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Journal of Extra-corporeal Technology

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https://www.readbyqxmd.com/read/28298670/erratum
#1
(no author information available yet)
[This corrects the article on p. 105 in vol. 48, PMID: 27729703.].
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298669/veno-venous-extracorporeal-membrane-oxygenation-for-continuous-renal-replacement-in-a-neonate-with-propionic-acidemia
#2
Jeffrey W Gander, Erika T Rhone, William G Wilson, John P Barcia, Melissa J Sacco
The usual indications for extra corporeal membrane oxygenation (ECMO) are for respiratory or cardiac failure. Although continuous renal replacement therapy (CRRT) is frequently used when patients are on ECMO, the need for CRRT as the primary indication for ECMO is rare. A case of a neonate placed onto veno-venous ECMO for the use of CRRT to treat hyperammonemia from propionic acidemia is presented.
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298668/unexplained-obstruction-of-an-integrated-cardiotomy-filter-during-cardiopulmonary-bypass
#3
Cory M Alwardt, Donald S Wilson, Octavio E Pajaro
Cardiopulmonary bypass (CPB) is considered relatively safe in most cases, yet is not complication free. We present a case of an integrated cardiotomy filter obstruction during CPB, requiring circuit reconfiguration. Approximately an hour after uneventful initiation of CPB the integrated cardiotomy filter became obstructed over several minutes, requiring circuit reconfiguration using an external cardiotomy filter to maintain functionality. Following reconfiguration, CPB was maintained with a fully functional circuit allowing safe patient support throughout the remainder of CPB...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298667/suspected-heparin-induced-thrombocytopenia-in-patients-receiving-extracorporeal-membrane-oxygenation
#4
Bhupinder Natt, Cameron Hypes, Robyn Basken, Joshua Malo, Toshinobu Kazui, Jarrod Mosier
Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management is critical in patients while on extracorporeal membrane oxygenation (ECMO) to prevent thromboembolism and for the optimal functioning of the circuit. We identified five patients with respiratory failure at our hospital managed with ECMO in the last 2 years that were treated for HIT. A brief clinical course and their management are discussed. We also briefly review the literature for best evidence for management of such patients...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298666/bivalirudin-as-an-alternative-anticoagulant-for-cardiopulmonary-bypass-during-adult-cardiac-surgery-a-change-in-practice
#5
Peter Gatt, Samuel Anthony Galea, Walter Busuttil, Charles Grima, Jeffrey Muscat, Yvette Farrugia
The referral of patients for open heart surgery, presenting with a history of heparin hypersensitivity instigated a multidisciplinary effort to find an alternative anticoagulant to heparin. The various options mentioned in the literature call for changes in the routine practice of open heart surgery on cardiopulmonary bypass. These changes involve mostly the perfusion setup and conduct on bypass and to a lesser extent the anesthetic and surgical practice. Nevertheless, the different professions involved in the cardiac surgical firm discussed the proposed changes in a multidisciplinary effort...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298665/application-of-micropore-filter-technology-exploring-the-blood-flow-path-in-arterial-line-filters-and-its-effect-on-bubble-trapping-functions
#6
Daniel P Herbst
Conventional arterial-line filters commonly use a large volume circular shaped housing, a wetted micropore screen, and a purge port to trap, separate, and remove gas bubbles from extracorporeal blood flow. Focusing on the bubble trapping function, this work attempts to explore how the filter housing shape and its resulting blood flow path affect the clinical application of arterial-line filters in terms of gross air handling. A video camera was used in a wet-lab setting to record observations made during gross air-bolus injections in three different radially designed filters using a 30-70% glycerol-saline mixture flowing at 4...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#7
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298663/lean-flow-optimizing-cardiopulmonary-bypass-equipment-and-flow-for-obese-patients-a-technique-article
#8
Joshua M Blessing, Jeffrey B Riley
The goal of this chart review was to investigate the use of down-sized cardiopulmonary bypass (CPB) circuits for obese patients. The effects of transitioning from larger to smaller oxygenators, reservoirs, and arteriovenous tubing loops were evaluated through a retrospective review of 2,816 adult non-congenital procedure perfusion records. This technique report and case series is a continuation of our original prescriptive CPB circuit quality improvement project. An algorithm was derived to adjust body surface area (BSA) to lower body mass index (BMI) to provide down-sized extracorporeal circuit components capable of meeting the metabolic needs of the patient...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298662/the-teg-%C3%A2-6s-on-shaky-ground-a-novel-assessment-of-the-teg-%C3%A2-6s-performance-under-a-challenging-condition
#9
Martin Gill
Thromboelastography(®) (TEG(®)) is used to guide clinical decision-making across many medical and surgical subspecialties. Advances in this field have resulted in analyzers becoming increasingly user friendly, and have led to a reduction in the possibility of user error. The new TEG(®)6s does not come with the warnings of vibration and movement avoidance of its predecessor. It was decided to test the capability of this device while being subject to motion. TEG(®)6s machine 1 was placed in an environment free from motion...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298661/deep-hypothermic-circulatory-arrest-vs-antegrade-cerebral-perfusion-in-cerebral-protection-during-the-surgical-treatment-of-chronic-dissection-of-the-ascending-and-arch-aorta
#10
Oksana Vasilyevna Kamenskaya, Asya Stanislavovna Klinkova, Alexander Mikhailovich Chernyavsky, Vladimir Vladimirovich Lomivorotov, Ivan Olegovich Meshkov, Alexander Mikhailovich Karaskov
Circulatory arrest during aortic surgery presents a risk of neurological complications. The present study aimed to investigate the effectiveness of deep hypothermic circulatory arrest (DHCA) vs. antegrade cerebral perfusion (ACP) in cerebral protection during the surgical treatment of chronic dissection of the ascending and arch aorta and to assess the quality-of-life (QoL) in the long-term postoperative period with respect to the used cerebral protection method. In a prospective, randomized study, 58 patients with chronic type I aortic dissection who underwent ascending aorta and aortic arch replacement surgery were included...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#11
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298659/from-the-editor
#12
EDITORIAL
Julie Wegner
No abstract text is available yet for this article.
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27999447/erratum
#13
(no author information available yet)
[This corrects the article on p. P34 in vol. 48.].
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994263/technology-use-and-patient-safety-at-the-intersection-of-change
#14
Daniel P Herbst
No abstract text is available yet for this article.
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994262/abstraction-techniques-for-the-sts-national-database
#15
EDITORIAL
Joy McLemore Stewart
No abstract text is available yet for this article.
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994261/use-of-cardiopulmonary-bypass-for-management-of-massive-air-embolism-during-hysteroscopic-metroplasty
#16
Ahmad Ali Amirghofran, Narjes Nick, Mina Amiri, Rahim Hemmati
The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994260/a-case-of-successful-thromboelastographic-guided-resuscitation-after-postpartum-hemorrhage-and-cardiac-arrest
#17
M Hurwich, D Zimmer, E Guerra, E Evans, T Shire, M Abernathy, J T Shreve, G R Kolettis, M T McCurdy, F J Castellino, M Walsh
Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG)...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994259/the-relationship-between-intra-operative-transfusions-and-nadir-hematocrit-on-post-operative-outcomes-after-cardiac-surgery
#18
Joshua B Goldberg, Kenneth G Shann, David Fitzgerald, John Fuller, Theron A Paugh, Timothy A Dickinson, Gaetano Paone, Richard L Prager, Donald S Likosky
Uncertainty exists regarding the optimal strategy for the management of anemia in the setting of cardiac surgery. We sought to improve our understanding of the role of intra-operative hematocrit (HCT) and transfusions on peri-operative outcomes following cardiac surgery. A total of 18,886 patients undergoing on-pump cardiac surgery were identified from a multi-institutional registry including surgical and perfusion data. Patients were divided into four groups based on their intra-operative nadir HCT (<21 or ≥21) and whether or not they received intra-operative red blood cell (+RBC or -RBC) transfusions...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994258/results-of-the-2015-perfusionist-salary-study
#19
Doreen M Lewis, Steven Dove, Ralph E Jordan
Presently, there exists no published valid and reliable salary study of clinical perfusionists. The objective of the 2015 Perfusionist Salary Study was to gather verifiable employee information to determine current compensation market rates (salary averages) of clinical perfusionists working in the United States. A salary survey was conducted between April 2015 and March 2016. The survey required perfusionists to answer questions about work volume, scheduling, and employer-paid compensation including benefits...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27994257/changes-in-cerebral-oxygenation-during-transfusion-therapy
#20
Mumin Hakim, Dmitry Tumin, David P Martin, Walter Samora, Allan C Beebe, Jan E Klamar, Ashley B Hodge, Joseph D Tobias
This study assesses the effects of transfusion of autologous or allogeneic blood on cerebral and tissue oxygenation during spinal surgery. Packed red blood cell transfusions are indicated to improve oxygen delivery to tissues. There are limited data demonstrating changes in tissue oxygenation with blood administration. Tissue (deltoid) and cerebral oxygenation were monitored using near-infrared spectroscopy during spinal surgery in patients. As indicated, cell saver or allogeneic blood was administered. Tissue and cerebral oxygenation were recorded before and after transfusion...
December 2016: Journal of Extra-corporeal Technology
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