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JOURNAL ARTICLE
Waqas Akhtar, Veronica Rial Baston, Marius Berman, Sai Bhagra, Colin Chue, Charles D Deakin, Jonathan R Dalzell, Joel Dunning, John Dunning, Roy S Gardner, Kristine Kiff, Shishir Kore, Sern Lim, Guy MacGowan, Ian Naldrett, Marlies Ostermann, Sofia Pinto, Stephen Pettit, Fernando Riesgo Gil, Alex Rosenberg, Antonio Rubino, Rana Sayeed, Joao Sequeira, Neil Swanson, Steven Tsui, Christopher Walker, Stephen Webb, Andrew Woods, Rajamiyer Ventkateswaran, Christopher T Bowles
An implantable left ventricular assist device (LVAD) is indicated as a bridge to transplantation or recovery in the United Kingdom (UK). The mechanism of action of the LVAD results in a unique state of haemodynamic stability with diminished arterial pulsatility. The clinical assessment of an LVAD recipient can be challenging because non-invasive blood pressure, pulse and oxygen saturation measurements may be hard to obtain. As a result of this unusual situation and complex interplay between the device and the native circulation, resuscitation of LVAD recipients requires bespoke guidelines...
March 25, 2024: Intensive Care Medicine
#62
Shingo Kunioka, Fumitaka Suzuki, Marino Nagata, Masahiro Tsutsui, Hiroyuki Kamiya
The leukemoid reaction (LR) is reported to be caused by severe stress conditions such as infection, malignancies, intoxication, severe hemorrhage, or acute hemolysis; this condition is attributed to a very severe prognosis. Some reports have suggested that the LR was associated with a systemic stress response. A 36-year-old man who required mechanical circulatory support (MCS), including veno-arterial extracorporeal membrane oxygenation and Impella 5.5 due to severe heart failure, was transferred to our hospital...
February 2024: Curēus
#63
JOURNAL ARTICLE
Mimi Xiaoming Deng, Christoph Haller, Kasey Moss, Sudipta Saha, Kyle Runeckles, Chun-Po Steve Fan, Bhavikkumar Langanecha, Alejandro Floh, Anne-Marie Guerguerian, Osami Honjo
BACKGROUND: Cardiopulmonary failure refractory to medical management after moderate-to-high-risk congenital cardiac surgery may necessitate mechanical support with veno-arterial extracorporeal membrane oxygenation (ECMO). On the extreme, ECMO can also be initiated in the setting of cardiac arrest (extracorporeal cardiopulmonary resuscitation, ECPR) unresponsive to conventional resuscitative measures. METHODS: This was a single-center retrospective cohort study of patients ( n = 510) aged <3 years old who underwent cardiac surgery with cardiopulmonary bypass with a RACHS-1 score ≥3 between 2011 and 2014...
2024: Frontiers in Pediatrics
#64
JOURNAL ARTICLE
Trent C Martin, Brittney E Duewell, Janelle J Juul, Joseph R G Rinka, Lisa Rein, Joel T Feih
OBJECTIVES: To evaluate the safety of cangrelor administered concurrently with heparin or bivalirudin in patients on mechanical circulatory support. DESIGN: A single-center, retrospective cohort study of adult patients consecutively admitted between January 2016 and October 2020. SETTING: A tertiary medical center. PARTICIPANTS: Adult patients admitted to the cardiovascular intensive care unit put on mechanical circulatory support for acute myocardial infarction (AMI) or non-AMI indications...
March 2, 2024: Journal of Cardiothoracic and Vascular Anesthesia
#65
REVIEW
Jiahui Shen, Lingling Hu, Xiaoyuan Huang, Jiajie Mao, Yuzhu Wu, Zhijian Xie, Yanhua Lan
The skeleton serves as a supportive and protective organ for the body. As individuals age, their bone tissue undergoes structural, cellular and molecular changes, including the accumulation of senescent cells. Extracellular vesicles (EVs) play a crucial role in aging through the cellular secretome and have been found to induce or accelerate age-related dysfunction in bones and to contribute further via the circulatory system to the aging of phenotypes of other bodily systems. However, the extent of these effects and their underlying mechanisms remain unclear...
March 21, 2024: Bone
#66
JOURNAL ARTICLE
Linus Ohlsson, Joanna-Maria Papageorgiou, Tino Ebbers, Meriam Åström Aneq, Éva Tamás, Hans Granfeldt
AIMS: While echocardiography remains essential within haemodynamic monitoring of durable mechanical circulatory support, previous echocardiographic guidelines are missing scientific evidence for the novel HeartMate 3™ (HM3) system. Accordingly, this review aims to summarize available echocardiographic evidence including HM3. METHODS AND RESULTS: This systematic review adhered to the PRISMA 2020 guidelines. Searches were conducted during August 2023 across PubMed, Embase, and Google Scholar using specific echocardiographic terms combined with system identifiers...
March 23, 2024: ESC Heart Failure
#67
REVIEW
Hoong Sern Lim, José González-Costello, Jan Belohlavek, Elric Zweck, Vanessa Blumer, Benedikt Schrage, Thomas C Hanff
Hemodynamic derangements are defining features of cardiogenic shock. Randomized clinical trials have examined the efficacy of various therapeutic interventions, from percutaneous coronary intervention to inotropes and mechanical circulatory support (MCS). However, hemodynamic management in cardiogenic shock has not been well-studied. This State-of-the-Art review will provide a framework for hemodynamic management in cardiogenic shock, including a description of the four therapeutic phases from initial 'Rescue' to 'Optimization', 'Stabilization' and 'de-Escalation or Exit therapy' (R-O-S-E), phenotyping and phenotype-guided tailoring of pharmacological and MCS support, to achieve hemodynamic and therapeutic goals...
March 20, 2024: Journal of Heart and Lung Transplantation
#68
Vanessa M Ferreira, Dayane Nunes Rodrigues, Carlos Alberto Mendez Contreras, João M Rossi, Rui Fernando Ramos, Gustavo Oliveira, Mayron F Oliveira
This case report describes the exercise program on a hospitalized 54-year-old male patient with cardiogenic shock waiting for a heart transplant assisted by an intra-aortic balloon pump, a temporary mechanical circulatory support device. The temporary mechanical circulatory support device, an intra-aortic balloon pump, was placed in the left subclavian artery, enabling the exercise protocol. Measurements and values from Swan-Ganz catheter, blood sample, brain natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP), as well as the six-minute walk test (6MWT) and venous oxygen saturation (SvO2) were obtained before and after an exercise protocol...
2024: Arquivos Brasileiros de Cardiologia
#69
REVIEW
Alexander Geppert, Kambis Mashayekhi, Kurt Huber
Contemporary medical practices allow complete percutaneous coronary intervention (PCI) in a considerable number of patients who previously would have been considered too 'high-risk' for such procedures. The use of mechanical circulatory support (MCS) devices during these high-risk PCIs (HR-PCIs) is thought to reduce the potential risk for major adverse events during and after revascularization. The intra-aortic balloon pump (IABP), veno-arterial extracorporeal membrane oxygenation (V-A ECMO), and the Impella are the most common MCS devices in use...
March 2024: Eur Heart J Open
#70
REVIEW
Huijie Li, Jianhe Yuan, Gavin Fennell, Vagif Abdulla, Ravi Nistala, Dima Dandachi, Dominic K C Ho, Yi Zhang
The COVID-19 pandemic has changed the lives of many people around the world. Based on the available data and published reports, most people diagnosed with COVID-19 exhibit no or mild symptoms and could be discharged home for self-isolation. Considering that a substantial portion of them will progress to a severe disease requiring hospitalization and medical management, including respiratory and circulatory support in the form of supplemental oxygen therapy, mechanical ventilation, vasopressors, etc. The continuous monitoring of patient conditions at home for patients with COVID-19 will allow early determination of disease severity and medical intervention to reduce morbidity and mortality...
September 2023: Biophysics reviews
#71
JOURNAL ARTICLE
Kevin G Buda, Katarzyna Hryniewicz, Peter M Eckman, Mir B Basir, Jennifer A Cowger, Khaldoon Alaswad, Srini Mukundan, Yader Sandoval, Andrea Elliott, Emmanouil S Brilakis, Michael S Megaly
BACKGROUND: Despite increased temporary mechanical circulatory support (tMCS) utilization for acute myocardial infarction complicated by cardiogenic shock (AMI-CS), data regarding efficacy and optimal timing for tMCS support are limited. This study aimed to describe outcomes based on tMCS timing in AMI-CS and to identify predictors of 30-day mortality and readmission. METHODS: Patients with AMI-CS identified in the National Readmissions Database were grouped according to the use of tMCS and early (<24 hours) vs...
March 19, 2024: European Heart Journal. Acute Cardiovascular Care
#72
JOURNAL ARTICLE
Jessica S Clothier, Serge Kobsa, Jonathan Praeger, Markian Bojko, Anahat Dhillon, Ajay Vaidya, Raymond Lee
Limited donor organ availability often necessitates mechanical circulatory support, and recently the Impella 5.5, as a bridge to heart transplant. Of 175 Impella 5.5-supported patients at our institution, 45 underwent transplantation in the largest series to date, for whom we analyzed outcomes. Two methods of complete device explant were evaluated: central Impella transection and removal via axillary graft. Median Impella days were 25 (16-41); median waitlist days were 21 (9-37). Eighty-nine percent (40/45) of patients had device placement via right axillary artery...
March 14, 2024: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
#73
JOURNAL ARTICLE
Frederik M Nielsen, Thomas L Klitgaard, Martin Siegemund, Jon H Laake, Katrin M Thormar, Jade M Cole, Søren R Aagaard, Anne-Marie G Bunzel, Stine R Vestergaard, Peter K Langhoff, Caroline H Pedersen, Josefine Ø Hejlesen, Salim Abdelhamid, Anna Dietz, Caroline E Gebhard, Nuria Zellweger, Alexa Hollinger, Lone M Poulsen, Sarah Weihe, Nina C Andersen-Ranberg, Ulf G Pedersen, Ole Mathiesen, Anne Sofie Andreasen, Helene Brix, Jonas J Thomsen, Christina H Petersen, Morten H Bestle, Sine Wichmann, Martin S Lund, Karoline M Mortensen, Björn A Brand, Nicolai Haase, Susanne A Iversen, Klaus V Marcussen, Anne C Brøchner, Morten Borup, Thorbjørn Grøfte, Thomas Hildebrandt, Maj-Brit N Kjær, Janus Engstrøm, Theis Lange, Anders Perner, Olav L Schjørring, Bodil S Rasmussen
IMPORTANCE: Supplemental oxygen is ubiquitously used in patients with COVID-19 and severe hypoxemia, but a lower dose may be beneficial. OBJECTIVE: To assess the effects of targeting a Pao2 of 60 mm Hg vs 90 mm Hg in patients with COVID-19 and severe hypoxemia in the intensive care unit (ICU). DESIGN, SETTING, AND PARTICIPANTS: Multicenter randomized clinical trial including 726 adults with COVID-19 receiving at least 10 L/min of oxygen or mechanical ventilation in 11 ICUs in Europe from August 2020 to March 2023...
March 19, 2024: JAMA
#74
JOURNAL ARTICLE
Uwe Janssens
Acute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. The prognosis of affected patients depends on the clinical severity. Therefore, risk stratification is imperative for therapeutic decision-making. Patients with high-risk PE need intensive care. These include patients who have successfully survived resuscitation, with obstructive shock or persistent haemodynamic instability. Bedside diagnostics by means of sonographic procedures are of outstanding importance in this high-risk population...
March 18, 2024: Hämostaseologie
#75
JOURNAL ARTICLE
Satsuki Yagi-Nakajima, Masanobu Miura, Shun Sawada, Takahiro Funaki, Kumi Uchimura, Kai Susukita, Tsubasa Hatakeyama, Yuta Kagaya, Hiroki Saito, Kenjiro Sato, Masanori Kanazawa, Masateru Kondo, Hideaki Endo, Hiroshi Yaegashi, Akihiro Nakamura
Myocardial calcification in myocarditis is rare and may be linked to poor outcomes. We herein report a case of fulminant myocarditis with massive myocardial calcification and its pathological outcomes at autopsy. A 49-year-old man experienced chest pain and was diagnosed with acute myocarditis. His cardiac function did not recover despite mechanical circulatory support in combination with V-A extracorporeal membrane oxygenation and IMPELLA CP® . He eventually developed sepsis and gastrointestinal bleeding and died on day 27...
2024: Internal Medicine
#76
JOURNAL ARTICLE
Mateusz Tajstra, Leszek Bryniarski, Kamil Bujak, Krzysztof Wilczek, Robert Gil, Sławomir Dobrzycki, Wojciech Wojakowski, Jacek Legutko, Marek Gierlotka, Mariusz Gąsior
BACKGROUND: Notwithstanding readily available revascularization, significant advancements in mechanical circulatory support, and pharmacological progress, cardiogenic shock (CS) secondary to unprotected left main culprit lesion-related acute myocardial infarction (ULMCL-related AMI) is associated with very high mortality. In this population, chronic total occlusion (CTO) is relatively frequent. AIMS: This study sought to assess the association between the presence of CTO and 12-month mortality in patients with CS due to ULMCL-related AMI...
2024: Kardiologia Polska
#77
REVIEW
Jamel Ortoleva, Adam A Dalia, Dominic V Pisano, Alexander Shapeton
Refractory vasodilatory shock, or vasoplegia, is a pathophysiologic state observed in the intensive care unit and operating room in patients with a variety of primary diagnoses. Definitions of vasoplegia vary by source but are qualitatively defined clinically as a normal or high cardiac index and low systemic vascular resistance causing hypotension despite high-dose vasopressors in the setting of euvolemia. This definition can be difficult to apply to patients undergoing mechanical circulatory support (MCS)...
February 23, 2024: Journal of Cardiothoracic and Vascular Anesthesia
#78
JOURNAL ARTICLE
Mehrdad Khamooshi, Avishka Wickramarachchi, Tim Byrne, Michael Seman, David F Fletcher, Aidan Burrell, Shaun D Gregory
PROBLEM: Despite advances in Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO), a significant mortality rate persists due to complications. The non-physiological blood flow dynamics of VA-ECMO may lead to neurological complications and organ ischemia. Continuous retrograde high-flow oxygenated blood enters through a return cannula placed in the femoral artery which opposes the pulsatile deoxygenated blood ejected by the left ventricle (LV), which impacts upper body oxygenation and subsequent hyperoxemia...
March 11, 2024: Computers in Biology and Medicine
#79
JOURNAL ARTICLE
Muhammad Usman Almani, Rasha Khan, Muhammad Qudrat-Ullah, Muhammad Yousuf, Yaqi Zhang, Naveen Baskaran, Mohammad Hamza, Raphael Bonita
BACKGROUND: Takotsubo cardiomyopathy (TCM) is classically associated with significant gender disparities, such that it is more prevalent in females, but the clinical outcomes are worse for male patients. The goal of this study was to assess contemporary gender disparities in clinical outcomes of TCM hospitalizations and to determine predictors of male in-hospital mortality. METHODS: This was a retrospective analysis involving adult hospitalizations for TCM in the U...
March 12, 2024: International Journal of Cardiology
#80
JOURNAL ARTICLE
Anju Bhardwaj, Ismael A Salas de Armas, Amanda Bergeron, R Michelle Sauer, Christa Gilley, Kathryn Reeves, Maria Patarroyo-Aponte, Mehmet H Akay, Manish Patel, Sachin Kumar, Jayeshkumar Patel, Juan Marcano, Sriram Nathan, Igor D Gregoric, Biswajit Kar
Physical therapy (PT) benefits for critically ill patients are well recognized; however, little data exist on PT in patients receiving temporary mechanical circulatory support. In this single-center retrospective study (February 2017-January 2022), we analyzed 37 patients who received an axillary Impella device (Abiomed, Danvers, MA) and PT to "prehabilitate" them before durable left ventricular assist device (dLVAD) implantation. The Activity Measure for Post-Acute Care (AM-PAC) Basic Mobility tool assessed the functional status at different points during admission...
March 13, 2024: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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