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Extracorporeal perfusion

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https://www.readbyqxmd.com/read/29660857/impact-of-different-perfusion-modalities-on-coronary-and-carotid-blood-flow-velocities-in-an-adult-ecls-swine-model
#1
Shigang Wang, Sunil Patel, Jenelle M Izer, Joseph B Clark, Allen R Kunselman, Ronald P Wilson, Akif Ündar
The objective of this study was to compare the effects of nonpulsatile and ECG-synchronized pulsatile extracorporeal life support on coronary and carotid blood flow velocities using transthoracic echocardiography and vascular ultrasound, respectively. Nine adult swine were randomly separated into nonpulsatile (NP, n = 5) and pulsatile (P, N = 4) groups and placed on ECLS for 24 h using an i-cor ECLS system. Noninvasive transthoracic images of the left and right coronary artery and the left carotid artery were acquired at the pre-ECLS (baseline), 30 min, 3, 6, 9, 12, and 24 h on-ECLS stages...
April 16, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29623765/long-venous-cannula-on-the-arterial-position-for-va-ecmo
#2
Maria L Rodriguez, Gyaandeo Maharajh
Differential hypoxia and the arterial mixing zone are two important factors in managing peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). With the aim of improving perfusion to the aortic arch branches and coronaries, we describe our approach for VA-ECMO cannulation: bicaval drainage through the femoral vein and proximal retrograde ECMO flow using a multi-stage venous cannula inserted in the femoral artery and the tip placed at the proximal descending thoracic aorta. We report the use of this VA-ECMO approach on a 15-year-old female with combined cardiorespiratory failure and on a 12-year-old male with acute cardiac failure...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29605270/pumpless-arteriovenous-extracorporeal-membrane-oxygenation-a-novel-mode-of-respiratory-support-in-a-lamb-model-of-congenital-diaphragmatic-hernia
#3
Emily A Partridge, Marcus G Davey, Matthew Hornick, Kevin C Dysart, Aliza Olive, Robert Caskey, James T Connelly, Holly L Hedrick, William H Peranteau, Alan W Flake
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is commonly required in neonates with congenital diaphragmatic hernia (CDH) complicated by pulmonary hypertension (PH). ECMO carries significant risk, and is contraindicated in the setting of extreme prematurity or intracranial hemorrhage. Pumpless arteriovenous ECMO (P-ECMO) may represent an alternative for respiratory support. The present study summarizes our initial experience with P-ECMO in a lamb model of CDH. STUDY DESIGN: Surgical creation of CDH was performed at 65-75days' gestation...
March 9, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29590671/primary-graft-dysfunction-pgd-following-lung-transplantation
#4
Rupal J Shah, Joshua M Diamond
Primary graft dysfunction (PGD) is a form of acute lung injury that results from ischemia reperfusion injury (IRI) and is the major cause of early posttransplant morbidity and mortality. Patients who survive PGD have decreased quality of life, an increased risk of chronic lung allograft dysfunction, specifically bronchiolitis obliterans syndrome, and a significantly increased risk of death. In 2017, the International Society for Heart and Lung Transplantation released updated consensus statements on the PGD definition, most up-to-date PGD risk factors, mechanisms of PGD development, and the state-of-the-art for PGD therapeutics...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29590367/selective-visceral-perfusion-improves-renal-flow-and-hepatic-function-in-neonatal-aortic-arch-repair
#5
Joaquín Fernández-Doblas, Christian Ortega-Loubon, Joaquín Pérez-Andreu, Marcos Linés, Manuel Fernández-Molina, Raúl F Abella
OBJECTIVES: The aortic arch repair in the neonatal period is a complex procedure with significant morbidity. We define a useful double-perfusion technique and its effect on the function of abdominal organs in the postoperative course. METHODS: Nine patients with double perfusion (Group 1) were compared with 14 patients with antegrade cerebral perfusion (Group 2). The objective was to discern the incidence of postoperative acute kidney injury and impaired hepatic function, as well as tissue perfusion and myocardial function parameters...
March 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29588078/pulsed-doppler-evaluation-of-renal-perfusion-during-pulsatile-extracorporeal-circulation-a-pilot-study
#6
B Carretero de la Encarnación, E Mateo Rodríguez, C S Romero García, M A Revert Ros
INTRODUCTION: Acute renal failure (ARF) after cardiac surgery is a risk factor associated with mortality and use of resources. Some studies have reported beneficial effects of pulsatile flow on cardiopulmonary bypass (CPB) on renal function. The aim of this study is to describe the echographic morphology of the renal arterial wave modifying the parameters of pulsatile CPB. MATERIAL AND METHOD: Descriptive study was performed on 10 patients without previous AFR and undergoing cardiac surgery with CPB...
March 24, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29571602/heart-failure-after-the-norwood-procedure-an-analysis-of-the-single-ventricle-reconstruction-trial
#7
William T Mahle, Chenwei Hu, Felicia Trachtenberg, JonDavid Menteer, Steven J Kindel, Anne I Dipchand, Marc E Richmond, Kevin P Daly, Heather T Henderson, Kimberly Y Lin, Michael McCulloch, Ashwin K Lal, Kurt R Schumacher, Jeffrey P Jacobs, Andrew M Atz, Chet R Villa, Kristin M Burns, Jane W Newburger
BACKGROUND: Heart failure results in significant morbidity and mortality in young children with hypoplastic left heart syndrome (HLHS) after the Norwood procedure. METHODS: We studied subjects enrolled in the prospective Single Ventricle Reconstruction (SVR) Trial who survived to hospital discharge after a Norwood operation and were followed up to age 6 years. The primary outcome was heart failure, defined as heart transplant listing after Norwood hospitalization, death attributable to heart failure, or symptomatic heart failure (New York Heart Association [NYHA] Class IV)...
February 16, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29517515/left-ventricular-unloading-during-veno-arterial-ecmo-a-simulation-study
#8
Dirk W Donker, Daniel Brodie, José P S Henriques, Michael Broomé
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is widely used in cardiogenic shock. It provides systemic perfusion, but left ventricular (LV) unloading is suboptimal. Using a closed-loop, real-time computer model of the human cardiovascular system, cardiogenic shock supported by peripheral VA ECMO was simulated and effects of various adjunct LV unloading interventions were quantified. After VA ECMO initiation (4 L/min) in cardiogenic shock (baseline), hemodynamics improved (mean arterial pressure (MAP) increased to 85 mmHg), while LV overload occurred (10% increase in end-diastolic volume (EDV), and 5 mmHg increase in pulmonary capillary wedge pressure (PCWP))...
March 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29485958/identifying-the-risk-factor-and-prevention-of-limb-ischemia-in-extracorporeal-membrane-oxygenation-with-femoral-artery-cannulation
#9
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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 used to fabricate functional liver grafts following recellularization. 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
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