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Extracorporeal perfusion

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https://www.readbyqxmd.com/read/28812428/microvascular-perfusion-in-cardiac-arrest-a-review-of-microcirculatory-imaging-studies
#1
Petra Krupičková, Zuzana Mormanová, Tomáš Bouček, Tomáš Belza, Jana Šmalcová, Jan Bělohlávek
Cardiac arrest represents a leading cause of mortality and morbidity in developed countries. Extracorporeal cardiopulmonary resuscitation (ECPR) increases the chances for a beneficial outcome in victims of refractory cardiac arrest. However, ECPR and post-cardiac arrest care are affected by high mortality rates due to multi-organ failure syndrome, which is closely related to microcirculatory disorders. Therefore, microcirculation represents a key target for therapeutic interventions in post-cardiac arrest patients...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28801040/extracorporeal-cardiopulmonary-resuscitation-for-blunt-cardiac-rupture-a-case-report
#2
Shunsuke Kudo, Keiji Tanaka, Kunihiko Okada, Takahiro Takemura
Extracorporeal cardiopulmonary resuscitation (ECPR) followed by operating room sternotomy, rather than resuscitative thoracotomy, might be life-saving for patients with blunt cardiac rupture and cardiac arrest who do not have multiple severe traumatic injuries. A 49-year-old man was injured in a vehicle crash and transferred to the emergency department. On admission, he was hemodynamically stable, but a plain chest radiograph revealed a widened mediastinum, and echocardiography revealed hemopericardium. A computed tomography scan revealed hemopericardium and mediastinal hematoma, without other severe traumatic injuries...
August 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28762511/efficacy-of-distal-perfusion-cannulae-in-preventing-limb-ischemia-during-extracorporeal-membrane-oxygenation-a-systematic-review-and-meta-analysis
#3
REVIEW
Yen-Yi Juo, Matthew Skancke, Yas Sanaiha, Aditya Mantha, Juan C Jimenez, Peyman Benharash
To date, no consensus exists regarding indication, technique, or efficacy of distal perfusion cannulae (DPC) in preventing limb ischemia among patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aim to examine the available literature and report association between DPC and risk of limb ischemia. PubMed/Medline, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and bibliographies of included studies were searched from database inception until August 2016. Original studies describing the DPC placement technique and incidence of limb ischemia following DPC placement among VA-ECMO patients were included for systematic review...
August 1, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28760671/application-of-phospho-cytof-to-characterize-immune-activation-in-patients-with-sickle-cell-disease-in-an-ex-vivo-model-of-thrombosis
#4
Jeffrey Glassberg, Adeeb H Rahman, Mohammad Zafar, Caroline Cromwell, Alexa Punzalan, Juan Jose Badimon, Louis Aledort
Sickle cell disease (SCD) is a genetic disease caused by mutations in the beta globin gene, and inflammation plays a key role in driving many aspects of disease pathology. Early immune activation is believed to be associated with hemodynamic stresses and thrombus formation as cells traffic through blood vessels. We applied an extracorporeal perfusion system to model these effects ex vivo, and combined this with a phospho-CyTOF workflow to comprehensively evaluate single-cell signatures of early activation across all major circulating immune subsets...
July 28, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28759964/extracorporeal-perfusion-reduced-to-a-one-way-infusion
#5
Christian D Taeger, Oliver Friedrich, Raymund E Horch, Caroline Drechsler, Annika Weigand, Fabio Hopf, Carol I Geppert, Frank Münch, Torsten Birkholz, Carina Wenzel, Sebastian Geis, Lukas Prantl, Rainer Buchholz, Konstantin Präbst
BACKGROUND: Extracorporeal perfusion (EP) is moving into focus of research in reconstructive and transplantation medicine for the preservation of amputates and free tissue transplants. The idea behind EP is the reduction of ischemia-related cell damage between separation from blood circulation and reanastomosis of the transplant. Most experimental approaches are based on a complex system that moves the perfusate in a circular course. OBJECTIVE AND METHODS: In this study, we aimed to evaluate if a simple perfusion by an infusion bag filled with an electrolyte solution can provide acceptable results in terms of flow stability, oxygen supply and viability conservation for EP of a muscle transplant...
July 25, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28741663/carbon-dioxide-flush-of-an-integrated-minimized-perfusion-circuit-prior-to-priming-prevents-spontaneous-air-release-into-the-arterial-line-during-clinical-use
#6
Marco C Stehouwer, Roel de Vroege, Gerard J F Hoohenkerk, Frederik N Hofman, Johannes C Kelder, Bas Buchner, Bastian A de Mol, Peter Bruins
Recently, an oxygenator with an integrated centrifugal blood pump (IP) was designed to minimize priming volume and to reduce blood foreign surface contact even further. The use of this oxygenator with or without integrated arterial filter was compared with a conventional oxygenator and nonintegrated centrifugal pump. To compare the air removal characteristics 60 patients undergoing coronary artery bypass grafting were alternately assigned into one of three groups to be perfused with a minimized extracorporeal circuit either with the conventional oxygenator, the oxygenator with IP, or the oxygenator with IP plus integrated arterial filter (IAF)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741002/extracorporeal-membrane-oxygenation-in-cardiac-arrest
#7
Boon Kiat Kenneth Tan
The survival of cardiac arrest patients is dependent on the efficient and timely application of the chain of survival. This includes early identification of cardiac arrest and activation of the emergency response system, high-quality cardiopulmonary resuscitation (CPR), rapid defibrillation, basic and advanced medical services, and advanced life support and post-cardiac arrest care. However, some patients may be refractory to these measures. Extracorporeal membrane oxygenation CPR (ECPR), otherwise known as extracorporeal life support, offers an alternative to such refractory cardiac arrest cases...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28726586/application-of-ureterorenoscope-and-flexible-ureterorenoscope-lithotripsy-in-removing-calculus-from-extracorporeal-living-donor-renal-graft-a-single-center-experience
#8
Chun-Hua Lin, Zuo-Fu Zhang, Jiahui Wang, Lu-Xin Yu, Wen-Ting Wang, Lei Shi, Xiang-Nan Lin
Here, we reported our clinical application of ureterorenoscope (URS) and flexible URS lithotripsy in stone removal on 10 cases of excised living donor kidney graft. After the extraction of donor kidney by retroperitoneal laparoscopy, the donor graft was perfused with 4 °C HCA solution. Calculus between 2-4 mm were removed intact with lithotomy forceps under direct vision of URS. Larger calculi of >4 mm were fractured with flexible URS combining holmium laser lithotripsy. Fragments of the calculus were extracted with basket extractor and lithotomy forceps...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#9
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#10
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/28705745/massive-diltiazem-and-metoprolol-overdose-rescued-with-extracorporeal-life-support
#11
James A Chenoweth, Daniel K Colby, Mark E Sutter, Joshua B Radke, Jonathan B Ford, J Nilas Young, John R Richards
The management of overdoses of cardioactive medications in the emergency department can be challenging. The reversal of severe toxicity from one or more types of cardioactive medication may fail maximal medical therapies and require extreme invasive measures such as transvenous cardiac pacing and extracorporeal life support. We present a case of massive diltiazem and metoprolol overdose refractory to maximal medical therapy, including intravenous calcium, glucagon, vasopressors, high dose insulin, and lipid emulsion...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#12
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#13
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28689646/higher-m30-and-high-mobility-group-box-1-protein-levels-in-ex-vivo-lung-perfusate-are-associated-with-primary-graft-dysfunction-after-human-lung-transplantation
#14
Kohei Hashimoto, Marcelo Cypel, Stephen Juvet, Tomohito Saito, Ricardo Zamel, Tiago N Machuca, Michael Hsin, Hyunhee Kim, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
BACKGROUND: Ex vivo lung perfusion (EVLP) enables assessment of marginal donor lungs for transplantation, with similar clinical outcomes to conventional lung transplantation. We investigated whether cell death-related proteins in the EVLP perfusate could predict primary graft dysfunction (PGD) after transplantation. METHODS: M30 (indicating epithelial apoptosis), M65 (indicating total epithelial cell death), and high mobility group box 1 (HMGB-1, related to cell death and inflammation) protein levels in EVLP perfusate were measured by enzyme-linked immunosorbent assay and correlated with clinical outcomes...
June 21, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28688873/extracorporeal-shockwave-therapy-for-peripheral-arterial-disease-a-review-of-the-potential-mechanisms-of-action
#15
REVIEW
Ali Raza, Amy Harwood, Joshua Totty, George Smith, Ian Chetter
BACKGROUND: Lower limb peripheral arterial disease (PAD) affects 20% of population over 65 years. Extracorporeal shockwave therapy (ESWT) has recently emerged as a novel, safe, and effective treatment option. This review aims to assess the mechanism of action by which ESWT improves symptoms in patients with PAD. METHODS: MEDLINE and EMBASE databases were searched in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Any article investigating the mechanism of action of ESWT in PAD was considered for inclusion...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28688059/a-case-of-severe-refractory-hypotension-after-amlodipine-overdose
#16
Melissa Chudow, Kevin Ferguson
Calcium channel blockers (CCBs) are responsible for a substantial portion of the mortality associated with cardiovascular medication overdose cases. Amlodipine, a dihydropyridine CCB, can cause prolonged hypotension in overdose. This report describes a severe amlodipine overdose case that was refractory to multiple therapeutic approaches. A 53-year-old male presented after ingesting eighty 10 mg amlodipine tablets in a suicide attempt. The patient was initially managed with calcium boluses, glucagon, multiple vasoactive agents, lipid emulsion infusions and hyperinsulinemic euglycemic therapy...
July 7, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28682992/connection-of-a-renal-replacement-therapy-or-plasmapheresis-device-to-the-ecmo-circuit
#17
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/28653554/the-role-of-simulation-to-support-donation-after-circulatory-death-with-extracorporeal-membrane-oxygenation-dcd-ecmo
#18
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Maciej Sip, Sebastian Stefaniak, Tomasz Kłosiewicz, Łukasz Gąsiorowski, Marek Karczewski, Tomasz Małkiewicz, Małgorzata Ładzińska, Marcin Zieliński, Aleksander Pawlak, Bartłomiej Perek, Michael Czekajlo, Marek Jemielity
Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland's first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28652420/cerebral-perfusion-after-repair-of-congenital-diaphragmatic-hernia-with-common-carotid-artery-occlusion-after-ecmo-therapy
#19
Claudia Henzler, Frank G Zöllner, Meike Weis, Fabian Zimmer, Stefan O Schoenberg, Katrin Zahn, Thomas Schaible, K Wolfgang Neff
AIM: To prospectively evaluate cerebral perfusion after repair of congenital diaphragmatic hernia (CDH) and right-common-carotid-artery (rCCA) occlusion after extracorporeal membrane oxygenation (ECMO) therapy. PATIENTS AND METHODS: A total of 29 2-year-old-children with a history of CDH repair underwent cerebral magnetic resonance perfusion imaging. In 14 patients, the rCCA was occluded after ECMO therapy. Fifteen patients with CDH without ECMO served as controls...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28651228/ante-situm-liver-resection-with-inferior-vena-cava-replacement-under-hypothermic-cardiopolmunary-bypass-for-hepatoblastoma-report-of-a-case-and-review-of-the-literature
#20
Roberta Angelico, Annalisa Passariello, Michele Pilato, Tommaso Cozzolino, Marcello Piazza, Roberto Miraglia, Paolo D'Angelo, Mariella Capasso, Maria Cristina Saffioti, Daniele Alberti, Marco Spada
INTRODUCTION: Hepatoblastoma with tumour thrombi extending into inferior-vena-cava and right atrium are often unresectable with an extremely poor prognosis. The surgical approach is technically challenging and might require major liver resection with vascular reconstruction and extracorporeal circulation. However, which is the best surgical technique is yet unclear. PRESENTATION OF CASE: A 11-months-old boy was referred for a right hepatic lobe mass(90×78mm) suspicious of hepatoblastoma with tumoral thrombi extending into the inferior-vena-cava and the right atrium, bilateral lung lesions and serum alpha-fetoprotein level of 50...
2017: International Journal of Surgery Case Reports
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