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Ecmo cardiac arrest

Yoshiaki Iwashita, Takuya Hiramoto, Kei Suzuki, Ryotaro Hashizume, Kazuo Maruyama, Hiroshi Imai
RATIONALE: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but lethal complication of carcinoma, defined as non-occlusive pulmonary tumor embolism complicated by fibrocellular intimal proliferation of the small pulmonary arteries, with eventual occlusion of the pulmonary arteries. Hemodynamic deterioration caused by this condition leads to high mortality. PATIENT CONCERNS: A 46-year-old woman who had undergone radiation therapy for anaplastic oligoastrocytoma and who was taking temozolomide presented with cough and palpitations...
September 2018: Medicine (Baltimore)
M Puślecki, M Ligowski, S Stefaniak, M Dąbrowski, M Zieliński, A Pawlak, T Kłosiewicz, M Sip, M Karczewski, T Małkiewicz, Ł Gąsiorowski, W Telec, M Ładzińska, K Baumgart, P Ładziński, B Perek, M Misterski, W Mrówczyński, P Sobczyński, I Kiel-Puślecka, P Buczkowski, M Kiel, M Czekajlo, M Jemielity
The "ECMO for Greater Poland" program takes full advantage of the extracorporeal membrane oxygenation (ECMO) perfusion therapy opportunities to promote the health of the 3.5 million inhabitants in the region. The main implementation areas are treatment of patients with hypothermia; severe reversible respiratory failure (RRF); critical states resulting in heart failure, that is, cardiac arrest, cardiogenic shock, or acute intoxication; and promotion of the donor after circulatory death (DCD) strategy in selected organ donor cases, after unsuccessful life-saving treatment, to achieve organ recovery...
September 2018: Transplantation Proceedings
Andrew L Dailey-Schwartz, Hanna J Tadros, Mahshid Sababi Azamian, Seema R Lalani, Shaine A Morris, Hugh D Allen, Jeffrey J Kim, Andrew P Landstrom
OBJECTIVE: To determine the prevalence, spectrum, and prognostic significance of copy number variants of undetermined significance (cnVUS) seen on chromosomal microarray (CMA) in neonates with hypoplastic left heart syndrome (HLHS). STUDY DESIGN: Neonates with HLHS who presented to Texas Children's Hospital between June 2008 and December 2016 were identified. CMA results were abstracted and compared against copy number variations (CNVs) in ostensibly healthy individuals gathered from the literature...
August 29, 2018: Journal of Pediatrics
Jason A Bartos, Kathleen Carlson, Claire Carlson, Ganesh Raveendran, Ranjit John, Tom P Aufderheide, Demetris Yannopoulos
BACKGROUND: Resuscitation of refractory out-of-hospital ventricular fibrillation/ventricular tachycardia (VF/VT) cardiac arrest using extracorporeal membrane oxygenation (ECMO) establishes a complex patient population. We aimed to describe the critical care strategies and outcomes in this population. METHODS: Between December 1, 2015 and January 1, 2018, 100 consecutive adult patients with refractory VF/VT out-of-hospital cardiac arrest and ongoing CPR were transported to the cardiac catheterization laboratory...
August 29, 2018: Resuscitation
Bishoy Zakhary, Vinodh B Nanjayya, Jayne Sheldrake, Kathleen Collins, Joshua F Ihle, Vincent Pellegrino
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is a promising adjunct to cardiopulmonary resuscitation (CPR) in refractory cardiac arrest (CA). Factors associated with outcome are incompletely characterised. The aim of our study was to identify pre-ECMO factors associated with in-hospital mortality after extracorporeal CPR (ECPR). DESIGN: Retrospective analysis of a prospective cohort of patients. SETTING: Academic quaternary referral hospital...
September 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Mathew Jose Chakaramakkil, Cumaraswamy Sivathasan
PURPOSE OF REVIEW: This review aims to discuss the role of ECMO in the treatment of cardiogenic shock in heart failure. RECENT FINDINGS: Trials done previously have shown that IABP does not improve survival in cardiogenic shock compared to medical treatment, and that neither Impella 2.5 nor TandemHeart improves survival compared to IABP. The "IMPRESS in severe shock" trial compared Impella CP with IABP and found no difference in survival. A meta-analysis of cohort studies comparing ECMO with IABP showed 33% improved 30-day survival with ECMO (risk difference 33%; 95% CI 14-52%; p = 0...
August 16, 2018: Current Cardiology Reports
Alexander Robinson, Aniket S Rali, Zubair Shah, Travis Abicht, Eric Hockstad, Andrew Sauer
National trends suggest that less than one in four patients experiencing in-hospital cardiac arrest (IHCA) in the United States survive to discharge. This is especially relevant as the rates of IHCA are expected to rise in the years to come. Only a modest upward trend in survival to discharge among patients with IHCA over the past decade warrants evaluation of novel ideas to improve outcomes postcardiopulmonary resuscitation. One such idea is that the use of veno-arterial-extracorporeal membrane oxygenation (VA-ECMO) to augment standard advanced cardiac life support algorithm in patients with an identifiable and reversible cause of cardiac arrest would improve survival to discharge...
July 2018: Indian Journal of Critical Care Medicine
Atsushi Sugiura, Ryuzo Abe, Takashi Nakayama, Noriyuki Hattori, Yoshihide Fujimoto, Toshiharu Himi, Koichi Sano, Shigeto Oda, Yoshio Kobayashi
AIM: While veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to resuscitate and stabilize haemodynamics in patients of acute myocardial infarction (AMI) complicated by cardiac arrest (CA), it is essential to predict the possibility of weaning from ECMO to determine further strategies, including use of ventricular assist device. We aimed to determine predictors of successful weaning from VA-ECMO in the early phase of ECMO treatment. METHODS: We identified consecutive patients of AMI complicated by CA treated with VA-ECMO and percutaneous coronary intervention (PCI)...
August 3, 2018: Shock
Xiao-Li Yuan, Chun-Sheng Li, Yun Zhang, Ji-Yang Ling, Qiang Zhang, Yong Liang, Bo Liu, Lian-Xing Zhao
Background: Acute kidney injury (AKI) frequently occurs in cardiopulmonary resuscitation patients. Studies comparing the effects of extracorporeal membrane oxygenation (ECMO) with conventional cardiopulmonary resuscitation (CCPR) on AKI were rare. This study aimed to compare the effects of ECMO with those of CCPR on survival rate and AKI and explore the underlying mechanisms in a swine model of cardiac arrest (CA). Methods: Sixteen male pigs were treated with ventricular fibrillation to establish CA model and then underwent CCPR (CCPR group, n = 8) or ECMO during cardiopulmonary resuscitation (ECPR group, n = 8)...
August 5, 2018: Chinese Medical Journal
Omar Ellouze, Julie Lamirel, Justine Perrot, Anis Missaoui, Theresa Daily, Serge Aho, Andranik Petrosyan, Pierre Gregoire Guinot, Oliver Bouchot, Belaid Bouhemad
INTRODUCTION: The use of extracorporeal life support (ECLS) is increasing worldwide, in particular for the management of refractory cardiac arrest, cardiogenic shock and post cardiopulmonary bypass ventricular failure. Extubation of patients under extracorporeal membrane oxygenation (ECMO) for respiratory failure is a growing practice for adult and pediatric patients, especially for lung transplantation candidates. Because of potential complications and, specifically, accidental arterial decannulation, extubation of patients under ECLS is not standard practice...
July 25, 2018: Perfusion
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Piotr Ładziński, Aleksander Pawlak, Marcin Zieliński, Agata Dąbrowska, Aniela Artyńska, Mariusz Gezela, Paweł Sobczyński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region (Greater Poland). The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF) and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication...
July 25, 2018: Artificial Organs
Rasha Al-Bawardy, Kenneth Rosenfield, Jorge Borges, Michael N Young, Mazen Albaghdadi, Rachel Rosovsky, Christopher Kabrhel
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been used to stabilize patients with massive pulmonary embolism though few reports describe this approach. We describe the presentation, management and outcomes of patients who received ECMO for massive pulmonary embolism (PE) in our pulmonary embolism response team (PERT) registry. METHODS: We enrolled a consecutive cohort of patients with confirmed PE for whom PERT was activated and selected patients treated with ECMO...
July 1, 2018: Perfusion
Francesco Burzotta, Giulio Russo, Eloisa Basile, Cristina Aurigemma, Antonio Maria Leone, Giampaolo Niccoli, Italo Porto, Piergiorgio Bruno, Massimo Massetti, Filippo Crea, Carlo Trani
The use of percutaneous mechanical circulatory support systems in the setting of both high-risk percutaneous coronary intervention (PCI) and cardiogenic shock is an emerging, controversial issue in contemporary clinical cardiology. The most common devices are the intra-aortic balloon pump (IABP), the Impella and the extracorporeal membrane oxygenator (ECMO). Technical progress, equipment improvement and growing cath-lab team expertise are allowing to offer critical patients different levels of assistance according to the selected device...
June 2018: Giornale Italiano di Cardiologia
Saraschandra Vallabhajosyula, Sri Harsha Patlolla, Harigopal Sandhyavenu, Saarwaani Vallabhajosyula, Gregory W Barsness, Shannon M Dunlay, Kevin L Greason, David R Holmes, Mackram F Eleid
BACKGROUND: There are limited data on the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) or cardiopulmonary bypass (CPB) to provide hemodynamic support periprocedurally during transcatheter aortic valve replacement. This study sought to evaluate patients receiving transcatheter aortic valve replacement with concomitant use of CPB/VA-ECMO. METHODS AND RESULTS: We systematically reviewed the published literature from 2000 to 2018 for studies evaluating adult patients requiring CPB/VA-ECMO periprocedurally during transcatheter aortic valve replacement...
July 9, 2018: Journal of the American Heart Association
Randi Connor-Schuler, Daniel Hrabec, Julio Pinto Corrales
Pulmonary emboli (PE) are commonly encountered events with presentations ranging from benign incidental findings to obstructive shock. We present a case of a 20 year old male with nephrotic syndrome who suffered complete cardiovascular collapse with cardiac arrest in the setting of a massive PE, requiring open surgical embolectomy and ECMO support. We reviewed the literature on massive PE's focusing on the use of ECMO and success of the rarely performed open embolectomy for the treatment of obstructive shock from a massive PE...
2018: Respiratory Medicine Case Reports
Xue-Ning Wang, Si-M Pham
This case study describes a 25-year-old patient who had a witnessed cardiac arrest in the medical intensive care unit. The patient received 107 minutes of cardiopulmonary resuscitation before the veno-arterial extracorporeal membrane oxygenation was initiated. During extracorporeal life support, the patient's cardiac function improved. The patient was weaned from extracorporeal membrane oxygenation on day 6 and was discharged without physical and neurological complications on day 28. The successful resuscitation in this case attributed to high-quality CCPR and timely ECMO support...
June 30, 2018: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Sonia Labarinas, Kristen Meulmester, Spencer Greene, James Thomas, Manpreet Virk, Gwen Erkonen
INTRODUCTION: Diphenhydramine is a widely used first-generation histamine (H1 ) antagonist that can be obtained without prescription in many countries. Massive ingestions can result in severe toxicity and even death. We describe a case of diphenhydramine overdose leading to cardiac arrest, cardiopulmonary resuscitation (CPR), and extracorporeal membrane oxygenation (ECMO) cannulation for refractory ventricular fibrillation, a process we refer to as extracorporeal cardiopulmonary resuscitation (ECPR)...
September 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
J Lauren Lindsey, Rajay Jain, Vidula Vachharajani
This case report discusses a previously healthy young male who suffered an in hospital cardiac arrest, found to be secondary to massive pulmonary emboli (PE). This patient was not a candidate for PE dosing of tPA, but continued to have worsening cardiogenic shock and acute hypoxic respiratory failure. The decision was made to initiate venoarterial extracorporeal membrane oxygenation (VA ECMO) in combination with catheter assisted thrombolysis. With time, the sequelae of his disease process changed. Although his cardiogenic shock improved, the hypoxemia worsened, and the patient was transitioned from VA to venovenous (VV) ECMO, while managing further complications due to multiple episodes of cardiac arrest and severe coagulopathy with multiple, acute, life-threatening bleeding events...
2018: Respiratory Medicine Case Reports
Adriano Peris, Chiara Lazzeri, Giovanni Cianchi, Manuela Bonizzoli, Stefano Batacchi, Andrea Franci, Mario Rugna, Lucia De Vito, Pier F Ticali, Vincenzo Li Marzi, Maria L Migliaccio
BACKGROUND: Donation after circulatory death (DCD) is an emerging way to implement organ procurement for transplantation. In Italy, until June 2016, the only formal DCD program was implemented in Pavia, the so-called "Alba program". METHODS: We describe our one-year experience of the DCD program implemented at the Careggi Teaching Hospital (Florence, Italy) since June 2016. We specifically describe organizational changes induced by the DCD program on our pre-existing Donation After Brain Death (DBD ) program and DCD activity...
May 28, 2018: Minerva Anestesiologica
Anna Solé, Iolanda Jordan, Sara Bobillo, Julio Moreno, Monica Balaguer, Lluisa Hernández-Platero, Susana Segura, Francisco José Cambra, Elisabeth Esteban, Javier Rodríguez-Fanjul
The objective of the study was to report our institutional experience in the management of children and newborns with refractory septic shock who required venoarterial extracorporeal membrane oxygenation (VA ECMO) treatment, and to identify patient-and infection-related factors associated with mortality. This is a retrospective case series in an intensive care unit of a tertiary pediatric center. Inclusion criteria were patients ≤ 18 years old who underwent a VA ECMO due to a refractory septic shock due to circulatory collapse...
August 2018: European Journal of Pediatrics
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