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extra corporeal membrane oxygenation

Hussein D Kanji, Alexandra Chouldechova, Chris Harvey, Ephraim O'dea, Gail Faulkner, Giles Peek
There is little published data on the safety and effectiveness of mobile (inter-hospital) extra-corporeal membrane oxygenation (ECMO) in adults, particularly focusing on the cannulation strategy. We sought to study the outcomes of patients cannulated with a bicaval dual lumen catheter needing mobile compared to conventional ECMO. Specifically, we evaluated the safety of using this cannulation strategy during initiation, in transport and overall performance. Multivariate adjustment was performed to report on adjusted 6-month survival as well as complications and performance from cannulation and the ECMO run...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Alexander Caicedo, Carolina Varon, Borbala Hunyadi, Maria Papademetriou, Ilias Tachtsidis, Sabine Van Huffel
Clinical data is comprised by a large number of synchronously collected biomedical signals that are measured at different locations. Deciphering the interrelationships of these signals can yield important information about their dependence providing some useful clinical diagnostic data. For instance, by computing the coupling between Near-Infrared Spectroscopy signals (NIRS) and systemic variables the status of the hemodynamic regulation mechanisms can be assessed. In this paper we introduce an algorithm for the decomposition of NIRS signals into additive components...
2016: Frontiers in Physiology
Aaron Blandino Ortiz, Irene Lamanna, Elio Antonucci, Selene Pozzebon, Antonio M Dell'anna, Jean L Vincent, Daniel DE Backer, Fabio S Taccone
BACKGROUND: Multiple organ dysfunction can occur in patients undergoing Veno-arterial Extra Corporal Membrane Oxygenation (VA-ECMO); however, liver function has not been well studied in this setting. METHODS: In a review of our institutional ECMO database (n=162), we collected aspartate (AST) and alanine (ALT) transaminases, total bilirubin and international normalized ratio (INR) at time of ECMO initiation (baseline) and once daily during therapy in patients who survived for at least 24 hours...
November 18, 2016: Minerva Anestesiologica
Maziar Khorsandi, Scott Dougherty, Andrew Sinclair, Keith Buchan, Fiona MacLennan, Omar Bouamra, Philip Curry, Vipin Zamvar, Geoffrey Berg, Nawwar Al-Attar
BACKGROUND: Refractory post-cardiotomy cardiogenic shock (PCCS) is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS), namely extra-corporeal membrane oxygenation (ECMO) or ventricular assist devices (VAD). In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO) and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period...
November 8, 2016: Journal of Cardiothoracic Surgery
Chiara Robba, Andrea Ortu, Federico Bilotta, Alessandra Lombardo, Mypinder S Sekhon, Fabio Gallo, Basil F Matta
BACKGROUND: Veno-venous extra-corporeal membrane oxygenation (vv-ECMO) is an established salvage therapy for severe respiratory failure, and may provide an alternative form of treatment for trauma-induced acute respiratory distress syndrome (ARDS) when conventional treatments have failed. The need for systemic anticoagulation is a relative contraindication in patients with bleeding risks, especially in multi traumatic injury. METHODS: We describe a case series of four trauma patients with ARDS who were managed with ECMO admitted to the Neuro Critical Care Unit (NCCU) at Addenbrooke's Hospital, Cambridge (UK), from January 2000 to January 2016...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Christopher E Woods, Ching Shang, Fouad Taghavi, Peter Downey, Adrian Zalewski, Gabriel R Rubio, Jing Liu, Julian R Homburger, Zachary Grunwald, Wei Qi, Christian Bollensdorff, Porama Thanaporn, Ayyaz Ali, R Kirk Riemer, Peter Kohl, Daria Mochly-Rosen, Edward Gerstenfeld, Stephen Large, Ziad A Ali, Euan A Ashley
BACKGROUND: Survival after sudden cardiac arrest is limited by postarrest myocardial dysfunction, but understanding of this phenomenon is constrained by a lack of data from a physiological model of disease. In this study, we established an in vivo model of cardiac arrest and resuscitation, characterized the biology of the associated myocardial dysfunction, and tested novel therapeutic strategies. METHODS: We developed rodent models of in vivo postarrest myocardial dysfunction using extracorporeal membrane oxygenation resuscitation followed by invasive hemodynamics measurement...
September 27, 2016: Circulation
Jemma Youdle, Sarah Penn, Olaf Maunz, Andre Simon
We report our first clinical use of the new Protek Duo(TM) cannula for peripheral veno-venous extra-corporeal life support (ECLS). A 53-year-old male patient underwent implantation of a total artificial heart (TAH) for biventricular failure. However, due to the development of post-operative respiratory dysfunction, the patient required ECLS for six days.
July 14, 2016: Perfusion
Anne Olland, Jérémie Reeb, Alexandre Leclerq, Benjamin Renaud-Picard, Pierre-Emmanuel Falcoz, Romain Kessler, Valérie Schini-Kerth, Laurence Kessler, Florence Toti, Gilbert Massard
Lung transplantation is the only life-saving treatment for end stage respiratory disease. The immediate outcome is still hampered by primary graft dysfunction. The latter is a form of acute lung injury occurring within the 30min following the unclamping of the pulmonary artery that prompts ischemia reperfusion injury. Severe forms may need prolonged mechanical ventilation and extra-corporeal membrane oxygenation. Overall, primary graft dysfunction accounts for at least one third of the deaths during the first post-operative month...
July 6, 2016: Human Immunology
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita-Fernández, Ramón Pérez-Caballero
We describe a neonate with aortic atresia and hypoplastic aorta, listed for heart transplant after extracorporeal membrane oxygenation resuscitation and ductal stenting. The donor aorta was detached from the graft, after an isolated arch reconstruction prior to the transplant itself in a routine fashion. To the best of our knowledge, this is the first reported case of neonatal arch reconstruction before transplantation performed with grafts from the same donor in a split-way strategy.
October 2016: Interactive Cardiovascular and Thoracic Surgery
Giuseppe Maria Raffa, Gabriele Di Gesaro, Sergio Sciacca, Fabio Tuzzolino, Marco Turrisi, Calogero Falletta, Chiara Minà, Giuseppe Romano, Giuseppe Vitale, Giovanna Panarello, Francesco Clemenza, Michele Pilato
BACKGROUND: Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed. METHODS: 133 HTx were done from 2004 to the end of 2015.The average donor age was 34±13.5years and the proportion of male donors was 67%...
September 15, 2016: International Journal of Cardiology
Francesca Maria Russo, Mary Patrice Eastwood, Richard Keijzer, Jamila Al-Maary, Jaan Toelen, Tim Van Mieghem, Jan A Deprest
OBJECTIVES: To identify antenatal predictors of persistent pulmonary hypertension (PPH) and need for extracorporeal membrane oxygenation (ECMO) in fetuses with congenital diaphragmatic hernia (CDH). MATERIAL AND METHODS: We performed a systematic literature review of antenatal diagnostic tests in fetuses with isolated CDH. The target conditions were PPH within 28 days of life and the need for ECMO. Quality of studies was assessed with the QUADAS-2 tool. Meta-analysis was performed when at least three studies reported on the same test...
June 17, 2016: Ultrasound in Obstetrics & Gynecology
Filippo Benassi, Enrico Giuliani, Davide Corticelli, Roberto Parravicni
UNLABELLED:  Abstract  PURPOSE: several therapeutic options are used in emergency situations, when heart and/or lung functions acutely fail. Because of the poor results of conventional treatments, the use of an extra-corporeal life support (ECLS) systems able to completely assume the heart and lung functions in emergency situations is becoming a viable alternative. We have developed a unique ECLS system for patients needing extended respiratory and/or circulatory support and controlled hypothermia...
2016: Acta Bio-medica: Atenei Parmensis
Tracy K Koogler
No abstract text is available yet for this article.
August 2016: Acta Paediatrica
Fernando Palizas, Christian Casabella García, Mariano Norese
Extracorporeal membrane oxygenation is used in refractory hypoxemia in many clinical settings. Thoracic trauma patients usually develop acute respiratory distress syndrome. Due to high risk of bleeding, thrombotic complications present in this context are particularly difficult to manage and usually require insertion of an inferior vena cava filter to prevent embolism from the distal veins to the pulmonary circulation. Here, we present a case of a thoracic trauma patient with severe acute respiratory distress syndrome requiring venovenous extracorporeal membrane oxygenation via a right internal jugular double lumen cannula due to a previously inserted inferior vena cava filter caused by distal bilateral calf muscle vein deep vein thrombosis...
January 2016: Revista Brasileira de Terapia Intensiva
Tae Kyung Yoo, Jong-Young Lee, Ki-Chul Sung, Sam Sae Oh, Young Seok Song, Seung Jae Lee, Kyung Jin Ko
Stress-induced cardiomyopathy has become a more recognized and reported entity. It can be caused by emotional or physical stress, which causes excessive catecholamine release. Typically, the clinical course is benign with conservative treatment being effective. However, stress-induced cardiomyopathy can be fatal. A 41-year-old female presented with cardiogenic shock followed by sudden back pain. Initial echocardiographic finding showed severely decreased ejection fraction with akinesia at all mid-to-apical walls with relatively preserved basal wall contractility...
March 2016: Journal of Cardiovascular Ultrasound
Husain Shabbir Ali, Ibrahim Fawzy Hassan, Saibu George
BACKGROUND: Pulmonary infections caused by Pneumocystis jirovecii in immunocompromised host can be associated with cysts, pneumatoceles and air leaks that can progress to pneumomediastinum and pneumothoraxes. In such cases, it can be challenging to maintain adequate gas exchange by conventional mechanical ventilation and at the same time prevent further ventilator-induced lung injury. We report a young HIV positive male with poorly compliant lungs and pneumomediastinum secondary to severe Pneumocystis infection, rescued with veno-venous extra corporeal membrane oxygenation (V-V ECMO)...
2016: BMC Pulmonary Medicine
Lian-Yu Lin, Che-Wei Liao, Chih-Hsien Wang, Nai-Hsin Chi, Hsi-Yu Yu, Nai-Kuan Chou, Juey-Jen Hwang, Jiunn-Lee Lin, Fu-Tien Chiang, Yih-Sharng Chen
Extra-corporeal membranous oxygenation (ECMO) has been applied in patients with cardiopulmonary failure. One critical drawback of peripheral ECMO is an increase in left ventricular (LV) afterload which could be counterbalanced by the combination of intra-aortic balloon counter-pulsation (IABP) therapy. We hypothesized that an add-on therapy with IABP could improve outcomes in patients receiving ECMO support. We included patients (>18 years old) from 2002 to 2013 requiring ECMO support due to cardiogenic shock in a medical center...
2016: Scientific Reports
George Makdisi, Peter B Makdisi, I-Wen Wang
The expansion of the extra corporeal membrane oxygenation (ECMO) use and its indication is strikingly increased in the past few years. ECMO use expanded to lung transplantation, difficult general thoracic resections, transcatheter aortic valve replacement (TAVR) and LVAD implantation. Here we will discuss the indications and the outcomes of non-emergent use of ECMO.
February 2016: Annals of Translational Medicine
Fong-Tzu Hsieh, Guey-Shiun Huang, Wen-Je Ko, Meei-Fang Lou
AIMS: To understand the influential factors related to quality of life for adult patients who have undergone extra corporeal membrane oxygenation. BACKGROUND: Extracorporeal membrane oxygenation is an invasive treatment for critically ill patients requiring temporary cardiac or respiratory support. Most studies have focused on survival outcomes for patients; few have evaluated health-related quality of life. DESIGN: A cross-sectional design...
July 2016: Journal of Advanced Nursing
Maziar Khorsandi, Kasra Shaikhrezai, Sai Prasad, Renzo Pessotto, William Walker, Geoffrey Berg, Vipin Zamvar
BACKGROUND: Post-cardiotomy cardiogenic shock (PCCS) has an incidence of 2-6 % after routine adult cardiac surgery. 0.5-1.5 % are refractory to inotropic and intra-aortic balloon pump (IABP) support. Advanced mechanical circulatory support (AMCS) can be used to salvage carefully selected number of such patients. High costs and major complication rates have lead to centralization and limited funding for such devices in the UK. We have looked the outcomes of such devices in a non-transplant, intermediate-size adult cardiothoracic surgery unit...
2016: Journal of Cardiothoracic Surgery
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