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Journal of Extra-corporeal Technology

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https://www.readbyqxmd.com/read/30250349/technique-of-complete-heart-isolation-with-continuous-cardiac-perfusion-during-cardiopulmonary-bypass-new-opportunities-for-gene-therapy
#1
Michael G Katz, Anthony S Fargnoli, Charles Yarnall, Angel Perez, Alice Isidro, Roger J Hajjar, Charles R Bridges
Cardiopulmonary bypass (CPB) featuring complete heart isolation and continuous cardiac perfusion is a very promising approach for solving the problem of efficient gene delivery. In the technique presented here, separate pumps are used for the systemic and cardiac circuits. This system permits continuous isolated arrested heart perfusion through optimizing a number of delivery parameters including temperature, flow rate, driving pressure, ionic composition, and exposure time to the cardiac vessels. During complete cardiac isolation, the blood vector concentration trended from 11...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250348/complete-myocardial-function-recovery-with-ecmo-in-a-woman-presenting-with-cardiogenic-shock-during-peripartum-period
#2
Mukund Das, Anil Rathi, Ashwad Afzal, Kumudha Ramasubbu
Peripartum cardiomyopathy is a potentially life-threatening cause of heart failure (HF) that affects women toward the end of pregnancy or in months after delivery. Treatment is similar to the treatment for HF with reduced ejection fraction (EF). Most women make full myocardial function recovery within 6 months on conventional HF therapy. In rare instances, catastrophic presentations may occur with hemodynamic instability requiring the use of mechanical support. Because of the small patient population, limited information is available regarding the recovery of myocardial function in women who received mechanical support...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250347/asanguinous-del-nido-cardioplegia-for-an-aortic-valve-replacement-patient-with-cold-agglutinins
#3
Michael Rosenbloom, Michael Hancock, Perry Weinstock, Allyson Paterek, Richard Highbloom, Frank Bowen, Kinjal Patel
A patient with known cold agglutinins requiring an aortic valve replacement was referred for surgery. Asanguinous, Del Nido cardioplegia was used for myocardial protection. Warm induction followed by cold infusion prevented any agglutination and eliminated the need for subsequent cardioplegia doses. Following the cross-clamp period, the heart returned to normal sinus rhythm without need for defibrillation. Postoperative ejection fraction and systolic function were normal.
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250346/bloodless-heart-surgery-for-an-11-kg-infant-of-the-jehovah-s-witness-faith-undergoing-second-repair-for-complete-atrioventricular-canal
#4
Gary Plancher, Bharat Datt, Moui Nguyen, Hamish Munro, William M DeCampli, Kamal Pourmoghadam
Bloodless pediatric cardiac surgery is the intent of most surgical centers especially in the Jehovah's Witness population where it is a desire not to administer blood products because of religious belief. It is a tremendous feat, considering that most pediatric cardiovascular prime volumes are more than 20% of the patient's estimated blood volume (EBV). We report on our bloodless strategy for a 2-year old Jehovah's Witness with trisomy 21 and complete atrioventricular canal repair, who underwent atrial septal defect and ventricular septal defect patch closure, pulmonary artery debanding, and pulmonary arterioplasty...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250345/the-novel-use-of-a-low-prime-modified-ultrafiltration-apparatus-in-a-13-kg-jehovah-s-witness-patient-a-case-report
#5
Bharat Datt, Hamish M Munro, William M DeCampli
Modified ultrafiltration (MUF) is used in neonates and infants to reduce volume overload and increase oxygen-carrying capacity post cardiopulmonary bypass (CPB). In addition, it decreases edema, attenuates complementation activation and immunogenic response to CPB. Hemodilution in the pediatric patient has always been a challenge, countered in part by miniaturization of CPB circuits. We describe a case in which we maintained an acceptable hematocrit level greater than 24%, considered the nadir below which the adverse effects of hemodilution can become evident...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250344/recombinant-factor-viii-measurement-in-a-hemophilia-a-patient-undergoing-cardiopulmonary-bypass-supported-cardiac-surgery
#6
Jennifer Bezaire, Dorothy Thomson, Erick McNair
Patients with hemophilia A (Hem A) requiring cardiopulmonary bypass-supported cardiac surgery pose unique challenges for perioperative hemostatic management. This report describes a staged perioperative approach to clinical hematologic management as applied to an 80-year-old male of O-positive blood type with mild Hem A, who underwent successful, uncomplicated coronary artery bypass graft surgery. Hematologic management primarily consisted of normalization of plasma factor VIII levels followed by standard care...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250343/malposition-of-the-extracorporeal-membrane-oxygenation-venous-cannula-in-an-accessory-hepatic-vein
#7
Hadrien Winiszewski, Andrea Perrotti, Sidney Chocron, Gilles Capellier, Gaël Piton
We report a case of a refractory cardiogenic shock secondary to myocardial infarction in a 70-year-old patient requiring femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO). At initial transesophageal echocardiography, the venous cannula tip was seen in the inferior vena cava (IVC), but not in right atrium. On day 8, ultrasonic examination identified that the end of the venous cannula was in the hepatic vein (HV). Despite such malposition, no disturbance in extracorporeal membrane oxygenation (ECMO) venous return was observed...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250342/bivalirudin-anticoagulation-dosing-protocol-for-extracorporeal-membrane-oxygenation-a-retrospective-review
#8
Jared Netley, James Roy, Joseph Greenlee, Shaun Hart, Michael Todt, Bryan Statz
Anticoagulation with unfractionated heparin during extracorporeal membrane oxygenation (ECMO) is common, but alternative agents are being evaluated for safety and efficacy. The objective of this analysis was to assess if a comprehensive bivalirudin dosing and monitoring protocol effectively guides dose adjustments and monitoring of bivalirudin in patients during ECMO. Our analysis included 11 patients who received bivalirudin during ECMO therapy and had dosing managed using our hospital derived protocol. Patients treated over a 1-year period were included in this retrospective analysis...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250341/distal-perfusion-cannulation-and-limb-complications-in-venoarterial-extracorporeal-membrane-oxygenation
#9
Adham Elmously, Thomas Bobka, Sandi Khin, Ashwad Afzal, Andreas R de Biasi, William J DeBois, T Sloane Guy, Marcus D'ayala, Iosif Gulkarov, Arash Salemi, Berhane Worku
The utility of distal perfusion cannula (DPC) placement for the prevention of limb complications in patients undergoing femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is poorly characterized. Patients undergoing femoral VA ECMO cannulation at two institutions were retrospectively assessed. Patients were grouped into those who did and those who did not receive a DPC at the time of primary cannulation. The primary outcome was any limb complication. Secondary outcomes included successfully weaning ECMO and in-hospital mortality...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250340/use-of-thromboelastography-to-predict-thrombotic-complications-in-pediatric-and-neonatal-extracorporeal-membranous-oxygenation
#10
Natalie Henderson, Janice E Sullivan, John Myers, Terri Wells, Aaron Calhoun, John Berkenbosch, Deanna Todd Tzanetos
The objectives of this study were to investigate the correlation between thromboelastography (TEG) and conventional measures of anticoagulation, and to determine optimum values for citrated kaolin TEG R time (TEG RCK) and anti-Xa activity that would minimize both bleeding and thrombotic complications in pediatric and neonatal patients requiring extracorporeal membranous oxygenation (ECMO). A retrospective chart review of patients requiring veno-venous (VV) and venoarterial (VA) ECMO was performed. Combined medical and cardiac ICU within a single-center, tertiary care, freestanding, children's hospital...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250339/incidence-of-cerebral-microemboli-in-single-dose-vs-multidose-cardioplegia-in-adult-cardiac-surgery
#11
Laith Mukdad, William Toppen, Yas Sanaiha, Aditya Mantha, Stephanie Bland, Richard Shemin, Peyman Benharash
Cerebral microemboli have been associated with neurocognitive deficits after cardiac operations using cardiopulmonary bypass (CPB). Interventions by the perfusionist and alterations in blood flow account for a large proportion of previously unexplained microemboli. This study compared the incidence of microemboli during cardiac operations using conventional (multidose) and del Nido (single-dose) cardioplegia delivery. Transcranial Doppler ultrasonography was used to detect microemboli in bilateral middle cerebral arteries of 30 adult patients undergoing cardiac operations using CPB and aortic clamping...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30250338/extending-the-reach-with-social-media
#12
Julie Wegner
No abstract text is available yet for this article.
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921996/response-to-letter-the-influence-of-intraoperative-autotransfusion-on-postoperative-hematocrit-after-cardiac-surgery-a-cross-sectional-study-by-robert-s-kramer-and-robert-c-groom
#13
LETTER
Andrew J Stasko, Alfred H Stammers, Linda B Mongero, Eric A Tesdahl, Samuel Weinstein
No abstract text is available yet for this article.
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921995/influence-of-intraoperative-autotransfusion-on-postoperative-hematocrit-after-cardiac-surgery-a-cross-sectional-study
#14
LETTER
Robert S Kramer, Robert C Groom
No abstract text is available yet for this article.
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921994/response-to-letter-risk-factors-for-acute-kidney-injury-after-cardiopulmonary-bypass-by-rik-h-j-hendrix-et-al
#15
LETTER
Richard F Newland, Robert A Baker
No abstract text is available yet for this article.
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921993/risk-factors-for-acute-kidney-injury-after-cardiopulmonary-bypass
#16
LETTER
Rik H J Hendrix, Yuri M Ganushchak, Patrick W Weerwind
No abstract text is available yet for this article.
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921992/cardiopulmonary-bypass-in-the-setting-of-waldenstr%C3%A3-m-s-macroglobulinemia
#17
Brandon D D'Aloiso, Sarah S Rupchak, Kaitlin J Gettle, Claudio Lima, Robert D Rush
Waldenström's Macroglobulinemia (WM) is a rare lymphoma caused by the overproduction of immunoglobulin M (IgM). The elevated level of IgM causes serum hyperviscosity, cold agglutinins, and cryoglobulinemia. Anemia is also present because of impaired production of erythrocytes. For these reasons, placing a patient with WM on cardiopulmonary bypass (CPB) requires careful preparation. In this case, the patient was a 73-year-old male with known Waldenström's disease who required coronary artery bypass graft surgery...
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921991/sickle-cell-hemoglobin-c-disease-patient-undergoing-coronary-artery-bypass-grafting-with-complete-exchange-blood-transfusion-during-cardiopulmonary-bypass
#18
Francesca Mullins, Shawn Ott, Nakia Mister, Jeffrey Travis
Sickle cell disorders are associated with increased risk of sickling and vaso-occlusive complications when undergoing cardiopulmonary bypass (CPB) surgery. Monitoring of certain parameters such as venous and arterial oxygen content, hematocrit, acid base homeostasis, and body temperature are required for a superior outcome. Furthermore, perioperative exchange transfusion has a positive effect on the outcome of surgery and on the survival of patients undergoing heart surgery. Avoiding intraoperative hypoxia and hypothermia, and minimizing hemoglobin S (HbS) and hemoglobin C (HbC) levels with exchange transfusion make bypass surgery relatively safe with enhanced outcomes in these cases...
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921990/the-impact-of-three-different-wash-solutions-on-autotransfusion-products
#19
COMPARATIVE STUDY
Todd M Ratliff, Jeffery L Burnside, Ashley B Hodge, Aymen N Naguib, Daniel Gomez
Many blood conservation techniques and strategies have been implemented to aid in decreasing the use of allogenic blood utilization during pediatric cardiothoracic surgery. Use of techniques, such as acute normovolemic hemodilution, retrograde autologous prime, venous autologous prime, and autotransfuion, may lead to a decrease in the need for allogenic blood products. Autotransfusion has become a standard of care for all cardiothoracic surgical procedures requiring cardiopulmonary bypass (CPB). Although widely used, there is still debate over which wash solution will produce the most physiologically normal autotransfusion product...
June 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29921989/integration-of-electronic-perfusion-data-for-perfusion-registries
#20
Richard F Newland, Robert A Baker, Chris A Barratt
Although the potential for the utilization of electronic perfusion data (EPD) from proprietary software to facilitate the understanding and improvement of cardiopulmonary bypass (CPB) has been recognized, the generalizability of previous reports of EPD integration are limited by superceded software or lack of sufficient detail for reproducibility. To date, the Australian and New Zealand Collaborative Perfusion Registry (ANZCPR) is the only multicentre perfusion registry to have reported the integration of EPD...
June 2018: Journal of Extra-corporeal Technology
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