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Ecmo, extracorporeal, sepsis, shock

Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
July 2017: Wiener Klinische Wochenschrift
N J Lees, Ajp Rosenberg, A I Hurtado-Doce, J Jones, N Marczin, M Zeriouh, A Weymann, A Sabashnikov, A R Simon, A F Popov
Sepsis-induced cardiogenic shock in combination with severe acute respiratory failure represents a life-threatening combination that is often refractory to the conventional methods of treatment. We describe the case of a 33-year-old patient who developed acute cardiovascular collapse and ARDS secondary to superinfection of Panton-Valentine leukocidin-positive Staphylococcus aureus and H1N1 pneumonia who underwent successful combination therapy for severe sepsis-related cardiomyopathy and respiratory failure using extracorporeal membrane oxygenation and cytokine adsorption therapy...
December 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
M Ting, C-H Wang, C-I Tsao, S-C Huang, N-H Chi, N-K Chou, Y-S Chen, S-S Wang
BACKGROUND: Acute fulminant myocarditis with intractable cardiogenic shock is a fatal condition; its only therapeutic option is mechanical circulatory support. The use of mechanical circulatory support, either extracorporeal membrane oxygenation (ECMO) or a ventricular assist device (VAD), serves as a bridge to recovery or as a bridge to transplantation. OBJECTIVES: The aim of this research was to advance our understanding of the outcome of heart transplantation under mechanical support for acute myocarditis...
April 2016: Transplantation Proceedings
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
Amanda Ruth, Courtney E McCracken, James D Fortenberry, Kiran B Hebbar
INTRODUCTION: Pediatric severe sepsis (PSS) continues to be a major health problem. Extracorporeal therapies (ETs), defined as extracorporeal membrane oxygenation (ECMO) and RRenal replacement therapyenal replacement therapy (RRT), are becoming more available for utilization in a variety of health conditions. We aim to describe (1) rates of utilization of ET in PSS, (2) outcomes for PSS patients receiving ET, and (3) epidemiologic characteristics of patients receiving ET. METHODS: We conducted a retrospective review of a prospectively collected database...
November 10, 2015: Critical Care: the Official Journal of the Critical Care Forum
Kevin E Griffith, Eric Jenkins, William Copenhaver, David M Williams
Extracorporeal membrane oxygenation (ECMO) was introduced to clinical medicine over 40 years ago. While initially used as a treatment for acute respiratory failure in infants, the use of ECMO has grown to include respiratory and circulatory failure in both children and adults, cardiogenic shock, pulmonary embolism, sepsis, trauma, malignancy, pulmonary hemorrhage and as a treatment for hypothermic drowning.(1) Recent technological improvements in ECMO circuitry make it possible to minimize anticoagulation of the ECMO patient, decreasing the incidence of bleeding...
March 2016: Perfusion
Pankaj Saxena, James Neal, Lyle D Joyce, Kevin L Greason, Hartzell V Schaff, Pramod Guru, William Y Shi, Harold Burkhart, Zhuo Li, William C Oliver, Roxann B Pike, Dawit T Haile, Gregory J Schears
BACKGROUND: We conducted a retrospective study to assess whether providing extracorporeal membrane oxygenation (ECMO) support to elderly patients (aged 70 years or more) who failed separation from cardiopulmonary bypass after cardiac surgery was a viable option. METHODS: From 2003 to 2013, 45 patients aged 70 years or more underwent 47 runs of ECMO postoperatively. RESULTS: There were 31 men (68.9%). The mean age was 76.8 years. Five patients were in cardiogenic shock preoperatively...
June 2015: Annals of Thoracic Surgery
Meng-Ta Tsai, Chih-Hsin Hsu, Chwan-Yau Luo, Yu-Ning Hu, Jun-Neng Roan
OBJECTIVES: Studies on mechanical-medical bridging for decompensated pulmonary hypertension (PH) are limited. We analysed the outcomes for critical PH patients who underwent extracorporeal membrane oxygenation (ECMO) support using a bridge-to-recovery (BTR) strategy. This study aimed to identify prognostic factors of BTR and evaluate the outcomes of survivors. METHODS: Between 2009 and 2012, 6 patients who received veno-arterial ECMO due to decompensated PH with cardiogenic shock were retrospectively reviewed...
July 2015: Interactive Cardiovascular and Thoracic Surgery
Frank Bruenger, Lukasz Kizner, Jan Weile, Michael Morshuis, Jan F Gummert
PURPOSE: A new hemoadsorption device intended as adjunctive treatment for patients with elevated cytokine levels in the setting of SIRS and sepsis has shown promising results. We report on the beneficial application of the device in a patient with cardiogenic septic shock receiving combined extracorporeal life support with rECMO, LVAD, and CVVH despite his highly septic condition. METHODS: A 39-year-old patient presented with fulminant ARDS and cardiogenic septic shock...
February 2015: International Journal of Artificial Organs
Akira Endo, Atsushi Shiraishi, Junichi Aiboshi, Yoshiro Hayashi, Yasuhiro Otomo
Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He developed fulminant cardiac dysfunction approximately 1 h after admission, and the cause was considered to be septic cardiomyopathy. Blood pressure and oxygenation were maintained at adequate levels with the aid of extracorporeal membrane oxygenation (ECMO). The cardiac dysfunction was reversible, and he was successfully weaned from ECMO on day 12 of hospitalization...
2014: Journal of Intensive Care
Taek Kyu Park, Jeong Hoon Yang, Kyeongman Jeon, Seung-Hyuk Choi, Jin-Ho Choi, Hyeon-Cheol Gwon, Chi Ryang Chung, Chi Min Park, Yang Hyun Cho, Kiick Sung, Gee Young Suh
OBJECTIVES: The role of extracorporeal membrane oxygenation (ECMO) remains controversial in adult patients with refractory septic shock. We sought to describe the clinical outcomes of adult patients supported by ECMO during septic shock refractory to conventional treatment. METHODS: We analysed consecutive adult patients with refractory septic shock, assisted by an ECMO system between January 2005 and December 2013 in a single-centre registry. The primary outcome was survival to hospital discharge...
February 2015: European Journal of Cardio-thoracic Surgery
Jeffrey J Cies, Wayne S Moore, Mindy J Dickerman, Christine Small, Dominick Carella, Arun Chopra, Jason Parker
Meropenem, a broad-spectrum carbapenem, is commonly used for empirical and definitive therapy in the pediatric intensive care unit (ICU). Pharmacokinetic data to guide dosing in children, however, are limited to healthy volunteers or patients who are not in the ICU. Adult data demonstrate that pharmacokinetic parameters such as the volume of distribution and clearance can be significantly altered in individuals receiving extracorporeal membrane oxygenation (ECMO). Alterations in the volume of distribution and clearance of antimicrobials in patients with sepsis and septic shock have also been documented, and these patients have demonstrated lower than expected antimicrobial serum concentrations based on standard dosing regimens...
October 2014: Pharmacotherapy
J Swol, D Buchwald, M Dudda, J Strauch, T A Schildhauer
BACKGROUND: In patients with a body mass index (BMI) > 35 kg/m(2) , or in extreme cases weighting > 250 kg, we are faced with special challenges in therapy and logistics. The aim was to analyze the feasibility of the extracorporeal membrane oxygenation (ECMO) in these patients. METHODS: We report 12 adult patients [10 male, 2 female; mean age 56.7 (34-74) years; mean BMI 47.9 (35-88.6) kg/m(2) ] with acute lung failure treated with veno-venous ECMO from 1 January 2009 to 30 June 2013...
May 2014: Acta Anaesthesiologica Scandinavica
Warwick Butt, Graeme Maclaren
Extracorporeal membrane oxygenation (ECMO) is an advanced form of life support technology whereby venous blood is oxygenated outside of the body and returned to the patient. ECMO was initially used as last-resort rescue therapy for patients with severe respiratory failure. Over the last four decades, it has developed into a safe, standard therapy for newborns with progressive cardiorespiratory failure, as a resuscitation therapy after cardiac arrest, and in combination with other treatments such as hypothermia and various blood filtration therapies...
December 3, 2013: F1000Prime Reports
S Hagiwara, M Murata, M Aoki, M Kaneko, K Oshima
We report two cases of Klebsiella oxytoca bacteremia. Case 1 was a 56-year-old man who was transferred to our hospital by ambulance due to diarrhea and general fatigue. On arrival, he was clearly conscious. However he was in septic shock. We injected broad spectrum antibacterial agents and started intensive care. Though intensive care included continuous hemodiafiltration (CHDF), he died 22 hours after admission. Case 2 was a 69-year-old man with a history of gastrectomy for gastric cancer. He had been admitted to a previous hospital due to ileus...
April 2013: Hippokratia
Elliot J Long, Anna Taylor, Carmel Delzoppo, Frank Shann, Gale Pearson, David Buckley, Warwick Butt
OBJECTIVE: To determine whether plasma filtration improves 28-day survival in infants and children with severe sepsis. DESIGN: A multicentre randomised controlled trial. SETTING: Paediatric intensive care units in teaching hospitals. PATIENTS: Forty-eight infants and children with severe sepsis. INTERVENTIONS: Patients were randomly assigned to receive plasma filtration (n = 25) or standard therapy (n = 23) for the treatment of septic shock...
September 2013: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Alberto Zangrillo, Giovanni Landoni, Giuseppe Biondi-Zoccai, Massimiliano Greco, Teresa Greco, Giacomo Frati, Nicolò Patroniti, Massimo Antonelli, Antonio Pesenti, Federico Pappalardo
OBJECTIVE: To comprehensively assess published peer-reviewed studies related to extracorporeal membrane oxygenation (ECMO), focusing on outcomes and complications of ECMO in adult patients. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE/PubMed was searched for articles on complications and mortality occurring during or after ECMO. DATA EXTRACTION: Included studies had more than 100 patients receiving ECMO and reported in detail fatal or nonfatal complications occurring during or after ECMO...
September 2013: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Luregn J Schlapbach, Joerg Ersch, Christian Balmer, René Prêtre, Maren Tomaske, Rosmarie Caduff, Jim Morwood, Sylvio Provenzano, Christian Stocker
Enteroviruses are a leading cause of viral infections in children. While most enteroviral infections are mild and self-limiting, severe disease such as a viral sepsis syndrome, myocarditis, hepatitis and meningoencephalitis may occur. We present two cases of neonatal enteroviral myocarditis. Cardiorespiratory failure occurred in both cases, and severe shock refractory to conventional treatment required support with extracorporeal membrane oxygenation (ECMO). One child with coxsackievirus B3 myocarditis failed to recover and died after 3 weeks on ECMO, while one child could be decannulated successfully after 9 days of ECMO and recovered completely subsequently...
September 2013: Journal of Paediatrics and Child Health
Ying-Jui Lin, Sheng-Ying Chung, Chi-Di Liang, Hsuan-Chang Kuo, Chien-Fu Huang, Shao-Ju Chien, I-Chun Lin, Steve Leu, Cheuk-Kwan Sun, Sheung-Fat Ko, Jiunn-Jye Sheu, Hon-Kan Yip
BACKGROUND: Conventional therapy against acute pediatric cardiopulmonary failure (APCPF) caused by a variety of disease entities remains unsatisfactory with extremely high morbidity and mortality. For refractory APCPF, extracorporeal membrane oxygenation (ECMO) is one of the last resorts. METHODS: In this study, the in-hospital outcomes of pediatric patients with refractory APCPF receiving ECMO support were reviewed. RESULTS: Between August 2006 and May 2011, a single-center cohort study was performed in pediatric patients who required ECMO support due to cardiogenic shock or severe hypoxemia...
January 2013: Biomedical Journal
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