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https://www.readbyqxmd.com/read/29336834/an-overview-of-medical-ecmo-for-neonates
#1
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/29333595/implanted-closed-loop-gastric-electrical-stimulation-clges-system-with-sensor-based-feedback-safely-limits-weight-regain-at-24%C3%A2-months
#2
S Morales-Conde, I Alarcón Del Agua, L Busetto, F Favretti, M Anselmino, G M Rovera, M Socas-Macias, A Barranco-Moreno, R Province-Azalde, A J Torres
BACKGROUND: Weight regain following bariatric surgery is not uncommon. Safe, effective weight loss treatment up to 1 year has been reported with the closed-loop gastric electrical stimulation (CLGES) system. Continuous recording of eating and activity behavior by onboard sensors is one of the novel features of this closed-loop electrical stimulation therapy, and may provide improved long-term weight maintenance by enhancing aftercare. METHODS: Four centers participating in a 12-month prospective multicenter randomized study monitored all implanted participants (n = 47) up to 24 months after laparoscopic implantation of a CLGES system...
January 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29329188/the-impact-of-combined-warm-ischemia-time-on-development-of-acute-kidney-injury-in-donation-after-circulatory-death-liver-transplantation-stay-within-the-golden-hour
#3
Marit Kalisvaart, Andrea Schlegel, Ilaria Umbro, Jubi E de Haan, Irene Scalera, Wojciech G Polak, Jan Nm IJzermans, Darius F Mirza, M Thamara Pr Perera, John I Isaac, James Ferguson, Anna Paola Mitterhofer, Jeroen de Jonge, Paolo Muiesan
BACKGROUND: Acute kidney injury (AKI) is a common complication after liver transplantation and more frequently observed when high-risk grafts, such as DCD grafts are used. Our aim was to investigate the impact of the ischemia periods on development of AKI in DCD liver transplantation. METHODS: We performed a 2-center retrospective study with 368 DCD graft-recipients. Donor warm ischemia time (DWIT) was divided into agonal phase (withdrawal of life-support - cardiac arrest) and asystolic phase (cardiac arrest - start cold perfusion)...
January 11, 2018: Transplantation
https://www.readbyqxmd.com/read/29326145/return-to-work-and-participation-in-society-after-out-of-hospital-cardiac-arrest
#4
Gisela Lilja, Niklas Nielsen, John Bro-Jeppesen, Hannah Dunford, Hans Friberg, Caisa Hofgren, Janneke Horn, Angelo Insorsi, Jesper Kjaergaard, Fredrik Nilsson, Paolo Pelosi, Tineke Winters, Matt P Wise, Tobias Cronberg
BACKGROUND: The aim of this study was to describe out-of-hospital cardiac arrest (OHCA) survivors' ability to participate in activities of everyday life and society, including return to work. The specific aim was to evaluate potential effects of cognitive impairment. METHODS AND RESULTS: Two hundred eighty-seven OHCA survivors included in the TTM trial (Target Temperature Management) and 119 matched control patients with ST-segment-elevation myocardial infarction participated in a follow-up 180 days post-event that included assessments of participation, return to work, emotional problems, and cognitive impairment...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29318612/transplanted-human-thymus-slices-induce-and-support-t-cell-development-in-mice-after-cryopreservation
#5
Susan Ross, Melissa Cheung, Ching-In Lau, Neil Sebire, Michael Burch, Peter Kilbride, Barry Fuller, G John Morris, E Graham Davies, Tessa Crompton
Here we show that slices of human thymus tissue that have been frozen and thawed can induce and support T-cell development when transplanted into nude mice. Babies born without a thymus require urgent treatment to reconstitute T-cell immunity. Thymus tissue is removed from infants during cardiac surgery, to allow access to the heart. This discarded thymus tissue can be transplanted into athymic infants to reconstitute T-cell immunity. Slices of thymus tissue are transplanted into the thigh, after a two-three week culture period to deplete thymocytes...
January 10, 2018: European Journal of Immunology
https://www.readbyqxmd.com/read/29314113/bridging-the-gap-extracorporeal-life-support-for-out-of-hospital-cardiac-arrest
#6
EDITORIAL
Adam Kessler, Michael Christopher Kurz
No abstract text is available yet for this article.
January 2018: Artificial Organs
https://www.readbyqxmd.com/read/29305926/lower-dose-epinephrine-administration-and-out-of-hospital-cardiac-arrest-outcomes
#7
Cameron A Fisk, Michele Olsufka, Lihua Yin, Andrew M McCoy, Andrew J Latimer, Charles Maynard, Graham Nichol, Jonathan Larsen, Leonard A Cobb, Michael R Sayre
BACKGROUND: International guidelines recommend administration of 1 mg of intravenous epinephrine every 3 to 5 minutes during cardiac arrest. The optimal dose of epinephrine is not known. We evaluated the association of reduced frequency and dose of epinephrine with survival after out-of-hospital cardiac arrest (OHCA). METHODS: Included were patients with non-traumatic OHCA treated by advanced life support (ALS) providers from January 1, 2008 to June 30, 2016...
January 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29305251/cardiac-arrest-during-pregnancy-ongoing-clinical-conundrum-an-expert-review
#8
REVIEW
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305227/current-trends-in-neonatal-ecmo
#9
REVIEW
Burhan Mahmood, Debra Newton, Eugenia K Pallotto
Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for patients with respiratory and cardiac failure refractory to maximal medical management. The extracorporeal life support organization registry is the largest available resource for describing the population and outcomes of patients treated with this therapy. The use of ECMO for neonatal patients is decreasing in proportion to the total annual ECMO runs most likely due to advancements in medical management. Although the overall survival for neonatal ECMO has decreased, this is likely a reflection of the increasingly complex neonatal patients treated with this therapy...
January 2, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29302124/extracorporeal-life-support-as-a-rescue-measure-for-managing-life-threatening-arrythmia-and-brugada-syndrome
#10
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#11
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29290337/kiaa1109-variants-are-associated-with-a-severe-disorder-of-brain-development-and-arthrogryposis
#12
Lucie Gueneau, Richard J Fish, Hanan E Shamseldin, Norine Voisin, Frédéric Tran Mau-Them, Egle Preiksaitiene, Glen R Monroe, Angeline Lai, Audrey Putoux, Fabienne Allias, Qamariya Ambusaidi, Laima Ambrozaityte, Loreta Cimbalistienė, Julien Delafontaine, Nicolas Guex, Mais Hashem, Wesam Kurdi, Saumya Shekhar Jamuar, Lim J Ying, Carine Bonnard, Tommaso Pippucci, Sylvain Pradervand, Bernd Roechert, Peter M van Hasselt, Michaël Wiederkehr, Caroline F Wright, Ioannis Xenarios, Gijs van Haaften, Charles Shaw-Smith, Erica M Schindewolf, Marguerite Neerman-Arbez, Damien Sanlaville, Gaëtan Lesca, Laurent Guibaud, Bruno Reversade, Jamel Chelly, Vaidutis Kučinskas, Fowzan S Alkuraya, Alexandre Reymond
Whole-exome and targeted sequencing of 13 individuals from 10 unrelated families with overlapping clinical manifestations identified loss-of-function and missense variants in KIAA1109 allowing delineation of an autosomal-recessive multi-system syndrome, which we suggest to name Alkuraya-Kučinskas syndrome (MIM 617822). Shared phenotypic features representing the cardinal characteristics of this syndrome combine brain atrophy with clubfoot and arthrogryposis. Affected individuals present with cerebral parenchymal underdevelopment, ranging from major cerebral parenchymal thinning with lissencephalic aspect to moderate parenchymal rarefaction, severe to mild ventriculomegaly, cerebellar hypoplasia with brainstem dysgenesis, and cardiac and ophthalmologic anomalies, such as microphthalmia and cataract...
December 27, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#13
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#14
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29276268/improved-outcomes-and-cost-savings-associated-with-pharmacist-presence-in-the-emergency-department
#15
Matthew W McAllister, Joshua G Chestnutt
Purpose: The study sought to determine whether the inclusion of a pharmacist on the emergency department (ED) resuscitation team was associated with improved compliance with the Advanced Cardiac Life Support (ACLS) guidelines and patient survival. The study also evaluated cost avoidance associated with a pharmacist providing clinical services to the ED. Methods: Cardiac arrest event records were evaluated for compliance with ACLS guidelines as well as for whether or not a pharmacist was involved as a member of the resuscitation team...
June 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273461/evolution-of-survival-in-cardiac-arrest-with-age-in-elderly-patients-is-resuscitation-a-dead-end
#16
Nicolas Segal, Christophe di Pompéo, Joséphine Escutnaire, Eric Wiel, Cyrielle Dumont, Laurent Castra, Karim Tazarourte, Carlos El Khoury, Pierre-Yves Gueugniaud, Hervé Hubert
BACKGROUND: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile. OBJECTIVE: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age...
December 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29250516/use-of-therapeutic-plasma-exchange-during-extracorporeal-life-support-in-critically-ill-cardiac-children-with-thrombocytopenia-associated-multi-organ-failure
#17
Mei Chong, Alejandro J Lopez-Magallon, Lucas Saenz, Mahesh S Sharma, Andrew D Althouse, Victor O Morell, Ricardo Munoz
Background: Thrombocytopenia-associated multi-organ failure (TAMOF) in children is a well-described factor for increased hospital mortality. Low cardiac output syndrome (LCOS) and the effects of cardiopulmonary bypass may manifest with several adverse physiologic and immunologic effects, with varying degrees of thrombocytopenia and multi-organ dysfunction, sometimes very similar to TAMOF. LCOS is a common occurrence in children with critical heart disease, presenting in as much as 23...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29249793/-coronary-artery-perforation-secondary-to-primary-percutaneous-coronary-intervention-report-of-a-case
#18
Eiji Kinoshita, Koji Kawahito, Arata Muraoka, Akira Sugaya, Kei Aizawa, Yoshio Misawa
Stent perforation of a coronary artery during percutaneous coronary intervention (PCI) is a rare but life-threatening complication. A 70-year-old man was admitted to our hospital for management of acute coronary syndrome. PCI was attempted for the left circumflex artery(LCX);however, catheterization was complicated by perforation of the LCX by the stent. He developed cardiac tamponade and was resuscitated using percutaneous cardiopulmonary support. Emergency surgery( ligation of the LCX and aorto-coronary bypass grafting for the distal LCX) was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29246742/timing-of-focused-cardiac-ultrasound-during-advanced-life-support-a-prospective-clinical-study
#19
Rasmus Aagaard, Bo Løfgren, Thorbjørn Grøfte, Erik Sloth, Roni R Nielsen, Christian A Frederiksen, Asger Granfeldt, Morten T Bøtker
INTRODUCTION: Focused cardiac ultrasound can potentially identify reversible causes of cardiac arrest during advanced life support (ALS), but data on the timing of image acquisition are lacking. This study aimed to compare the quality of images obtained during rhythm analysis, bag-mask ventilations, and chest compressions. METHODS: Adult patients in cardiac arrest were prospectively included during 23 months at a Danish community hospital. Physicians who had completed basic ultrasound training performed subcostal focused cardiac ultrasound during rhythm analysis, bag-mask ventilations, and chest compressions...
December 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/29241598/organ-donation-after-controlled-cardiac-death-under-maastricht-category-iii-ethical-implications-and-end-of-life-care
#20
M Isabel González-Méndez, Luís López-Rodríguez
The decrease in potential donation after brain death has resulted in a need to evaluate alternative sources. Donation after cardiac death is a good option. The objectives of this article were to describe the Maastricht type iii controlled organ donation characteristics and to determine end-of-life care and the role of nurses in the donation process. In this type of donation, cardiocirculatory arrest is predictable after the limitation of life sustaining treatments. These are patients for whom there are no effective therapy options and, in the context of an organised and planned practice involving all the professionals involved in the care of the patient, the decision is made, in consultation with the family, to withdraw life support measures...
December 11, 2017: Enfermería Clínica
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