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Venoarterial extracorporeal membrane oxygenation

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https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#1
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yutaka Fujii, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
BACKGROUND: Femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to maintain blood flow in patients with cardiogenic shock. However, retrograde blood flow increases left ventricular (LV) afterload during femoral VA-ECMO. Additional support by means of an intraaortic balloon pump (IABP) alleviates LV afterload but is associated with significant adverse events. We previously developed a system for rotational speed modulation in synchrony with the native cardiac cycle, for use with implantable continuous-flow LV assist devices...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707719/extracorporeal-membrane-oxygenation-application-in-post-partum-hemorrhage-patients-is-post-partum-hemorrhage-contraindicated
#2
Kuan-Ying Huang, Yi-Ping Li, Shin-Yu Lin, Jin-Chung Shih, Yih-Sharng Chen, Chien-Nan Lee
Extracorporeal membrane oxygenation (ECMO) is commonly used in patients who experience circulatory arrest or significant cardiac dysfunction and is associated with improved clinical outcomes. We conducted a retrospective observational study on ECMO application at a single tertiary center over a five-year period. Five patients who suffered post-partum hemorrhage resulting from uterine atony were treated with ECMO. The mean age was 36.8 ± 3.9 years; the mean gestational age was 37.8 ± 2.2 weeks; the initial mean maternal hemoglobin level was 5...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#3
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28694357/floating-clots-in-the-descending-aorta-a-rare-complication-of-femoral-venoarterial-extracorporeal-membrane-oxygenation-combined-with-microaxial-pump-for-cardiogenic-shock
#4
Masahiko Ando, Arthur R Garan, Kelly M Axom, Koji Takeda
No abstract text is available yet for this article.
July 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28693931/maintenance-of-drug-eluting-stent-patency-through-use-of-a-cangrelor-infusion-in-the-clinical-setting-of-massive-pulmonary-hemorrhage-and-venoarterial-extracorporeal-membrane-oxygenation
#5
Troy G Seelhammer, Erica D Wittwer, Scott D Nei, James Skiba
No abstract text is available yet for this article.
March 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28682992/connection-of-a-renal-replacement-therapy-or-plasmapheresis-device-to-the-ecmo-circuit
#6
Florent Laverdure, Laurent Masson, Guillaume Tachon, Julien Guihaire, François Stephan
In patients under extracorporeal membrane oxygenation (ECMO) support requiring renal replacement therapy or plasmapheresis, connecting such extracorporeal therapy device to the ECMO circuit provides many advantages compared with central venous catheterization. However, high pressures of the ECMO circuit limit the usefulness of this technique. We propose a new approach to connect extracorporeal therapy lines to the ECMO circuit. Inlet line is connected to the oxygenator, and outlet line is connected either to the femoral artery antegrade perfusion cannula in case of venoarterial ECMO or to the lateral vent of the return cannula in case of venovenous ECMO...
July 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28674057/population-pharmacokinetics-and-dose-optimization-of-teicoplanin-during-venoarterial-extracorporeal-membrane-oxygenation
#7
Jin Wi, Hayeon Noh, Kyoung Lok Min, Seungwon Yang, Byung Hak Jin, Jongsung Hahn, Soo Kyung Bae, Jiseon Kim, Min Soo Park, Donghoon Choi, Min Jung Chang
Pharmacokinetics (PK) of drugs are known to be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). However, clinical PK studies of drugs administered during ECMO are scarce and proper dosing adjustment is yet to be established. We developed a population PK model for teicoplanin, investigated covariates influencing teicoplanin exposure, and suggested an optimal dosing regimen for ECMO patients. PK samples were collected from ten adult patients, and a population PK analysis as well as simulations were performed to identify an optimal teicoplanin dose needed to provide a >50% probability of target attainment at 72 hours using a trough concentration target of >10 μg/mL for mild to moderate infections and of >15 μg/mL for severe infections...
July 3, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28673618/extracorporeal-membrane-oxygenation-and-interfacility-transfer-a-regional-referral-experience
#8
David N Ranney, Desiree Bonadonna, Babatunde A Yerokun, Michael S Mulvihill, Nawar Al-Rawas, Michael Weykamp, Rathnayaka M Gunasingha, Raquel R Bartz, John C Haney, Mani A Daneshmand
BACKGROUND: The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. METHODS: A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record...
June 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28664820/ten-thousand-kilometre-transfer-of-cardiogenic-shock-patients-on-venoarterial-extracorporeal-membrane-oxygenation-for-emergency-heart-transplantation-cooperation-between-reunion-island-and-metropolitan-france
#9
Clément Charon, Jérôme Allyn, Bruno Bouchet, Fréderic Nativel, Eric Braunberger, Caroline Brulliard, Olivier Martinet, Nicolas Allou
BACKGROUND: There is no heart transplantation centre on the French overseas territory of Reunion Island (distance of 10,000 km). The aim of this study was to describe the characteristics of cardiogenic shock adult patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) who were transferred from Reunion Island to mainland France for emergency heart transplantation. METHODS: This retrospective observational study was conducted between 2005 and 2015...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28655868/double-peripheral-venous-and-arterial-cannulation-for-extracorporeal-membrane-oxygenation-in-combined-septic-and-cardiogenic-shock
#10
Markus Kredel, Steffen Kunzmann, Paul-Gerhardt Schlegel, Matthias Wölfl, Peter Nordbeck, Christoph Bühler, Christopher Lotz, Philipp M Lepper, Johannes Wirbelauer, Norbert Roewer, Ralf M Muellenbach
BACKGROUND The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle. CASE REPORT A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries...
June 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#11
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625752/neurologic-complications-of-extracorporeal-membrane-oxygenation-a-review
#12
REVIEW
Ashleigh Xie, Phillip Lo, Tristan D Yan, Paul Forrest
OBJECTIVE: To review the evidence on neurologic complications in adult extracorporeal membrane oxygenation (ECMO) patients with regard to incidence, pathophysiology, risk factors, diagnosis, monitoring techniques, prevention, and management. DESIGN: Literature review. SETTING: Observational studies and case reports from a variety of institutions. PARTICIPANTS: Adult ECMO patients. INTERVENTIONS: Six electronic databases were searched from their dates of inception to October 2016...
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28616327/intra-aortic-balloon-pump-during-venoarterial-extracorporeal-membrane-oxygenation-still-a-matter-of-debate-contemporary-multi-device-approach-to-cardiogenic-shock
#13
EDITORIAL
Anna Mara Scandroglio, Marina Pieri, Federico Pappalardo, Giovanni Landoni
No abstract text is available yet for this article.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28593159/delayed-repair-of-ventricular-septal-rupture-following-preoperative-awake-extracorporeal-membrane-oxygenation-support
#14
Bong Suk Park, Weon Yong Lee, Jung Hyeon Lim, Yong Joon Ra, Yong Han Kim, Hyoung Soo Kim
Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28591467/the-effect-of-impella-cp-on-cardiopulmonary-physiology-during-venoarterial-extracorporeal-membrane-oxygenation-support
#15
Hoong Sern Lim
Left ventricle (LV) distension is a complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. The effects of Impella on the pulmonary circulatory physiology were studied in a single-center study of six consecutive patients on VA-ECMO support who had LV unloading with Impella. Right ventricular stroke volume, pulmonary hemodynamics, and partial pressure of end-tidal CO2 (PETCO2 ) were measured on echocardiogram, pulmonary artery catheter, and capnography, respectively. The addition of Impella CP increased total blood flow and reduced pulmonary artery wedge pressure...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#16
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28574276/intra-aortic-balloon-pump-protects-against-hydrostatic-pulmonary-oedema-during-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#17
Nicolas Bréchot, Pierre Demondion, Francesca Santi, Guillaume Lebreton, Tai Pham, Apostolos Dalakidis, Laetitia Gambotti, Charles-Edouard Luyt, Matthieu Schmidt, Guillaume Hekimian, Philippe Cluzel, Jean Chastre, Pascal Leprince, Alain Combes
BACKGROUND: Increased left ventricular afterload during peripheral venoarterial-extracorporeal membrane oxygenation (VA-ECMO) support frequently causes hydrostatic pulmonary oedema. Because physiological studies demonstrated left ventricular afterload decrease during VA-ECMO assistance combined with the intra-aortic balloon pump (IABP), we progressively changed our standard practice systematically to associate an IABP with VA-ECMO. This study aimed to evaluate IABP efficacy in preventing pulmonary oedema in VA-ECMO-assisted patients...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28574109/a-new-approach-combining-venoarterial-extracorporeal-membrane-oxygenation-and-crrt-for-adults-a-retrospective-study
#18
Xing-Liang Zhou, Yan-He Chen, Qing-Yun Wang
PURPOSE: This study aimed to assess a new approach combining venoarterial (VA) extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) in adults, while monitoring CRRT circuit pressures. METHODS: The inlet and outlet of the CRRT circuit were connected to preoxygenator port and postoxygenator port, respectively. Then, complications and CRRT circuit pressures were evaluated. RESULTS: 7 patients underwent combined VA-ECMO and CRRT; 16 filters were used...
May 28, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28567315/respiratory-syncytial-virus-associated-myocarditis-requiring-venoarterial-extracorporeal-membrane-oxygenation
#19
Anamaria Milas, Aditya Shah, Neesha Anand, Meghan Saunders-Kurban, Samir Patel
Severe fulminant myocarditis causing cardiogenic shock can be a rapidly progressing, life threatening condition. Respiratory syncytial virus (RSV) is a very rare infectious culprit infrequently described in medical literature as a cause of myocarditis, particularly in adults. We present a case of acute fulminant myocarditis in a patient with PCR positive RSV infection requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO).
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28557862/quantification-of-postmembrane-gaseous-microembolization-during-venoarterial-extracorporeal-membrane-oxygenation
#20
York Jiao, Keith E Gipson, Pramod Bonde, Abeel Mangi, Robert Hagberg, David J Rosinski, Jeffrey B Gross, Robert B Schonberger
Prolonged use of venoarterial extracorporeal membrane oxygenation (VA ECMO) may be complicated by end-organ dysfunction. Although gaseous microemboli (GME) are thought to damage end organs during cardiopulmonary bypass, patient exposures to GME have not been well characterized during VA ECMO. We therefore performed an observational study of GME in adult VA ECMO patients, with correlation to clinical events during routine patient care. After institutional review board (IRB) approval, we used two Doppler probes to detect GME noninvasively in extracorporeal membrane oxygenation (ECMO) circuits on four patients for 15 hours total while also recording patient care events...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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