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Ecmo CRRT

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https://www.readbyqxmd.com/read/28341867/a-safe-procedure-for-connecting-a-continuous-renal-replacement-therapy-device-into-an-extracorporeal-membrane-oxygenation-circuit
#1
Natsumi Suga, Yosuke Matsumura, Ryuzo Abe, Noriyuki Hattori, Taka-Aki Nakada, Shigeto Oda
Patients receiving extracorporeal membrane oxygenation (ECMO) often require continuous renal replacement therapy (CRRT). The intra-circuit pressure of adult ECMO usually deviates from the physiological range. We investigated the use of CRRT connected to an ECMO circuit with physiological intra-circuit pressures (0-150 mmHg, defined as the "safety range") using an in vitro experiment involving a water-filled ECMO circuit. The intra-circuit pressure pre-pump, post-pump, and post-oxygenator were measured while varying the height of the pump or ECMO flow...
March 24, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#2
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28298669/veno-venous-extracorporeal-membrane-oxygenation-for-continuous-renal-replacement-in-a-neonate-with-propionic-acidemia
#3
Jeffrey W Gander, Erika T Rhone, William G Wilson, John P Barcia, Melissa J Sacco
The usual indications for extra corporeal membrane oxygenation (ECMO) are for respiratory or cardiac failure. Although continuous renal replacement therapy (CRRT) is frequently used when patients are on ECMO, the need for CRRT as the primary indication for ECMO is rare. A case of a neonate placed onto veno-venous ECMO for the use of CRRT to treat hyperammonemia from propionic acidemia is presented.
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27867816/severe-ards-caused-by-adenovirus-early-initiation-of-ecmo-plus-continuous-renal-replacement-therapy
#4
Sang Ook Ha, Hyoung Soo Kim, Sunghoon Park, Ki-Suck Jung, Seung Hun Jang, Sang Jin Han, Hyun-Sook Kim, Sun Hee Lee
The reported survival rates of patients with acute respiratory distress syndrome (ARDS) caused by human adenovirus (HAdV) pneumonia are poor. The results do not differ much in immunocompetent patients supported by extracorporeal membrane oxygenation (ECMO). We report two immunocompetent patients with severe ARDS complicating HAdV pneumonia who were treated successfully and survived to discharge. Compared with previous cases, our cases might have benefited from several factors. First, the time interval between mechanical ventilator support and ECMO implantation was shorter...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27851504/1869-therapeutic-drug-monitoring-of-continuous-infusion-cefepime-with-concurrent-ecmo-and-crrt
#5
Wayne Moore, Arun Chopra, Jeffrey Cies
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851486/1851-continuous-infusion-of-meropenem-in-a-patient-on-ecmo-and-crrt
#6
Yasir Alqaqaa, Robert Witcher, Michelle Ramirez, Jason Fisher, Laura Malaga-Dieguez, Arun Chopra
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851259/1624-ecmo-crrt-configuration-in-two-pediatric-septic-shock-patients
#7
Tanya Chadha, Thomas Beaulieu, Fredrick Hill, Laura Malaga-Dieguez, Jason Fisher, Arun Chopra
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27660903/crrt-connected-to-ecmo-managing-high-pressures
#8
Christian de Tymowski, Pascal Augustin, Hamda Houissa, Nicolas Allou, Philippe Montravers, Alienor Delzongle, Quentin Pellenc, Mathieu Desmard
Metabolic disorders and fluid overload are indications of continuous renal replacement therapy (CRRT) including continuous venovenous hemofiltration in patients on extracorporeal membrane oxygenation (ECMO). Direct connection of CRRT machine to the ECMO circuit provides many advantages. Nevertheless, because pressures in CRRT lines relate to ECMO blood flow, high ECMO blood flow may be associated with high pressures in CRRT lines. Thus, management of CRRT pressure lines becomes challenging. We evaluated a protocol for managing high CRRT pressures...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27600419/-predictive-values-of-different-critical-scoring-systems-for-mortality-in-patients-with-severe-acute-respiratory-failure-supported-by-extracorporeal-membrane-oxygenation
#9
R Wang, B Sun, X Y Li, H Y He, X Tang, Q Y Zhan, Z H Tong
OBJECTIVE: To investigate the predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO). METHODS: Forty-two patients with severe ARF supported by VV-ECMO were enrolled from November 2009 to July 2015.There were 25 males and 17 females. The mean age was (44±18) years (rang 18-69 years). Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ⅲ, Ⅳ, Simplified Acute Physiology Score Ⅱ (SAPS) Ⅱ, Sequential Organ Failure Assessment (SOFA), ECMO net, PRedicting dEath for SEvere ARDS on VVECMO (PRESERVE), and Respiratory ECMO Survival Prediction (RESP) scores were collected within 6 hours before VV-ECMO support...
September 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27562206/role-of-technology-for-the-management-of-aki-in-critically-ill-patients-from-adoptive-technology-to-precision-continuous-renal-replacement-therapy
#10
COMMENT
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
https://www.readbyqxmd.com/read/27437064/derivation-and-validation-of-a-search-algorithm-to-retrospectively-identify-crrt-initiation-in-the-ecmo-patients
#11
Pramod K Guru, Tarun D Singh, Melissa Passe, Kianoush B Kashani, Gregory J Schears, Rahul Kashyap
BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) in refractory cardiorespiratory failure is gaining momentum with recent advancements in technology. However, the need for dialysis modes such as continuous renal replacement therapy (CRRT) has also increased in the management for acute kidney injury. Establishing the exact timing of CRRT initiation in these patients from the electronic medical record is vital for automated data extraction for research and quality improvement efforts...
2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27189339/monitoring-of-potential-safety-events-and-vital-signs-during-active-mobilization-of-patients-undergoing-continuous-renal-replacement-therapy-in-a-medical-intensive-care-unit
#12
Hyun Lee, Young Jun Ko, Jinhee Jung, Aeng Ja Choi, Gee Young Suh, Chi Ryang Chung
BACKGROUND/AIMS: This study aims to evaluate potential safety events and vital sign changes during active mobilization physical therapy (PT) in critically ill patients undergoing continuous renal replacement therapy (CRRT). METHODS: A retrospective review was performed on 29 patients who were treated with CRRT and who underwent 81 PT sessions in a medical intensive care unit at a single referral hospital; 15 patients underwent 33 sessions with passive range of motion (PROM) and 17 patients underwent 48 active mobilization PT sessions...
2016: Blood Purification
https://www.readbyqxmd.com/read/27139839/the-impact-of-renal-failure-and-renal-replacement-therapy-on-outcome-during-extracorporeal-membrane-oxygenation-therapy
#13
Elio Antonucci, Irene Lamanna, David Fagnoul, Jean-Louis Vincent, Daniel De Backer, Fabio Silvio Taccone
Acute kidney injury (AKI) is common in patients treated with veno-arterial (VA-) or veno-venous (VV-) extracorporeal membrane oxygenation (ECMO). In this setting, the use of continuous renal replacement therapy (CRRT) can help to optimize fluid status but may also negatively impact on patients' outcome. In contrast, the relationship between AKI, CRRT, and survival in critically ill adult patients receiving ECMO is not well defined. The institutional ECMO database (n = 162) from November 2008 to December 2013, excluding patients with ICU survival <24 hours was reviewed...
August 2016: Artificial Organs
https://www.readbyqxmd.com/read/26885411/cytokine-reduction-in-the-setting-of-an-ards-associated-inflammatory-response-with-multiple-organ-failure
#14
Karl Träger, Christian Schütz, Günther Fischer, Janpeter Schröder, Christian Skrabal, Andreas Liebold, Helmut Reinelt
A 45-year-old male was admitted to our hospital with a small bowel obstruction due to torsion and was immediately scheduled for surgical intervention. At anesthesia induction, the patient aspirated and subsequently developed a severe SIRS with ARDS and multiple organ failure requiring the use of ECMO, CRRT, antibiotics, and low dose steroids. Due to a rapid deterioration in clinical status and a concurrent surge in inflammatory biomarkers, an extracorporeal cytokine adsorber (CytoSorb) was added to the CRRT blood circuit...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/25656009/outcome-of-patients-on-combined-extracorporeal-membrane-oxygenation-and-continuous-renal-replacement-therapy-a-retrospective-study
#15
Bijin Thajudeen, Mahmoud Kamel, Cibi Arumugam, Syed Asad Ali, Santhosh G John, Edward E Meister, Jarrod M Mosier, Yuval Raz, Machaiah Madhrira, Jess Thompson, Amy N Sussman
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy used in the management of cardiopulmonary failure. Continuous renal replacement therapy (CRRT) is often added to the treatment for the correction of fluid and electrolyte imbalance in patients with acute kidney injury. Most of the literature on the use of combined ECMO and CRRT has been on pediatric patients. There are limited outcome data on the use of these combined modalities in adult patients. METHODS: This is a retrospective analysis of all the patients above the age of 18 years who underwent combined ECMO and CRRT at a tertiary care medical center during the period January 2007 to January 2012...
March 2015: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/25482187/combination-of-extracorporeal-membrane-oxygenation-and-continuous-renal-replacement-therapy-in-critically-ill-patients-a-systematic-review
#16
REVIEW
Han Chen, Rong-Guo Yu, Ning-Ning Yin, Jian-Xin Zhou
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is used in critically ill patients presenting acute cardiac and/or pulmonary dysfunctions, who are at high risk of developing acute kidney injury and fluid overload. Continuous renal replacement therapy (CRRT) is commonly used in intensive care units (ICU) to provide renal replacement and fluid management. We conducted a review to assess the feasibility, efficacy and safety of the combination of ECMO and CRRT and to illustrate the indications and methodology of providing renal replacement therapy during the ECMO procedure...
December 8, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25195931/continuous-renal-replacement-therapy-during-extracorporeal-membrane-oxygenation-in-patients-treated-in-medical-intensive-care-unit-technical-considerations
#17
REVIEW
Bożena Seczyńska, Wiesław Królikowski, Ilona Nowak, Miłosz Jankowski, Konstanty Szułdrzyński, Wojciech Szczeklik
Extracorporeal membrane oxygenation (ECMO) is used as a salvage therapy in refractory acute respiratory distress syndrome (ARDS). Although technological progress in the ECMO systems improved the survival rate, prognosis is still significantly worsened by acute kidney injury (AKI), particularly if renal replacement therapy (RRT) is required. There are no exact guidelines recommending which techniques of ECMO and continuous RRT (CRRT) should be used for management of AKI coexisting with respiratory or circulatory failure, and how to combine them...
December 2014: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/24934814/impact-of-fluid-balance-on-outcome-of-adult-patients-treated-with-extracorporeal-membrane-oxygenation
#18
Matthieu Schmidt, Michael Bailey, Joshua Kelly, Carol Hodgson, D James Cooper, Carlos Scheinkestel, Vincent Pellegrino, Rinaldo Bellomo, David Pilcher
PURPOSE: To assess the relationship between early daily fluid balance (FB) and 90-day outcome in adult patients treated with extracorporeal membrane oxygenation (ECMO). DESIGN: Retrospective observational study. SETTING: Tertiary referral centre for ECMO. PATIENTS: 115 patients treated with ECMO for refractory heart failure and 57 patients treated with ECMO for refractory respiratory failure. METHODS: We analysed the association between early daily FB versus hospital and 90-day mortality using multivariable logistic regression model, Cox proportional-hazards model and propensity score...
September 2014: Intensive Care Medicine
https://www.readbyqxmd.com/read/24888283/vascular-access-site-influences-circuit-life-in-continuous-renal-replacement-therapy
#19
Ashley Crosswell, Matthew J Brain, Owen Roodenburg
OBJECTIVE: To determine the influence of vascular access site on continuous renal replacement therapy (CRRT) filter survival. DESIGN, SETTING AND PATIENTS: Retrospective study of the records of patients who received CRRT in The Alfred intensive care unit from June 2011 to May 2012. MAIN OUTCOME MEASURE: Filter run time. METHODS: We matched filter run time to site and type of vascular access. Mean run times were compared using a linear mixed-effects model between: temporary femoral, internal jugular (IJ) and subclavian catheters, tunnelled semipermanent IJ catheters, and extracorporeal membrane oxygenation (ECMO) circuit access...
June 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/24842474/the-challenges-of-multiple-organ-dysfunction-syndrome-and-extra-corporeal-circuits-for-drug-delivery-in-critically-ill-patients
#20
REVIEW
Maya Hites, Antonio Maria Dell'Anna, Sabino Scolletta, Fabio Silvio Taccone
The multiple organ dysfunction syndrome (MODS) is characterized by more than one organ system failing, especially during critical illness. MODS is the leading cause of morbidity and mortality in current ICU practice; moreover, multiple organ dysfunction, especially liver and kidneys, may significantly affect the pharmacokinetics (PKs) of different drugs that are currently administered in critically ill patients. These PK alterations may either result in insufficient drug concentrations to achieve the desired effects or in blood and tissue accumulation, with the development of serious adverse events...
November 20, 2014: Advanced Drug Delivery Reviews
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