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https://read.qxmd.com/read/33482432/extubation-during-extracorporeal-membrane-oxygenation-in-adults-an-international-qualitative-study-on-experts-opinions
#1
Monika Tukacs, Kenrick D Cato
No abstract text is available yet for this article.
January 19, 2021: Heart & Lung: the Journal of Critical Care
https://read.qxmd.com/read/33480831/occurrence-of-invasive-pulmonary-fungal-infections-in-severe-covid-19-patients-admitted-to-the-icu
#2
Arnaud Fekkar, Alexandre Lampros, Julien Mayaux, Corentin Poignon, Sophie Demeret, Jean-Michel Constantin, Anne-Geneviève Marcelin, Antoine Monsel, Charles-Edouard Luyt, Marion Blaize
RATIONALE: Whether severe COVID-19 is a significant risk factor for the development of invasive fungal superinfections is of great medical interest and remains for now an open question. OBJECTIVES: We aim to assess the occurrence of invasive fungal respiratory superinfections in patients with severe COVID-19. METHODS: We conducted the study on patients with severe SARS-CoV2 related pneumonia admitted to 5 intensive care units in France, who had respiratory and serum sampling performed for specific screening of fungal complication...
December 2, 2020: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/33480618/lung-protective-ventilation-and-adjunctive-strategies-to-manage-respiratory-failure-are-they-safe-in-the-neurological-patient
#3
Pirouz Piran, Robert D Stevens
PURPOSE OF REVIEW: The coexistence of neurological injury and respiratory failure is common in intensive care. This article provides a contemporary overview of the safety and efficacy of different strategies for mechanical ventilation and adjunctive respiratory approaches in patients with acute brain injury. RECENT FINDINGS: Available evidence indicates that lung-protective ventilation (LPV) can be implemented safely in a range of patients with concurrent respiratory failure and brain injury of different etiologies; however, the clinical efficacy of LPV in this setting needs to be established...
January 18, 2021: Current Opinion in Critical Care
https://read.qxmd.com/read/33478880/initial-postoperative-hemoglobin-values-are-independently-associated-with-one-year-mortality-in-patients-undergoing-double-lung-transplantation-requiring-intraoperative-transfusion
#4
Johannes Menger, Stefan Koch, Mohamed Mouhieddine, Stefan Schwarz, Konrad Hoetzenecker, Peter Jaksch, Barbara Steinlechner, Martin Dworschak
OBJECTIVE: To evaluate the association of postoperative hemoglobin values and mortality in patients undergoing double- lung transplantation with intraoperative transfusion. DESIGN: Retrospective cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients who underwent double-lung transplantation at the authors' institution, with intraoperative transfusion of packed red blood cells between 2009 and 2015. INTERVENTIONS: None...
December 29, 2020: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/33478326/severe-hepatopulmonary-syndrome-with-hypoxemia-refractory-to-liver-transplant-recovery-after-67-days-of-ecmo-support
#5
Rodrigo Piltcher-da-Silva, Marcio Fernandes Chedid, Tomaz Jesus Maria Grezzana Filho, Ian Leipnitz, Alexandre de Araújo, Marcelo Basso Gazzana, Mauricio Guidi Saueressig, William Lorenzi, Mario Gurvitez Cardoni, Priscila Bellaver, Mario Reis Alvares-da-Silva, Flavia Heinz Feier, Aljamir Duarte Chedid, Cleber Rosito Pinto Kruel
Hepatopulmonary syndrome (HPS) is a complication of end stage liver disease (ESLD) and is manifested by severe hypoxemia, which usually responds to liver transplantation (LT). As compared to patients undergoing LT for other etiologies, patients with HPS present an increased risk of postoperative morbidity and mortality. There is no effective treatment for patients whose hypoxemia does not respond to LT. This subset of patients is at a highly increased risk of death. There are very few reports on the use of extracorporeal membrane oxygenation (ECMO) in this setting with rapid response...
January 21, 2021: International Journal of Artificial Organs
https://read.qxmd.com/read/33477175/effects-of-inhaled-iloprost-for-the-management-of-persistent-pulmonary-hypertension-of-the-newborn
#6
Sourabh Verma, Rishi Lumba, Sadaf H Kazmi, Michelle J Vaz, Shrawani Soorneela Prakash, Sean M Bailey, Pradeep V Mally, Tara M Randis
OBJECTIVE:  The study aimed to evaluate the effects of inhaled iloprost on oxygenation indices in neonates with persistent pulmonary hypertension of the newborn (PPHN). STUDY DESIGN:  We conducted a retrospective chart review of 30 patients with PPHN from January 2014 to November 2018, who did not respond to inhaled nitric oxide (iNO) alone and received inhaled iloprost. Twenty-two patients met the inclusion criteria and eight patients were excluded from the study (complex cardiac disease and extreme prematurity)...
January 21, 2021: American Journal of Perinatology
https://read.qxmd.com/read/33476064/pharmacokinetics-of-meropenem-in-children-with-sepsis-undergoing-extracorporeal-life-support-a-prospective-observational-study
#7
Yixue Wang, Zhiping Li, Weiming Chen, Gangfeng Yan, Guangfei Wang, Guoping Lu, Chao Chen
WHAT IS KNOWN AND OBJECTIVE: Meropenem, a broad-spectrum carbapenem, is frequently used to treat severe bacterial infections in critically ill children. Recommendations for meropenem doses in adult infections are available; however, few studies have been published regarding the use of meropenem in children with sepsis, especially in those receiving continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO). We aimed to investigate the pharmacokinetic (PK) parameters of meropenem in children with sepsis receiving extracorporeal life support (ECLS)...
January 21, 2021: Journal of Clinical Pharmacy and Therapeutics
https://read.qxmd.com/read/33475044/platelet-count-reduction-during-in-vitro-membrane-oxygenation-affects-platelet-activation-neutrophil-extracellular-trap-formation-and-clot-stability-but-does-not-prevent-clotting
#8
Patrick Winnersbach, Jan Rossaint, Eva M Buhl, Smriti Singh, Jonas Lölsberg, Matthias Wessling, Rolf Rossaint, Christian Bleilevens
INTRODUCTION: Due to improved technology and increased application the mortality during extracorporeal membrane oxygenation (ECMO) is constantly declining. Nevertheless, complications including haemorrhage or thrombus formation remain frequent. Local mitigation of coagulation within an ECMO system to prevent thrombus formation on ECMO components and optimizing systemic anticoagulation is an approach to reduce clotting and bleeding complications at once. Foreign surfaces of ECMO systems, activate platelets (PLTs), which besides their major role in coagulation, can trigger the formation of neutrophil extracellular traps (NETs) contributing to robust thrombus formation...
January 21, 2021: Perfusion
https://read.qxmd.com/read/33473053/long-term-outcomes-of-cadaveric-lobar-lung-transplantation-an-important-surgical-option
#9
Ilhan Inci, Mace M Schuurmans, Claudio Caviezel, Sven Hillinger, Isabelle Opitz, Didier Schneiter, Walter Weder
BACKGROUND: Cadaveric lobar lung transplantation (L-LTx) is developed to overcome donor-recipient size mismatch. Controversial short- and long-term outcomes following L-LTx have been reported compared to full-sized lung transplantation (F-LTx). This study reports long-term outcomes after L-LTx. METHODS: We reviewed patients undergoing lung transplantation (LTx) between 2000 and 2016. The decision to perform L-LTx was made based mainly on donor-recipient height discrepancy and visual assessment of donor lungs...
January 20, 2021: Annals of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/33472914/brain-histopathology-of-adult-decedents-after-extracorporeal-membrane-oxygenation
#10
Imad R Khan, Yang Gu, Benjamin P George, Laura Malone, Kyle S Conway, Fabienne Francois, Jack Donlon, Nadim Quazi, Ashwin Reddi, Cheng-Ying Ho, Daniel L Herr, Mahlon D Johnson, Gunjan Y Parikh
OBJECTIVE: To test the hypothesis that brain injury is more common and varied in ECMO patients than radiographically observed, we described neuropathology findings of ECMO decedents and associated clinical factors from three institutions. METHODS: We conducted a retrospective multi-center observational study of brain autopsies from adult ECMO recipients. Pathology findings were examined for correlation with demographics, clinical data, ECMO characteristics, and outcomes...
January 20, 2021: Neurology
https://read.qxmd.com/read/33471364/structural-recirculation-and-refractory-hypoxemia-under-femoro-jugular-veno-venous-extracorporeal-membrane-oxygenation
#11
Jonathan Charbit, Pauline Deras, Elie Courvalin, Thomas Laumon, Geoffrey Dagod, Orianne Martinez, Xavier Capdevila
BACKGROUND: The performance of each veno-venous extracorporeal membrane oxygenation (vv-ECMO) configuration is determined by the anatomic context and cannula position. METHODS: A mathematical model was built considering bicaval specificities to simulate femoro-jugular configuration. The main parameters to define were cardiac output (QC ), blood flow in the superior vena cava (QSVC ), extracorporeal pump flow (QEC ), and pulmonary shunt (kS-PULM ). The obtained variables were extracorporeal flow ratio in the superior vena cava (EFRSVC =QEC /[QEC +QSVC ]), recirculation coefficient (R), effective extracorporeal pump flow (Qeff-EC =[1-R]×QEC ), Qeff-EC /QC ratio, and arterial blood oxygen saturation (SaO2 )...
January 20, 2021: Artificial Organs
https://read.qxmd.com/read/33471172/autopsy-findings-after-long-term-treatment-of-covid-19-patients-with-microbiological-correlation
#12
Katja Evert, Thomas Dienemann, Christoph Brochhausen, Dirk Lunz, Matthias Lubnow, Markus Ritzka, Felix Keil, Matthias Trummer, Alexander Scheiter, Bernd Salzberger, Udo Reischl, Peter Boor, André Gessner, Jonathan Jantsch, Diego F Calvisi, Matthias Evert, Barbara Schmidt, Michaela Simon
Between April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e...
January 20, 2021: Virchows Archiv: An International Journal of Pathology
https://read.qxmd.com/read/33470780/prevalence-of-thrombotic-complications-in-icu-treated-patients-with-coronavirus-disease-2019-detected-with-systematic-ct-scanning
#13
Saeed Mirsadraee, Diana A Gorog, Ciara F Mahon, Bhavin Rawal, Thomas R Semple, Edward D Nicol, Deepa R J Arachchillage, Anand Devaraj, Susanna Price, Sujal R Desai, Carole A Ridge, Suveer Singh, Simon P G Padley
OBJECTIVES: Severe coronavirus disease 2019 is associated with an extensive pneumonitis and frequent coagulopathy. We sought the true prevalence of thrombotic complications in critically ill patients with severe coronavirus disease 2019 on the ICU, with or without extracorporeal membrane oxygenation. DESIGN: We undertook a single-center, retrospective analysis of 72 critically ill patients with coronavirus disease 2019-associated acute respiratory distress syndrome admitted to ICU...
January 6, 2021: Critical Care Medicine
https://read.qxmd.com/read/33470779/improving-outcomes-for-children-requiring-extracorporeal-membrane-oxygenation-therapy-following-hematopoietic-stem-cell-transplantation
#14
Taylor L Olson, Erika R O'Neil, Kristen J Kurtz, Graeme MacLaren, Marc M Anders
OBJECTIVES: The objective of this study was to provide an updated review of survival for pediatric hematopoietic stem cell transplantation patients requiring extracorporeal membrane oxygenation therapy as well as characterize the demographics, clinical variables, and complications associated with mortality. DESIGN: Retrospective database review of the Extracorporeal Life Support Organization Registry from 1990 to 2019. SETTING: Extracorporeal membrane oxygenation centers reporting to Extracorporeal Life Support Organization...
January 6, 2021: Critical Care Medicine
https://read.qxmd.com/read/33470772/precision-in-cardiovascular-care-using-targeted-neonatal-echocardiography-in-lethal-neonatal-disseminated-herpes-infection-a-case-series
#15
Soume Bhattacharya, Patrick J McNamara, Regan E Giesinger
Neonates with disseminated neonatal herpes simplex virus infection often present with cardiorespiratory failure. The pathophysiological contributors to the disease phenotype, biologic mechanisms underlying the hemodynamic instability and optimal approach to cardiovascular treatment have not been well described. We describe clinical and echocardiography features of cardiovascular dysfunction, in a case series of neonates with disseminated herpes simplex virus, and response to physiology-based hemodynamic management...
January 19, 2021: Pediatric Infectious Disease Journal
https://read.qxmd.com/read/33470643/extracorporeal-membrane-oxygenation-for-covid-19-respiratory-distress-syndrome-an-italian-society-for-cardiac-surgery-report
#16
Antonio Loforte, Michele Di Mauro, Carlo Pellegrini, Christian Monterosso, Stefano Pelenghi, Antonella Degani, Mauro Rinaldi, Erik Cura Stura, Gabriele Sales, Giorgia Montrucchio, Domenico Mangino, Alberto Terrini, Davide Pacini, Alessandro Affronti, Vincenzo Tarzia, Tomaso Bottio, Antonio Pantaleo, Francesco Donatelli, Antonio Miceli, Francesco Santini, Antonio Salsano, Andrea Colli, Giacomo Ravenni, Andrea Montalto, Francesco Musumeci, Loris Salvador, Gino Gerosa, Alessandro Parolari, Marco Picichè
An increased need of Extracorporeal Membrane Oxygenation (ECMO) support is going to become evident as treatment of SARS-CoV-2 respiratory distress syndrome. This is the first report of Italian Society for Cardiac Surgery (SICCH) on preliminary experience with COVID-19 patients receiving ECMO support. Data from 12 Italian hospitals participating in SICCH were retrospectively analyzed. Between March 1st and September 15th, 2020, a veno-venous (VV) ECMO system was installed in 67 patients (94%) and a veno-arterio-venous (VAV) ECMO in four (6%)...
January 18, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/33470641/prevalence-of-deep-vein-thrombosis-in-patients-supported-with-extracorporeal-membrane-oxygenation
#17
Zoë G S Vazquez, Neel R Sodha, Cynthia Devers, Corey E Ventetuolo, Adeel Abbasi
No abstract text is available yet for this article.
January 11, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/33470639/disseminated-intravascular-coagulation-score-is-related-to-short-term-mortality-in-patients-undergoing-venoarterial-extracorporeal-membrane-oxygenation-after-cardiac-surgery
#18
Liangshan Wang, Juanjuan Shao, Eddy Fan, Ming Jia, Hong Wang, Xiaotong Hou
Disseminated intravascular coagulation (DIC) score is associated with short-term mortality in various conditions but has not been studied in postcardiotomy cardiogenic shock (PCS) patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO). The objective of this study was to evaluate the relationship between DIC score at day 1 from VA-ECMO initiation and short-term mortality. We included all PCS patients supported with VA-ECMO at the Beijing Anzhen Hospital between January 2015 and December 2018...
January 11, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/33470638/extracorporeal-membrane-oxygenation-for-primary-graft-dysfunction-after-lung-transplantation
#19
Takashi Harano, John P Ryan, Matthew R Morrell, James D Luketich, Pablo G Sanchez
Extracorporeal membrane oxygenation (ECMO) is used as the last resort for primary graft dysfunction (PGD). The aim of this study is to explore the predictors and outcomes for early mortality in postlung transplant patients who required ECMO for PGD. Between January 2006 and December 2015, 1,049 cases of lung transplantation were performed at our center. Ninety-six patients required ECMO support after lung transplantation, 52 patients (54%) had PGD. Seven patients (13.5%) required venoarterial ECMO due to concomitant hemodynamical instability, and the others required venovenous ECMO...
January 11, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/33469720/migrated-avalon-elite-cannula-in-an-infant-transcatheter-repositioning-without-interruption-of-ecmo-flow
#20
Robin Hay-Son Chen, Nicholson Yam, Kin-Shing Lun, Timmy Wing-Kuk Au
Inadvertent migration of Avalon-Elite cannula in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) support is often difficult to manage. Cannula repositioning conventionally requires temporary discontinuation of the ECMO support which is often poorly tolerated in small infants with poor pulmonary reserve. We reported a case of a small infant weighing 3.9 kg requiring VV-ECMO support with a 13Fr Avalon-Elite cannula for respiratory failure secondary to severe pneumonitis, complicated by 2 episodes of cannula migration which were both successfully managed by transcatheter repositioning in the cardiac catheterization laboratory without interruption of ECMO flow...
January 19, 2021: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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