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ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs

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https://www.readbyqxmd.com/read/28719441/fourteen-day-in-vivo-testing-of-a-compliant-thoracic-artificial-lung
#1
David J Skoog, Joshua R Pohlmann, David S Demos, Christopher N Scipione, Amit Iyengar, Rebecca E Schewe, Ahmed B Suhaib, Kelly L Koch, Keith E Cook
The compliant thoracic artificial lung (cTAL) has been studied in acute in vivo and in vitro experiments. The cTAL's long-term function and potential use as a bridge to lung transplantation are assessed presently. The cTAL without anticoagulant coatings was attached to sheep (n = 5) via the pulmonary artery and left atrium for 14 days. Systemic heparin anticoagulation was used. Compliant thoracic artificial lung resistance, cTAL gas exchange, hematologic parameters, and organ function were recorded. Two sheep were euthanized for nondevice-related issues...
July 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28692527/sildenafil-in-left-ventricular-assist-device-is-safe-and-well-tolerated
#2
Ashwin K Ravichandran, Shane J LaRue, Eric Novak, Susan A Joseph, Joel D Schilling
Right heart failure is a potentially devastating complication of mechanical circulatory support, occurring at a rate of 0.49 events per 100 patient-months. Pulmonary vasodilators such as phosphodiesterase-5 inhibitors (PDE5i) have been frequently used to unload the right ventricle in left ventricular assist device (LVAD) patients, but there is scant evidence to support this practice. The purpose of this analysis is to provide additional data regarding the safety and efficacy of the PDE5i sildenafil in a real world population of patients supported with LVADs at Washington University in St...
July 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28692526/preoperative-nutritional-assessment-with-the-prognostic-nutrition-index-in-patients-undergoing-left-ventricular-assist-device-implantation
#3
Gardner Yost, Antone Tatooles, Geetha Bhat
The prognostic nutritional index (PNI) is a simple metric that uses serum albumin and total lymphocyte count to provide a basic indicator for nutritional status. It has recently garnered attention as a prognosticator of outcomes in many types of cancer. We investigated the utility of the PNI as a marker for poor outcomes following left ventricular assist device (LVAD) implantation. Two hundred eighty-eight consecutive patients implanted with continuous-flow LVADs were included. Prognostic nutritional index was calculated for all patients (PNI = [10 × serum albumin {g/dl}] + [0...
July 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28682992/connection-of-a-renal-replacement-therapy-or-plasmapheresis-device-to-the-ecmo-circuit
#4
Florent Laverdure, Laurent Masson, Guillaume Tachon, Julien Guihaire, François Stephan
In patients under extracorporeal membrane oxygenation (ECMO) support requiring renal replacement therapy or plasmapheresis, connecting such extracorporeal therapy device to the ECMO circuit provides many advantages compared with central venous catheterization. However, high pressures of the ECMO circuit limit the usefulness of this technique. We propose a new approach to connect extracorporeal therapy lines to the ECMO circuit. Inlet line is connected to the oxygenator, and outlet line is connected either to the femoral artery antegrade perfusion cannula in case of venoarterial ECMO or to the lateral vent of the return cannula in case of venovenous ECMO...
July 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28682991/the-effect-of-cold-dialysis-in-motor-and-sensory-symptoms-of-rls-wed-occurring-during-hemodialysis-a-double-blind-study
#5
Giorgos K Sakkas, Evaggelia Tsaknaki, Clara S Rosa, Christoforos D Giannaki, Argyro A Krase, Eleftherios Lavdas, Georgios M Hadjigeorgiou, Ioannis Stefanidis, Christina Karatzaferi
Restless legs syndrome/Willis-Ekbom disease (RLS/WED) is a common sensorimotory disorder affecting almost 30% of hemodialysis (HD) patients. RLS/WED induces discomfort during rest hours, and its symptoms have also been observed during HD sessions. Anecdotal reports suggest that cooling the dialysate solution during dialysis could help patients overcome those symptoms and improve restlessness. The aim of this double-blind study was to assess whether a reduction of the dialysate temperature by 1°C could reduce motor and sensory symptoms of RLS/WED occurring during HD...
July 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28678046/coagulation-profile-is-not-a-predictor-of-acute-cerebrovascular-events-in-pediatric-extracorporeal-membrane-oxygenation-patients
#6
Pilar Anton-Martin, Janna Journeycake, Vinai Modem, Sailaja Golla, Lakshmi Raman, Jefferson Tweed, Cindy Darnell-Bowens
We performed a retrospective matched case-control study evaluating whether the traditional coagulation profile predicts cerebrovascular events in children on extracorporeal membrane oxygenation (ECMO) in a 71 bed intensive care unit at a tertiary children's hospital. Between 2009 and 2014, 241 neonates and children were initiated on ECMO. The cumulative 5 year incidence of intracranial hemorrhage and infarct was 9.2% and 7.9%, respectively. Thirty-six cases were individually matched 1:1 with control subjects based on age, primary diagnosis, ECMO type, cannulation site, and the presence of pre-ECMO coagulopathy...
July 3, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28682993/quantification-of-von-willebrand-factor-cleavage-by-adamts-13-in-patients-supported-by-left-ventricular-assist-devices
#7
Yong Zhou, Shizhen Qin, Tristan Hilton, Li Tang, Miguel Cruz, Ruben Hernandez, Joel L Moake, Qiang Tian, O H Frazier, Jing-Fei Dong, Angelo Nascimbene
Patients supported by left ventricular assist devices (LVADs) often present with the loss of large von Willebrand factor (VWF) multimers. This VWF deficiency is believed to contribute to the bleeding diathesis of patients on LVAD support and is caused by excessive VWF cleavage by the metalloprotease ADAMTS-13 under high shear stress. However, only a small percentage of patients who have suffered the loss of large VWF multimers bleed. The actual rates of VWF cleavage in these patients have not been reported, primarily because of the lack of reliable detection methods...
July 1, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665827/cessation-of-continuous-flow-left-ventricular-assist-device-related-gastrointestinal-bleeding-after-heart-transplantation
#8
Snehal R Patel, Kyung Taek Oh, Tolulope Ogriki, Daniel Sims, J Julia Shin, Shivank Madan, Omar Saeed, Daniel J Goldstein, Ulrich P Jorde
Gastrointestinal bleeding (GIB) is a major complication of continuous flow left ventricular assist device (CF LVAD) therapy. The precise pathophysiology of CF LVAD-related bleeding remains poorly understood, and the effect of pump removal at the time of transplantation on actual bleeding frequency has not previously been studied. A single-center retrospective review was conducted on patients who received CF LVAD and subsequently developed GIB. Baseline demographics and markers of pulsatility (aortic valve opening and the HeartMate II [HM2] pulse index) were compared between those with and without GIB...
June 28, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665829/a-membrane-lung-design-based-on-circular-blood-flow-paths
#9
U Piyumindri Fernando, Alex J Thompson, Joseph Potkay, Hannah Cheriyan, John Toomasian, Andreas Kaesler, Peter Schlanstein, Jutta Arens, Ronald B Hirschl, Joseph L Bull, Robert H Bartlett
Current hollow fiber membrane lungs feature a predominantly straight blood path length across the fiber bundle, resulting in limited O2 transfer efficiency because of the diffusion boundary layer effect. Using computational fluid dynamics and optical flow visualization methods, a hollow fiber membrane lung was designed comprising unique concentric circular blood flow paths connected by gates. The prototype lung, comprising a fiber surface area of 0.28 m, has a rated flow of 2 L/min, and the oxygenation efficiency is 357 ml/min/m...
June 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665828/monitoring-volume-status-using-bioelectrical-impedance-analysis-in-chronic-hemodialysis-patients
#10
Chae Rim Kim, Jung-Ho Shin, Jin Ho Hwang, Su Hyun Kim
Fluid overload can be an independent risk factor of cardiovascular events and all-cause death in end-stage renal disease (ESRD) patients on chronic hemodialysis. We performed a retrospective study to investigate whether intermittent control of fluid status decreases the rate of these complications using bioelectrical impedance analysis (BIA). In ESRD patients on chronic hemodialysis, we identified the ratio of extracellular water to total body water (ECW/TBW) every 6 months using InBody S10 (Biospace, Seoul, Korea), which was measured within 30 minutes after dialysis initiation on the first dialysis day of the week...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665826/unrecognized-left-heart-failure-in-lvad-recipients-the-role-of-routine-invasive-hemodynamic-testing
#11
Palak Shah, Nina Badoe, Sheila Phillips, Kamil Abdullah, Christopher W May, Jose L Nabut, Ramesh Singh, Christopher deFilippi, Shashank S Desai
The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661912/favorable-effects-on-pulmonary-vascular-hemodynamics-with-continuous-flow-left-ventricular-assist-devices-are-sustained-5-years-after-heart-transplantation
#12
Abdulfattah Saidi, Craig H Selzman, Abdulmohsin Ahmadjee, Mohammad Al-Sarie, Gregory L Snow, Omar Wever-Pinzon, Rami A Alharethi, Bruce Reid, Josef Stehlik, Abdallah G Kfoury, Feras Bader
It is unclear whether pulmonary hemodynamics improvement with left ventricle unloading with left ventricular assist devices (LVADs) is sustained long term after heart transplant (HT). We sought to assess the effects on pulmonary vascular hemodynamics during continuous-flow (CF-LVAD) and pulsatile flow (PF-LVAD) support up to 5 years after HT. Invasive hemodynamics were evaluated before LVAD, before HT, and at 3 months, 1, and 3-5 years posttransplant. Thirty-eight patients were included in the study and divided into two groups according to the type of LVAD support...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661911/pump-in-parallel-mechanical-assistance-of-partial-cavopulmonary-circulation-using-a-conventional-ventricular-assist-device
#13
Pranava Sinha, Nina Deutsch, Kanishka Ratnayaka, Dingchao He, Murfad Peer, Mustafa Kurkluoglu, Mark Nuszkowski, Erin Montague, Gerald Mikesell, David Zurakowski, Richard Jonas
Mechanical assistance of systemic single ventricle is effective in pulling blood through a cavopulmonary circuit. In patients with superior cavopulmonary connection, this strategy can lead to arterial desaturation secondary to increased inferior caval flow. We hypothesized that overall augmentation in cardiac output with mechanical assistance compensates for the drop in oxygen saturation thereby maintaining tissue oxygen delivery (DO2). Bidirectional Glenn (BDG) was established in seven swine (25 kg) after a common atrium had been established by balloon septostomy...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661910/determination-of-reynolds-shear-stress-level-for-hemolysis
#14
Choon-Sik Jhun, Megan A Stauffer, John D Reibson, Eric E Yeager, Raymond K Newswanger, Joshua O Taylor, Keefe B Manning, William J Weiss, Gerson Rosenberg
Reynolds shear stress (RSS) has served as a metric for the effect of turbulence on hemolysis. Forstrom (1969) and Sallam and Hwang (1984) determined the RSS threshold for hemolysis to be 50,000 and 4,000 dyne/cm, respectively, using a turbulent jet. Despite the order of magnitude discrepancy, the threshold by Sallam and Hwang has been frequently cited for hemolytic potential in blood pumps. We recreated Sallam apparatus (SA) to resolve this discrepancy and provide additional data to be used in developing a more accurate hemolysis model...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661909/increased-risk-of-bleeding-in-left-ventricular-assist-device-patients-treated-with-enoxaparin-as-bridge-to-therapeutic-inr
#15
Ankit Bhatia, Colleen Juricek, Nitasha Sarswat, Sirtaz Adatya, Gene Kim, Gabriel Sayer, Takeyoshi Ota, Valluvan Jeevanandam, Nir Uriel
Anticoagulation therapy is used to prevent thromboembolic events in patients with left ventricular assist devices (LVADs). This study aims to determine the safety of low molecular weight heparin (enoxaparin) for bridging subtherapeutic INRs in LVAD patients. In this retrospective single-center study, all patients who underwent LVAD implantation were examined between January 1, 2013, and December 31, 2014. Patients were divided into two groups: enoxaparin bridge and no bridge, with identification of major bleeding episodes (MBEs) and thrombotic events (TEs)...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28617694/the-spectrum-of-general-surgery-interventions-in-pediatric-patients-with-ventricular-assist-devices
#16
Fady Kamel, Holger Buchholz, Bryan Dicken, Jennifer Conway
Ventricular assist devices (VADs) have positively impacted the management of heart failure. However, they come with a range of complications. Although general surgical complications have been assessed in adults with VADs, there is no study to date that has assessed general surgery intervention in the pediatric population. Fifty-two patients who received VADs from 2005 to 2015 at the Stollery Children's Hospital were assessed for general surgery intervention and anticoagulation status at the time of intervention...
June 13, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28617693/brukhonenko-s-autojector-the-first-apparatus-for-cardiopulmonary-bypass-and-extracorporeal-life-support
#17
Sergey P Glyantsev, Pavel M Bogopolsky, Vakhtang Tchantchaleishvili
Sergey Brukhonenko was a prominent Soviet physician-scientist who from 1922 to 1924 developed a methodology for perfusing a canine head and keeping it alive using the first extracorporeal life support device he created called "Autojector." From 1926 to 1927, in collaboration with surgeon Nikolay Terebinsky, he performed a series of perfusion experiments of the entire canine body using a more advanced model of Autojector. Subsequently, Brukhonenko concluded the possibility of extending this methodology to heart surgery...
June 13, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28604571/hvad-waveform-analysis-as-a-noninvasive-marker-of-pulmonary-capillary-wedge-pressure-a-first-step-toward-the-development-of-a-smart-left-ventricular-assist-device-pump
#18
Jonathan Grinstein, Daniel Rodgers, Sara Kalantari, Gabriel Sayer, Gene H Kim, Nitasha Sarswat, Sirtaz Adatya, Takeyoshi Ota, Valluvan Jeevanandam, Daniel Burkhoff, Nir Uriel
Flow waveforms are an important feature of the HVAD left ventricular assist device (LVAD) that provides information about HVAD function and patient hemodynamics. We assessed the properties of one specific aspect of the waveform, the slope of the ventricular filling phase (VFP), and its correlation with pulmonary capillary wedge pressure (PCWP). A total of 101 screenshots from the HVAD monitor and simultaneous hemodynamic measurements were obtained simultaneously during sequential stages of invasive hemodynamic ramp studies...
June 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28604570/successful-treatment-of-pediatric-ventricular-assist-device-thrombosis
#19
Devin Chetan, Holger Buchholz, Mary Bauman, Vijay Anand, Paula Holinski, Jennifer Conway
Pump thrombosis represents a significant cause of morbidity and mortality in patients on continuous flow ventricular assist devices (CF-VAD). Pump thrombosis in the pediatric CF-VAD population has been reported between 11% and 44%, with the largest reported series from the PediMACS registry reporting a rate of approximately 15%. We report our early experience with four pediatric patients who developed pump thrombosis on a CF-VAD. Our limited experience suggests that the treatment of pediatric VAD thrombosis can be approached with similar principles to the adult population...
June 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28557863/pediatric-extracorporeal-life-support-organization-registry-international-report-2016
#20
Ryan P Barbaro, Matthew L Paden, Yigit S Guner, Lakshmi Raman, Lindsay M Ryerson, Peta Alexander, Viviane G Nasr, Melania M Bembea, Peter T Rycus, Ravi R Thiagarajan
The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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