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Extracorporeal perfusion

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https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#1
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29434789/effects-of-pumpless-extracorporeal-lung-assist-on-hemodynamics-gas-exchange-and-inflammatory-cascade-response-during-experimental-lung-injury
#2
Zhihai Ju, Jinhui Ma, Chen Wang, Jie Yu, Yeru Qiao, Feilong Hei
Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO 2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#3
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29404520/liver-tissue-engineering-from-implantable-tissue-to-whole-organ-engineering
#4
REVIEW
Giuseppe Mazza, Walid Al-Akkad, Krista Rombouts, Massimo Pinzani
The term "liver tissue engineering" summarizes one of the ultimate goals of modern biotechnology: the possibility of reproducing in total or in part the functions of the liver in order to treat acute or chronic liver disorders and, ultimately, create a fully functional organ to be transplanted or used as an extracorporeal device. All the technical approaches in the area of liver tissue engineering are based on allocating adult hepatocytes or stem cell-derived hepatocyte-like cells within a three-dimensional structure able to ensure their survival and to maintain their functional phenotype...
February 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29393012/short-stature-is-associated-with-the-development-of-lower-limb-ischaemia-during-extracorporeal-life-support
#5
Byoung-Won Park, So-Ryoung Lee, Min-Ho Lee, Duk Won Bang, Min-Su Hyon, Won-Ho Chang, Hong Chul Oh, Young Woo Park, Suyeon Park
BACKGROUND: Percutaneous cannulation of femoral vessels has been widely used for the rapid deployment of extracorporeal life support (ECLS). Limb ischaemia is a devastating complication in patients receiving ECLS. Our aim was to evaluate the predictors of limb ischaemia during ECLS and to determine the role of preventative distal perfusion. METHODS: Two hundred and fifty-five consecutive patients who received veno-arterial ECLS due to cardiac and/or respiratory failure were enrolled from January 2009 to December 2015...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29389820/conquering-combined-thoracic-organ-and-liver-transplantation-indications-and-outcomes-for-heart-liver-and-lung-liver-transplantation
#6
Stephanie G Yi, Keri E Lunsford, Courtenay Bruce, R Mark Ghobrial
PURPOSE OF REVIEW: Combined thoracic organ and liver transplantation has been shown to be a viable treatment option for patients with end-stage disease lung or heart and disease. There are increasing number cases reported in the literature, as the number of institutions utilizing this strategy is growing. Herein, we review the current literature of combined thoracic and liver transplantation. RECENT FINDINGS: A larger number of combined heart or lung and liver transplants (CHLT and CLLT) are being performed...
January 30, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29386002/extended-left-hepatectomy-for-intrahepatic-cholangiocarcinoma-hepatic-vein-reconstruction-with-in-situ-hypothermic-perfusion-and-extracorporeal-membrane-oxygenation
#7
Deniz Balci, Menekse Ozcelik, Elvan Onur Kirimker, Arda Cetinkaya, Evren Ustuner, Mehmet Cakici, Bahadir Inan, Zekeriyya Alanoglu, Sadik Bilgic, Ahmet Ruchan Akar
BACKGROUND: Liver resection for intrahepatic cholangiocarcinoma (ICC) with invasion of the inferior vena cava (IVC) and hepatic veins (HV) is a challenging procedure. CASE PRESENTATION: We report a case of a 63-year-old woman with a 6-cm, centrally located liver mass. Her biochemistry results were normal except for a Ca19-9 level of 1199 U/ml. The liver biopsy was consistent with ICC and 60% macrosteatosis. Abdominal CT scans revealed a large central mass invading the left HV, middle HV and right HV, infringing on their junction with the vena cava...
January 31, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29373368/adenosine-2a-receptor-activation-attenuates-ischemia-reperfusion-injury-during-extracorporeal-cardiopulmonary-resuscitation
#8
James H Mehaffey, Dustin Money, Eric J Charles, Sarah Schubert, Angela Fernandez Piñeros, Di Wu, Sai Vineela Bontha, Robert Hawkins, Nicholas R Teman, Victor E Laubach, Valeria R Mas, Curtis G Tribble, Daniel G Maluf, Ashish K Sharma, Zequan Yang, Irving L Kron, Mark E Roeser
OBJECTIVE: We tested the hypothesis that systemic administration of an A2AR agonist will reduce multiorgan IRI in a porcine model of ECPR. SUMMARY BACKGROUND DATA: Advances in ECPR have decreased mortality after cardiac arrest; however, subsequent IRI contributes to late multisystem organ failure. Attenuation of IRI has been reported with the use of an A2AR agonist. METHODS: Adult swine underwent 20 minutes of circulatory arrest, induced by ventricular fibrillation, followed by 6 hours of reperfusion with ECPR...
January 25, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29356851/fast-confirmation-of-correct-position-of-distal-perfusion-cannula-during-venoarterial-extracorporeal-membrane-oxygenation
#9
J J H Bunge, E A F Mahtab, K Caliskan, D Reis Miranda
No abstract text is available yet for this article.
January 22, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29354178/the-role-of-extracorporeal-membrane-oxygenation-in-patients-after-irreversible-cardiac-arrest-as-potential-organ-donors
#10
REVIEW
Tomasz Kłosiewicz, Mateusz Puślecki, Marcin Zieliński, Michał Mandecki, Marcin Ligowski, Sebastian Stefaniak, Marek Dąbrowski, Marek Karczewski, Łukasz Gąsiorowski, Maciej Sip, Agata Dąbrowska, Wojciech Telec, Bartłomiej Perek, Marek Jemielity
The number of people waiting for a kidney or liver transplant is growing systematically. Due to the latest advances in transplantation, persons after irreversible cardiac arrest and confirmation of death have become potential organ donors. It is estimated that they may increase the number of donations by more than 40%. However, without good organization and communication between pre-hospital care providers, emergency departments, intensive care units and transplantation units, it is almost impossible to save the organs of potential donors in good condition...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29338127/establishment-of-practical-recellularized-liver-graft-for-blood-perfusion-using-primary-rat-hepatocytes-and-liver-sinusoidal-endothelial-cells
#11
H Kojima, K Yasuchika, K Fukumitsu, T Ishii, S Ogiso, Y Miyauchi, R Yamaoka, T Kawai, H Katayama, E Y Yoshitoshi-Uebayashi, S Kita, K Yasuda, N Sasaki, J Komori, S Uemoto
Tissue decellularization produces a three-dimensional scaffold that can be potentially used to fabricate functional liver grafts following recellularization. An inappropriate cell distribution and clotting during blood perfusion hinder the practical use of recellularized livers. Here, we aimed to establish a seeding method for the optimal distribution of parenchymal and endothelial cells, and to evaluate the effect of liver sinusoidal endothelial cells (LSECs) in the decellularized liver. Primary rat hepatocytes and LSECs were seeded into decellularized whole-liver scaffolds via the biliary duct and portal vein, respectively...
January 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29333461/extracorporeal-shock-wave-therapy-for-coronary-artery-disease-relationship-of-symptom-amelioration-and-ischemia-improvement
#12
Youko Takakuwa, Masayoshi Sarai, Hideki Kawai, Akira Yamada, Kenji Shiino, Kayoko Takada, Yasuomi Nagahara, Meiko Miyagi, Sadako Motoyama, Hiroshi Toyama, Yukio Ozaki
Objectives: The current management of coronary artery disease (CAD) relies on three major therapeutic options, namely medication, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). However, severe CAD that is not indicated for PCI or CABG still bears a poor prognosis due to the lack of effective treatments. In 2006, extracorporeal cardiac shock wave (SW) therapy reported on human for the first time. This treatment resulted in better myocardial perfusion as evaluated by dipyridamole stress thallium scintigraphy, angina symptoms, and exercise tolerance...
2018: Asia Oceania Journal of Nuclear Medicine & Biology
https://www.readbyqxmd.com/read/29330940/extracorporeal-shockwave-therapy-for-treatment-of-keloid-scars
#13
Ching-Jen Wang, Jih-Yang Ko, Wen-Yi Chou, Jai-Hong Cheng, Yur-Ren Kuo
The purpose of this investigation was to study the effectiveness of extracorporeal shockwave therapy (ESWT) for the treatment of keloid scars, and compared the results with intralesional steroid injection. Thirty-nine patients were randomly divided into 22 in ESWT group and 17 in steroid group. The ESWT group received 3 ESWT treatments in 6 weeks. The steroid group received 3 intra-lesional triamcinolone injections in 6 weeks. The evaluations included gross morphology, functional outcome, local blood flow perfusion, biopsy for histopathological examination and immunohistochemical analysis...
January 13, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29310045/densitometry-of-the-optically-magnified-dried-residues-representing-carbon-microparticles-as-a-simple-and-affordable-technique-for-determining-their-concentrations-in-aqueous-suspensions
#14
Bogdan I Gerashchenko, Oleksii S Sydorenko, Elisaveta A Snezhkova, Dmytro O Klymchuk, Vladimir G Nikolaev
In extracorporeal blood purification, such as hemoperfusion, activated carbon (activated charcoal) beads are commonly used as an adsorbent, but their judgment in terms of extent of microparticle release is of great importance since the microparticles may represent the risk of entering the bloodstream. To quantitatively assess the release of carbon microparticles (CMPs) in the samples of the aqueous perfusion medium, in which the beads have been perfused, the calibration procedure with different concentrations of CMPs is likely to be needed...
January 4, 2018: Micron: the International Research and Review Journal for Microscopy
https://www.readbyqxmd.com/read/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#15
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29241967/survey-of-the-american-pediatric-surgical-association-on-cannulation-practices-in-pediatric-ecmo
#16
Alejandro V Garcia, Maniraj Jeyaraju, Mitchell R Ladd, Eric B Jelin, Melania M Bembea, Samuel Alaish, Daniel Rhee
AIMS: Extracorporeal membrane oxygenation (ECMO) is a commonly used modality of life support for children with cardiopulmonary failure. Consensus on pediatric cannulation strategies and management does not currently exist. The goal of this study was to investigate individual surgeon approaches towards ECMO cannulations in children. METHODS: A 21-question online survey was developed and disseminated to the American Pediatric Surgical Association (APSA) membership...
November 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29218106/extracorporeal-shock-wave-therapy-effectively-protects-brain-against-chronic-cerebral-hypo-perfusion-induced-neuropathological-changes
#17
Han-Tan Chai, Kuan-Hung Chen, Christopher Glenn Wallace, Chih-Hung Chen, Pei-Hsun Sung, Yung-Lung Chen, Chun-Man Yuen, Pei-Lin Shao, Cheuk-Kwan Sun, Hsueh-Wen Chang, Ching-Jen Wang, Mel S Lee, Hon-Kan Yip, Sheung-Fat Ko
This study tested the hypothesis that extracorporeal shock wave (ECSW) therapy could protect mouse brain from chronic cerebral hypoperfusion (CHP)-induced neuropathological changes in a bilateral carotid arterial stenosis (CAS) model. Adult-male C57BL/6 (B6) mice (n=36) were randomized into group 1 (sham-control), group 2 (CHP) and group 3 [CHP+ECSW (100 impulses at 0.15 mJ/mm2) on day 5, 10 and 15 after CHP induction]. By day 60 after CHP induction, the white matter lesion, protein expressions of inflammatory (TNF-α/NF-κB/iNOS), oxidative-stress (NOX-1/NOX-2/NOX-4/nitrotyrosine), angiogenesis (eNOS/CD31), apoptotic (Bax/caspase-3/PARP), fibrotic (Smad3/TGF-ß) and mitochondrial-damaged (cytosolic cytochrome-C) biomarkers were significantly higher in group 2 than in groups 1 and 3, and significantly higher in group 3 than in group 1, whereas the protein expressions of anti-apoptotic (Bcl-2), anti-fibrotic (BMP-2/Smad1/5), and mitochondrial-integrity (mitochondrial cytochrome-C) biomarkers showed an opposite pattern to inflammation among the three groups (all P<0...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29175469/histogram-based-analysis-of-lung-perfusion-of-children-after-congenital-diaphragmatic-hernia-repair
#18
Nora Kassner, Meike Weis, Katrin Zahn, Thomas Schaible, Stefan O Schoenberg, Lothar R Schad, Frank G Zöllner
OBJECTIVES: To investigate a histogram based approach to characterize the distribution of perfusion in the whole left and right lung by descriptive statistics and to show how histograms could be used to visually explore perfusion defects in two year old children after Congenital Diaphragmatic Hernia (CDH) repair. METHODS: 28 children (age of 24.2±1.7months; all left sided hernia; 9 after extracorporeal membrane oxygenation therapy) underwent quantitative DCE-MRI of the lung...
November 23, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29141964/acute-decompensated-pulmonary-hypertension
#19
Laurent Savale, Jason Weatherald, Xavier Jaïs, Constance Vuillard, Athénaïs Boucly, Mitja Jevnikar, David Montani, Olaf Mercier, Gerald Simonneau, Elie Fadel, Olivier Sitbon, Marc Humbert
Acute right heart failure in chronic precapillary pulmonary hypertension is characterised by a rapidly progressive syndrome with systemic congestion resulting from impaired right ventricular filling and/or reduced right ventricular flow output. This clinical picture results from an imbalance between the afterload imposed on the right ventricle and its adaptation capacity. Acute decompensated pulmonary hypertension is associated with a very poor prognosis in the short term. Despite its major impact on survival, its optimal management remains very challenging for specialised centres, without specific recommendations...
December 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29140963/when-the-momentum-has-gone-what-will-be-the-role-of-extracorporeal-lung-support-in-the-future
#20
Darryl Abrams, Matthew Bacchetta, Daniel Brodie
PURPOSE OF REVIEW: There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain. RECENT FINDINGS: Outcomes for patients supported with extracorporeal devices continue to show favorable trends...
February 2018: Current Opinion in Critical Care
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