetic parameters such as the ultrafiltration to dry weight ratio UF/DW, the dialyzer clearance, Kd , the intercompartment mass-transfer coefficient, Kc , and the central compartment to extracellular volume ratio, α...

Continuous renal replacement therapy (CRRT) has become the most commonly used acute blood purification therapy for critically ill patients. As a key point of extracorporeal blood circulation, the CRRT filter plays a decisive role in therapeutic efficacy. However, few in vitro studies have been conducted on CRRT filters, particularly concerning the effects of design factors on filter effectiveness and safety profile; no comprehensive evaluation system has been established. Here, we designed nine CRRT filters with various combinations of hollow fiber packing density ( PD ) and housing shape (effective hollow fiber length ( L ) and inner housing diameter ( D ) ratio ( L / D ratio)) and introduced a high-frequency sampling pressure monitor to accurately monitor small changes in transmembrane pressure ( TMP ) and ultrafiltration rate ( UFR ) over time...

OBJECTIVE: To investigate non-anticoagulant factors that affect blood coagulation in the extracorporeal circulation (ECC) circuit of regional citrate anticoagulation (RCA) protocol for hemodialysis (HD). METHOD: The clinical characteristics of patients undergoing an individualized RCA protocol for HD between February 2021 and March 2022 were collected; Coagulation scores, pressures in various parts of the ECC circuit, the incidence of coagulation, and citrate concentrations in the ECC circuit during treatment were determined, and non-anticoagulant factors affecting coagulation in the ECC circuit were analyzed...

BACKGROUNDS: In patients with liver failure, continuous renal replacement therapy (CRRT) without anticoagulation may be necessary. A new heparin coated membrane (oXiris® ) may prolong circuit life in this setting. OBJECTIVES: In liver failure patients not receiving anticoagulation, to compare CRRT circuit life with the oXiris® versus the AN69 ST100 (usual care) membrane. METHODS: Randomized single cross-over trial. RESULTS: We studied 20 patients and 39 circuits...

We sought to evaluate whether differences in left ventricular assist device (LVAD) canula alignment are associated with stroke. There is a paucity of clinical data on contribution of LVAD canulae alignment to strokes. We conducted a retrospective analysis of patients who underwent LVAD implantation at Houston Methodist hospital from 2011 to 2016 and included those who had undergone cardiac computed tomography (CT) with contrast. LVAD graft alignment using X-ray, echocardiography, and cardiac CT was evaluated...

Driveline infection is a frequent complication in recipients of durable left ventricular assist devices (LVAD), but its cause is largely unclear. Since vitamin D supplementation can reduce the risk of infections, we aimed at investigating the association of vitamin D deficiency with driveline infection. In 154 patients with continuous flow LVAD implants, we assessed 2-year risk of driveline infection according to vitamin D status (circulating 25-hydroxyvitamin D < 25 nmol/L or ⩾25 nmol/L). Of the study cohort, 34% ( n  = 53) had 25-hydroxyvitamin D concentrations <25 nmol/L...

A systematic review of the role of extracorporeal life support (ECLS) in pediatric patients with burn and smoke inhalation injury was undertaken. A systematic search of the literature according to a specific combination of keywords to ascertain the effectiveness of this treatment strategy was conducted. A total of 14 articles out of 266 were considered suitable for the analysis in pediatric patients. The PICOS approach and PRISMA flow chart were followed for the purpose of this review. Despite the limited number of studies on the subject, ECMO in burn and smoke inhalation injury provides an additional level of support in pediatric patients leading to positive outcomes...

INTRODUCTION: There were controversial opinions on the use of bivalirudin versus heparin for anticoagulant therapy in extracorporeal membrane oxygenation. The aim of our present study is to evaluate the efficacy and safety of bivalirudin versus heparin for the maintenance of systemic anticoagulation during adult veno-venous extracorporeal membrane oxygenation (V-V ECMO). METHODS: Adult patients who received V-V ECMO support in our center between February 2018and February 2022 were retrospectively recruited...

BACKGROUNDS: Nitric oxide has a broad-spectrum antibacterial property promising as a new therapeutic agent for severe acute respiratory syndrome coronavirus-2 because nitric oxide donor (such as S-nitroso-N-acetylpenicillamine) reduces the replication of coronavirus-2. Patients with coronavirus disease 2019 undergoing dialysis generally have a higher mortality rate than the general population. Although the higher mortality rate in these patients may be related to their advanced age, it has been suggested that plasma nitrite and nitrate levels (products of nitric oxide metabolism) are significantly decreased after hemodialysis which may compromise the nitrate-nitrite-nitric oxide pathway and impair nitric oxide homeostasis...

BACKGROUND: Sepsis could affect the outcomes of patients with postcardiotomy cardiogenic shock supported with extracorporeal membrane oxygenation (ECMO). Our objectives were to characterize sepsis patients with ECMO support for postcardiotomy cardiogenic shock and assess its predictors and effect on patients' outcomes. METHODS: This retrospective study included 103 patients with ECMO for postcardiotomy cardiogenic shock from 2009 to 2020. Patients were divided according to the occurrence and timing of sepsis into three groups...

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No abstract text is available yet for this article.

RATIONALE: Current estimation of body fluid volumes in hemodialysis patients using bioimpedance analysis assumes constant specific electrical characteristics of biological tissues despite a large variation in plasma Na+ concentrations [Na+ ], ranging from 130 to 150 mmol/L. Here, we examined the potential effect of variable [Na+ ] on bioimpedance-derived volume overload. METHOD: Volumes were calculated from published whole-body extra- and intracellular resistance data and relationships using either "standard" or "revised" specific electrical characteristics modeled as functions of [Na+ ]...

Acute respiratory distress syndrome (ARDS) can develop early in burn patients with inhalation injury in the presence of cytokine storm and the proinflammatory response can be a supplemental factor for ARDS aggravation. We report the case of a 41-years old male with 25% total body surface area deep partial thickness burns to upper body extremity and grade II inhalational injury who developed severe ARDS, nosocomial pneumonia, and septic shock. Veno-venous extracorporeal membrane oxygenation (VV ECMO) and continuous renal replacement therapy (CRRT) with hemoadsorption were successfully used at different moments to overcome critical situations...

OBJECTIVE: Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19. METHODS: Systematic literature search in NHS library, Medline (Pubmed) and EMBASE using appropriate keywords as well as PICOS and PRISMA approach. RESULTS: Out of 285 publications found, 5 publications met the search criteria and were included in this review. A total of 194 patients with ARDS secondary to COVID-19 underwent ProtekDuo placement to establish a combination of respiratory [veno-venous extracorporeal membrane oxygenation (V-V ECMO)] and right ventricular support...

A person becomes disabled when they lose any of their sensory organs, the eye being one of the most delicate. Loss of an eye can happen due to different reasons and can be restored using different materials and strategies. Ocular defects and congenital deformations show up as a result of tumors or injury. For the most part, fabricated eyes are accessible as ocular prostheses. This method describes how to create a custom ocular prosthesis using a digital photo and UV printing. The greatest esthetically pleasing results are also achieved using this production method, which does not necessitate painting or color-selecting expertise...

No abstract text is available yet for this article.

PURPOSE: This study aimed to observe the effect of basic fibroblast growth factor (bFGF) gel preparation on wound repair in a full-thickness skin defect rat model and to further explore its mechanism. METHODS: The full-thickness skin defect model of Wistar rats was created with circular wounds of 20 mm or 10 mm in diameter on both sides of the spine. The animals were divided into the normal, model, control gel, and bFGF gel groups (300 IU/cm2 )...