Collections ED ECMO


Collection of papers regarding Emergency Medicine and Prehospital use of ECMO
Justyna Swol, Jan Belohlávek, Daniel Brodie, Joseph Bellezzo, Scott D Weingart, Zachary Shinar, Andreas Schober, Matthew Bachetta, Jonathan W Haft, Shingo Ichiba, Tetsuya Sakamoto, Giles J Peek, Roberto Lorusso, Steven A Conrad
BACKGROUND: Extracorporeal life support (ECLS) describes the use of blood perfusion devices to provide advanced cardiac or respiratory support. Advances in percutaneous vascular cannula insertion, centrifugal pump technologies, and the miniaturization of extracorporeal devices have simplified ECLS. The intention of this discussion is to review the role of ECLS as a potential rescue method for emergency department (ED) clinicians in critical clinical scenarios and to focus on the prerequisites for managing an ECLS program in an ED setting...
December 2018: Resuscitation
Ben Singer, Joshua C Reynolds, David J Lockey, Ben O'Brien
Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Hospital-based ECPR is currently offered to selected OHCA patients in specialized centres. The interval between collapse and restoration of circulation is inversely associated with good clinical outcomes after ECPR...
March 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Jae Jun Lee, Sang Jin Han, Hyoung Soo Kim, Kyung Soon Hong, Hyun Hee Choi, Kyu Tae Park, Jeong Yeol Seo, Tae Hun Lee, Heung Cheol Kim, Seonju Kim, Sun Hee Lee, Sung Mi Hwang, Sang Ook Ha
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a useful treatment for refractory out-of-hospital cardiac arrest (OHCA). However, little is known about the predictors of survival and neurologic outcome after ECMO. We analyzed our institution's experience with ECMO for refractory OHCA and evaluated the predictors of survival and neurologic outcome after ECMO. METHODS: This was a retrospective review of the medical records of 23 patients who were treated with ECMO due to OHCA that was unresponsive to conventional cardiopulmonary resuscitation, between January 2009 and January 2014...
May 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
May 2017: Emergency Medicine Journal: EMJ
Tae Sun Ha, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Chi-Min Park, Kyeongman Jeon, Gee Young Suh
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to have survival benefit in patients who had in-hospital cardiac arrest (IHCA). However, limited data are available on the role of extracorporeal membrane oxygenation (ECMO) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate clinical outcomes and predictors of in-hospital mortality in patients who had OHCA and who underwent ECPR. METHODS: From January 2004 to December 2013, 235 patients who received ECPR were enrolled in a retrospective, single-centre, observational registry...
February 2017: Emergency Medicine Journal: EMJ
Aleksandra Leligdowicz, Eddy Fan
PURPOSE OF REVIEW: To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications. RECENT FINDINGS: ECMO use has increased during the past 5 years. Advances in cannulation, circuit design, and patient selection have made it a safer therapeutic option in severe ARDS, and its use has become more widespread for nonconventional indications...
February 2015: Current Opinion in Critical Care
Ken Parhar, Alain Vuylsteke
No abstract text is available yet for this article.
November 2014: Intensive Care Medicine
Hsi-Wen Huang, Chun-Chieh Chiu, Hsu-Heng Yen, Yao-Li Chen, Fu-Yuan Siao
Pulseless electrical activity (PEA) can rapidly transform into sudden cardiac death, if the etiology cannot be identified and corrected immediately. The clinical challenge is how to resuscitate the patient with prolonged PEA. We present a case of a 51-year-old man with PEA due to acute myocardial infarction caused by total occlusion of the main coronary artery, which was refractory to prolonged conventional cardiopulmonary resuscitation. Extracorporeal membrane oxygenation was initiated approximately 75 minutes after prolonged cardiopulmonary resuscitation; this achieved a sustained return of spontaneous circulation, which permitted adequate time for subsequent coronary intervention...
March 2015: American Journal of Emergency Medicine
Vincent Pellegrino, Lisen E Hockings, Andrew Davies
PURPOSE OF REVIEW: To examine the utility and technical challenges of applying veno-arterial extracorporeal membrane oxygenation for acute cardiovascular failure in adults with acute and chronic causes of heart failure. RECENT FINDINGS: The role of mechanical circulatory support in acute cardiovascular continues to evolve as technology and clinical experience develop. There is increasing interest in the role of veno-arterial extracorporeal membrane oxygenation as a bridging therapy and as an adjunct to conventional cardiopulmonary resuscitation...
October 2014: Current Opinion in Critical Care
Yvonnick Boue, Julien Lavolaine, Pierre Bouzat, Sophie Matraxia, Olivier Chavanon, Jean-François Payen
OBJECTIVE: To describe the successful neurologic recovery from profound accidental hypothermia with cardiac arrest despite the longest reported duration of cardiopulmonary resuscitation. DESIGN: Case report. SETTING: Mountain. PATIENT: A 57-year-old woman experienced profound accidental hypothermia (16.9°C) in a mountainous region of Grenoble. She was unconscious and had extreme bradycardia (6 beats/min) at presentation...
February 2014: Critical Care Medicine
James T Thompson, Joseph A Molnar, Michael H Hines, Michael C Chang, Thomas Pranikoff
Pulmonary complications remain one of the leading causes of mortality in patients with burns. We report two cases of adult patients with thermal and inhalation injuries who were placed on extracorporeal membrane oxygenation (ECMO) and survived. Patient 1 was a 42-year-old male who suffered 15% TBSA and a severe inhalation injury requiring intubation upon arrival to the emergency department. Patient 2 was a 24-year-old female in a house fire who received 20%TBSA and was noted to be in respiratory distress and intubated on the scene by the paramedic team...
January 2005: Journal of Burn Care & Rehabilitation
David Morley, Kentaro Yamane, Rika O'Malley, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Accidental hypothermia complicated by cardiac arrest carries a high mortality rate in urban areas. For moderate hypothermia cases conventional rewarming methods are usually adequate, however in severe cases extracorporeal membrane oxygenation (ECMO) is known to provide the most efficient rewarming with complete cardiopulmonary support. We report a case of severe hypothermia complicated by prolonged cardiac arrest successfully resuscitated using ECMO. CASE REPORT: A 45 year old female was brought to our emergency department with a core body temperature <25°C...
2013: American Journal of Case Reports
Giuseppe Gatti, Gabriella Forti, Alessandro Bologna, Gianfranco Sagrati, Gianfranco Gustin, Renata Korcova, Elisabetta Benci, Luca Visintin
A 27-year-old man with haemorrhagic shock and acute cardiac tamponade due to a stab in the chest underwent successful resuscitation and surgical repair of the right ventricular perforation thanks to the use of extracorporeal membrane oxygenation (ECMO) in the emergency department. To the best of the authors' knowledge, this is the first report around the use of ECMO to rescue a victim of a penetrating cardiac trauma. The physicians who have portable ECMO device should be aware of this option when a life-threatening internal bleeding in haemodynamically unstable patients could be quickly controlled by surgery, even if performed in ill-suited settings...
September 2014: Injury
Robert B Kelly, Penny A Porter, Andreas H Meier, John L Myers, Neal J Thomas
Despite the extensive resources required, extracorporeal cardiopulmonary resuscitation (ECPR) has been recognized as an extension of traditional CPR. The reported duration of CPR before ECPR initiation is similar between survivors and nonsurvivors, but the duration of CPR that results in futility of care is unknown. We report two cases of prolonged CPR followed by ECPR resulting in acceptable neurologic outcomes. Ventricular tachycardia developed in a 4-year-old with myocarditis, resulting in a cardiac arrest requiring CPR for 176 minutes before initiation of extracorporeal membrane oxygenation (ECMO)...
September 2005: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Eva Maria Delmo Walter, Vladimir Alexi-Meskishvili, Michael Huebler, Matthias Redlin, Wolfgang Boettcher, Yuguo Weng, Felix Berger, Roland Hetzer
We describe our experience with extracorporeal cardiopulmonary resuscitation (CPR) using extracorporeal membrane oxygenation (ECMO) in children with refractory cardiac arrest, and determine predictors for mortality. ECMO support was instituted on 42 children, median age 0.7 years (1 day-17.8 years), median weight 7.05 (range 2.7-80) kg who suffered refractory cardiac arrest (1992-2008). Patients were postcardiotomy (n=27), or had uncorrected congenital heart diseases (n=3), cardiomyopathy (n=3), myocarditis (n=2), respiratory failure (n=3), or had trauma (n=4)...
June 2011: Interactive Cardiovascular and Thoracic Surgery
Feng-Chun Tsai, Yao-Chang Wang, Yao-Kuang Huang, Chi-Nan Tseng, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng Jing Lin
OBJECTIVE: Extracorporeal life support (ECLS) has been applied successfully to patients with cardiopulmonary failure in extreme situations. Refractory ventricular tachycardia has high mortality and morbidity rates if not terminated in time. This study describes our preliminary experiences in using ECLS to treat patients with refractory ventricular tachycardia. DESIGN: Retrospective chart review. SETTING: Hospital. PATIENTS: Eleven patients suffering from ventricular tachycardia refractory to antiarrhythmia agents and cardioversion attempts...
July 2007: Critical Care Medicine
M Arlt, A Philipp, S Voelkel, B M Graf, C Schmid, M Hilker
We report the use of out-of-hospital extracorporeal life support (ECLS) in cardiac arrest. We treated a 9-year-old girl with cardiac arrest after warm-water drowning with percutaneous venoarterial extracorporeal membrane oxygenation (ECMO) using a new portable Mini-ECMO system. A beating-heart circulation was reestablished on ECMO, but, unfortunately, our patient did not survive. This case shows that Mini-ECMO support can be used to restore an effective circulation and gas exchange in the out-of-hospital setting...
September 2011: Resuscitation
Michael H Stroud, Regina Okhuysen-Cawley, Robert Jaquiss, Ariel Berlinski, Richard T Fiser
OBJECTIVE: To report the successful use of extracorporeal membrane oxygenation (ECMO) as rescue therapy for severe necrotizing pneumonia secondary to infection by the Staphylococcus aureus species. DESIGN: Case series. SETTING: Pediatric intensive care unit at a freestanding tertiary care children's hospital. PATIENTS: Two pediatric patients with severe S. aureus-induced necrotizing pneumonia requiring rescue with ECMO...
May 2007: Pediatric Critical Care Medicine
Nestoras Papadopoulos, Ali El-Sayed Ahmad, Spiros Marinos, Anton Moritz, Andreas Zierer
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) therapy for patients with influenza A (H1N1)-related acute respiratory distress syndrome (ARDS) has been described once all other therapeutic options have been exhausted. The current report reviews our institutional experience and lessons learned in 18 consecutive patients. METHODS: Between December 2009 and March 2011, 18 patients underwent ECMO therapy for severe H1N1-related ARDS. Mean age was 40 ± 18 years (range 4-67 years)...
September 2013: Thoracic and Cardiovascular Surgeon
William T Mahle, Joseph M Forbess, Paul M Kirshbom, Angel R Cuadrado, Janet M Simsic, Kirk R Kanter
BACKGROUND: Indications for extracorporeal membrane oxygenation therapy have expanded to include cardiopulmonary arrest and support after congenital heart surgery. Data from a national registry have reported that cardiac patients have the poorest survival of all extracorporeal membrane oxygenation recipients. Concerns have been raised about the appropriateness of such an aggressive strategy, especially in light of the high costs and potential for long-term neurologic disability. We reviewed our experience with salvage cardiac extracorporeal membrane oxygenation to determine the cost-utility, which accounts for both costs and quality of life...
May 2005: Journal of Thoracic and Cardiovascular Surgery
2014-06-24 00:33:24
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