Thibaut Genty, Stanislas Burguburu, Audrey Imbert, Calypso Roman, Wirth Camille, Jacques Thès, François Stéphan
BACKGROUND: Bleeding and thrombosis induce major morbidity and mortality in patients under extracorporeal membrane oxygenator (ECMO). Circuit changes can be performed for oxygenation membrane thrombosis but are not recommended for bleeding under ECMO. The objective of this study was to evaluate the course of clinical, laboratory, and transfusion parameters before and after ECMO circuit changes warranted by bleeding or thrombosis. METHODS: In this single-center, retrospective, cohort study, clinical parameters (bleeding syndrome, hemostatic procedures, oxygenation parameters, transfusion) and laboratory parameters (platelet count, hemoglobin, fibrinogen, PaO2 ) were collected over the seven days surrounding the circuit change...
June 2, 2023: Critical Care: the Official Journal of the Critical Care Forum
Yanlin Yang, Jing Lv, Yajiao Li, Changping Gan, Peng Ji
BACKGROUND: Intracardiac thrombosis (ICT) is a rare complication after the cardiopulmonary surgery for interrupted aortic arch (IAA) or total anomalous pulmonary venous connection (TAPVC) without previous records. There are still no general guidelines regarding as the mechanism or management of postoperative ICT in neonates and younger infants. CASE PRESENTATION: We reported the conservative and surgical therapies in two neonates with intra-ventricular and intra-atrial thrombosis after the anatomical repair for IAA and TAPVC, respectively...
June 2, 2023: BMC Pediatrics
Andrey Y Bulanov, Ekaterina L Bulanova, Irina B Simarova, Elizaveta A Bovt, Olesya O Eliseeva, Soslan S Shakhidzhanov, Mikhail A Panteleev, Aleksandr G Roumiantsev, Fazoil I Ataullakhanov, Sergey S Karamzin
BACKGROUND: Blood coagulation abnormalities play a major role in COVID-19 pathophysiology. However, the specific details of hypercoagulation and anticoagulation treatment require investigation. The aim of this study was to investigate the status of the coagulation system by means of integral and local clotting assays in COVID-19 patients on admission to the hospital and in hospitalized COVID-19 patients receiving heparin thromboprophylaxis. METHODS: Thrombodynamics (TD), thromboelastography (TEG), and standard clotting assays were performed in 153 COVID-19 patients observed in a hospital setting...
2023: PloS One
Kazuya Kikutani, Tatsutoshi Shimatani, Atsushi Kawaguchi, Takanari Ikeyama, Daisuke Yamaguchi, Osamu Nishida, Shinichiro Ohshimo
BACKGROUND: Although many critically ill patients require inter-facility transport for definitive or specialized therapy, the medical equipment required to enhance transport safety remains unclear. This review was performed to summarize the evidence regarding devices used to improve the safety and survival in patients requiring such transport. METHODS: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for randomized controlled trials and observational studies comparing outcomes according to the presence or absence of devices (or new vs conventional devices) during transfer of critically ill patients...
June 2, 2023: Medicine (Baltimore)
Wenyang Wang, Zhirui Zhu, Wenlong He, Yaoqin Hu, Qiao Zeng
RATIONALE: Recurrent laryngeal papillomatosis (RLP) is a common benign tumor in the larynx of children, which is characterized by high recurrence rate and rapid growth, leading to clinical symptoms such as hoarseness and difficulty breathing. Low-temperature plasma radiofrequency ablation (RFA) is the main treatment, but ventilation problems are often encountered during surgery. PATIENT CONCERNS: We report a case of a 2-year-old child with RLP who underwent low-temperature plasma RFA with the assistance of a laryngoscope...
June 2, 2023: Medicine (Baltimore)
Tyler N Brown, Thomas V Brogan
Acute respiratory distress syndrome is characterized by non-cardiogenic pulmonary edema, decreased pulmonary compliance, and abnormalities in gas exchange, especially hypoxemia. Patients with acute respiratory distress syndrome (ARDS) who receive support with venovenous (V-V) extracorporeal membrane oxygenation (ECMO) usually have severe lung disease. Many patients with ARDS have associated pulmonary vascular injury which can result in elevated pulmonary vascular resistance and right heart dysfunction. Since V-V ECMO relies upon preserved cardiac function, right heart failure has important implications for patient evaluation, management, and outcomes...
2023: Frontiers in Cardiovascular Medicine
Jae Yeong Cho, Kye Hun Kim, Nuri Lee, Soo Hyeon Cho, Seung Yun Kim, Eun Kyoung Kim, Jae-Hyeong Park, Eui-Young Choi, Jin-Oh Choi, Hyukjin Park, Hyung Yoon Kim, Hyun Ju Yoon, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho
AIMS: A comprehensive nationwide study on the incidence and outcomes of COVID-19 vaccination-related myocarditis (VRM) is in need. METHODS AND RESULTS: Among 44 276 704 individuals with at least 1 dose of COVID-19 vaccination, the incidence and clinical courses of VRM cases confirmed by the Expert Adjudication Committee of the Korea Disease Control and Prevention Agency were analyzed. COVID-19 VRM was confirmed in 480 cases (1.08 cases per 100 000 persons). Vaccination-related myocarditis incidence was significantly higher in men than in women (1...
June 2, 2023: European Heart Journal
Paul Abraham, Vitor Mendes, Matthias Kirsch, Antoine Schneider
Extracorporeal circulation (ECC) such as cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO) may induce a complex activation of the immune system. To date, strategies to mitigate this activation have failed to translate into meaningful improvement of clinical outcomes. Hemoperfusion is a blood purification technique, which relies on mass separation by a solid agent (hemoadsorption). It can be performed by adding a cartridge filled with adsorptive sorbent in the extracorporeal circuit. These devices have the theoretical advantage to enable the removal of excess pro- and anti-inflammatory molecules...
June 1, 2023: Contributions to Nephrology
Matthew P Fox
No abstract text is available yet for this article.
June 1, 2023: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Ryohei Ono, Togo Iwahana, Shuji Toriumi, Kaoruko Aoki, Hirotoshi Kato, Kodai Kato, Masahiro Yasui, Yuzuho Nakagawa, Shunsuke Furuta, Hiroshi Nakajima, Yoshio Kobayashi
Myocarditis has been reported as a life-threatening complication of adult-onset Still's disease (AOSD), but fulminant myocarditis with AOSD is very rare. We hereby report a case of a 43-year-old female with fulminant myocarditis with AOSD. She had a refractory AOSD and cardiogenic shock with markedly elevated ferritin level up to 67,370 ng/mL. She was successfully treated with canakinumab and mechanical circulatory support (MCS) such as venoarterial extracorporeal membrane oxygenation and Impella CP. We also reviewed the previous cases of fulminant myocarditis with AOSD published from 1976 to December 2022, and only 8 cases of fulminant myocarditis with AOSD have been reported...
June 1, 2023: Clinical Rheumatology
Meera Raja, Ricardo Leal, James Doyle
Methods of continuous renal replacement therapy (CRRT) in extracorporeal membrane oxygenation (ECMO) patients include dedicated central venous cannula (CVC) (vCRRT), in-series with filter connected to ECMO circuit (eCRRT) or in-line with haemodiafilter incorporated within ECMO circuit. We assessed the efficacy and safety of eCRRT versus vCRRT in 20 ECMO-CRRT patients. Average filter lifespan was 42 vs 28 hours and filter runs completing 72hours were 40% vs 13.8% (eCRRT vs vCRRT, respectively). One incidence of ECMO circuit air embolus occurred (vCRRT)...
May 2023: Journal of the Intensive Care Society
Peta M A Alexander, Victoria Habet, Ryan P Barbaro
No abstract text is available yet for this article.
June 1, 2023: Pediatric Critical Care Medicine
Sin-Ying Lin, Shin-Tsyr Hwang, Chien-Heng Lai, Tsung-Rung Wei, Yung-Yu Tang, Sih-Chi Lin, Pao-Yu Chuang
BACKGROUND & PROBLEMS: Extracorporeal membrane oxygenation (ECMO) is an intervention that replaces cardiopulmonary function temporarily to reduce injury to vital organs. As important members of the ECMO medical team, intensive care unit nurses must be well trained and alert to possible critical events. Failure to troubleshoot and manage ECMO promptly and correctly significantly increases the risk of mortality. A previous ECMO critical event in our unit resulted in lingering concerns and stress among nurses related to implementing this intervention...
June 2023: Hu Li za Zhi the Journal of Nursing
Hsiu-Chin Chao, Ya-Chu Hsiao, Ming-Dar Woon, Tsuey-Yuan Huang
BACKGROUND: Improvements in medical science and technology have increased the average number of years that older adults survive with impaired quality of life. Understanding behavioral intentions and related factors affecting advance decision (AD) decision-making can help medical professionals improve the decision-making ability of patients, allowing patients and their family members to make better medical decisions that reduce ineffective medical treatments, improve quality of life, and facilitate a good death...
June 2023: Hu Li za Zhi the Journal of Nursing
Tatsuya Nagai, Kyoko Yoshida, Ayumu Otsuki, Yuko So, Toshiyuki Karumai, Hiroshi Sugimura, Yuri Tachibana, Junya Fukuoka, Hiroyuki Ito, Kei Nakashima
Lung cancer can cause fatal central airway obstruction. Rapid airway clearance is necessary in some cases, but ventilator management may be insufficient to maintain oxygenation levels. Venovenous extracorporeal membrane oxygenation (VV-ECMO) may be an effective rescue therapy for respiratory failure, but its efficacy in treating tumor-related airway obstruction is unknown. We herein report a case of central airway obstruction and severe acute respiratory failure due to small-cell lung cancer successfully treated with VV-ECMO, bronchoscopic airway intervention, and chemotherapy...
May 31, 2023: Internal Medicine
Sherry Griggs, Debra Hampton, Jean Edward, Jessica McFarlin
BACKGROUND: Moral distress occurs when nurses know the ethically correct action to take but are restrained from taking it. Moral distress is prevalent in nurses who work in intense stress situations, as do extracorporeal membrane oxygenation nurses. LOCAL PROBLEM: Nurses who work in critical care settings have higher levels of moral distress than nurses who work in other practice areas. The purpose of this project was to evaluate the effectiveness of case review debriefings on moral distress of extracorporeal membrane oxygenation nurses...
June 1, 2023: Critical Care Nurse
Jens Gottlieb
Pulse oximetry has high sensitivity but low specificity for detecting hypoxemia. Arterial blood gas analyses are the gold standard for monitoring O2 therapy. Venous blood gas analyses should not be used in this setting. TARGET VALUES OF O2 THERAPY: The target range of acute O2 therapy for ventilated patients and nonventilated patients not at risk of hypercapnia should be between 92% and 96% for oxygen saturation (SpO2) measured by pulse oximetry. Indications for high-dose O2 therapy without a target range in critical care include carbon monoxide poisoning and patients with severe respiratory distress when SpO2 cannot be derived...
June 2023: Deutsche Medizinische Wochenschrift
Sabina P W Guenther, Rayan Cheaban, Lisa Hoepner, Nicole Weinrautner, Thomas Kirschning, Riad Al-Khalil, Frank Bruenger, Maria R Serrano, Iris Barndt, Marcus Wiemer, Jost Niedermeyer, Markus Rudloff, Sven Helms, René Schramm, Jan F Gummert
Extracorporeal membrane oxygenation (ECMO) is increasingly used in COVID-19-related pulmonary failure and the number of patients recovering from COVID-19 is growing. Here, we assess survival and recovery 6 months after ECMO for COVID-19. From April 2020 to September 2021, n = 60 (60.5 [51.0-65.0] years, 23.3% female) were treated with venovenous/venoarterial ECMO for COVID-19. 41.7% were weaned off ECMO, survival-to-discharge was 40.0% (n = 24). Age (63.0 [60.0-66.8] vs. 55.0 [43.8-60.0] years, p < 0.001), vasoactive support (97...
June 1, 2023: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Lyvonne N Tume, Gail Beech, Chi Tse, Shirley Nolan, Alison Brady, Yetunde Odutolu, Lynne Latten
BACKGROUND: Extracorporeal life support is an accepted treatment modality for children with severe cardiac and/or respiratory dysfunction. However, after a period of inadequate gut perfusion clinicians are often reluctant to initiate enteral nutrition. METHODS: A retrospective cohort study in a single large pediatric intensive care unit in Northwest England over 5.5 years (2017 - 2022). RESULTS: 156 children were included with a median age of two months (IQR 0...
May 31, 2023: JPEN. Journal of Parenteral and Enteral Nutrition
James Childs, Anna Fischbach, Artur Smirnov, Bill Farinelli, Talisa Bühl, Walfre Franco, Fumito Ichinose, Llya Yaroslavsky, Gregory Altshuler, Rox Anderson
UNLABELLED: BACKGROUND AND OBJECTIVES: Approximately 50,000 emergency department visits per year due to carbon monoxide (CO) poisoning occur in the United States alone. Tissue hypoxia can occur at very low CO concentration exposures because CO binds with a 250-fold higher affinity than oxygen to hemoglobin. The most effective therapy is 100% hyperbaric oxygen (HBO) respiration. However, there are only a limited number of cases with ready accessibility to the specialized HBO chambers...
May 30, 2023: Lasers in Surgery and Medicine
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