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Extracorporeal perfusion

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https://www.readbyqxmd.com/read/28901993/vascular-complications-and-use-of-a-distal-perfusion-cannula-in-femorally-cannulated-patients-on-extracorporeal-membrane-oxygenation
#1
David N Ranney, Ehsan Benrashid, James M Meza, Jeffrey E Keenan, Desiree Bonadonna, Leila Mureebe, Mitchell W Cox, Mani A Daneshmand
Femoral arterial cannulation in adult venoarterial (VA) extracorporeal membrane oxygenation (ECMO) predisposes patients to ipsilateral limb ischemia. Placement of a distal perfusion catheter (DPC) is one of few techniques available to prevent or manage this complication. Although frequently used, the indications for and timing of DPC placement are poorly characterized, and no guidelines are available to guide its use. The purpose of this study was to compare the incidences of vascular complications and limb ischemia between patients who did and did not receive a DPC at the time of primary ECMO cannulation...
September 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#2
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28887929/vascular-complications-in-extracoporeal-membrane-oxygenation
#3
REVIEW
Kathleen M Lamb, Hitoshi Hirose
Venoarterial extracorporeal membrane oxygenation is a rescue therapy in patients with severe cardiopulmonary failure. Often, cannulation is done emergently and the femoral vessels are most readily accessible for venous and arterial access. Unfortunately, complications with arterial femoral access can lead to devastating complications, primarily related to limb ischemia. A coordinated protocol of diligent limb examination by trained intensive care unit staff, near infrared spectroscopy monitoring of limbs, and placement of a distal perfusion catheter at the time of femoral cannulation or when signs of ischemia develop, can lead to successful limb salvage...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28884638/low-intensity-extracorporeal-shockwave-therapy-can-improve-erectile-function-in-patients-who-failed-to-respond-to-phosphodiesterase-type-5-inhibitors
#4
Chia-Chun Tsai, Chii-Jye Wang, Yung-Chin Lee, Yen-Ting Kuo, Hsiao-Hua Lin, Ching-Chia Li, Wen-Jeng Wu, Chia-Chu Liu
Managing patients with erectile dysfunction (ED) who failed to respond to phosphodiesterase type 5 inhibitors (PDE5is) is a challenging task. Recently, low-intensity extracorporeal shockwave therapy (LI-ESWT) was reported to improve ED by enhancing perfusion of the penis. The current study was performed to evaluate whether combined treatment with LI-ESWT and PDE5is can restore erectile function in patients who failed to respond to PDE5is alone. This was an open-label single-arm prospective study. ED patients with an erection hardness score (EHS) ≦2 under a maximal dosage of PDE5is were enrolled...
September 1, 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28879778/percutaneous-extracorporeal-membrane-oxygenation-in-electrical-storm-five-case-reports-addressing-efficacy-transferring-allowance-or-radiofrequency-ablation-support
#5
Aitor Uribarri, Loreto Bravo, Javier Jimenez-Candil, Javier Martin-Moreiras, Eduardo Villacorta, Pedro L Sanchez
Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28877346/comparable-outcome-of-out-of-hospital-cardiac-arrest-and-in-hospital-cardiac-arrest-treated-with-extracorporeal-life-support
#6
Omar Ellouze, Melitine Vuillet, Justine Perrot, Sandrine Grosjean, Anis Missaoui, Serge Aho, Ghislain Malapert, Belaid Bouhemad, Oliver Bouchot, Claude Girard
Extracorporeal life support (ECLS) has shown benefits in the management of refractory in-hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out-of-hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single-center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality...
September 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28877216/an-in-vitro-lung-model-to-assess-true-shunt-fraction-by-multiple-inert-gas-elimination
#7
Balamurugan Varadarajan, Andreas Vogt, Volker Hartwich, Rakesh Vasireddy, Jolanda Consiglio, Beate Hugi-Mayr, Balthasar Eberle
The Multiple Inert Gas Elimination Technique, based on Micropore Membrane Inlet Mass Spectrometry, (MMIMS-MIGET) has been designed as a rapid and direct method to assess the full range of ventilation-to-perfusion (V/Q) ratios. MMIMS-MIGET distributions have not been assessed in an experimental setup with predefined V/Q-distributions. We aimed (I) to construct a novel in vitro lung model (IVLM) for the simulation of predefined V/Q distributions with five gas exchange compartments and (II) to correlate shunt fractions derived from MMIMS-MIGET with preset reference shunt values of the IVLM...
2017: PloS One
https://www.readbyqxmd.com/read/28832794/coronary-perfusion-pressure-during-antegrade-cardioplegia-in-on-pump-cabg-patients
#8
Jackson Brandão Lopes, Carlos Cezar Monteiro Dos Santos
Objective: The aim of this study was to investigate whether aortic tension estimated by palpation and cardioplegia infusion line pressure provide results equivalent to those obtained with direct aortic intraluminal pressure measurement. Methods: Sixty consecutive patients who underwent coronary artery bypass graft surgeries with extracorporeal circulation were analyzed. Sanguineous cardioplegic solution in a ratio of 4:1 was administered using a triple lumen antegrade cannula...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28827516/development-and-assessment-of-normothermic-machine-perfusion-preservation-for-extracorporeal-splitting-of-pig-liver
#9
Zhi-Bin Zhang, Wei Gao, Lei Liu, Yuan Shi, Ning Ma, Zhong-Yang Shen
BACKGROUND Studies have shown that normothermic machine perfusion (NMP) exerts a significant protective role for donations after cardiac death (DCD) livers and verified the effects of NMP in preservation, repair, and preoperative assessment of human donor livers. The objective of this study was to verify the effectiveness and stability of NMP system by splitting pig livers in perfusion preservation. MATERIAL AND METHODS Four healthy Ba-Ma miniature pigs were used. The livers were harvested, and then connected to the NMP system to split the livers...
August 22, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28820030/epidemiology-of-cardiovascular-disease-in-the-united-states-implications-for-the-perfusion-profession-a-2017-update
#10
Joseph J Sistino, David C Fitzgerald
INTRODUCTION: By analyzing epidemiological trends in cardiovascular disease (CVD), key stakeholders can make informed decisions on the future of disease burden and treatment. Accordingly, the cardiovascular perfusion community would benefit from data that would help predict future professional resource utilization. METHODS: In 2003, the changes in the number of hospital discharges for CVD from 1990 to 2000 were published, based on data from the National Center for Health Statistics (NCHS)...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28812428/microvascular-perfusion-in-cardiac-arrest-a-review-of-microcirculatory-imaging-studies
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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