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Extracorporeal membrane oxygenation

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https://www.readbyqxmd.com/read/28546860/predictors-of-intracranial-hemorrhage-in-adult-patients-on-extracorporeal-membrane-oxygenation-an-observational-cohort-study
#1
Alexander Fletcher Sandersjöö, Jiri Bartek, Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman, Bo-Michael Bellander
BACKGROUND: Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH in this patient category are poorly understood. The purpose of this study was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who were treated with ECMO for less than 12 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#2
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#3
John C Lin
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546374/pediatric-ards
#4
Ira M Cheifetz
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28542046/elective-venovenous-extracorporeal-membrane-oxygenation-for-resection-of-endotracheal-tumor-a-case-report
#5
W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard
We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery...
May 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28538440/neurologic-injury-in-adults-supported-with-veno-venous-extracorporeal-membrane-oxygenation-for-respiratory-failure-findings-from-the-extracorporeal-life-support-organization-database
#6
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Michele Di Mauro, Fabio Barili, Gijs Geskes, Enrico Vizzardi, Peter T Rycus, Raf Muellenbach, Thomas Mueller, Antonio Pesenti, Alain Combes, Giles Peek, Bjorn Frenckner, Matteo Di Nardo, Justyna Swol, Jos Maessen, Ravi R Thiagarajan
OBJECTIVES: To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING: Data reported to Extracorporeal Life Support Organization from 350 international extracorporeal membrane oxygenation centers during 1992-2015. PATIENTS: Adults (≥ 18 yr old) supported with veno-venous extracorporeal membrane oxygenation for respiratory failure...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#7
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28536661/successful-use-of-extracorporeal-membrane-oxygenation-for-the-treatment-of-cardiogenic-shock-due-to-scorpion-envenomation
#8
Amine Tarmiz, Imene Mgarrech, Chokri Kortas, Sofiane Jerbi
Introduction. The occurrence of a cardiogenic shock is a rare presentation after scorpion envenomation. The treatment includes classically the use of inotropes and specific vasodilators. Case Presentation. We report a case of an 11-year-old boy presenting with cardiogenic shock and pulmonary edema after a scorpion sting. Despite adequate management at the emergency department and intensive care unit, the patient's hemodynamic status worsened rapidly, justifying his transfer to our department for ventricular mechanical assistance by venoarterial extracorporeal membrane oxygenation...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28536282/predicting-survival-after-extracorporeal-membrane-oxygenation-for-ards-an-external-validation-of-resp-and-preserve-scores
#9
Jennifer Brunet, Xavier Valette, Dimitrios Buklas, Philippe Lehoux, Pierre Verrier, Bertrand Sauneuf, Calin Ivascau, Yves Dalibert, Amélie Seguin, Nicolas Terzi, Gérard Babatasi, Damien du Cheyron, Jean-Jacques Parienti, Cédric Daubin
BACKGROUND: We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. METHODS: All consecutive patients treated with ECMO for refractory ARDS, regardless of cause, in the Caen University Hospital in northwestern France over the last decade were included in a retrospective cohort study. The receiver operating characteristic curves of each score were plotted, and the area under the curve was computed to assess their performance in predicting mortality (c-index)...
May 23, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28535198/transcatheter-aortic-valve-implantation-for-recurrent-valsalva-sinus-re-dissection-and-severe-aortic-regurgitation-shortly-after-surgery-for-type-a-aortic-dissection
#10
Elena Caporali, Giovanni Pedrazzini, Stefanos Demertzis, Enrico Ferrari
Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#11
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#12
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528989/infections-during-extracorporeal-membrane-oxygenation-epidemiology-risk-factors-pathogenesis-and-prevention
#13
REVIEW
Stefano Biffi, Stefano Di Bella, Vittorio Scaravilli, Anna Maria Peri, Giacomo Grasselli, Laura Alagna, Antonio Pesenti, Andrea Gori
Extracorporeal membrane oxygenation (ECMO) is a life support technique used in patients with respiratory and/or cardiac failure. The ECMO circuit consists of vascular cannulae, a pump and an artificial lung. Infections are among the most common complications associated with ECMO and have a significant impact on the mortality rate. Here we present a narrative literature review regarding the epidemiology, risk factors, pathogenesis and prevention of infectious complications during ECMO support. The prevalence of hospital-acquired infections during ECMO is 10-12% and their occurrence is likely to be more frequent compared with other critically ill patients...
May 18, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28525615/embolic-foreign-material-in-the-central-nervous-system-of-pediatric-autopsy-patients-with-instrumented-heart-disease
#14
Matthew Torre, Mirna Lechpammer, Vera Paulson, Sanjay Prabhu, Audrey C Marshall, Amy L Juraszek, Robert F Padera, Elizabeth A Bundock, Sara O Vargas, Rebecca D Folkerth
Upon detection of foreign-body embolization to the central nervous system (CNS) following a specific invasive cardiovascular procedure in 1 autopsied child, we undertook a quality assurance analysis to determine whether other patients had had similar events. Autopsies of all infants and children with history of cardiac catheterization, heart surgery on cardiopulmonary bypass, and/or extracorporeal membrane oxygenation over a 5-year period at a single tertiary care institution were reviewed for light-microscopic evidence of foreign material...
May 19, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#15
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/28525416/is-there-a-preinterventional-mechanical-ventilation-time-limit-for-candidates-of-adult-respiratory-extracorporeal-membrane-oxygenation
#16
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/28524034/-value-of-preoperative-pulmonary-artery-diastolic-pressure-on-predicting-primary-graft-dysfunction-after-bilateral-lung-transplantation-for-patients-with-idiopathic-pulmonary-fibrosis
#17
Feng Zhang, Hongyang Xu, Shuyun Jiang, Jiaqiong Li, Shunmei Lu, Dapeng Wang, Zhidong Zang, Hong Pan, Jingyu Chen
OBJECTIVE: To analyze the value of the potential risk factors on predicting primary graft dysfunction (PGD) after bilateral lung transplantation for the patients with idiopathic pulmonary fibrosis (IPF). METHODS: A retrospective study was conducted. Fifty-eight patients with IPF who underwent the bilateral lung transplantation admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2014 to March 2017 were enrolled. The grade 3 PGD happened within 72 hours after transplantation was taken as the outcome event, and these patients were divided into PGD and non-PGD groups...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523194/pneumomediastinum-and-bilateral-pneumothoraces-causing-respiratory-failure-after-thyroid-surgery
#18
Michael Koeppen, Benjamin Scott, Joseph Morabito, Matthew Fiegel, Tobias Eckle
We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. During surgery, the patient developed pneumomediastinum with bilateral pneumothoraces. Despite early treatment with bilateral chest tubes and no evidence of a tracheal perforation, the patient developed severe respiratory failure after extubation on the intensive care unit...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28515746/veno-arterial-extracorporeal-membrane-oxygenation-as-cardiogenic-shock-therapy-support-in-adult-patients-after-heart-surgery
#19
Robert Musiał, Krystyna Ochońska, Andrzej Proc, Jarosław Stoliński, Dariusz Plicner, Bogusław Kapelak, Rafał Drwiła
INTRODUCTION: The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock. AIM: The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed. MATERIAL AND METHODS: We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#20
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
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