keyword
https://read.qxmd.com/read/32657950/a-case-report-of-donnai-barrow-syndrome
#1
Melissa K Robinson, Kristi Coe, Wanda T Bradshaw
BACKGROUND: A genetic disorder should be considered when an infant presents with multiple congenital anomalies. Because of the acute presentation of an infant with multiple life-threatening defects, a genetic diagnosis of a rare disorder took weeks to delineate. CLINICAL FINDINGS: This case describes a late preterm infant who presented at birth with congenital diaphragmatic hernia, tetralogy of Fallot, cleft lip, low-set ears, and hypertelorism. PRIMARY DIAGNOSIS: Donnai-Barrow syndrome was the final diagnosis confirmed by a defect observed on the LRP2 (2q31...
July 7, 2020: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://read.qxmd.com/read/32657829/breathing-life-back-into-the-kidney-continuous-renal-replacement-therapy-and-veno-venous-extracorporeal-membrane-oxygenation
#2
Kristopher B Deatrick, Michael A Mazzeffi, Samuel M Galvagno, Kimberly Boswell, David J Kaczoroswki, Ronald P Rabinowitz, Ronson J Madathil, Christopher R Cornachione, Daniel L Herr, Thomas M Scalea, Jay Menaker
The purpose of this study was to evaluate the incidence of continuous renal replacement therapy (CRRT) in patients supported with veno-venous extracorporeal membrane oxygenation (VV ECMO). Secondary outcomes included mortality and the need for hemodialysis on hospital discharge. We performed a retrospective cohort study of all patients admitted to a specialty unit on VV ECMO between August 2014 and August 2018. Trauma and bridge to lung transplant patients were excluded. Demographics, comorbidities, pre-ECMO, ECMO, and renal replacement therapy outcome data were collected and analyzed with parametric and nonparametric statistics as appropriate...
July 7, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/32657828/extracorporeal-life-support-in-hemorrhagic-conditions-a-systematic-review
#3
Anne Willers, Justyna Swol, Mariusz Kowalewski, Giuseppe Maria Raffa, Paolo Meani, Federica Jiritano, Matteo Matteucci, Dario Fina, Samuel Heuts, Elham Bidar, Ehsan Natour, Jan Willem Sels, Thijs Delnoij, Roberto Lorusso
Extracorporeal life support (ECLS) is indicated in refractory acute respiratory or cardiac failure. According to the need for anticoagulation, bleeding conditions (e.g., in trauma, pulmonary bleeding) have been considered a contraindication for the use of ECLS. However, there is increasing evidence for improved outcomes after ECLS support in hemorrhagic patients based on the benefits of hemodynamic support outweighing the increased risk of bleeding. We conducted a systematic literature search according to the PRISMA guidelines and reviewed publications describing ECLS support in hemorrhagic conditions...
July 7, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/32657798/assessment-of-right-heart-function-during-extracorporeal-therapy-by-modified-thermodilution-in-a-porcine-model
#4
Kaspar F Bachmann, Lena Zwicker, Kay Nettelbeck, Daniela Casoni, Paul Phillipp Heinisch, Hansjörg Jenni, Matthias Haenggi, David Berger
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation therapy is a growing treatment modality for acute cardiorespiratory failure. Cardiac output monitoring during veno-arterial extracorporeal membrane oxygenation therapy remains challenging. This study aims to validate a new thermodilution technique during veno-arterial extracorporeal membrane oxygenation therapy using a pig model. METHODS: Sixteen healthy pigs were centrally cannulated for veno-arterial extracorporeal membrane oxygenation, and precision flow probes for blood flow assessment were placed on the pulmonary artery...
July 8, 2020: Anesthesiology
https://read.qxmd.com/read/32657091/a-case-of-covid-19-with-acute-myocardial-infarction-and-cardiogenic-shock
#5
Hong Nyun Kim, Jang Hoon Lee, Hun Sik Park, Dong Heon Yang, Se Yong Jang, Myung Hwan Bae, Yongkeun Cho, Shung Chull Chae, Yong Hoon Lee
A 60-year-old male patient with coronavirus disease-2019 showed new onset ST-segment elevation in V1-V2 leads on electrocardiogram and cardiac enzyme elevation in intensive care unit. He had a history of type 2 diabetes mellitus, hypertension, and dyslipidemia. He was receiving mechanical ventilation and veno-venous extracorporeal membrane oxygenation treatment for severe hypoxia. Two-D echocardiogram showed regional wall motion abnormalities. We performed primary percutaneous coronary intervention for acute myocardial infarction complicating cardiogenic shock under hemodynamic support...
July 13, 2020: Journal of Korean Medical Science
https://read.qxmd.com/read/32656591/blood-type-and-outcomes-in-patients-with-covid-19
#6
Christopher A Latz, Charles DeCarlo, Laura Boitano, C Y Maximilian Png, Rushad Patell, Mark F Conrad, Matthew Eagleton, Anahita Dua
This study aimed to determine if there is an association between ABO blood type and severity of COVID-19 defined by intubation or death as well as ascertain if there is variability in testing positive for COVID-19 between blood types. In a multi-institutional study, all adult patients who tested positive for COVID-19 across five hospitals were identified and included from March 6th to April 16th, 2020. Hospitalization, intubation, and death were evaluated for association with blood type. Univariate analysis was conducted using standard techniques and logistic regression was used to determine the independent effect of blood type on intubation and/or death and positive testing...
July 12, 2020: Annals of Hematology
https://read.qxmd.com/read/32654712/counterpoint-should-patients-with-advanced-lung-disease-be-offered-extracorporeal-membrane-oxygenation-as-a-bridge-to-transplant-if-they-have-not-yet-been-listed-for-lung-transplant-no
#7
EDITORIAL
https://read.qxmd.com/read/32654711/point-should-patients-with-advanced-lung-disease-be-offered-extracorporeal-membrane-oxygenation-as-a-bridge-to-transplant-if-they-have-not-yet-been-listed-for-lung-transplant-yes
#8
EDITORIAL
https://read.qxmd.com/read/32653986/thrombotic-circuit-complications-during-venovenous-extracorporeal-membrane-oxygenation-in-covid-19
#9
Xavier Bemtgen, Viviane Zotzmann, Christoph Benk, Jonathan Rilinger, Katrin Steiner, Alexander Asmussen, Christoph Bode, Tobias Wengenmayer, Sven Maier, Dawid L Staudacher
The novel coronavirus SARS-CoV-2 and the resulting disease COVID-19 causes pulmonary failure including severe courses requiring venovenous extracorporeal membrane oxygenation (V-V ECMO). Coagulopathy is a known complication of COVID-19 leading to thrombotic events including pulmonary embolism. It is unclear if the coagulopathy also increases thrombotic circuit complications of the ECMO. Aim of the present study therefor was to investigate the rate of V-V ECMO complications in COVID-19. We conducted a retrospective registry study including all patients on V-V ECMO treated at our centre between 01/2018 and 04/2020...
July 11, 2020: Journal of Thrombosis and Thrombolysis
https://read.qxmd.com/read/32653160/clinical-characteristics-and-outcomes-of-74-patients-with-severe-or-critical-covid-19
#10
Junli Li, Ge Xu, Heping Yu, Xiang Peng, Yongwen Luo, Cheng'an Cao
BACKGROUND: The outbreak of the coronavirus disease (COVID-19) has led to a major concern and caused a pandemic globally. The goal of this study was to clarify the clinical characteristics of recovery and death in patients with severe or critical COVID-19. MATERIALS AND METHODS: In this retrospective single-center study, clinical data were collected from 74 severe or critical COVID-19 patients in Wuhan Fourth Hospital between Jan. 25th and Feb. 26th, 2020. All patients were divided into a recovery group or a death group according to clinical outcomes, and the differences between the groups were compared...
June 1, 2020: American Journal of the Medical Sciences
https://read.qxmd.com/read/32653054/intensive-care-admissions-of-children-with-paediatric-inflammatory-multisystem-syndrome-temporally-associated-with-sars-cov-2-pims-ts-in-the-uk-a-multicentre-observational-study
#11
Patrick Davies, Claire Evans, Hari Krishnan Kanthimathinathan, Jon Lillie, Joseph Brierley, Gareth Waters, Mae Johnson, Benedict Griffiths, Pascale du Pré, Zoha Mohammad, Akash Deep, Stephen Playfor, Davinder Singh, David Inwald, Michelle Jardine, Oliver Ross, Nayan Shetty, Mark Worrall, Ruchi Sinha, Ashwani Koul, Elizabeth Whittaker, Harish Vyas, Barnaby R Scholefield, Padmanabhan Ramnarayan
BACKGROUND: In April, 2020, clinicians in the UK observed a cluster of children with unexplained inflammation requiring admission to paediatric intensive care units (PICUs). We aimed to describe the clinical characteristics, course, management, and outcomes of patients admitted to PICUs with this condition, which is now known as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). METHODS: We did a multicentre observational study of children (aged <18 years), admitted to PICUs in the UK between April 1 and May 10, 2020, fulfilling the case definition of PIMS-TS published by the Royal College of Paediatrics and Child Health...
July 9, 2020: Lancet Child & Adolescent Health
https://read.qxmd.com/read/32652731/massive-coronary-spasm-of-the-native-coronary-system-after-coronary-artery-bypass-grafting-two-patients-with-different-outcomes
#12
Matej Ondrusek, Panagiotis Artemiou, Ivan Glonek, Michal Hulman
We report the cases of two patients who developed a massive spasm of the native coronary system in the immediate postoperative period, following a coronary artery bypass grafting operation with different outcomes. The first patient was hemodynamic stable and it was manifested as ischemic electrocardiographic changes in different leads (ST elevation or depression). He was treated with intracoronary and intravenous administration of nitroglycerin and calcium channel blocker and had a favorable outcome. The second patient died due to multiorgan failure and hemorrhagic shock, after the implantation of a central venoarterial extracorporeal membrane oxygenation...
July 11, 2020: Journal of Cardiac Surgery
https://read.qxmd.com/read/32652726/peripheral-femoral-venoarterial-extracorporeal-membrane-oxygenation-as-bridge-to-heart-lung-transplant-omne-iter-incipit-primus
#13
Erik J Orozco-Hernandez, Brett Melnikoff, Megan Lusby, Jose Tallaj, Charles W Hoopes
Heart-lung transplant (HLT) is a widely accepted modality for certain patients with advanced and refractory cardiopulmonary disease. Some of these patients are critically ill on the transplant waiting list, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) can be used as a bridge to transplantation. Although the experience with ECMO as a bridge to lung transplant is promising, there is limited evidence to use ECMO as a bridge to HLT. Femoral cannulation remains a concern for ambulation given the risk of bleeding and cannula complications despite studies reporting its safety...
July 11, 2020: Journal of Cardiac Surgery
https://read.qxmd.com/read/32652073/monocytic-human-leukocyte-antigen-dr-expression-in-young-infants-undergoing-cardiopulmonary-bypass
#14
Alexis Chenouard, Marie Rimbert, Nicolas Joram, Cécile Braudeau, Antoine Roquilly, Pierre Bourgoin, Karim Asehnoune
BACKGROUND: Monocytic human leukocyte antigen DR (mHLA-DR) expression levels have been reported to be a marker of immunosuppression and a predictor of sepsis and mortality. There is, however, scant data regarding mHLA-DR monitoring in young infants after cardiopulmonary bypass. Our objectives were to investigate the kinetics of mHLA-DR expression and to determine whether mHLA-DR levels are associated with healthcare-associated infection (HAI) after cardiopulmonary bypass in young infants...
July 8, 2020: Annals of Thoracic Surgery
https://read.qxmd.com/read/32652072/extracorporeal-membrane-oxygenation-combined-surgery-for-hemoptysis-caused-by-mediastinal-hemangioma
#15
Weizhao Huang, Hongyu Ye, Ting Yang, Zhou Cheng, Jian Zhang, Zhuofeng Miu, Yingmeng Wu, Jianwei Su, Yi Liang, Haiming Jiang
The diagnosis and treatment of massive hemoptysis remain challenging. We report about a 28-year-old woman with refractory massive hemoptysis owing to mediastinal hemangioma. Despite multiple bronchial artery embolizations and fiberoptic bronchoscopy treatments, effective control of the bleeding and clearing of the airway was not possible. Finally, with the support of veno-venous extracorporeal membrane oxygenation(VV-ECMO), mediastinal hemangioma resection and right upper lobe sleeve resection were simultaneously performed...
July 8, 2020: Annals of Thoracic Surgery
https://read.qxmd.com/read/32652068/interventions-associated-with-treatment-of-low-cardiac-output-following-stage-1-norwood-palliation
#16
George M Hoffman, Robert A Niebler, John P Scott, Rebecca A Bertrandt, Martin K Wakeham, Nathan E Thompson, Nancy S Ghanayem, Eckehard A Stuth, Michael E Mitchell, Ronald K Woods, Viktor Hraska, Kathleen A Mussatto, James S Tweddell
BACKGROUND: Mortality following stage one palliation of hypoplastic left heart syndrome remains significant. Both cardiac output (CO) and systemic vascular resistance (SVR) contribute to hemodynamic vulnerability. Simultaneous measures of mean arterial pressure and somatic regional NIRS saturation can classify complex hemodynamics into four distinct states, with a low-CO state of higher risk. We sought to identify interventions associated with low-CO state occupancy and transition. METHODS: Perioperative data were prospectively collected in an IRB approved database...
July 8, 2020: Annals of Thoracic Surgery
https://read.qxmd.com/read/32650992/acceptable-post-heart-transplant-outcomes-support-temporary-mcs-prioritization-in-the-new-optn-unos-heart-allocation-policy
#17
Heidi Reich, Danny Ramzy, Jaime Moriguchi, Sadia Dimbil, Ryan Levine, Elizabeth Passano, Michelle Kittleson, Robert Cole, Lawrence Czer, David Chang, Dael Geft, Alfredo Trento, Joanna Chikwe, Jon Kobashigawa, Fardad Esmailian
BACKGROUND: Temporary mechanical circulatory support (MCS) devices are generally used short term to maintain adequate organ perfusion in patients with advanced heart failure and cardiogenic shock. Unacceptably high waitlist mortality in this cohort motivated changes to heart allocation policy, which recognized the severity of illness by prioritization for temporary MCS and broader sharing in the new U.S. donor heart allocation policy. We evaluated the post-heart transplant outcomes for patients bridged with temporary MCS, a control population not bridged with MCS, and a cohort bridged with durable MCS...
July 7, 2020: Transplantation Proceedings
https://read.qxmd.com/read/32650702/case-report-of-successful-peripheral-veno-arterial-extracorporeal-membrane-oxygenation-in-a-patient-with-chronic-type-b-aortic-dissection
#18
Shek-Yin Au, Ka-Man Fong, Wing-Yiu George Ng, Sheung-On So, Kit-Hung Anne Leung
A case report of successful application of peripheral veno-arterial extracorporeal membrane oxygenation in a patient with chronic type B aortic dissection and myocardial stunning to bridge to recovery was presented. Good outcomes from the application of peripheral veno-arterial extracorporeal membrane oxygenation in aortic dissection have rarely been reported, and the considerations of starting veno-arterial extracorporeal membrane oxygenation in this situation were seldom discussed. The orthodox that peripheral veno-arterial extracorporeal membrane oxygenation is an absolute contraindication for initiation of peripheral veno-arterial extracorporeal membrane oxygenation should be challenged...
July 10, 2020: Perfusion
https://read.qxmd.com/read/32650697/antithrombin-use-during-pediatric-cardiac-extracorporeal-membrane-oxygenation-admission-insights-from-a-national-database
#19
Salvatore R Aiello, Saul Flores, Megan Coughlin, Enrique G Villarreal, Rohit S Loomba
INTRODUCTION: The frequency of extracorporeal membrane oxygenation in pediatric patients continues to increase, especially in patients with complex congenital heart disease. Providing adequate anticoagulation is necessary for patients on extracorporeal membrane oxygenation and is achieved with adequate heparin administration. Antithrombin is administered to potentiate heparin's effects. However, the efficacy of antithrombin supplementation is unclear and a clear clinical benefit has not been established...
July 10, 2020: Perfusion
https://read.qxmd.com/read/32649064/optimization-of-extracorporeal-membrane-oxygenation-therapy-using-near-infrared-spectroscopy-to-assess-changes-in-peripheral-circulation-a-pilot-study
#20
Hsiao-Hhuang Chang, Yi-Chih Chen, Chun-Jung Huang, Chia-Cheng Kuo, Yi-Min Wang, Chia-Wei Sun
Near-infrared spectroscopy (NIRS) has been proposed as a noninvasive modality for detecting complications in patients undergoing extracorporeal membrane oxygenation (ECMO), and it can simultaneously reveal the global circulatory status of these patients. We optimized ECMO therapy on the basis of real-time peripheral NIRS probing. Three patients underwent venoarterial (VA) ECMO and one patient underwent venovenous (VV) ECMO. All patients received peripheral ECMO cannulation with routine distal perfusion catheter placement...
July 10, 2020: Journal of Biophotonics
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