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Extracorporeal membrane oxygenation

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https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#1
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#2
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29340723/veno-venous-extracorporeal-membrane-oxygenation-vv-ecmo-for-acute-respiratory-failure-following-injury-outcomes-in-a-high-volume-adult-trauma-center-with-a-dedicated-unit-for-vv-ecmo
#3
Jay Menaker, Ronald B Tesoriero, Ali Tabatabai, Ronald P Rabinowitz, Christopher Cornachione, Terence Lonergan, Katelyn Dolly, Raymond Rector, James V O'Connor, Deborah M Stein, Thomas M Scalea
INTRODUCTION: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) has increased over the past decade. The purpose of this study was to evaluate outcomes in adult trauma patients requiring VV ECMO. METHODS: Data were collected on adult trauma patients admitted between January 1, 2015, and November 1, 2016. Demographics, injury-specific data, ECMO data, and survival to discharge were recorded. Medians [interquartile range (IQR)] were reported. A p value ≤0...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29338874/extracorporeal-membrane-oxygenation-in-infants-with-congenital-diaphragmatic-hernia
#4
REVIEW
Theresa R Grover, Natalie E Rintoul, Holly L Hedrick
Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly which impairs normal pulmonary development leading to acute and chronic respiratory failure, pulmonary hypoplasia, pulmonary hypertension, and mortality. CDH is the most common non-cardiac indication for neonatal ECMO. Prenatal and postnatal predictors of CDH severity aid in patient selection. Centers vary in preferred mode of ECMO and timing of CDH repair. Survivors of severe CDH with ECMO are at risk for long-term sequelae including neurodevelopmental delays...
January 12, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29338861/extracorporeal-membrane-oxygenation-before-surgical-repair-of-a-postinfarction-ventricular-septal-defect
#5
Hellmuth R Muller Moran, Vikas Dutta, Weiang Yan, Nitin N Ghorpade, Rakesh C Arora, Rohit K Singal, Johann Strumpher
No abstract text is available yet for this article.
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29337807/extracorporeal-membrane-oxygenation-associated-infections-carefully-consider-cannula-infections
#6
Jonathan Messika, Matthieu Schmidt, Alexandra Aubry, Alain Combes, Jean-Damien Ricard
No abstract text is available yet for this article.
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29337729/evaluation-of-almitrine-infusion-during-veno-venous-extracorporeal-membrane-oxygenation-for-severe-acute-respiratory-distress-syndrome-in-adults
#7
Pierre Esnault, Sami Hraiech, Julien Bordes, Jean-Marie Forel, Mélanie Adda, Romain Rambaud, Samuel Lehingue, Antoine Roch, Laurent Papazian, Christophe Guervilly
This single-center case series investigated the effect of almitrine infusion on PaO2/fraction of inspired oxygen (FIO2) in 25 patients on veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. A positive trial was defined as an increase of PaO2/FIO2 ratio ≥20%. Thirty-two trials were performed. Twenty (62.5%, 95% confidence interval, 37.5%-75%) trials in 18 patients were positive, with a median PaO2/FIO2 ratio increase of 35% (25%-43%). A focal acute respiratory distress syndrome and inhaled nitric oxide therapy were more frequent in patients with a positive response to almitrine...
January 15, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29336834/an-overview-of-medical-ecmo-for-neonates
#8
REVIEW
Kathryn Fletcher, Rachel Chapman, Sarah Keene
Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer...
January 11, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29336832/anticoagulation-in-neonatal-ecmo
#9
REVIEW
Aditi Kamdar, Natalie Rintoul, Leslie Raffini
Despite advances made in technology and neonatal intensive care, the rate of hemorrhagic and thrombotic complications remains unacceptably high in patients undergoing extracorporeal membrane oxygenation (ECMO) and these complications negatively impact morbidity and mortality. Management of anticoagulation in neonates who have a developing hemostatic system is vastly different from adults and poses unique challenges. Variation in practice among ECMO centers regarding anticoagulation monitoring and titration reflects the lack of high-quality evidence...
January 11, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29335831/quality-of-inter-hospital-transportation-in-431-transport-survivor-patients-suffering-from-acute-respiratory-distress-syndrome-referred-to-specialist-centers
#10
Sebastian Blecha, Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Michael Dittmar, Bernhard M Graf, Christian Karagiannidis, Christian Apfelbacher, Thomas Bein
BACKGROUND: The acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODS: We evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study...
January 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29332781/pediatric-extracorporeal-cardiopulmonary-resuscitation-patient-with-traumatic-subarachnoid-hemorrhage-and-takotsubo-syndrome
#11
Thomas E Pearson, Meg A Frizzola, Marc A Priest, Monica A Rochman, Curtis D Froehlich
Takotsubo syndrome is rare in pediatric patients but must be considered in patients with subarachnoid hemorrhage with pulmonary edema and cardiomyopathy. A systematic, collaborative approach is needed to facilitate emergent transfer of patients where extracorporeal cardiopulmonary resuscitation (e-CPR) is used as a lifesaving measure. Extracorporeal membrane oxygenation (ECMO) use in transport requires preplanning, role delineation, resources, and research efforts to be successful. We present an unusual transport case of successful e-CPR/ECMO treatment of Takotsubo syndrome in a 12-year-old boy with an isolated traumatic intracranial injury, cardiomyopathy with pulmonary edema, and multiple cardiac arrests...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332617/decontamination-of-extracorporeal-membrane-oxygenator-devices-with-an-intensified-disinfection-protocol-how-strict-is-too-strict
#12
Rami Sommerstein, Tobias M Merz, Stephan M Jakob, Jukka Takala, Jonas Marschall
No abstract text is available yet for this article.
January 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29332614/serelaxin-for-infant-heart-failure-in-congenital-dilated-cardiomyopathy
#13
Patrick O Myers, Alice Bordessoule, Cécile Tissot
Serelaxin has been studied in trials in adults with acute heart failure, but not in children. We report the first compassionate use of serelaxin in an infant. A 6-month-old girl with dilated cardiomyopathy was placed on extracorporeal membrane oxygenation following cardiac arrest unresponsive to medical treatment. Extracorporeal membrane oxygenation weaning failed despite maximal ino-dilator therapy. During the 48-hour infusion of serelaxin, we observed marked improvement in brain natriuretic peptide, left ventricular systolic function, and dilatation...
January 15, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29330690/extracorporeal-membrane-oxygenation-for-severe-middle-east-respiratory-syndrome-coronavirus
#14
Mohammed S Alshahrani, Anees Sindi, Fayez Alshamsi, Awad Al-Omari, Mohamed El Tahan, Bayan Alahmadi, Ahmed Zein, Naif Khatani, Fahad Al-Hameed, Sultan Alamri, Mohammed Abdelzaher, Amenah Alghamdi, Faisal Alfousan, Adel Tash, Wail Tashkandi, Rajaa Alraddadi, Kim Lewis, Mohammed Badawee, Yaseen M Arabi, Eddy Fan, Waleed Alhazzani
BACKGROUND: Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies. METHODS: We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia...
January 10, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29325841/single-center-experience-with-venovenous-ecmo-for-influenza-related-ards
#15
Jessica Buchner, Michael Mazzeffi, Zachary Kon, Jay Menaker, Lewis Rubinson, Gregory Bittle, Chetan Pasrija, Daniel Herr
OBJECTIVES: This study was designed to determine whether venovenous extracorporeal membrane oxygenation (VV ECMO) reduced mortality in patients with influenza-related acute respiratory distress syndrome (ARDS). DESIGN: A retrospective cohort study was performed. Baseline characteristics of participants were compared and Kaplan-Meier survival analysis was used to compare survival at last medical center follow-up. Cox proportional hazards modeling also was performed to test for univariate associations between salient variables and mortality...
September 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324515/acute-cor-pulmonale-in-veno-venous-extracorporeal-membrane-oxygenation-three-case-reports
#16
Erik R Dong, David G Ng, Danny Ramzy, Joshua S Chung, Oren Friedman, Alain Combes, Francisco A Arabia, Michael Nurok
A retrospective review of three patients with acute respiratory distress syndrome (ARDS) and normal baseline right ventricular function admitted to the Cardiac Surgery Intensive Care Unit whom developed acute cor pulmonale while on veno-venous extracorporeal membrane oxygenation. These patients were diagnosed with ARDS using Berlin Criteria definitions and cannulated with a dual lumen (Avalon) cannula. Despite variations in history, presentation, and course, findings of acute cor pulmonale were encountered 4 to 6 weeks after extracorporeal membrane oxygenation cannulation...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29323413/extracorporeal-membrane-oxygenation-for-refractory-severe-respiratory-failure-in-acute-interstitial-pneumonia
#17
Gabriela Gonçalves-Venade, Nuno Lacerda-Príncipe, Roberto Roncon-Albuquerque, José Artur Paiva
Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial lung disease with rapid progressive respiratory failure and high mortality. In the present report, three cases of AIP complicated by refractory respiratory failure supported with extracorporeal membrane oxygenation (ECMO) are presented. One male and two female patients (ages 27-59) were included. Venovenous ECMO support was provided using miniaturized systems, with two-site femoro-jugular circuit configuration. Despite lung protective ventilation, prone position and neuromuscular blockade, refractory respiratory failure of unknown etiology supervened (ratio of arterial oxygen partial pressure to fractional inspired oxygen 46-130) and ECMO was initiated after 3-7 days of mechanical ventilation...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29319635/low-dose-epinephrine-boluses-for-acute-hypotension-in-the-picu
#18
Pamela D Reiter, Jennifer Roth, Beth Wathen, Jaime LaVelle, Leslie A Ridall
OBJECTIVES: To describe the use of low-dose bolus epinephrine in critically ill children during an acute hypotensive episode or prearrest condition. DESIGN: Institutional Review Board approved, single-center, retrospective medical chart review. SETTING: Large medical-surgical PICU within a freestanding, tertiary care children's hospital. PATIENTS: Patients admitted to the PICU between June 1, 2015, and June 1, 2016, who received low-dose (≤ 5 µg/kg) IV bolus epinephrine...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319634/hyperoxia-and-hypocapnia-during-pediatric-extracorporeal-membrane-oxygenation-associations-with-complications-mortality-and-functional-status-among-survivors
#19
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Robert Tamburro, Kathleen L Meert
OBJECTIVES: To determine the frequency of hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation and their relationships to complications, mortality, and functional status among survivors. DESIGN: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network. SETTING: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals. PATIENTS: Age less than 19 years and treated with extracorporeal membrane oxygenation...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319632/extracorporeal-membrane-oxygenation-for-pertussis-predictors-of-outcome-including-pulmonary-hypertension-and-leukodepletion
#20
Michele Domico, Deborah Ridout, Graeme MacLaren, Ryan Barbaro, Gail Annich, Luregn J Schlapbach, Katherine L Brown
OBJECTIVE: The recent increase of pertussis cases worldwide has generated questions regarding the utility of extracorporeal membrane oxygenation for children with pertussis. We aimed to evaluate factors associated with extracorporeal membrane oxygenation outcome. DESIGN: The study was designed in two parts: a retrospective analysis of the Extracorporeal Life Support Organization Registry to identify factors independently linked to outcome, and an expanded dataset from individual institutions to examine the association of WBC count, pulmonary hypertension, and leukodepletion with survival...
January 9, 2018: Pediatric Critical Care Medicine
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