Andja Bojic, Peter Schellongowski, Oliver Robak, Alexander Hermann, Nina Buchtele, Bernhard Nagler, Wolfgang Lamm, Thomas Staudinger
The duration of extracorporeal membrane oxygenation (ECMO) treatments increases, however, data presented from prolonged support is limited. We retrospectively analyzed all patients during a 4-year period undergoing respiratory ECMO for duration of therapy, demographics, therapy-associated parameters, and outcome according to ECMO duration (<28 days and ≥28 days = long-term ECMO). Out of 55 patients undergoing ECMO for ARDS or during bridging to lung transplantation, 18 were on ECMO for ≥28 days (33%)...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Ahmed A Rabie, Ayed Asiri, Mostafa Rajab, Hani N Mufti, Medhat Alsherbiny, Mohamed H Azzam, Akram Abdelbary, Bishoy Zakhary, Yaseen Arabi, Abdulrahman Alharthy, Mohamed Futaih, Mohamed Sobhy, Ismael Alenazi, Fahad Bafaqeeh
Extracorporeal membrane oxygenation (ECMO) use in acute respiratory failure is increasing. We aim to compare characteristics and outcomes of patients with prolonged (≥21 days) veno-venous (VV) ECMO runs (pECMO), to patients with short (<21 days) VV ECMO runs (sECMO). The observational retrospective single-center study compared patients who received VV ECMO from January 2018 to June 2019 at Prince Mohamed Bin Abdulaziz Center in Riyadh, Saudi Arabia. Forty-three patients were supported with VV ECMO during the study period, of whom 37 are included as six patients were still receiving ECMO at time of data collection: 24 sECMO and 13 pECMO patients...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Marina Rieder, Daniel Duerschmied, Timm Zahn, Corinna Lang, Christoph Benk, Achim Lother, Paul Biever, Christoph Bode, Tobias Wengenmayer, Dawid Staudacher, Alexander Supady
Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a last resort treatment option for patients with acute respiratory failure (acute respiratory distress syndrome [ARDS]). Cytokine adsorption has been incorporated in the management of some of these patients on an individual basis to control the imbalance of danger-associated molecular patterns and proinflammatory cytokines. However, little is known about the combination of V-V ECMO and cytokine adsorption as earlier reports contained mixed patient cohorts in terms of disease and mode of ECMO, veno-venous and veno-arterial...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Dirk W Donker, Marko Sallisalmi, Michael Broomé
Left ventricular (LV) dilatation is commonly seen with LV failure and is often aggravated during venoarterial extracorporeal membrane oxygenation (VA ECMO). In this context, the intricate interaction between left and right heart function is considered to be of pivotal importance, yet mechanistically not well understood. We hypothesize that a preserved or enhanced right heart contractility causes increased LV loading both with and without VA ECMO. A closed-loop in-silico simulation model containing the cardiac chambers, the pericardium, septal interactions, and the pulmonary and systemic vascular systems with an option to connect a simulated VA ECMO circuit was developed...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Sven R Olson, Catherine R Murphree, David Zonies, Andrew D Meyer, Owen J T Mccarty, Thomas G Deloughery, Joseph J Shatzel
Extracorporeal membrane oxygenation (ECMO) causes both thrombosis and bleeding. Major society guidelines recommend continuous, systemic anticoagulation to prevent thrombosis of the ECMO circuit, though this may be undesirable in those with active, or high risk of, bleeding. We aimed to systematically review thrombosis and bleeding outcomes in published cases of adults treated with ECMO without continuous systemic anticoagulation. Ovid MEDLINE, Cochrane CENTRAL and CDSR, and hand search via SCOPUS were queried...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Farhad Rikhtegar Nezami, Farhan Khodaee, Elazer R Edelman, Steven P Keller
Extracorporeal membrane oxygenation (ECMO) is increasingly deployed to provide percutaneous mechanical circulatory support despite incomplete understanding of its complex interactions with the failing heart and its effects on hemodynamics and perfusion. Using an idealized geometry of the aorta and its major branches and a peripherally inserted return cannula terminating in the iliac artery, computational fluid dynamic simulations were performed to (1) quantify perfusion as function of relative ECMO flow and (2) describe the watershed region produced by the collision of antegrade flow from the heart and retrograde ECMO flow...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Charles I McDonald, Daniel Brodie, Matthieu Schmidt, Karen Hay, Kiran Shekar
Optimal management of cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO) is still an evolving area in which assessment and optimization of the microcirculation may be critically important. We hypothesized that the venous arterial carbon dioxide gap (P(v-a)CO2 gap); the ratio of this gap to arterio-venous oxygen content (P(v-a)CO2/C(a-v)O2 ratio) and the anion gap would be early indicators of microcirculatory status and useful parameters for outcome prediction during ECMO support. We retrospectively reviewed 31 cardiogenic shock patients requiring veno-arterial ECMO, calculating P(v-a)CO2 gap and P(v-a)CO2/C(a-v)O2 ratios in the first 36 hours and the final 24 hours of ECMO support...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Huda Alfoudri, Mohammad Shamsah, Beena Yousuf, Nasayem AlQuraini
Pediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared with the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe acute respiratory distress syndrome (ARDS) that necessitates admission to the intensive care unit (ICU) requiring a maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO)...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Cara Agerstrand, Richard Dubois, Koji Takeda, Nir Uriel, Philippe Lemaitre, Justin Fried, Amirali Masoumi, Eva W Cheung, Yuji Kaku, Lucas Witer, Peter Liou, Claire Gerall, Rafael Klein-Cloud, Darryl Abrams, Jennifer Cunningham, Purnema Madahar, Madhavi Parekh, Briana Short, Natalie H Yip, Alexis Serra, James Beck, Michael Brewer, Kenmund Fung, Dana Mullin, Roy Oommen, Bryan Payne Stanifer, William Middlesworth, Joshua Sonett, Daniel Brodie
The coronavirus disease 2019 (COVID-19) pandemic has placed extraordinary strain on global healthcare systems. Use of extracorporeal membrane oxygenation (ECMO) for patients with severe respiratory or cardiac failure attributed to COVID-19 has been debated due to uncertain survival benefit and the resources required to safely deliver ECMO support. We retrospectively investigated adult patients supported with ECMO for COVID-19 at our institution during the first 80 days following New York City's declaration of a state of emergency...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Alexander Sacha C Richardson, Joseph E Tonna, Vinodh Nanjayya, Paul Nixon, Darryl C Abrams, Lakshmi Raman, Stephen Bernard, Simon J Finney, Brian Grunau, Scott T Youngquist, Stephen H McKellar, Zachary Shinar, Jason A Bartos, LanceB Becker, Demetris Yannopoulos, Jan BˇelohlÁvek, Lionel Lamhaut, Vincent Pellegrino
Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly being deployed for selected patients in cardiac arrest who do not attain a native circulation with conventional CPR (ECPR). This ELSO guideline is intended to be a practical guide to implementing ECPR and the early management following establishment of ECMO support. Where a paucity of high-quality evidence exists, a consensus has been reached amongst the authors to provide guidance to the clinician. This guideline will be updated as further evidence in this field becomes available...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Ilija Djordjevic, Christopher Gaisendrees, Christoph Adler, Kaveh Eghbalzadeh, Simon Braumann, Borko Ivanov, Julia Merkle, Antje-Christin Deppe, Elmar Kuhn, Robert Stangl, Alex Lechleuthner, Christian Miller, Roman Pfister, Navid Mader, Stephan Baldus, Anton Sabashnikov, Thorsten Wahlers
OBJECTIVES: Out-of-hospital cardiac arrest (OHCA) is associated with excessively high mortality rates. Recent studies suggest benefits from extracorporeal cardiopulmonary resuscitation (ECPR) performed in selected patients. We sought to present the first results from our interdisciplinary ECPR program with a particular focus on early outcomes and potential risk factors associated with in-hospital mortality. METHODS: Between January 2016 and December 2019, 44 patients who underwent ECPR selected according to our institutional ECPR protocol were retrospectively analyzed regarding pre-hospital, in-hospital, and early outcome parameters...
February 24, 2021: Perfusion
Annabelle Dupont, Antoine Rauch, Senna Staessens, Mouhamed Moussa, Mickael Rosa, Delphine Corseaux, Emmanuelle Jeanpierre, Julien Goutay, Morgan Caplan, Pauline Varlet, Guillaume Lefevre, Fanny Lassalle, Anne Bauters, Karine Faure, Marc Lambert, Alain Duhamel, Julien Labreuche, Delphine Garrigue, Simon F De Meyer, Bart Staels, Flavien Vincent, Natacha Rousse, Eric Kipnis, Peter Lenting, Julien Poissy, Sophie Susen
OBJECTIVE: Whether endotheliopathy only mirrors coronavirus disease 2019 (COVID-19) severity or plays an intrinsic role in microvascular thrombosis and organ failure remains unanswered. We assessed whether markers of endothelial damage and immune dysregulation were associated with organ failure, thrombus formation, and death. Approach and Results: Markers of endothelial damage (VWF:Ag [von Willebrand factor antigen], PAI-1 [plasminogen activator inhibitor-1], syndecan-1, TFPI [tissue factor pathway inhibitor], and soluble thrombomodulin), complement activation (C5a and C5b-9), cytokines (IL [interleukin]-6, TNF [tumor necrosis factor]-α, and IL-2R), and neutrophil extracellular traps (cell-free DNA, nucleosomes, and myeloperoxidase-DNA) were measured at intensive care unit admission in 82 patients with COVID-19...
February 25, 2021: Arteriosclerosis, Thrombosis, and Vascular Biology
Charles Puelz, Zach Danial, Jay S Raval, Jonathan L Marinaro, Boyce E Griffith, Charles S Peskin
This paper focuses on the derivation and simulation of mathematical models describing new plasma fraction in blood for patients undergoing simultaneous extracorporeal membrane oxygenation and therapeutic plasma exchange. Models for plasma exchange with either veno-arterial or veno-venous extracorporeal membrane oxygenation are considered. Two classes of models are derived for each case, one in the form of an algebraic delay equation and another in the form of a system of delay differential equations. In special cases, our models reduce to single compartment ones for plasma exchange that have been validated with experimental data (Randerson et al...
February 25, 2021: Mathematical Medicine and Biology: a Journal of the IMA
Nicolas Brozzi
No abstract text is available yet for this article.
February 24, 2021: Journal of Cardiac Surgery
Anthony R Prisco, Jazmin Aguado-Sierra, Constantine Butakoff, Mariano Vazquez, Guillaume Houzeaux, Beatriz Eguzkitza, Jason A Bartos, Demetris Yannopoulos, Ganesh Raveendran, Mikayle Holm, Tinen Iles, Claudius Mahr, Paul A Iaizzo
Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment for acute cardiogenic shock in patients who also have acute lung injury predisposes development of a serious complication called "north-south syndrome" (NSS) which causes cerebral hypoxia. NSS is poorly characterized and hemodynamic studies have focused on cerebral perfusion ignoring the heart. We hypothesized in NSS the heart would be more likely to receive hypoxemic blood than the brain due to the proximity of the coronary arteries to the aortic annulus...
February 23, 2021: Journal of Cardiovascular Translational Research
Hussain T Bakhsh
Background: Hydroxychloroquine (HCQ) has been widely investigated for the treatment of COVID-19. Although it is rare, several case reports of acute toxicity of HCQ due to overdose have been reported during the last two decades. The aim of this review is to summarize the management options of acute HCQ toxicity. Methods: A literature review that was conducted using an electronic search in the Google Scholar search engine. The inclusion criteria include any patient over 12 years old presenting with HCQ intoxication symptoms from January 1999 to January 2020...
October 2020: Journal of Microscopy and Ultrastructure
Inez Eiben, Paola Eiben, Mobinula Syed
Extracorporeal membrane oxygenation (ECMO) is often employed to manage persistent pulmonary hypertension of the newborn where non-invasive therapies have failed. Delivery of ECMO requires insertion of indwelling catheters into central or peripheral vasculature; and this predisposes the recipient to development of catheter-associated skin infection; however, chronic non-healing wounds with granuloma formation are rare. We describe a case of an 8-month-old child who presented to our Plastic Surgery Services with a chronic left groin wound at ECMO cannula insertion site that failed medical management...
February 2021: Journal of Surgical Case Reports
Yigit S Guner, Patrick T Delaplain, John Schomberg, Matteo Di Nardo, Peter T Yu, Danny Lam, Tim Jancelewicz, Matthew T Harting, Joanne P Starr, Danh V Nguyen
BACKGROUND: Neonates receiving extracorporeal life support (ECLS) for congenital diaphragmatic hernia (CDH) require prolonged support compared with neonates with other forms of respiratory failure. Hemolysis is a complication that can be seen during ECLS and can lead to renal failure and potentially to worse outcomes. The purpose of this study was to identify risk factors for the development of hemolysis in CDH patients treated with ECLS. METHODS: The Extracorporeal Life Support Organization database was used to identify infants with CDH (2000-2015)...
February 20, 2021: Journal of Surgical Research
Jacob Bradley Meers, Navin C Nanda, Thomas Evan Watts, Shane Prejean, Charles W Hoopes, Andrew Lenneman, Mustafa I Ahmed
A patient with heart failure due to nonischemic cardiomyopathy presented as a transfer to our institution following peripheral (femoral) venoarterial (VA) extracorporeal membrane oxygenation (ECMO) placement. With peripheral VA ECMO cannulation, the patient continued to have unstable ventricular tachyarrhythmias. Echocardiography demonstrated left ventricular (LV) dilation and severe mitral regurgitation (MR) with clinical and chest X-ray evidence of pulmonary edema. To provide venous drainage and simultaneous decompression of the left atrium (LA) and thereby indirect LV venting, a single multistage venous cannula was placed across the inter-atrial septum (IAS) using the previously described left atrial venoarterial (LA-VA) ECMO cannulation technique...
February 22, 2021: Echocardiography
Corinna N Lang, Johanna S Dettinger, Michael Berchtold-Herz, Stefan Utzolino, Xavier Bemtgen, Viviane Zotzmann, Bonaventura Schmid, Paul M Biever, Christoph Bode, Katharina Müller-Peltzer, Daniel Duerschmied, Tobias Wengenmayer, Wolf-Dirk Niesen, Dawid L Staudacher
BACKGROUND: Hypercoagulability in Coronavirus Disease 2019 (COVID-19) causes deep vein thrombosis and pulmonary embolism necessitating systemic anticoagulation. Case reports of intracerebral hemorrhages in ventilated COVID-19 patients warrant precaution. It is unclear, however, if COVID-19 patients with acute respiratory distress syndrome (ARDS) with or without veno-venous extracorporeal membrane oxygenation therapy (VV-ECMO) have more intracerebral hemorrhages (ICH) compared to other ARDS patients...
February 23, 2021: Neurocritical Care
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