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Extracorporeal circulation

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https://www.readbyqxmd.com/read/28306594/extending-normothermic-regional-perfusion-to-the-thorax-in-donors-after-circulatory-death
#1
Steven S L Tsui, Gabriel C Oniscu
PURPOSE OF REVIEW: Despite a significant increase in the utilization of donors after circulatory death (DCD), the number of organs recovered and their function are largely inferior to those from donors after brain death. This review summarizes recent advances in in-situ normothermic regional perfusion of DCD organs prior to procurement. RECENT FINDINGS: The combination of warm and cold ischemia in DCD donation are detrimental to organ function. As a consequence, the acceptance criteria are far more restrictive and many organs are discarded...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28306515/decentralized-safety-concept-for-closed-loop-controlled-intensive-care
#2
Jan Kühn, Christian Brendle, André Stollenwerk, Martin Schweigler, Stefan Kowalewski, Thorsten Janisch, Rolf Rossaint, Steffen Leonhardt, Marian Walter, Rüdger Kopp
This paper presents a decentralized safety concept for networked intensive care setups, for which a decentralized network of sensors and actuators is realized by embedded microcontroller nodes. It is evaluated for up to eleven medical devices in a setup for automated acute respiratory distress syndrome (ARDS) therapy. In this contribution we highlight a blood pump supervision as exemplary safety measure, which allows a reliable bubble detection in an extracorporeal blood circulation. The approach is validated with data of animal experiments including 35 bubbles with a size between 0...
March 17, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28275225/low-flow-veno-venous-extracorporeal-co2-removal-for-acute-hypercapnic-respiratory-failure
#3
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
BACKGROUND: Ventilation with low tidal volume and airway pressure results in a survival benefit in ARDS patients. Previous research suggests that avoiding mechanical ventilation altogether may be beneficial in some cases of respiratory failure. Our hypothesis was that low flow veno-venous extracorporeal CO2 removal (ECCO2R) enables maintenance of a lung protective ventilation strategy or awake spontaneous ventilation despite severe hypercapnic respiratory failure (HRF). METHODS: Twenty patients with HRF were investigated while mechanically ventilated (n=14) or breathing spontaneously close to respiratory exhaustion (n=6)...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28259310/impact-of-periapical-abscess-on-infectious-complications-in-patients-undergoing-extracorporeal-circulation-auxiliary-to-open-heart-surgical-procedures
#4
Veerasathpurush Allareddy, Sivaraman Prakasam, Sankeerth Rampa, Kyle Stein, Romesh P Nalliah, Veerajalandhar Allareddy, Shankar Rengasamy Venugopalan
OBJECTIVE: Extracorporeal circulation auxiliary to open-heart surgeries (ECAOHS) may exert nonphysiological stresses on periapical abscessed tissues leading to hematogenous spread of microbes. The aim of this report was to estimate risk of postoperative infectious complications in patients with periapical abscesses and undergoing ECAOHS. METHODS: A retrospective analysis of Nationwide Inpatient Sample (years 2009 and 2010) was conducted. All patients (aged 19 to 65 years) who underwent ECAOHS were selected...
March 2017: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/28257296/extracorporeal-circulation-during-lung-transplantation-procedures-a-meta-analysis
#5
Dominik J Hoechter, Yu-Ming Shen, Tobias Kammerer, Sabina Günther, Weig Thomas, René Schramm, Christian Hagl, Frank Born, Bruno Meiser, Gerhard Preissler, Hauke Winter, Stephan Czerner, Bernhard Zwissler, Mansmann Ulrich, Vera von Dossow
Extracorporeal circulation is an invaluable tool in lung transplantation. Over the past years, an increasing number of centers changed their standard for intraoperative extracorporeal circulation from cardiopulmonary bypass to extracorporeal membrane oxygenation - with differing results. This meta-analysis reviews the existing evidence.An online literature research on Medline, Embase, and Pubmed has been performed. Two persons independently judged the papers using the ACROBAT-NRSI tool of the Cochrane collaboration...
February 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28240641/transcatheter-mitral-valve-replacement-with-a-novel-self-expandable-prosthesis-single-institutional-experience-procedural-outcomes-and-follow-up
#6
Gian Paolo Ussia, Valeria Cammalleri, Jawahar L Mehta, Kunal Sarkar, Saverio Muscoli, Pasquale de Vico, Giovanni Ruvolo, Francesco Romeo
AIMS: We report our experience with the CardiAQ prosthetic valve using both transapical and transseptal access. Aim of our study was proving the feasibility, safety and effectiveness of a novel transcatheter mitral valve bioprosthesis. METHODS: Four patients with severe mitral regurgitation, not eligible for mitral valve surgery, were treated with the CardiAQ valve. The procedures were performed under general anaesthesia, fluoroscopic and transesophageal echocardiographic guidance...
February 24, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28201958/blood-infusion-and-the-risk-of-haemorrhage-in-patients-undergoing-cardiac-surgery-with-extracorporeal-circulation
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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