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Extracorporeal circulation

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https://www.readbyqxmd.com/read/28201958/blood-infusion-and-the-risk-of-haemorrhage-in-patients-undergoing-cardiac-surgery-with-extracorporeal-circulation
#1
Manuel Luque-Oliveros, María Ángeles García-Carpintero, Omar Cauli
PURPOSE: Patients undergoing cardiac surgery with extracorporeal circulation (ECC) frequently present haemorrhages as a complication associated with high morbidity and mortality. One of the factors that influences this risk is the volume of blood infused during surgery. The objective of this study was to determine the optimal volume of autologous blood that can be processed during cardiac surgery with ECC. We also determined the number of salvaged red blood cells to be reinfused into the patient in order to minimize the risk of haemorrhage in the postoperative period...
February 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28183575/choreoathetotic-syndrome-following-cardiac-surgery
#2
Michela Bisciglia, Frédéric London, Jonathan Hulin, André Peeters, Adrian Ivanoiu, Anne Jeanjean
Movement disorders following heart surgery are very unusual. Post-pump chorea is mainly a pediatric complication of heart surgery, typically manifesting after a latent period of normality and is usually related with long extracorporeal circulation time and deep hypothermia. We report a 73-year-old woman, without risk factors predisposing to paroxysmal movement disorders, presenting acute choreoathetoid movements 5 days after aortic valvular replacement with normal extracorporeal circulation time and perioperative normothermia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28164555/continuous-hemodiafiltration-with-an-an69st-hemofilter-an69st-chdf-as-fgf-23-lowering-therapy
#3
Masafumi Yamato, Yusuke Minematsu, Yuta Ikemiya, Junichi Shibata, Junya Fujii, Takumi Minato, Sachie Miyagawa, Kaori Takaori, Yoko Tomiyama, Ikue Nagayama, Akira Wada, Takahito Ito, Hirotsugu Iwatani
BACKGROUND: Recent studies have shown that fibroblast growth factor-23 (FGF-23) is elevated not only in chronic kidney disease (CKD), but also in acute illnesses such as acute kidney injury, septic shock, and acute heart failure. FGF-23 would be not only a simple biomarker but also a direct toxic factor in acute illness. Therefore, lowering circulating FGF-23 levels in clinical practice would be an exciting and valuable interventional strategy. Continuous hemodiafiltration (CHDF) is often performed for the treatment of the aforementioned acute illnesses...
December 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28155889/platelets-protect-lung-from-injury-induced-by-systemic-inflammatory-response
#4
Shuhua Luo, Yabo Wang, Qi An, Hao Chen, Junfei Zhao, Jie Zhang, Wentong Meng, Lei Du
Systemic inflammatory responses can severely injure lungs, prompting efforts to explore how to attenuate such injury. Here we explored whether platelets can help attenuate lung injury in mice resulting from extracorporeal circulation (ECC)-induced systemic inflammatory responses. Mice were subjected to ECC for 30 min, then treated with phosphate-buffered saline, platelets, the GPIIb/IIIa inhibitor Tirofiban, or the combination of platelets and Tirofiban. Blood and lung tissues were harvested 60 min later, and lung injury and inflammatory status were assessed...
February 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#5
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28139304/development-and-implementation-of-a-comprehensive-multidisciplinary-emergency-department-extracorporeal-membrane-oxygenation-program
#6
Joseph E Tonna, Craig H Selzman, Michael P Mallin, Brigham R Smith, Scott T Youngquist, Antigoni Koliopoulou, Frederick Welt, Kathleen Diane Stoddard, Ram Nirula, Richard Barton, James Franklin Fair, James C Fang, Stephen McKellar
Despite advances in the medical and surgical management of cardiovascular disease, greater than 350,000 patients experience out-of-hospital cardiac arrest in the United States annually, with only a 12% neurologically favorable survival rate. Of these patients, 23% have an initial shockable rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), a marker of high probability of acute coronary ischemia (80%) as the precipitating factor. However, few patients (22%) will experience return of spontaneous circulation and sufficient hemodynamic stability to undergo cardiac catheterization and revascularization...
January 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28127437/effect-of-extracorporeal-cytokine-removal-on-vascular-barrier-function-in-a-septic-shock-patient
#7
Sascha David, Kristina Thamm, Bernhard M W Schmidt, Christine S Falk, Jan T Kielstein
BACKGROUND: Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28125963/effect-of-ultrasonography-and-fluoroscopic-guidance-on-the-incidence-of-complications-of-cannulation-in-extracorporeal-cardiopulmonary-resuscitation-in-out-of-hospital-cardiac-arrest-a-retrospective-observational-study
#8
Masahiro Kashiura, Kazuhiro Sugiyama, Takahiro Tanabe, Akiko Akashi, Yuichi Hamabe
BACKGROUND: It remains unclear which cannulation method is best in cases of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest. We assessed the effect of ultrasound- and fluoroscopy-guided percutaneous cannulation on complication incidence, compared with that using only ultrasound guidance. METHODS: This single-center retrospective observational study was conducted between February 2011 and December 2015. In the comparison group, cannulation was performed percutaneously using only ultrasound guidance...
January 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28123726/post-hysterectomy-intravenous-leiomyomatosis-a-case-of-successful-multidisciplinary-surgery-under-non-extracorporeal-circulation
#9
Yucui Zeng, Huiru Tang, Liping Zeng, Lihui Wei, Xiaoming Zhang, Ruifang Wu
Intravenous leiomyomatosis is a rare benign disease. We here in present the case of a 39-year-old woman with a history of hysterectomy who presented with intermittent abdominal pain, palpitations and tightness of the chest. Physical examination revealed the presence of a pelvic mass of regular shape. Gynecological ultrasonography, computed tomography scans and three-dimensional (3D) cardiac ultrasonography were used to evaluate the imaging characteristics of the mass and reach a final diagnosis. The mass appeared to extend to the iliac veins, renal veins and inferior vena cava on imaging examination...
January 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28109393/a-modified-and-less-invasive-procedure-in-aortic-arch-replacement
#10
Feng Gao, Jing Chen, Qian Zeng, Fangming Lin
Circulation arrest is widely used during total aortic arch replacement. However, the conventional procedures have high morbidity and mortality. We modified the hybrid procedure by optimizing the sequence of anastomosis between the graft and aorta. As a result, the time of extracorporeal circulation was obviously shortened, and cardiac arrest was needed only during the two anastomoses of the aorta with aorta graft main body. In addition, both circulation arrest and deep hypothermia were avoided. Leakage was also prevented by creating a lengthened sealing zone for stent graft deployment...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28109108/-brachiocephalic-artery-sparing-aortic-arch-repair-combined-with-stent-graft-elephant-trunk-technique-for-stanford-type-a-aortic-dissection-analysis-of-23-cases
#11
Song-Lin DU, Jun Wan, Wu-Jun Wang, Kai-Can Cai, Ya-Xiang Liu, Xiang-Hui Mao
OBJECTIVE: To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. METHODS: Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28093804/successful-bridge-to-transplant-of-functionally-univentricular-patients-with-a-modified-continuous-flow-ventricular-assist-device
#12
Michael C Mongé, Bradley T Kulat, Osama Eltayeb, Neale R Zingle, Steven T Moss, Jeffrey G Gossett, Elfriede Pahl, John M Costello, Carl L Backer
A continuous flow extracorporeal ventricular assist device (VAD) was modified to support functionally univentricular infants and children awaiting heart transplantation. A centrifugal VAD, designed to flow from 1.5 to 8 L/min, was used as a bridge-to-transplant in four patients with functionally univentricular circulation. A variable restrictive recirculation shunt permitted lower flow ranges in small patients. In hypoxic patients, an oxygenator was incorporated into the circuit. From 2012 to 2015, the modified VAD was placed in four patients with Glenn physiology...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28092256/-resection-of-intracardiac-myxoma-case-report
#13
Víctor Manuel Carmona-Delgado, Angélica María Deloya-Maldonado, María Lourdes Carranza-Bernal, Arturo Hinojosa-Pérez, Leobardo Farías-Mayene
Myxomas are the most common benign cardiac tumors, which are considered emergency surgery. The resection should not be delayed because 8-9% of affected patients may die due to intracardiac blood flow obstruction. We presente a clinical case of a 47 year old female, history of dyslipidemia. Disease starts with retrosternal oppression feeling, dyspnea on moderate exercise, dizziness, pain in joints hands. Arrhytmic heart sounds, diastolic mitral murmur II/IV, breth sounds present, no lymph. Laboratory: hemoglobin 11...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#14
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28045844/return-of-viable-cardiac-function-after-sonographic-cardiac-standstill-in-pediatric-cardiac-arrest
#15
Katherine Steffen, W Reid Thompson, Aliaksei Pustavoitau, Erik Su
Sonographic cardiac standstill during adult cardiac arrest is associated with failure to get return to spontaneous circulation. This report documents 3 children whose cardiac function returned after standstill with extracorporeal membranous oxygenation. Sonographic cardiac standstill may not predict cardiac death in children.
January 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28045547/peptide-macrocycle-inhibitor-of-coagulation-factor-xii-with-subnanomolar-affinity-and-high-target-selectivity
#16
Simon J Middendorp, Jonas Wilbs, Claudia Quarroz, Sara Calzavarini, Anne Angelillo-Scherrer, Christian Heinis
Factor XII (FXII) is a plasma protease that has emerged in recent years as a potential target to treat or prevent pathological thrombosis, to inhibit contact activation in extracorporeal circulation, and to treat the swelling disorder hereditary angioedema. While several protein based inhibitors with high affinity for activated FXII (FXIIa) were developed, the generation of small molecule inhibitors has been challenging. In this work, we have generated a potent and selective FXIIa inhibitor by optimizing a peptide macrocycle that was recently evolved by phage display (Ki = 0...
February 9, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28018512/prevention-of-embolization-in-concomitant-endovascular-therapy-for-thoracic-and-abdominal-aneurysms-with-severely-atheromatous-aorta
#17
Tomohiro Takano, Shinya Takase, Akihito Kagoshima, Hitoshi Yokoyama
A 74-year-old man with multiple aortic aneurysms and shaggy aorta was simultaneously treated by conventional open repair for an abdominal aortic aneurysm and endoluminal stent grafting for a thoracic aortic aneurysm. We performed intermittent clamping of the visceral and carotid arteries under an extracorporeal circulation circuit without a blood flow pump, which lead to the avoidance of embolization in spite of the disadvantage of endoluminal stent grafting for atheromatous aorta.
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28009768/thrombus-in-transit-a-potentially-life-threatening-complication-of-cerebral-sinus-thrombosis
#18
Martina Petracca, Rosalinda Calandrelli, Aldobrando Broccolini, Pietro Caliandro, Giacomo Della Marca, Giovanni Frisullo, Roberta Morosetti, Paolo Profice, Priscilla Lamendola, Faustino Pennestrì, Fabio Pilato
We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.
January 2017: Neurologist
https://www.readbyqxmd.com/read/28007877/mechanical-reperfusion-with-leucocyte-filtered-blood-does-not-prevent-injury-following-global-cerebral-ischaemia
#19
Rickard P F Lindblom, Thomas Tovedal, Bo Norlin, Lars Hillered, Svetlana N Popova, Irina Alafuzoff, Stefan Thelin
OBJECTIVES: Prolonged global cerebral ischaemia leads to irreversible injury, often with lethal outcome. Brain injuries are partly caused by the uncontrolled reperfusion that occurs once the circulation is re-established. Recent animal experiments suggest that controlled reperfusion following lengthy ischaemia might prevent severe brain injury. This study aimed at further exploring cerebral alterations and outcome following prolonged global cerebral ischaemia and mechanically manipulated reperfusion...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28007740/early-coronary-reperfusion-facilitates-return-of-spontaneous-circulation-and-improves-cardiovascular-outcomes-after-ischemic-cardiac-arrest-and-extracorporeal-resuscitation-in-pigs
#20
Alice Hutin, Lionel Lamhaut, Fanny Lidouren, Matthias Kohlhauer, Nicolas Mongardon, Pierre Carli, Alain Berdeaux, Bijan Ghaleh, Renaud Tissier
BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is widely proposed for the treatment of refractory cardiac arrest. It should be associated with coronary angiography if coronary artery disease is suspected. However, the prioritization of care remains unclear in this situation. Our goal was to determine whether coronary reperfusion should be instituted as soon as possible in such situations in a pig model. METHODS AND RESULTS: Anesthetized pigs were instrumented and submitted to coronary artery occlusion and ventricular fibrillation...
December 22, 2016: Journal of the American Heart Association
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