Kenichi A Tanaka, Michael A Mazzeffi, Jerrold H Levy
No abstract text is available yet for this article.
July 1, 2024: Anesthesiology
Zasha Vazquez-Colon, Joseph E Marcus, Emily Levy, Aditya Shah, Graeme MacLaren, Giles Peek
As survival after ECMO improves and use of ECMO support increases in both pediatric and adult population, there is a need to focus on both the morbidities and complications associated with ECMO and how to manage and prevent them. Infectious complications during ECMO often have a significant clinical impact, resulting in increased morbidity or mortality irrespective of the underlying etiology necessitating cardiorespiratory support. In this review article, we discuss the prevention, management, challenges, and differences of infectious complications in adult and pediatric patients receiving ECMO support...
June 11, 2024: Perfusion
Matthew Oliver, Andrew Coggins, Natalie Kruit, Brian Burns, Brian Plunkett, Steve Morgan, Tim J Southwood, Richard Totaro, Paul Forrest, Saartje Berendsen Russell, Ruaidhri Carey, Mark Dennis
Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge. The best outcomes for ECPR occur when the time from cardiac arrest to implementation of ECPR is minimised. To reduce this time, systems must be in place to identify the correct patient, expedite transfer to hospital, facilitate rapid cannulation and ECMO circuit flows...
June 10, 2024: International Journal of Emergency Medicine
Wei-Yan Chen, Ze-Bin Guo, Tian-Yu Kong, Wei-Xiao Chen, Xiao-Hua Chen, Qilin Yang, Yi-Chao Wen, Qi-Rui Wen, Feng Zhou, Xu-Ming Xiong, De-Liang Wen, Zhen-Hui Zhang
INTRODUCTION: Severe septic cardiomyopathy (SCM) is one of the main causes of refractory septic shock (RSS), with a high mortality. The application of venoarterial extracorporeal membrane oxygenation (ECMO) to support the impaired cardiac function in patients with septic shock remains controversial. Moreover, no prospective studies have been taken to address whether venoarterial ECMO treatment could improve the outcome of patients with sepsis-induced cardiogenic shock. The objective of this study is to assess whether venoarterial ECMO treatment can improve the 30-day survival rate of patients with sepsis-induced refractory cardiogenic shock...
June 10, 2024: BMJ Open
Andrew Kalra, Christopher Wilcox, Sari D Holmes, Joseph E Tonna, In Seok Jeong, Peter Rycus, Marc M Anders, Akram M Zaaqoq, Roberto Lorusso, Daniel Brodie, Steven P Keller, Bo Soo Kim, Glenn J R Whitman, Sung-Min Cho
PURPOSE: Skin pigmentation influences peripheral oxygen saturation (SpO2 ) compared to arterial saturation of oxygen (SaO2 ). Occult hypoxemia (SaO2  ≤ 88% with SpO2  ≥ 92%) is associated with increased in-hospital mortality in venovenous-extracorporeal membrane oxygenation (VV-ECMO) patients. We hypothesized VV-ECMO cannulation, in addition to race/ethnicity, accentuates the SpO2 -SaO2 discrepancy due to significant hemolysis. METHODS: Adults (≥ 18 years) supported with VV-ECMO with concurrently measured SpO2 and SaO2 measurements from over 500 centers in the Extracorporeal Life Support Organization Registry (1/2018-5/2023) were included...
June 10, 2024: Lung
Jeroen J H Bunge, Silvia Mariani, Christiaan Meuwese, Bas C T van Bussel, Michele Di Mauro, Dominik Wiedeman, Diyar Saeed, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Hergen Buscher, Leonardo Salazar, Bart Meyns, Daniel Herr, Sacha Matteucci, Sandro Sponga, Graeme MacLaren, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, I-Wen Wang, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Kiran Shekar, Glenn J R Whitman, Diederik Gommers, Dinis Dos Reis Miranda, Roberto Lorusso
OBJECTIVES: Most post-cardiotomy (PC) extracorporeal membrane oxygenation (ECMO) runs last less than 7 days. Studies on the outcomes of longer runs have provided conflicting results. This study investigates patient characteristics and short- and long-term outcomes in relation to PC ECMO duration, with a focus on prolonged (> 7 d) ECMO. DESIGN: Retrospective observational cohort study. SETTING: Thirty-four centers from 16 countries between January 2000 and December 2020...
June 10, 2024: Critical Care Medicine
Panagiotis Papamichalis, Katerina G Oikonomou, Maria Xanthoudaki, Asimina Valsamaki, Apostolia-Lemonia Skoura, Sophia K Papathanasiou, Achilleas Chovas
Extracorporeal organ support (ECOS) has made remarkable progress over the last few years. Renal replacement therapy, introduced a few decades ago, was the first available application of ECOS. The subsequent evolution of ECOS enabled the enhanced support to many other organs, including the heart [veno-arterial extracorporeal membrane oxygenation (ECMO), slow continuous ultrafiltration], the lungs (veno-venous ECMO, extracorporeal carbon dioxide removal), and the liver (blood purification techniques for the detoxification of liver toxins)...
June 9, 2024: World Journal of Critical Care Medicine
Yuxi Jin, Juan Xu, Yimin Hua, Haiyang Zhang, Yifei Li
BACKGROUND: Restrictive cardiomyopathy (RCM) represents a rare cardiovascular disorder stemming from filament-associated genes. Nonetheless, treating RCM presents considerable challenges, particularly concerning device implantation and mechanical support. Furthermore, elucidating the molecular function of specific variants holds promise in benefiting patients and enhancing prognosis, given the significant heterogeneity among RCM variants. CASE PRESENTATION: The proband, an eight-year-old female, was admitted to our hospital post cardiopulmonary resuscitation due to sudden cardiac arrest...
2024: Frontiers in Cardiovascular Medicine
Carolina Salgueirinho, André Correia, Inês Graça, Raquel Oliveira, José Dias
Refractory pediatric intraoperative cardiac arrest is a rare but challenging situation for the anesthesiologist. This case describes an intraoperative extracorporeal cardiopulmonary resuscitation (ECPR) in a 16-year-old male who suffered a sudden cardiac arrest during elective thoracolumbar stabilization. The patient recovered to his pre-operative baseline without any neurological sequela secondary to cardiac arrest. Good quality of conventional resuscitation measures, prompt activation of the extracorporeal membrane oxygenation (ECMO) team, and a multidisciplinary coordinated approach were key factors in ECPR success...
May 2024: Curēus
Jake M Kieserman, Ivan A Kuznetsov, Joseph Park, James W Schurr, Omar Toubat, Salim Olia, Christian Bermudez, Marisa Cevasco, Joyce Wald
INTRODUCTION: A feared complication of an acute myocardial infarction (AMI) is cardiac arrest (CA). Even if return of spontaneous circulation is achieved, cardiogenic shock (CS) is common. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) supports patients with CS and is often used in conjunction with an Impella device (2.5 and CP) to off-load the left ventricle, although limited evidence supports this approach. METHODS: The goal of this study was to determine whether a mortality difference was observed in VA-ECMO alone versus VA-ECMO with Impella (ECPELLA) in patients with CS from AMI and CA...
June 10, 2024: International Journal of Artificial Organs
Michael J Martinez, Tahmineh Romero, Myke D Federman
OBJECTIVE: To evaluate the association of RBC transfusions with thrombosis in pediatric patients on extracorporeal membrane oxygenation (ECMO) and compare this with the transfusion of other blood products and their association with thrombosis. METHODS: This was a secondary analysis of the Bleeding and Thrombosis during ECMO (BATE) study, which was a multicenter prospective observational study involving patients less than 19 years of age treated with ECMO. RESULTS: 514 patients were analyzed, of which 282 (55%) were neonates (≤31 days) and 302 (58...
June 8, 2024: Perfusion
Chiara Catalano, Fabrizio Crascì, Silvia Puleo, Roberta Scuoppo, Salvatore Pasta, Giuseppe M Raffa
Cardiovascular diseases persist as a leading cause of mortality and morbidity, despite significant advances in diagnostic and surgical approaches. Computational Fluid Dynamics (CFD) represents a branch of fluid mechanics widely used in industrial engineering but is increasingly applied to the cardiovascular system. This review delves into the transformative potential for simulating cardiac surgery procedures and perfusion systems, providing an in-depth examination of the state-of-the-art in cardiovascular CFD modeling...
June 7, 2024: Perfusion
Kei Sato, Silver Heinsar, Jonathan Chan, Samia M Farah, Karin Wildi, Nchafatso G Obonyo, Keibun Liu, Carmen Ainola, Noriko Sato, Gabriella Abbate, Emily S Wilson, Mahé Bouquet, Kieran Hyslop, Margaret R Passmore, Shinichi Ijuin, Sun Kyun Ro, Gabriele Fior, Lucia Gandini, Brooke Lundon, David G Platts, Jacky Y Suen, Gianluigi Li Bassi, John F Fraser
BACKGROUND: Left ventricular stroke work index (LVSWI) and cardiac power index (CPI) account for the haemodynamic load of the left ventricle and are promising prognostic values in cardiogenic shock. However, accurately and non-invasively measuring these parameters during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is challenging and potentially biased by the extracorporeal circulation. This study aimed to investigate, in an ovine model of cardiogenic shock, whether Pressure-Strain Product (PSP), a novel speckle-tracking echocardiography parameter, (1) can correlate with pressure-volume catheter-based LVSWI and CPI, and (2) can be load-independent during the flow modification of V-A ECMO...
June 7, 2024: European Journal of Clinical Investigation
Meng-Chiu Pai, Yun-Chung Liu, Ting-Yu Yen, Kuan-Ying Huang, Chun-Yi Lu, Jong-Min Chen, Ping-Ing Lee, Luan-Yin Chang, Li-Min Huang
BACKGROUND: Human parainfluenza viruses (HPIVs) commonly cause childhood respiratory illness requiring hospitalization in Taiwan. This study aimed to investigate clinical severity and identify risk factors predisposing to severe disease in hospitalized children with HPIV infection. METHODS: We included hospitalized patients with lab-confirmed HPIV infection from 2007 to 2018 and collected their demographic and clinical characteristics. Patients with ventilator support, intravenous inotropic agents, and extracorporeal membrane oxygenation were defined as severe cases...
May 10, 2024: Journal of Microbiology Immunology and Infection
Jakob Gjedsted, Steffen Christensen, Hasse Møller-Sørensen
No abstract text is available yet for this article.
May 27, 2024: Ugeskrift for Laeger
Hugh A Glazier, Amir Kaki
Massive/high-risk pulmonary embolism (PE) is associated with a 30-day mortality rate of approximately 65%. In searching for strategies that may make a dent on this dismal mortality rate, investigators have, over the last decade, shown renewed interest in the potential beneficial role of venoarterial (V-A) extracorporeal membrane oxygenation (ECMO) in the treatment of patients with high-risk PE. There is a dearth of high-quality evidence regarding the value of ECMO in the treatment of massive PE. Studies examining this issue have generally been retrospective, often single center and frequently with small patient numbers...
June 2024: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Clinton T Morgan, Sibu P Saha
Pulmonary embolism is a major cause of mortality worldwide. In this historical perspective, we aim to provide an overview of the rich medical history surrounding pulmonary embolism. We highlight Virchow's first steps toward understanding the pathophysiology in the 1800s. We see how those insights inspired early attempts at intervention such as surgical pulmonary embolectomy and caval ligation. Those early interventions were refined and ultimately led to the development of inferior vena cava filters, the earliest clinical applications of anticoagulation, and even apparently disparate medical advances such as the successful development of cardiopulmonary bypass...
June 2024: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Xinying Liu, Ruizhong Ye
No abstract text is available yet for this article.
June 1, 2024: Quantitative Imaging in Medicine and Surgery
Nael Al-Sarraf, Adel Maher, Nanda Kishore Muddaiah, Yuldash Agzamov, Nawar Jabbour
Acute mitral regurgitation (MR) secondary to papillary muscle rupture is a rare mechanical complication of acute myocardial infarction occurring in 0.05-0.26% of all cases of myocardial infarction. The only treatment is emergency mitral valve surgery with high operative mortality reaching up to 39%. The use of extracorporeal membrane oxygenator (ECMO) as a stabilization strategy and a bridge to recovery may potentially improve the outcome of such cases. Here, we report a case of acute MR presenting with cardiogenic shock and severe hypoxia that required insertion of veno-veno-arterial ECMO initially and followed by emergency mitral valve replacement...
June 2024: Journal of Surgical Case Reports
Su Yeon Lee, Jee Hwan Ahn, Ho Cheol Kim, Tae Sun Shim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Seung-Il Park, Sang-Bum Hong
This study aimed to assess the lung transplantation (LT) outcomes of patients with right ventricular dysfunction (RVD), focusing on the impact of various extracorporeal membrane oxygenation (ECMO) configurations. We included adult patients who underwent LT with ECMO as a bridge-to-transplant from 2011 to 2021 at a single center. Among patients with RVD ( n = 67), veno-venous (V-V) ECMO was initially applied in 79% (53/67) and maintained until LT in 52% (35/67). Due to the worsening of RVD, the configuration was changed from V-V ECMO to veno-arterial (V-A) ECMO or a right ventricular assist device with an oxygenator (Oxy-RVAD) in 34% (18/67)...
2024: Transplant International
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