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Ecmo cardiac arrest

Atthasit Komindr, Ryuzo Abe, Yoshihisa Tateishi, Yuka Takahashi, Jun Goto, Keita Wada, Yutaka Furukawa, Atsushi Sugiura, Taro Imaeda, Natsumi Suga, Noriyuki Hattori, Shigeto Oda
Background: For patients treated with extracorporeal membrane oxygenation (ECMO), employing a well-coordinated, multidisciplinary team specializing in ECMO has reportedly been effective in delivering better clinical outcomes. This study aims to assess the impact of establishing such a specialized team for patients treated with ECMO. Method: This retrospective cohort study was performed at a tertiary-care hospital in Japan. We reviewed medical records of all consecutive patients treated with ECMO during October 2010-September 2016...
2019: Journal of Intensive Care
Benedict Kjaergaard, Jens Hedegaard Kristensen, Jesper Eske Sindby, Susanne de Neergaard, Bodil Steen Rasmussen
INTRODUCTION: In massive pulmonary embolism (PE) with circulatory collapse or with cardiac arrest, treatment can be difficult. Often, the diagnosis is unclear, and the time to treatment is crucial. Our institution has had an out-of-hospital team intended for the treatment of accidental hypothermia with extra corporeal membrane oxygenation (ECMO) since 2004. The team has occasionally been involved in patients suffering massive PE. METHODS: We were called to 38 patients with PE, but two were assessed as untreatable...
February 17, 2019: Perfusion
Maya Guglin, Mark J Zucker, Vanessa M Bazan, Biykem Bozkurt, Aly El Banayosy, Jerry D Estep, John Gurley, Karl Nelson, Rajasekhar Malyala, Gurusher S Panjrath, Joseph B Zwischenberger, Sean P Pinney
Venoarterial extracorporeal membrane oxygenation (ECMO) is a rescue therapy that can stabilize patients with hemodynamic compromise, with or without respiratory failure, for days or weeks. In cardiology, the main indications for ECMO include cardiac arrest, cardiogenic shock, post-cardiotomy shock, refractory ventricular tachycardia, and acute management of complications of invasive procedures. The fundamental premise underlying ECMO is that it is a bridge-to recovery, to a more durable bridge, to definitive treatment, or to decision...
February 19, 2019: Journal of the American College of Cardiology
Murtaza Bharmal, Joseph M Venturini, Rhys F M Chua, Willard Sharp, David G Beiser, Corey Tabit, Taishi Hirai, Jonathan R Rosenberg, Janet Friant, John E A Blair, Jonathan D Paul, Sandeep Nathan, Atman P Shah
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is a resource-intensive tool that provides haemodynamic and respiratory support in patients who have suffered cardiac arrest. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution. METHODS: We performed a retrospective review of patients who received ECPR following cardiac arrest between 2012 and 2018. All medical care-associated charges with ECPR and subsequent hospital admission were recorded...
February 1, 2019: Resuscitation
Wei Huang, Yongxin Qin
In 2018, a bunch of considerable positive progresses have been presented, including a revised "hour-1 bundle" introduced by international guideline for management of sepsis and septic shock, trans-pulmonary pressure monitoring via esophageal manometry in acute respiratory distress syndrome (ARDS) models, successful trials for new antibiotics, angiotensin II in patients with vasodilatory shock and renal replacement therapy, advanced airway management in out-of-hospital cardiac arrest (OHCA) patients as well cellular immunotherapy for septic shock...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Brent D Bauman, Amanda Louiselle, Rachel M Nygaard, Victor Vakayil, Robert Acton, Donavan Hess, Daniel Saltzman, Nathaniel Kreykes, Gwenyth Fischer, Jeffrey Louie, Bradley Segura
OBJECTIVES: Drowning is the second leading cause of death in children. Extracorporeal membrane oxygenation (ECMO) has become the criterion standard therapy to resuscitate the hypothermic drowning victim in cardiac arrest. We present our own experience treating 5 children with hypothermic cardiac arrest in conjunction with a systematic review to analyze clinical features predictive of survival. METHODS: Our search resulted in 55 articles. Inclusion criteria were as follows: (1) younger than 18 years, (2) ECMO therapy, and (3) drowning...
January 29, 2019: Pediatric Emergency Care
Kazuki Miyazaki, Mayu Hikone, Yusuke Kuwahara, Takuto Ishida, Kazuhiro Sugiyama, Yuichi Hamabe
AIM: Patients with massive pulmonary embolism (PE) have poor outcomes and their management remains challenging. An interventional radiology (IVR)-computed tomography (CT) system available in our emergency room (ER) allows immediate access to CT and extracorporeal membrane oxygenation (ECMO) with safe cannulation under fluoroscopy. We aimed to determine if initial treatment in this "hybrid ER" is helpful in patients with PE requiring extracorporeal cardiopulmonary resuscitation (ECPR)...
January 22, 2019: American Journal of Emergency Medicine
Daniel Patricio, Lorenzo Peluso, Alexandre Brasseur, Olivier Lheureux, Mirko Belliato, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: The potential benefit of extracorporeal cardiopulmonary resuscitation (ECPR) compared to conventional CPR (CCPR) for patients with refractory cardiac arrest (CA) remains unclear. METHODS: This study is a retrospective analysis of a prospective database of CA patients, which includes all consecutive adult patients admitted to the Department of Intensive Care after CA between January 2012 and December 2017. The decision to initiate ECPR was made by the attending physician and ECPR performed by the ECPR team, which is composed of ICU physicians...
January 28, 2019: Critical Care: the Official Journal of the Critical Care Forum
Jamie L Bell, Lucas Saenz, Yuliya Domnina, Tracy Baust, Ashok Panigrahy, Michael J Bell, Marta Camprubí-Camprubí, Joan Sanchez-de-Toledo
BACKGROUND: Children with both acquired and congenital heart disease have low mortality but increased risk of neurologic morbidity which is multi-factorial. We hypothesize that acute neurologic injuries contributes to mortality in such children and are an important cause of death. METHODS: Retrospective review of all admissions to the pediatric cardiac intensive care unit from January 2011 through January 2015. Patients were assessed for any acute neurologic events during admission (ANE) as defined by radiologic findings or electrographic seizures...
January 22, 2019: Annals of Thoracic Surgery
Melania M Bembea, Ryan J Felling, Sherrill D Caprarola, Derek Ng, Aylin Tekes, Katharine Boyle, Alvin Yiu, Nicole Rizkalla, Jamie Schwartz, Allen D Everett, And Cynthia Salorio
Contemporary studies of long-term outcomes in children supported on extracorporeal membrane oxygenation (ECMO) in the United States are limited. We enrolled 99 ECMO patients between July 2010 and June 2015 in a two-center prospective observational study that included neurologic and neuropsychologic evaluation at 6 and 12 months, using standardized outcome measures. Pre-ECMO, 20 (20%) had a pre-existing neurologic diagnosis, 40 (40%) had cardiac arrest, and 10 of 47 (21%) children with neuroimaging had acute abnormal findings...
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kai Chen, Jianfeng Hou, Hanwei Tang, Shengshou Hu
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely used in postcardiotomy cardiac shock (PCS). The factors that affect mortality in patients who receive ECMO for PCS remain unclear. In this study, we analyzed the outcomes, predictive factors and complications of ECMO use for PCS. METHODS: A total of 152 adult subjects who received VA-ECMO for PCS in Fuwai Hospital were consecutively included. We retrospectively collected the baseline characteristics, outcomes and complications...
January 23, 2019: Annals of Intensive Care
Laura Ruggeri, Annalisa Franco, Ada Carla Alba, Rosalba Lembo, Samuele Frassoni, Anna Mara Scandroglio, Maria Grazia Calabrò, Alberto Zangrillo, Federico Pappalardo
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (eCPR) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is gaining importance as a rescue therapy for refractory cardiac arrest. VA-ECMO, especially in the setting of eCPR, is plagued by hemorrhagic and thromboembolic complications. The authors' aims were to describe the coagulation profile in refractory cardiac arrest and assess its prognostic role. DESIGN: Single-center retrospective study...
November 14, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Valentina Della Torre, Chiara Robba, Paolo Pelosi, Federico Bilotta
PURPOSE OF REVIEW: The purpose of this review is to describe recent evidence regarding the use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for severe cardiac or respiratory failure in patients with trauma. The characteristics of this cohort of patients, including the risk of bleeding and the need for systemic anticoagulation, are generally considered as relative contraindications to ECMO treatment. However, recent evidence suggests that the use of ECMO should be taken in consideration even in this group of patients...
January 2, 2019: Current Opinion in Anaesthesiology
Kathleen L Meert, Ralph Delius, Beth S Slomine, James R Christensen, Kent Page, Richard Holubkov, J Michael Dean, Frank W Moler
BACKGROUND: Limited data exist regarding neurobehavioral outcomes of children treated with open-chest cardiopulmonary resuscitation (CPR). Our objective was to describe neurobehavioral outcomes one year post-arrest among children who received open-chest CPR during in-hospital cardiac arrest; and explore factors associated with one-year survival and survival with good neurobehavioral outcome. METHODS: The study is a secondary analysis of the Therapeutic Hypothermia after Pediatric Cardiac Arrest In-Hospital Trial...
December 14, 2018: Annals of Thoracic Surgery
Balkenze Imankulova, Milan Terzic, Talshyn Ukybassova, Gauri Bapayeva, Timur Lesbekov, Gulnar Mustafinova, Nurlan Smagulov, Fariza Shauyen
OBJECTIVE: Uterine arteriovenous malformation (AVM) is an abnormal and nonfunctional communication between uterine arteries and veins, currently managed by uterine artery embolization (UAE). Pulmonary embolism (PE) is the most severe and life-threatening complication of this procedure. CASE REPORT: We report a case of 27 year-old woman with heavy vaginal bleeding and abdominal pain caused by AVM. UAE was performed uneventfully, but 2 h after the procedure the first attack of pulmonary embolism occurred, treated by anticoagulation therapy...
December 2018: Taiwanese Journal of Obstetrics & Gynecology
Zheng Guo, Yinyu Yang, Wei Zhang, Jia Shen, Lei Jiang, Xindi Yu, Wei Wang
PURPOSE: Extracorporeal membrane oxygenation (ECMO) provides cardiorespiratory support during cardiopulmonary resuscitation unresponsive to conventional methods. Here, we analyzed the extracorporeal cardiopulmonary resuscitation (ECPR) results of children in a cardiac arrest setting after cardiac surgery. METHODS: Of 3119 cases of pediatric open-heart surgery, 31 required postoperative ECMO. Among the 31 patients, 11experienced cardiac arrest and ECPR in the early postoperative period...
December 4, 2018: Artificial Organs
Junhong Wang, Qingbian Ma, Hua Zhang, Shaoyu Liu, Yaan Zheng
BACKGROUND: This systemic review aimed to explore the predictors of discharge and neurologic outcome of adult extracorporeal cardiopulmonary resuscitation (ECPR) to provide references for patient selection. METHODS: Electronically searching of the Pubmed, Embase, Cochrane Library, and manual retrieval were done for clinical trials about predictors for adult ECPR which were published between January 2000 and January 2018 and included predictors for discharge and neurologic outcome...
November 2018: Medicine (Baltimore)
David Ranney, Sarah Hatch, Desiree Bonadonna, Mani Daneshmand
Although life-saving, cardiopulmonary resuscitation (CPR) has been associated with traumatic injuries in adult patients surviving cardiac arrest. In addition to rib and sternal fractures, intraabdominal injuries have also been shown to occur, particularly after prolonged external cardiac massage. Early detection of these injuries remains difficult and is often masked by concomitant hemodynamic instability and the higher likelihood of other injuries such as retroperitoneal hemorrhage. Accurate diagnosis is further complicated when venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is instituted...
November 28, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Arslan Shaukat, Katarzyna Hryniewicz-Czeneszew, Benjamin Sun, Karol Mudy, Kelly Wilson, Peter Tajti, Larissa Stanberry, Ross Garberich, Yader Sandoval, M Nicholas Burke, Ivan Chavez, Mario Gössl, Timothy Henry, Daniel Lips, Michael Mooney, Anil Poulose, Paul Sorajja, Jay Traverse, Yale Wang, Steven Bradley, Emmanouil S Brilakis
OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is most commonly used in patients with cardiac arrest and cardiogenic shock. There are limited data on the use of VA-ECMO for elective, high-risk percutaneous coronary intervention (PCI). We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS: . We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017...
December 2018: Journal of Invasive Cardiology
Li Wang, Zhen Xing
The effectiveness of intra-aortic balloon pump (IABP) combined with venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock or cardiac arrest remains controversial. The aim of this systematic review and meta-analysis was to investigate the short-term clinical outcomes of IABP combined with VA-ECMO versus VA-ECMO alone. We searched PubMed, Embase, and the Cochrane Library for English language articles published from inception to August 18, 2018. Observational studies comparing IABP combined with VA-ECMO with VA-ECMO were considered eligible for the current study...
November 28, 2018: Artificial Organs
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