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Parker J Hu, Lauren Griswold, Lauren Raff, Rachel Rodriguez, Gerald McGwin Jr, Jeffrey David Kerby, Patrick Bosarge
Background: The use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for patients with severe acute respiratory distress syndrome is gaining greater acceptance among trauma intensivists. The objective of this study was to review ECMO usage in trauma patients in the USA. Methods: The National Inpatient Sample (NIS) from years 2002 to 2012 was queried for patients aged 15 and older treated with ECMO who had one or more acute traumatic injuries as defined by the International Diagnostic Codes, Ninth Edition (ICD-9)...
2019: Trauma Surgery & Acute Care Open
J W Awori Hayanga
No abstract text is available yet for this article.
March 16, 2019: Annals of Thoracic Surgery
Giacomo Grasselli, Vittorio Scaravilli, Daniela Tubiolo, Riccarda Russo, Francesco Crimella, Francesca Bichi, Letizia Corinna Morlacchi, Eleonora Scotti, Lorenzo Patrini, Luciano Gattinoni, Antonio Pesenti, Davide Chiumello
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Extracorporeal membrane oxygenation is used in severe acute respiratory distress syndrome; whereas the long-term complications among survivors of acute respiratory distress syndrome treated without extracorporeal membrane oxygenation are well described, the status of extracorporeal membrane oxygenation survivors is poorly understood WHAT THIS ARTICLE TELLS US THAT IS NEW: In a single-center cohort of acute respiratory distress syndrome survivors, management with (vs...
April 2019: Anesthesiology
Claire Depondt, Darko Arnaudovski, Audrey Voulgaropoulos, Olivier Milleron, Walid Ghodbane, Alexy Tran Dinh, Philippe Montravers, Elie Kantor
Amniotic fluid embolism is a rare but dreaded complication of pregnancy, with an incidence between 2 and 7/100,000 deliveries. We report an amniotic fluid embolism after urgent cesarean delivery diagnosed on a cardiac arrest, complicated by cardiogenic shock and acute respiratory distress syndrome. This report describes the indication, efficacy, and success of venoarterial extracorporeal membrane oxygenation in the early management of cardiac arrest, cardiac failure driven by amniotic fluid embolism, and acute respiratory distress syndrome...
March 6, 2019: A&A Practice
Jonathan Kozinn, W Cole Wrisinger
The technology to provide Extracorporeal Life Support (ELS) has existed for over four decades. Its use has increased markedly in the last decade, initially in response to severe Acute Respiratory Distress Syndrome (ARDS) in adults during the 2009 H1N1 influenza epidemic and continuing with the increasing acceptance of Extracorporeal Membrane Oxygenation (ECMO) for the treatment of severe respiratory failure in adults from other causes.1 We highlight the use of ECMO, particularly at our institution.
January 2019: Missouri Medicine
Won Young Kim, SeungYong Park, Hwa Jung Kim, Moon Seong Baek, Chi Ryang Chung, So Hee Park, Byung Ju Kang, Jin Young Oh, Woo Hyun Cho, Yun Su Sim, Young Jae Cho, Sunghoon Park, Jung Hyun Kim, Sang Bum Hong
BACKGROUND: Beyond its current function as a rescue therapy in acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) may be applied in ARDS patients with less severe hypoxemia to facilitate lung protective ventilation. The purpose of this study was to evaluate the efficacy of extended ECMO use in ARDS patients. METHODS: This study reviewed 223 adult patients who had been admitted to the intensive care units of 11 hospitals in Korea and subsequently treated using ECMO...
February 28, 2019: Tuberculosis and Respiratory Diseases
Hyoung Soo Kim, Jung-Hyun Kim, Chi Ryang Chung, Sang-Bum Hong, Woo Hyun Cho, Young-Jae Cho, Yun Su Sim, Won-Young Kim, Byung Ju Kang, So Hee Park, Jin Young Oh, SeungYong Park, Sunghoon Park
BACKGROUND: Limited data are available regarding mechanical ventilation strategies in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO). METHODS: A retrospective analysis of ARDS patients on ECMO was conducted in nine hospitals in Korea. Data on ventilator settings (pre-ECMO, and 0, 4, 24, 48 hours after ECMO) were collected. Based on the effect of the duration and intensity of mechanical ventilator on outcomes, time-weighted average (TWA) values were calculated for ventilator parameters...
March 2, 2019: Annals of Thoracic Surgery
Valentina Della Torre, Chiara Robba, Paolo Pelosi, Federico Bilotta
PURPOSE OF REVIEW: The purpose of this review is to describe recent evidence regarding the use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for severe cardiac or respiratory failure in patients with trauma. The characteristics of this cohort of patients, including the risk of bleeding and the need for systemic anticoagulation, are generally considered as relative contraindications to ECMO treatment. However, recent evidence suggests that the use of ECMO should be taken in consideration even in this group of patients...
April 2019: Current Opinion in Anaesthesiology
Chul Park, Soo Jin Na, Chi Ryang Chung, Yang Hyun Cho, Gee Young Suh, Kyeongman Jeon
BACKGROUND: Bacterial pneumonia is a major cause of acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) support. However, it is unknown whether the type of pneumonia, community-acquired pneumonia (CAP) versus hospital-acquired pneumonia (HAP), should be considered when predicting outcomes for ARDS patients treated with ECMO. METHODS: We divided a sample of adult patients receiving ECMO for acute respiratory distress syndrome caused by bacterial pneumonia between January 2012 and December 2016 into CAP ( n = 21) and HAP ( n = 35) groups and compared clinical and bacteriological characteristics and outcomes...
January 2019: Therapeutic Advances in Respiratory Disease
Mitchell S Buckley, Amy L Dzierba, Justin Muir, Jeffrey P Gonzales
Acute respiratory distress syndrome (ARDS) remains a common complication associated with significant negative outcomes in critically ill patients. Lung-protective mechanical ventilation strategies remain the cornerstone in the management of ARDS. Several therapeutic options are currently available including fluid management, neuromuscular blocking agents, prone positioning, extracorporeal membrane oxygenation, corticosteroids, and inhaled pulmonary vasodilating agents (prostacyclins and nitric oxide). Unfortunately, an evidence-based, standard-of-care approach in managing ARDS beyond lung-protective ventilation remains elusive, contributing to significant variability in clinical practice...
February 21, 2019: Journal of Pharmacy Practice
Samuel M Galvagno, Nirav G Shah, Christopher R Cornachione, Kristopher B Deatrick, Michael A Mazzeffi, Jay Menaker
INTRODUCTION: Diffuse alveolar damage is the histologic hallmark for the acute phase of acute respiratory distress syndrome and can occasionally present as diffuse alveolar hemorrhage. CASE REPORT: We report a patient with diffuse alveolar hemorrhage and acute respiratory distress syndrome requiring veno-venous extracorporeal life support for 210 days, who was successfully treated for a period of 130 consecutive days without intravenous anticoagulation. DISCUSSION: Although there are a few brief reports detailing long extracorporeal life support runs, the literature is largely devoid of data regarding long-term extracorporeal life support without full systemic anticoagulation...
February 11, 2019: Perfusion
Danqiong Wang, Guozheng Zhang, Weiwen Zhang, Jian Luo, Lihua Zhu, Jianhua Hu
RATIONALE: Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported. PATIENT CONCERNS: A 40-year-old man ingested in 100 ml of diquat (20 g/100 ml) and 400 ml glyphosate (41 g/100 ml) was admitted to the intensive care unit (ICU), immediately complicated by the development of ventricular fibrillation, respiratory failure, renal failure, and multi-organ failure...
February 2019: Medicine (Baltimore)
Falk Fichtner, Onnen Moerer, Sven Laudi, Steffen Weber-Carstens, Monika Nothacker, Udo Kaisers
BACKGROUND: Mechanical ventilation is life-saving for patients with acute respiratory insufficiency. In a German prevalence study, 13.6% of patients in intensive care units received mechanical ventilation for more than 12 hours; 20% of these patients received mechanical ventilation as treatment for acute respiratory distress syndrome (ARDS). The new S3 guideline is the first to contain recommendations for the entire process of treatment in these groups of patients (indications, ventilation modes/parameters, ac- companying measures, treatments for refractory impairment of gas exchange, weaning, and follow-up care)...
December 14, 2018: Deutsches Ärzteblatt International
Christina L Costantino, Abraham D Geller, Cameron D Wright, Harald C Ott, Ashok Muniappan, Douglas J Mathisen, Michael Lanuti
OBJECTIVES: Complete resection of neoplasms involving the carina are technically challenging and have high operative morbidity and mortality. This study examines the last 2 decades of clinical experience at our institution. METHODS: Medical records were retrospectively reviewed between 1997 and 2017 to identify all patients who underwent carinal resection. Primary outcome measures include risk factors for complications and overall survival. RESULTS: In total, 45 carinal resections were performed with a median follow-up of 3...
December 15, 2018: Journal of Thoracic and Cardiovascular Surgery
Wei Huang, Yongxin Qin
In 2018, a bunch of considerable positive progresses have been presented, including a revised "hour-1 bundle" introduced by international guideline for management of sepsis and septic shock, trans-pulmonary pressure monitoring via esophageal manometry in acute respiratory distress syndrome (ARDS) models, successful trials for new antibiotics, angiotensin II in patients with vasodilatory shock and renal replacement therapy, advanced airway management in out-of-hospital cardiac arrest (OHCA) patients as well cellular immunotherapy for septic shock...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Stefan Felix Ehrentraut, Barbara Schroll, Stefan Lenkeit, Heidi Ehrentraut, Christian Bode, Stefan Kreyer, Florian Kögl, Felix Lehmann, Thomas Muders, Martin Scholz, Claudia Strater, Folkert Steinhagen, Nils Ulrich Theuerkauf, Carsten Weißbrich, Christian Putensen, Jens-Christian Schewe
BACKGROUND: Extra Corporeal Membrane Oxygenation (ECMO) has become an accepted treatment option for severely ill patients. Due to a limited availability of ECMO support therapy, patients must often be transported to a specialised centre before or after cannulation. According to the ELSO guidelines, an ECMO specialist should be present for such interventions. Here we describe the safety and efficacy of a reduced team approach involving one anaesthesiologist, experienced in specialised intensive care medicine, and a specialised critical care nurse...
January 31, 2019: BMC Anesthesiology
Filippo Sanfilippo, Mariachiara Ippolito, Cristina Santonocito, Gennaro Martucci, Tiziana Carollo, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Giovanna Panarello, Antonino Giarratano, Antonio Arcadipane
BACKGROUND: Acute respiratory distress syndrome (ARDS) survivors are affected with long- term physical/mental impairments, with improvements limited mostly to the first year after inten- sive care (ICU) discharge. Furthermore, caregivers of ICU patients exhibit psychological problems after family-member recovery. We evaluated the long-term physical and mental recovery of ARDS survivors treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), and the long-term psychological impact on their caregivers...
January 18, 2019: Minerva Anestesiologica
Edda Vesteinsdottir, Gunnar Myrdal, Kristinn O Sverrisson, Sigurbjorg J Skarphedinsdottir, Olafur Gudlaugsson, Sigurbergur Karason
Tuberculosis is a rare cause of acute respiratory distress syndrome (ARDS) and mortality rates are high in tuberculosis patients that need treatment with mechanical ventilation. Experience of the use of extracorporeal membrane oxygenation (ECMO) in such circumstances is scarce. We report the case of an 18 year old man where prolonged therapy (50 days) with extracorporeal membrane oxygenation (ECMO) allowed extensive lung damage from miliary tuberculosis to heal. The case reflects how challenging the diagnosis of tuberculosis may be and how difficult it is to reach adequate blood levels of anti-tuberculosis drugs while on ECMO...
2019: Respiratory Medicine Case Reports
Darryl Abrams, Niall D Ferguson, Laurent Brochard, Eddy Fan, Alain Mercat, Alain Combes, Vin Pellegrino, Matthieu Schmidt, Arthur S Slutsky, Daniel Brodie
No abstract text is available yet for this article.
January 11, 2019: Lancet Respiratory Medicine
Michael A Matthay
No abstract text is available yet for this article.
January 11, 2019: Lancet Respiratory Medicine
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