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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/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#1
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28525417/assessing-frailty-in-patients-undergoing-destination-therapy-left-ventricular-assist-device-observations-from-interagency-registry-for-mechanically-assisted-circulatory-support
#2
Lauren B Cooper, Bradley G Hammill, Larry A Allen, JoAnn Lindenfeld, Robert J Mentz, Joseph G Rogers, Carmelo A Milano, Chetan B Patel, Karen P Alexander, Adrian F Hernandez
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28525416/is-there-a-preinterventional-mechanical-ventilation-time-limit-for-candidates-of-adult-respiratory-extracorporeal-membrane-oxygenation
#3
Meng-Yu Wu, Chung-Chi Huang, Tzu-I Wu, Yu-Sheng Chang, Chin-Liang Wang, Pyng-Jing Lin
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319523/plasma-levels-of-microrna-155-are-upregulated-with-long-term-left-ventricular-assist-device-support
#4
Teresa Wang, Emily C O'Brien, Joseph G Rogers, Daniel L Jacoby, Michael E Chen, Jeffrey M Testani, Dawn E Bowles, Carmelo A Milano, G Michael Felker, Chetan B Patel, Pramod N Bonde, Tariq Ahmad
Left ventricular assist device (LVAD) therapy unloads the failing heart but exposes the human body to unique pathophysiologic demands such as continuous blood flow and complete univentricular support, which are associated with increased risk of adverse clinical outcomes. MicroRNAs (miRNAs) are 22-23 nucleotide RNAs involved in regulation of multiple biologic processes including the pathogenesis of heart failure (HF). Thus, measurement of miRNAs may have potential in both diagnostics as circulating biomarkers and in therapeutics for targeted interventions...
May 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28514263/ventricular-energetics-in-pediatric-left-ventricular-assist-device-patients-a-retrospective-clinical-study
#5
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Luca Di Chiara, Paolo Guccione, Antonio Amodeo
The aim of this study is to estimate the trend of right and left energetic parameters in left ventricular assist device (LVAD) pediatric patients. Echocardiographic data were retrospectively collected at the baseline, in the acute phase after and at the monthly follow-ups till the LVAD explantation to estimate left and right ventricular energetic parameters. A significant relationship between the left and right ventricular energetic parameter trends was found along all the study period. Left ventricular end-systolic pressure-volume relationship improved till the follow-up of 2 months and then progressively decreases...
May 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28509676/isolated-right-ventricular-mechanical-support-outcomes-and-prognosis
#6
Teresa A Mulaikal, Laura H Bell, Boyangzi Li, Gebhard Wagener, Hiroo Takayama
Right ventricular (RV) failure that necessitates isolated mechanical support is extremely rare. Outcomes have not been described and are limited to case reports. We sought to evaluate this select group of patients and determine their 30 day and 1 year survival. We retrospectively reviewed the Mechanical Assist Device Database at Columbia University from 2007 to 2015. Inclusion criteria consisted of patients who received isolated RV assist devices (RVADs) without mechanical support of the left ventricle. We evaluated survival, duration of support, intensive care unit (ICU) length of stay, and adverse events...
May 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28509675/acute-and-long-term-effects-of-left-ventricular-assist-device-support-on-right-ventricular-function-in-children-with-pediatric-pulsatile-ventricular-assist-devices
#7
Roberta Iacobelli, Arianna Di Molfetta, Gianluca Brancaccio, Sergio Filippelli, Stefano Morelli, Benedetta Natali, Alessandra Toscano, Fabrizio Drago, Antonio Amodeo
Right ventricular failure (RVF) is a significant issue when considering left ventricular assist device (LVAD) implantation in pediatrics. The aim of this study was to evaluate the effects of LVAD on right ventricular (RV) function in children. We retrospectively reviewed clinical and echocardiographic data of children who underwent Berlin Heart EXCOR LVAD focusing on RV function before and after implantation (1, 3, and 6 month follow-up). An isolated LVAD was used in 27 patients. Median age was 11 months (interquartile range [IQR]: 5-24 months), with a median weight of 6...
May 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28504984/melding-a-high-risk-patient-for-continuous-flow-left-ventricular-assist-device-into-a-low-risk-patient
#8
Javier Amione-Guerra, Ana S Cruz-Solbes, Hilda Gonzalez Bonilla, Jerry D Estep, Ashrith Guha, Arvind Bhimaraj, Erik E Suarez, Brian A Bruckner, Guillermo Torre-Amione, Myung H Park, Barry H Trachtenberg
The model for end-stage liver disease (MELD) has been used as a predictor of mortality after left ventricular assist device (LVAD) placement. However, improvement or worsening of MELD and how those changes affect outcomes is unknown. We performed a retrospective analysis of 244 patients implanted with a continuous flow (CF) LVAD. Patients were dichotomized at admission into low- or high-risk categories using a cutoff of MELD ≥ 19, and they were reclassified at day of implant forming four groups: Group LL (remained low risk), LH (worsened to high risk), HH (remained high risk), and HL (improved to low risk)...
May 10, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28492415/anticoagulation-control-in-patients-with-ventricular-assist-devices
#9
Amelia K Boehme, Salpy V Pamboukian, James F George, T Mark Beasley, James K Kirklin, Jose Tallaj, Chrisly Dillon, Emily B Levitan, Russell Griffin, Gerald McGwin, William B Hillegass, Nita A Limdi
Anticoagulation control has been associated with risk of thromboembolism and hemorrhage. Herein, we explore the relationship between anticoagulation control achieved in left ventricular assist device (LVAD) patients and evaluate the association with risk of thromboembolism and hemorrhage. Patients (19 years old or older) with a continuous flow LVAD placed from 2006 to 2012. Proportion of time spent in target range (PTTR) for international normalized ratio (INR) was estimated with target range of 2.0-3.0. Proportion of time spent in target range was categorized into PTTR > 60%, PTTR ≥ 50 < 60%, and PTTR < 50%...
May 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28489644/an-open-source-ultrasound-software-for-diagnosis-of-fistula-maturation
#10
Barry Belmont, Dae Woo Park, William F Weitzel, Albert J Shih
Vascular access is essential for hemodialysis patients. The mature native arteriovenous fistula has been the preferred vascular access for hemodialysis, because it has greater longevity than synthetic grafts. However, once surgically created, fistulas often fail to develop (mature) into viable points of vascular access, requiring surgical or radiologic interventions before their use. Because maturation depends on vascular mechanics (e.g., distensibility and wall shear), we developed open-source ultrasound software to investigate these metrics clinically...
May 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28475562/leukocyte-adhesion-as-an-indicator-of-oxygenator-thrombosis-during-extracorporeal-membrane-oxygenation-therapy
#11
Julius Wilm, Alois Philipp, Thomas Müller, Andre Bredthauer, Otto Gleich, Christof Schmid, Karla Lehle
Thrombosis is the most common technical complication with extracorporeal membrane oxygenation (ECMO). Accumulations of leukocytes on the gas exchange membranes within a membrane oxygenator (MO) may initiate thrombosis and influence outcome. MOs (n = 41) were removed routinely from adult patients on ECMO, preserved, and analyzed for their cellular deposits using nuclear (4',6-diamidino-2-phenylindole) and cell type-specific markers (CD45; von Willebrand factor, vWF). The extent of cellular colonization was correlated with patient data...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28475561/adverse-event-rates-change-favorably-over-time-for-patients-bridged-with-the-heartware-left-ventricular-assist-device
#12
Simon Maltais, Keith D Aaronson, Jeffrey J Teuteberg, Mark S Slaughter, Samer S Najjar, Valluvan Jeevanandam, Duc T Pham, Ed McGee, Katrin Leadley, Robert L Kormos
The HeartWare Ventricular Assist System (HVAD) provides significant improvements in survival and quality of life, and here, we seek to evaluate temporal differences in the adverse event (AE) rates. Patients (n = 382) in the ADVANCE bridge-to-transplant and continued access protocol trial were assessed for bleeding, cardiac arrhythmia, infection, ischemic and hemorrhagic stroke, and right heart failure during predetermined time periods (≤30, >30-180, >180-365, >365-730, >730-1,095 days) after HVAD implant...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28475560/hydrodynamic-and-geometric-behavior-of-two-pericardial-prostheses-implanted-in-small-aortic-roots
#13
Giordano Tasca, Gianfranco Beniamino Fiore, Paola Redaelli, Claudia Romagnoni, Alberto Redaelli, Amando Gamba, Carlo Antona, Riccardo Vismara
Hydrodynamic performance of stented bioprostheses is far below that of the native valve. One of the reasons is that the internal diameter of the prosthesis is usually smaller than that of the native valve. However, other valve characteristics are also important in generating the pressure drop. We aimed to assess, in an ex vivo pulsatile mock loop, the hydrodynamic behavior of two bioprostheses, Trifecta and Mitroflow, to ascertain which geometric terms are limiting factors in hydrodynamic performance. At stroke volumes between 30 and 60 ml, Trifecta showed lower pressure drop, energy dissipation and valve resistance, and greater effective orifice area...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28471759/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#14
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart, Lung, and Blood Institute (NHLBI) convened a Working Group of experts from June 2 to 3, 2016, in Bethesda, Maryland, to develop NHLBI recommendations aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MCS devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
April 29, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28402990/the-use-of-gmp-produced-bone-marrow-derived-stem-cells-in-combination-with-extra-corporeal-membrane-oxygenation-in-ards-an-animal-model
#15
Ergin Kocyildirim, Nayra Cárdenes, Antony Ting, Eder Cáceres, Christian Bermúdez, Mauricio Rojas
RDS is the result of a wide variety of disorders, which can be associated with different clinical disorders or systemic diseases directly affecting the lungs. Currently, the only existing therapy is limited to supportive care. In a 6-hour pilot study, we analyzed the use of the combination of both stem cell and ECMO strategies to prevent or treat severe lung injury. A total of 11 sheep were used. 5 sheep received E. coli endotoxin as a control group (Group 1). 3 sheep that received E. coli endotoxin were treated with veno-venous ECMO support in Group 2...
April 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28394817/comparative-bone-regeneration-potential-studies-of-collagen-heparin-and-polydopamine-coated-multichannelled-bcp-granules
#16
Gun Hee Lee, Preeti Makkar, Kallyanshis Paul, Byong Taek Lee
The present work is a comparative assessment of the bone regeneration potentiality of bone substitutes comprised of bioactive polymer coated biphasic calcium phosphate (BCP) granules. The bone substitutes were primarily composed of multichanneled BCP granules which were coated separately with biochemical polymer coatings, namely collagen, heparin or polydopamine, using chemical methods. The morphological features and chemical structure of the granules and surface coatings were characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) respectively...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28394816/brain-mri-findings-in-pediatric-patients-post-ecmo
#17
Venessa L Pinto, Sumit Pruthi, Ashly C Westrick, Chevis N Shannon, Brian C Bridges, Truc M Le
Neurologic complications can occur with ECMO due to several factors. Prior studies identified neonates as having unique risk factors and neuro-imaging findings post-ECMO. The aim of this study is to describe brain MRI findings of pediatric patients treated with ECMO. We conducted a retrospective study of non-neonatal pediatric patients who underwent a comprehensive brain MRI after ECMO, between January 2000 and July 2015. We identified 47 pediatric patients in the study cohort with a median age of 8 months (IQR 3-170mo) and a median ECMO run duration of 7...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28394815/normothermic-ex-vivo-heart-perfusion-effects-of-live-animal-blood-and-plasma-cross-circulation
#18
Joseph T Church, Fares Alghanem, Kristopher B Deatrick, John M Trahanas, Joseph P Phillips, Min Hee Song, Elena M Perkins, Robert H Bartlett, Alvaro Rojas-Pena, Martin L Bocks, Gabe E Owens
Prolonged normothermic ex-vivo heart perfusion (NEVHP) could transform cardiac transplantation. To help identify perfusate components that might enable long-term perfusion, we evaluated the effects of cross-circulated whole blood and cross-circulated plasma from a live paracorporeal animal on donor porcine hearts preserved via NEVHP. Standard perfusion (n=40) utilized red blood cell/plasma perfusate and Langendorf technique for a goal of 12 hours. Cross-circulation groups used a similar circuit with the addition of cross-circulated venous whole blood (XC-Blood; n=6) or cross-circulated filtered plasma (XC-Plasma; n=7) between a live paracorporeal pig under anesthesia and the perfusate reservoir...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#19
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28338480/the-challenges-in-predicting-ecmo-survival-and-a-path-forward
#20
Marco Huesch, Christopher Brehm
Extracorporeal membrane oxygenation (ECMO) support is a life-saving but complex technique for patients suffering from severe cardiac and/or pulmonary dysfunction. Increasingly greater utilization in the last 15 years means that a suite of mortality risk analytics is both feasible for researchers and required by clinicians, patients, administrators and insurers. We argue that to date, research into such risk analytics has been insufficient and does not adequately reflect the various indications and configurations of ECLS...
March 22, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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