journal
MENU ▼
Read by QxMD icon Read
search

Journal of Extra-corporeal Technology

journal
https://www.readbyqxmd.com/read/29559757/successful-use-of-extracorporeal-life-support-in-a-hematopoietic-stem-cell-transplant-patient-with-neuroblastoma
#1
Feifei Z Williams, Atul Vats, Thomas Cash, James D Fortenberry
Respiratory failure associated with hematopoietic stem cell transplantation (HSCT) has been considered a contraindication for use of extracorporeal membrane oxygenation (ECMO) at many centers. We describe a child with neuroblastoma and hypoxemic respiratory failure following HSCT who was successfully managed with veno-venous (VV) ECMO. The patient was an 18-month-old female with high-risk neuroblastoma status post tumor resection, chemotherapy, autologous HSCT, and primary site radiation. On day 113 posttransplant while receiving maintenance immunotherapy, she had an acute respiratory decompensation because of rhinovirus, aspiration pneumonia, and capillary leak syndrome...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559756/acute-bowel-ischemia-associated-with-left-ventricular-thrombus-and-arteriovenous-extracorporeal-membrane-oxygenation
#2
Mary Huerter, Dean Govostis, Martin Ellenby, Eduardo Smith-Singares
Indications for extra corporeal membrane oxygenation (ECMO) have expanded in recent years, and it has become an invaluable tool in the care of adult patients in severe cardiogenic shock or respiratory failure. Understanding the physiologic effect of ECMO has also further developed, allowing for improvements in the management of the potential morbidities associated with this technology. Here, we present a case of acute bowel ischemia that developed while the patient was on central venoarterial ECMO.
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559755/high-frequency-percussive-ventilation-facilitates-weaning-from-extracorporeal-membrane-oxygenation-in-adults
#3
Iosif Gulkarov, James Schiffenhaus, Ivan Wong, Ashwad Afzal, Felix Khusid, Berhane Worku
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559754/does-the-type-of-cardioplegia-solution-affect-intraoperative-glucose-levels-a-propensity-matched-analysis
#4
Linda B Mongero, Eric A Tesdahl, Alfred H Stammers, Andrew J Stasko, Samuel Weinstein
Myocardial protection during cardiac surgery is a multifaceted process that is structured to limit injury and preserve function. Evolving techniques use solutions with varying constituents that enter the systemic circulation and alter intrinsic systemic concentrations. This study compared two distinct cardioplegia solutions on affecting intraoperative glucose levels. Data were abstracted from a multi-institutional perfusion registry, including a total of 1,188 propensity-matched cases performed from January through October 2016, at 17 cardiac surgical centers across the United States in which both del Nido and 4:1 cardioplegia were used during the study period...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559753/clinical-evaluation-of-measuring-the-act-during-elective-cardiac-surgery-with-two-different-devices
#5
Florian Falter, Nabeel Razzaq, Martin John, Jens Fassl, Markus Maurer, Sean Ewing, Ross Hofmeyr
Unfractionated heparin is the mainstay of anticoagulation during cardiac surgery on cardiopulmonary bypass (CPB) due to its low cost, quick onset, and ease of reversal. Since over 30 years, the activated clotting time (ACT) has been used to assess the level of heparin activity both before and after CPB. We compared two different methods of measuring the ACT: i-STAT, which uses amperometric detection of thrombin cleavage, and Hemochron Jr, which is based on detecting viscoelastic changes in blood. We included 402 patients from three institutions (Papworth Hospital, Cambridge, UK; Groote Schuur, Cape Town, South Africa; University Hospital Basel, Basel, Switzerland) undergoing elective cardiac surgery on CPB in our study...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559752/anticoagulation-management-during-first-five-days-of-infant-pediatric-extracorporeal-life-support
#6
Kirk R Bingham, Jeffrey B Riley, Gregory J Schears
Anticoagulation during infant-pediatric extracorporeal life support (ECLS) has been a topic of study for many years, but management of anticoagulation is still only partially understood. Adequate anticoagulation during ECLS is imperative for successful outcomes and understanding the individual variables that play part is crucial for properly implementing anticoagulation management strategies. The purpose of our study was to compare the relationships between the variables of activated partial thromboplastin time (aPTT), activated clotting time, international normalized ratio, bleeding, thrombus formation, kaolin + heparinase thromboelastograph alpha angle, kaolin thromboelastograph reaction time (KTEG R-time), heparin dose rates (HDR), antithrombin (AT), anti-Xa, bivalirudin dose rate, argatroban dose rate, interventions, and transfusions...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559751/circulating-and-urinary-mir-210-and-mir-16-increase-during-cardiac-surgery-using-cardiopulmonary-bypass-a-pilot-study
#7
Annette L Mazzone, Robert A Baker, Kym McNicholas, Richard J Woodman, Michael Z Michael, Jonathan M Gleadle
A pilot study to measure and compare blood and urine microRNAs miR-210 and miR-16 in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting surgery. Frequent serial blood and urine samples were taken from patients undergoing cardiac surgery with CPB (n = 10) and undergoing off-pump cardiac surgery (n = 5) before, during, and after surgery. Circulating miR-210 and miR-16 levels were determined by relative quantification real-time polymerase chain reaction...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559750/sts-sca-amsect-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#8
Linda Shore-Lesserson, Robert A Baker, Victor Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) developed an Evidence Based Workgroup...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29559749/from-the-editor
#9
Julie Wegner
No abstract text is available yet for this article.
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302124/extracorporeal-life-support-as-a-rescue-measure-for-managing-life-threatening-arrythmia-and-brugada-syndrome
#10
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#11
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#12
Antonio Salsano, Elena Sportelli, Guido Maria Olivieri, Nicola Di Lorenzo, Silvia Borile, Francesco Santini
Patients with submassive pulmonary embolism (PE), although normotensive, are characterized by right ventricular (RV) dysfunction and elevated levels of biomarkers of cardiac damage. The best treatment option in these cases is still a subject of debate and the use of thrombolysis in submassive PE remains controversial. A 57-year-old Caucasian male with unprovoked PE, normal blood pressure, and elevated troponin I values was referred to the cardiovascular department. In view of the presence of a right atrium thrombus, the patient underwent surgical embolectomy under extracorporeal circulation, with the extraction of a huge thrombus together with fragmented thrombi from both pulmonary arteries...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302121/use-of-a-modified-cardiopulmonary-bypass-circuit-for-suction-embolectomy-with-the-angiovac-device
#13
Cara M Michelson, Cornelius M Dyke, Douglas J Wick, Rory Guenther, Dylan Dangerfield, Matthew E Wiisanen
The AngioVac suction cannula and circuit were designed for the percutaneous removal of soft thrombus and emboli in procedures requiring extracorporeal circulatory support. We describe a modification of the AngioVac suction catheter and cardiopulmonary bypass (CPB) circuit to effectively remove thrombus while maintaining the ability to rapidly initiate full CPBs during a medical crisis. This article will discuss the design concepts of the modified circuit as well as procedural protocols and considerations. The design modifications of incorporating an oxygenator, reservoir, and bridge allow for an increased flexibility that allows adaption to veno-venous extracorporeal membrane oxygenation or full CPB support when required for oxygenation or hemodynamic support...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302120/a-dedicated-perfusion-electronic-medical-record-with-discrete-epic-integration
#14
James A Reagor
Enterprise electronic medical records (EMR) have largely become a standard since their use was mandated by The American Recovery and Reinvestment Act of 2009. However, perfusion departments have adopted true perfusion EMRs at various rates. In our efforts to integrate with the institutions EMR while enjoying the benefits of an EMR designed specifically for perfusion practice, we developed a discrete data integration solution between Epic and the Spectrum Medical VIPER Perfusion EMR. This report describes our perfusion EMR selection criteria, design challenges, and documentation process...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#15
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302118/blood-and-blood-product-conservation-results-of-strategies-to-improve-clinical-outcomes-in-open-heart-surgery-patients-at-a-tertiary-hospital
#16
Junaid H Khan, Emily A Green, Jimmin Chang, Alexandria M Ayala, Marilyn S Barkin, Emily E Reinys, Jeffrey Stanton, Russell D Stanten
Blood product usage is a quality outcome for patients undergoing cardiac surgery. To address an increase in blood product usage since the discontinuation of aprotinin, blood conservation strategies were initiated at a tertiary hospital in Oakland, CA. Improving transfusion rates for open heart surgery patients requiring Cardiopulmonary bypass (CPB) involved multiple departments in coordination. Specific changes to conserve blood product usage included advanced CPB technology upgrades, and precise individualized heparin dose response titration assay for heparin and protamine management...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302117/an-in-vitro-study-comparing-the-gme-handling-of-two-contemporary-oxygenators
#17
COMPARATIVE STUDY
Carl J Gisnarian, Angela Hedman, Kenneth G Shann
Gaseous microemboli (GME) are a potential complication of cardiopulmonary bypass (CPB). Though it is difficult to prove that GME is the only major cause of neurological deficits, it may increase the chance of post-operative cognitive dysfunction if not removed. The objectives of this research were to compare LivaNova-Sorin Inspire (Inspire) oxygenator with a Medtronic arterial filter to the Medtronic Fusion (Fusion) oxygenator with and without a Medtronic arterial filter based on each system's ability to handle GME...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302116/quantification-of-carbon-dioxide-removal-at-low-sweep-gas-and-blood-flows
#18
Juan de Villiers Hugo, Ajay S Sharma, Usaama Ahmed, Patrick W Weerwind
Advancement in oxygenator membrane technology has further expanded the boundaries in the clinical application of extracorporeal carbon dioxide removal (ECCO2 R). Despite the advent of modern poly-4-methyl-1-pentene (PMP) membranes, limited information exists on the performance of these membranes at low sweep gas and blood flows. Moreover, physiological relationships for CO2 removal at these flows are less explored. Hence, CO2 removal was quantified in an in vitro setting using a PMP membrane oxygenator. ECCO2 R was performed using a ...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302115/colloid-oncotic-pressure-monitoring-its-effects-in-cardiac-surgery
#19
Jeffrey B Chores, David W Holt
Hemodilution is a common perioperative practice. The deleterious effects of excessive hemodilution and subsequent edema formation have been well documented by numerous authors. Colloid oncotic pressure (COP) is a reliable clinical indicator of hemodilution in cardiac surgery. The intent of this study is to determine if a correlation exists between COP and various patient outcome variables. It would also be helpful to know if there is a particular COP value to avoid preventing or limiting patient morbidity. Blood samples from 61 adult patients (mean age = 70 years old) undergoing cardiopulmonary bypass surgery were collected for COP calculation and comparison...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302114/the-influence-of-intraoperative-autotransfusion-on-postoperative-hematocrit-after-cardiac-surgery-a-cross-sectional-study
#20
Andrew J Stasko, Alfred H Stammers, Linda B Mongero, Eric A Tesdahl, Samuel Weinstein
Utilization of intraoperative autotransfusion (IAT) during cardiac surgery with cardiopulmonary bypass (CPB) has been shown to reduce allogeneic red blood cell transfusion. Previous research has emphasized the benefits of using IAT in the intraoperative period. The present study was designed to evaluate the effects of using IAT on overall hematocrit (Hct) drift between initiation of CPB and the immediate postoperative period. We reviewed 3,225 adult cardiac procedures occurring between February 2016 and January 2017 at 84 hospitals throughout the United States...
December 2017: Journal of Extra-corporeal Technology
journal
journal
22677
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"