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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/29768283/cerebral-oxygenation-as-a-monitoring-parameter-for-mortality-during-venoarterial-extracorporeal-membrane-oxygenation
#1
Hyoung Soo Kim, Sang Ook Ha, Kyung-Ho Yu, Mi Sun Oh, Sunghoon Park, Sun Hee Lee, Sang Jin Han, Hyun-Sook Kim, In Bok Chang, Jun Hyong Ahn
There are no recommended guidelines for monitoring parameters during venoarterial extracorporeal membrane oxygenation (VA-ECMO). We evaluated whether regional cerebral oxygen saturation (rScO2) could be a monitoring parameter for mortality during VA-ECMO. We retrospectively searched our database for adult patients who underwent VA-ECMO between April 2015 and October 2016 and identified 21 patients with rScO2 data. Their baseline and clinical characteristics during the first 7 days (vital signs, arterial blood gas results, ECMO variables, rScO2, Swan-Ganz catheter parameters, transthoracic echocardiography parameters, and outcomes) were collected and evaluated for associations with 28 day mortality...
May 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29768282/baseline-thromboelastogram-as-a-predictor-of-left-ventricular-assist-device-thrombosis
#2
Shannon L Piche, Scott D Nei, Erin Frazee, Sarah D Schettle, Barry A Boilson, Matthew F Plevak, Ross A Dierkhising, John M Stulak
Left ventricular assist device (LVAD) pump thrombosis occurs in up to 8.4% of patients within 3-months postimplantation. Thromboelastography (TEG) could be used to signal hypercoagulability at LVAD implantation to predict patients at high risk for thrombosis. We sought to evaluate whether TEG maximum amplitude (MA) hypercoagulability (MA ≥69 mm) at the time of LVAD implantation predicts pump thrombosis. A single center, retrospective, nested case-control study was conducted using patients from January 1, 2005, to March 31, 2015...
May 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29762232/modified-exosomes-reduce-apoptosis-and-ameliorate-neural-deficits-induced-by-traumatic-brain-injury
#3
Bo Wang, Shuangshuang Han
Apoptosis contributes to the pathogenesis of traumatic brain injury (TBI). Engineered exosomes incorporated with therapeutic nuclear acids have been explored for gene therapy for human diseases. The current study sought to investigate the effect of modified exosome-containing plasmids expressing B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X-protein (Bax) shRNA on apoptosis and neural functions after TBI. C57BL/6J mice were subjected to controlled cortical impact injury and were treated with the modified exosomes...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29762231/surfactant-administration-during-pediatric-cardiac-extracorporeal-membrane-oxygenation
#4
Constantinos Chrysostomou, Timothy Maul, Filip Istvanic, Peter Wearden
We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2)...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29762230/outcomes-after-infections-in-adolescents-and-young-adults-with-continuous-flow-left-ventricular-assist-devices
#5
Sharon Chen, Ryan S Cantor, Scott Auerbach, Kurt Schumacher, Christopher S Almond, Pirooz Eghtesady, Juan Alejos, Bibhuti B Das, Borah J Hong, Robert Jaquiss, James K Kirklin, Aamir Jeewa
Infections in adult ventricular assist device patients increase subsequent mortality and stroke risk. Less is known about outcomes after infections in younger patients, where diabetes and obesity, risk factors associated with poor outcomes, are less prevalent. The purpose of this study was to examine outcomes after infections in adolescents and young adults with continuous-flow left ventricular assist devices (VAD) bridged to transplant. From Pediatric Interagency Registry for Mechanically Assisted Circulatory Support and Interagency Registry for Mechanical Circulatory Support registries, we identified patients aged 12-29 years with continuous-flow VADs implanted as bridged to transplant from September 2012 to March 2016...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29762229/what-is-the-optimal-blood-pressure-on-veno-arterial-extracorporeal-membrane-oxygenation-impact-of-mean-arterial-pressure-on-survival
#6
Daizo Tanaka, Shogo Shimada, Megan Mullin, Kristin Kreitler, Nicholas Cavarocchi, Hitoshi Hirose
Blood pressure management is crucial for patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Lower pressure can lead to end-organ malperfusion, whereas higher pressure may compete with ECMO flow and cardiac output. The impact of mean arterial pressure (MAP) on outcomes of patients on VA ECMO was evaluated. Patients who were supported on VA ECMO from September 2010 to March 2016 were retrospectively analyzed for average MAP throughout their course on ECMO, excluding the first and last day...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29757760/cannula-tip-with-integrated-volume-sensor-for-rotary-blood-pump-control-early-stage-development
#7
Joshua Cysyk, Ray Newswanger, Eric Popjes, Walter Pae, Choon-Sik Jhun, Jenelle Izer, William Weiss, Gerson Rosenberg
The lack of direct measurement of left ventricular unloading is a significant impediment to the development of an automatic speed control system for continuous-flow left ventricular assist devices (cf-LVADs). We have developed an inlet cannula tip for cf-LVADs with integrated electrodes for volume sensing based on conductance. Four platinum-iridium ring electrodes were installed into grooves on a cannula body constructed from polyetheretherketone (PEEK). A sinusoidal current excitation waveform (250 μA pk-pk, 50 kHz) was applied across one pair of electrodes, and the conductance-dependent voltage was sensed across the second pair of electrodes...
May 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29757759/mechanical-circulatory-support-of-the-right-ventricle-for-adult-and-pediatric-patients-with-heart-failure
#8
Steven G Chopski, Nohra M Murad, Carson S Fox, Randy M Stevens, Amy L Throckmorton
The clinical implementation of mechanical circulatory assistance for a significantly dysfunctional or failing left ventricle as a bridge-to-transplant or bridge-to-recovery is on the rise. Thousands of patients with left-sided heart failure are readily benefitting from these life-saving technologies, and left ventricular failure often leads to severe right ventricular dysfunction or failure. Right ventricular failure (RVF) has a high rate of mortality caused by the risk of multisystem organ failure and prolonged hospitalization for patients after treatment...
May 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746315/antithrombin-during-extracorporeal-membrane-oxygenation-in-adults-national-survey-and-retrospective-analysis
#9
Giacomo E Iapichino, Alessandro Protti, Davide T Andreis, Mauro Panigada, Andrea Artoni, Cristina Novembrino, Antonio Pesenti, Luciano Gattinoni
The impact of antithrombin replacement during extracorporeal membrane oxygenation (ECMO) in adults remains unclear. This work comprises a survey, showing that antithrombin is routinely supplemented in many Italian ECMO-Centers, and a retrospective analysis on 66 adults treated with veno-venous ECMO and unfractionated heparin at our Institution. Twenty-four to 72 h after the beginning of ECMO, antithrombin activity was ≤70% in 47/66 subjects and activated partial thromboplastin time (aPTT) ratio was <1...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#10
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746313/avalonelite-double-lumen-cannula-for-total-cavopulmonary-assist-in-failing-fontan-sheep-model-with-valved-extracardiac-conduit
#11
Cheng Zhou, Dongfang Wang, Francesca Condemi, Guangfeng Zhao, Stephen Topaz, Cherry Ballard-Croft, Joseph B Zwischenberger
The AvalonElite double lumen cannula (DLC) provides total cavopulmonary assist (CPA) in failing Fontan sheep, but recirculation limits reliability. To improve CPA performance, a two-valve extracardiac conduit (ECC) was used to bracket infusion blood toward pulmonary artery (PA). A total cavopulmonary connection with failing Fontan circulation adult sheep model was created with valved ECC (n = 6). The valved ECC was connected to superior/inferior venae cavae (SVC/IVC) and right PA. The AvalonElite DLC was inserted from right jugular vein with infusion opening between the ECC valves...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746312/calculation-of-the-alma-risk-of-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#12
Antonio Loforte, Andrea Montalto, Francesco Musumeci, Cristiano Amarelli, Carlo Mariani, Vincenzo Polizzi, Paola Lilla Della Monica, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88)...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746311/evaluating-mortality-risk-adjustment-among-children-receiving-extracorporeal-support-for-respiratory-failure
#13
Ryan P Barbaro, Philip S Boonstra, Kevin W Kuo, David T Selewski, David K Bailly, Cheryl L Stone, Chin Ying Chow, Gail M Annich, Frank W Moler, Matthew L Paden
This study evaluates whether three commonly used pediatric intensive care unit (PICU) severity of illness scores, pediatric risk of mortality score (PRISM) III, pediatric index of mortality (PIM) 2, and pediatric logistic organ dysfunction (PELOD), are the appropriate tools to discriminate mortality risk in children receiving extracorporeal membrane oxygenation (ECMO) support for respiratory failure. This study also evaluates the ability of the Pediatric Risk Estimate Score for Children Using Extracorporeal Respiratory Support (Ped-RESCUERS) to discriminate mortality risk in the same population, and whether Ped-RESCUERS' discrimination of mortality is improved by additional clinical and laboratory measures of renal, hepatic, neurologic, and hematologic dysfunction...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29750687/evaluation-of-clinical-outcomes-with-phosphodiesterase-5-inhibitor-therapy-for-right-ventricular-dysfunction-after-left-ventricular-assist-device-implantation
#14
Katherine L Roberts, Jerrica E Shuster, Nicholas S Britt, Keki R Balsara, Thomas J Graetz, Mohammad Helwani, Akinobu Itoh, Bethany R Tellor
Few studies have evaluated the use of phosphodiesterase-5 inhibitors (PDE5-i) for right ventricular (RV) dysfunction after left ventricular assist device (LVAD) implantation. The study purpose was to examine the impact of postoperative inpatient PDE5-i therapy on clinical outcomes in patients with LVADs. This single-center, retrospective cohort study screened 428 LVAD recipients between January 2011 and May 2015 for eligibility. Subjects receiving post-LVAD PDE5-i were compared with those who did not. The primary outcome was the proportion of all-cause hospital readmission at 30 days...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29750686/physiologic-basis-for-venovenous-extracorporeal-membrane-oxygenation-management
#15
Hoong Sern Lim
No abstract text is available yet for this article.
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29750685/predicting-plasma-free-hemoglobin-levels-in-patients-due-to-medical-device-related-hemolysis
#16
David M Saylor, Paul W Buehler, Ronald P Brown, Richard A Malinauskas
Blood passage through medical devices can cause hemolysis and increased levels of plasma-free hemoglobin (pfH) that may lead to adverse effects such as vasoconstriction and renal tubule injury. Although the hemolytic potential of devices is typically characterized in vitro using animal blood, the results can be impacted by various blood parameters, such as donor species. Moreover, it is unclear how to relate measured in vitro hemolysis levels to clinical performance because pfH accumulation in vivo depends on both hemolysis rate and availability of plasma haptoglobin (Hpt) that can bind and safely eliminate pfH...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29750684/impact-of-30-day-readmission-after-left-ventricular-assist-device-implantation
#17
Saurabh Gupta, Rebecca J Cogswell, Samit S Roy, John R Spratt, Kenneth K Liao, Cindy M Martin, Ranjit John
Early readmission (within 30 days) after left ventricular assist device (LVAD) implantation might be a marker for increased mortality. We retrospectively reviewed the records of 277 adults who underwent continuous-flow LVAD implantation from 2005 through 2015 at our institution. The baseline characteristics of patients who were (versus were not) readmitted within 30 days after LVAD implantation were compared. To assess the impact of 30 day readmission on long-term survival, we used multivariate Cox regression...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29734261/the-combination-of-tricuspid-annular-plane-systolic-excursion-and-heartmate-risk-score-predicts-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#18
David S Raymer, Jonathan D Moreno, Marc A Sintek, Michael E Nassif, Christopher T Sparrow, Luigi Adamo, Eric L Novak, Shane J LaRue, Justin M Vader
Right ventricular (RV) failure is difficult to predict and is a major determinant of poor outcomes after left ventricular assist device (LVAD) implantation. We evaluated the associations of the following variables with severe RV failure in LVAD patients: tricuspid annular plane systolic excursion (TAPSE), pulmonary artery pulsatility index (PAPi), simplified RV contraction pressure index (sRVCPI), and HeartMate Risk Score (HMRS). We performed a retrospective case-control study on 216 patients who underwent continuous-flow LVAD implantation between 2008 and 2014...
April 26, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29734260/the-hemopump-the-first-intravascular-ventricular-assist-device
#19
Richard Wampler, O H Frazier
Development of durable left ventricular assist devices (LVADs), based on rotary flow blood pumps, began in earnest after the successful implantation of a catheter-mounted axial flow blood pump via intravascular access in 1988. This device, the Hemopump, successfully supported the circulation of a patient in cardiogenic shock secondary to acute rejection of a transplanted heart. Duration of support was 46 hours, resulting in complete recovery of cardiac function and hospital discharge. In effect, this sentinel event demonstrated that continuous-flow blood pumps could be used to support patients in cardiogenic shock...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#20
Olutosin J Akanni, Koji Takeda, Lauren K Truby, Paul A Kurlansky, Codruta Chiuzan, Jiho Han, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Jeffery W Moses, Yoshifumi Naka, A Reshad Garan, Ajay J Kirtane, Hiroo Takayama
Combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and a percutaneous microaxial left ventricular assist device (pLVAD), or "EC-VAD," has been reported in cases of left ventricular decompression with mixed results. We conducted a retrospective review of patients who received EC-VAD (n = 29) or isolated VA-ECMO therapy (ECMO-only; n = 196) for refractory cardiogenic shock between February 2011 and October 2014. Fourteen patients received VA-ECMO and then Impella pLVAD (E→EC-VAD), and 15 received the Impella pump then VA-ECMO (I→EC-VAD)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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