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Extracorporeal circulation

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https://www.readbyqxmd.com/read/29233022/reduced-inflammatory-response-by-transcatheter-as-compared-to-surgical-aortic-valve-replacement
#1
Karoline K H Fiane, Gry Dahle, Bjørn Bendz, Per Steinar Halvorsen, Michael Abdelnoor, Tom Eirik Mollnes, Erik Fosse
OBJECTIVES: The inflammatory response to on-pump cardiac surgery is well known. Systemic inflammatory response syndrome after transcatheter valve implantation (TAVI) has been reported. The objective of this study was to study the inflammatory response during TAVI, and compare with the response during surgical aortic valve replacement. METHODS: Eighteen patients undergoing transcatheter implantation, either by a transfemoral (n = 9) or transaortal (n = 9) approach were compared with eighteen patients admitted for surgical replacement...
December 12, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29230564/adsorptive-filtration-systems-for-effective-removal-of-blood-amyloid-%C3%AE-a-potential-therapy-for-alzheimer-s-disease
#2
Nobuya Kitaguchi, Kazunori Kawaguchi, Kazunori Yamazaki, Hiroshi Kawachi, Miwa Sakata, Megumi Kaneko, Masao Kato, Kazuyoshi Sakai, Norimi Ohashi, Midori Hasegawa, Yoshiyuki Hiki, Yukio Yuzawa
Accumulation of amyloid-β protein (Aβ) in the brain causes cognitive impairment in Alzheimer's disease. We hypothesized that an extracorporeal system that rapidly removed Aβ from the blood may accelerate Aβ drainage from the brain. We previously reported that dialyzers remove blood Aβs effectively, mainly by adsorption on the inner surfaces of the hollow fibers, resulting in lower Aβ accumulation in the brains of patients undergoing hemodialysis than the controls without hemodialysis. The aim of the present study was to create a more convenient and effective blood Aβ removal system using adsorptive filtration, in which the filtrate returned to the body...
December 11, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29222315/extracorporeal-photopheresis-cellular-therapy-for-the-treatment-of-acute-and-chronic-graft-versus-host-disease
#3
REVIEW
Jennifer Schneiderman
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative option for many disease states. Despite significant improvements in strategies used to prevent and treat acute and chronic graft-versus-host disease (a/cGVHD), they continue to negatively affect outcomes of HSCT significantly. Standard, first-line treatment consists of corticosteroids; beyond this, there is little consistency in therapeutic regimens. Current options include the addition of various immunosuppressive agents, the use of which puts patients at even higher risks for infection and other morbidities...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29216952/-sepsis-induced-cardiomyopathy-complicated-with-cardiogenic-shock-patients-supported-with-extracorporeal-membrane-oxygenation
#4
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216295/alpha-1-antichymotrypsin-is-involved-in-astrocyte-injury-in-concert-with-arginine-vasopressin-during-the-development-of-acute-hepatic-encephalopathy
#5
Jonghyuk Park, Takahiro Masaki, Yoshihiro Mezaki, Hiroshi Yokoyama, Mariko Nakamura, Haruka Maehashi, Takahiko J Fujimi, Sabine S Gouraud, Keisuke Nagatsuma, Madoka Nakagomi, Naofumi Kimura, Tomokazu Matsuura
BACKGROUND AND AIMS: We developed a bio-artificial liver (BAL) using a radial-flow bioreactor and rescued mini-pig models with lethal acute liver failure (ALF). The point of the rescue is the recovery from hepatic encephalopathy (HE). HE on ALF has sometimes resulted in brain death following brain edema with astrocyte swelling. Several factors, including ammonia and glutamine, have been reported to induce astrocyte swelling and injury. However, many clinicians believe that there are any other factors involved in the development of HE...
2017: PloS One
https://www.readbyqxmd.com/read/29211215/predictive-factors-of-long-term-stay-in-the-icu-after-cardiac-surgery-logistic-casus-score-serum-bilirubin-dosage-and-extracorporeal-circulation-time
#6
Marcio Fernandes Pimentel, Marcelo José Ferreira Soares, Jamil Alli Murad, Marcos Aurelio Barboza de Oliveira, Fernanda Luiza Faria, Vinicius Zani Faveri, Yuzo Iano, Rodrigo Capobianco Guido
OBJECTIVE: To test the capacity of the Logistic CASUS Score on the second postoperative day, the total serum bilirubin dosage on the second postoperative day and the extracorporeal circulation time, as possible predictive factors of long-term stay in Intensive Care Unit after cardiac surgery. METHODS: Eight-two patients submitted to cardiac surgery with extracorporeal circulation were selected. The Logistic CASUS Score on the second postoperative day was calculated and bilirubin dosage on the second postoperative day was measured...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29204888/initial-robotic-assistance-in-the-surgical-management-of-renal-cell-carcinoma-with-level-4-cavoatrial-thrombus
#7
Isaac Palma-Zamora, Deepansh Dalela, Ravi Barod, Linda Hsu, Mani Menon, Craig G Rogers
We report a case of left-sided renal cell carcinoma (RCC) with level 4 cavoatrial tumor thrombus where robotic assistance was used to achieve hemostasis around the kidney in order to minimize coagulopathic hemorrhage from the nephrectomy bed during subsequent open completion nephrectomy and cavoatrial thrombectomy under extracorporeal circulation and hypothermic circulatory arrest. Robotic assistance allowed for meticulous dissection and ligation of parasitic and arterial vessels to the kidney, release of renal attachments, and exposure of the inferior vena cava...
December 4, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29183830/improving-cannulation-time-for-extracorporeal-life-support-in-refractory-cardiac-arrest-of-presumed-cardiac-cause-comparison-of-two-percutaneous-cannulation-techniques-in-the-catheterization-laboratory-in-a-center-without-on-site-cardiovascular-surgery
#8
Sebastian Voicu, Patrick Henry, Isabelle Malissin, Dillinger Jean-Guillaume, Anastasios Koumoulidis, Nikos Magkoutis, Demetris Yannopoulos, Damien Logeart, Stéphane Manzo-Silberman, Nicolas Péron, Nicolas Deye, Bruno Megarbane, Georgios Sideris
BACKGROUND: Cardiac arrest (CA) without return of spontaneous circulation can be treated with veno-arterial extracorporeal membrane oxygenation (vaECMO) implemented surgically or percutaneously. We performed a study assessing time for vaECMO percutaneous cannulation in the catheterization laboratory. METHODS: Single-centre retrospective study in a University hospital without on-site cardiovascular surgery, including patients aged >18 receiving vaECMO for out- or in-hospital refractory CA of presumed cardiac cause between 2010 and 2016, cannulated by interventional cardiologists...
November 26, 2017: Resuscitation
https://www.readbyqxmd.com/read/29182741/off-label-use-of-thoracic-aortic-endovascular-stent-grafts-to-simplify-difficult-resections-and-procedures-in-general-thoracic-surgery
#9
Tanja Walgram, Nicolas Attigah, Igor Schwegler, Markus Weber, Omer Dzemali, Christian Berthold, Dirk Wagnetz, Giovanni L Carboni
OBJECTIVES: Tumour infiltration, or gross infectious involvement of the thoracic aortic wall, poses a significant intraoperative risk for fatal bleeding and therefore could compromise adequate resection or efficient surgical management of pleural infection in a considerable amount of cases. We present 3 successful cases of off-label thoracic aortic endografting to safeguard thoracic aortic wall integrity. METHODS: After all patients received thoracic stent grafts through femoral access into the descending aorta, the first patient underwent a resection of a locally advanced squamous cell carcinoma of the left inferior lobe cT4cN0-1cM0 after neoadjuvant chemoradiation, which had infiltrated the descending aortic wall...
November 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29180869/ecmo-as-an-effective-rescue-therapeutic-for-fulminant-myocarditis-complicated-with-refractory-cardiac-arrest
#10
Ya-Ting Li, Li-Fen Yang, Zhuang-Gui Chen, Li Pan, Meng-Qi Duan, Yan Hu, Cheng-Bin Zhou, Yu-Xiong Guo
Fulminant myocarditis (FM) is a life-threatening disease in children. With a rapid, progressive course of deterioration, it causes refractory cardiorespiratory failure even with optimal clinical intervention. We present the case of a 9-year-old girl with FM complicated by cardiogenic shock, malignant arrhythmia, and refractory cardiac arrest. She received effective cardiopulmonary resuscitation, therapeutic hypothermia, and other supportive treatments. However, the patient rapidly worsened into pulseless ventricular tachycardia and refractory cardiac arrest...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29161706/endotoxin-effects-on-cardiac-and-renal-functions-and-cardiorenal-syndromes
#11
Grazia Maria Virzì, Anna Clementi, Alessandra Brocca, Claudio Ronco
Gram-negative sepsis is a major cause of morbidity and mortality in critical ill patients. Recent findings in molecular biology and in signaling pathways have enhanced our understanding of its pathogenesis and opened up opportunities of innovative therapeutic approaches. Endotoxin plays a pivotal role in the pathogenesis of multi-organ dysfunction in the setting of gram-negative sepsis. Indeed, heart and kidney impairments seem to be induced by the release of circulating pro-inflammatory and pro-apoptotic mediators triggered by endotoxin interaction with immune cells...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29149820/mechanisms-of-cardioprotection-of-halogenated-agents-during-extracorporeal-circulation-in-cardiac-surgery
#12
M Ramirez Aliaga, J J Escalona Belmonte, Alicia Ramirez-Fernandez, M Rubio Navarro, J Cruz Manas
The implementation of cardioprotective strategies involving pre-, intra-, and postoperative interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal of this study was to review the physiopathology of and protection strategies against myocardial damage secondary to ECC during cardiac surgery. The administration of halogenated anesthetics for cardiac anesthesia is commonplace due to their well-known cardioprotective effects and their capacity to ensure hypnosis...
November 16, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#13
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29140963/when-the-momentum-has-gone-what-will-be-the-role-of-extracorporeal-lung-support-in-the-future
#14
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...
November 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29130582/periprocedural-transfusion-in-patients-undergoing-transfemoral-transcatheter-aortic-valve-implantation
#15
N Patrick Mayr, Gunther Wiesner, Alexander Hapfelmeier, Pieter van der Starre, Oliver Husser, Sabine Bleiziffer, Heribert Schunkert, Rüdiger Lange, Peter Tassani-Prell, Klaus Martin
OBJECTIVES: The aim of this investigation was to identify patient's characteristics and periprocedural variables related to periprocedural transfusion in transfemoral Transcatheter Aortic Valve Implantation (tf-TAVI). BACKGROUND: Transfusion of allogenic red-blood cells (RBC) in tf-TAVI and the number of transfused units has been linked to an increased 30-day mortality. In line with the trend of minimization and cost-effectiveness, transfusion should be avoided, wherever possible...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29126457/chest-compression-related-fatal-internal-mammary-artery-injuries-manifesting-after-venoarterial-extracorporeal-membrane-oxygenation-a-case-series
#16
Toshinobu Yamagishi, Masahiro Kashiura, Kazuhiro Sugiyama, Kazuha Nakamura, Takuto Ishida, Takahiro Yukawa, Kazuki Miyazaki, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: Cardiopulmonary resuscitation-related bleeding, especially internal mammary artery injuries, can become life-threatening complications after initiating venoarterial extracorporeal membrane oxygenation owing to the frequent involvement of concomitant anticoagulant treatment, antiplatelet treatment, targeted temperature management, and bleeding coagulopathy. We report the cases of five patients who experienced this complication and discuss their management. CASE PRESENTATION: We retrospectively evaluated five patients with cardiopulmonary resuscitation-related internal mammary artery injuries who were treated between February 2011 and February 2016 at our institution...
November 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29125124/predictable-capability-control-scheme-for-oxygen-exchange-blood-flow-regulation-in-an-extracorporeal-membrane-oxygenation-system
#17
Chung-Dann Kan, Wei-Ling Chen, Chia-Hung Lin, Ying-Shin Chen
Extracorporeal membrane oxygenation system is used for rescue treatment strategies for temporary cardiopulmonary function support to facilitate adequately oxygenated blood to return into the systemic and pulmonary circulation systems. Therefore, a servo flow regulator is used to adjust the roller motor speed, while support blood flow can match the sweep gas flow (GF) in a membrane oxygenator. A generalised regression neural network is designed as an estimator to automatically estimate the desired roller pump speed and control parameters...
December 2017: IET Systems Biology
https://www.readbyqxmd.com/read/29125053/twenty-minutes-of-normothermic-cardiac-arrest-in-a-pig-model-the-role-of-short-term-hypothermia-for-neurological-outcome
#18
Katharina Foerster, Christoph Benk, Friedhelm Beyersdorf, Heidi Cristina Schmitz, Karin Wittmann, Itumeleng Taunyane, Claudia Heilmann, Georg Trummer
INTRODUCTION: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named "controlled integrated resuscitation device" (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29123911/perimortem-cesarean-delivery-and-subsequent-emergency-hysterectomy-new-strategy-for-maternal-cardiac-arrest
#19
Mayako Goto, Hiroaki Watanabe, Kazuhide Ogita, Tetsuya Matsuoka
Cases: Perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiac arrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiac arrest, on the basis of a review of published work, and present two case reports from our medical center. Outcomes: In case 1, PMCD led to death by massive bleeding...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123887/two-cases-of-life-threatening-arrhythmia-induced-by-risperidone-evaluation-of-risperidone-and-9-hydroxy-risperidone-concentrations
#20
Asami Ito, Tomoyuki Enokiya, Eiji Kawamoto, Yoshiaki Iwashita, Taichi Takeda, Kenji Ikemura, Masahiro Okuda, Hiroshi Imai
Cases: Case 1: A 20-year-old woman suffering a suspected overdose was transported to the hospital. She presented bradycardia with wide QRS waves and QT prolongation, followed by cardiac arrest. Extracorporeal cardiopulmonary resuscitation was implemented, improving circulation. Risperidone and 9OH-RIS levels were 9.6 ng/mL and 127.6 ng/mL, respectively. Case 2: A 54-year-old woman was hospitalized for femoral fracture and underwent surgery. Her electrocardiogram showed bradycardia and complete AV block...
July 2017: Acute Medicine & Surgery
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