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Extracorporeal circulation

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https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#1
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27914636/open-surgical-repair-remains-the-gold-standard-for-treating-aortic-arch-pathology
#2
Vishal Khullar, Hartzell V Schaff, Joseph A Dearani, Richard C Daly, Kevin L Greason, Lyle D Joyce, Alberto Pochettino
BACKGROUND: Endovascular arch repair technology is driven in large part by the assumption that open arch operations are high-risk. We wanted to evaluate the clinical results of open arch reconstruction in the modern era in a large group practice. METHODS: From October 2003 to June 2014, 567 patients underwent aortic arch operations: hemiarch repair was performed in 429 patients (75.7%; group A), total arch repair in 129 (22.7%; group B), and patch repair in the remaining 9 (1...
November 30, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27903392/-resuscitation-efficacy-of-extracorporeal-membrane-oxygenation-in-non-postcardiotomy-adult-patients-with-cardiac-arrest
#3
L Huang, Y W Liu, T Li, X M Hu, D W Duan, P Wu
Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27903207/direct-cerebral-perfusion-and-cooling-in-experimental-cardiac-arrest
#4
Rinaldo Bellomo, Bruno Marino, Peter Angelopoulos, Scott Carson, Glenn Eastwood, Junko Kosaka, Naoya Iguchi, Andrew Hilton, Clive May
BACKGROUND: Cerebral protection is a key priority during cardiac arrest (CA). However, current approaches are suboptimal. OBJECTIVE: To test whether direct perfusion and cooling of the anterior cerebral circulation by means of cerebral vessel cannulation and extracorporeal membrane oxygenation (ECMO) increases cerebral oxygenation and induces cerebral hypothermia during CA. METHODS: We performed proof-of-concept animal experiments in sheep...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27890016/the-inflammatory-response-to-extracorporeal-membrane-oxygenation-ecmo-a-review-of-the-pathophysiology
#5
REVIEW
Jonathan E Millar, Jonathon P Fanning, Charles I McDonald, Daniel F McAuley, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a technology capable of providing short-term mechanical support to the heart, lungs or both. Over the last decade, the number of centres offering ECMO has grown rapidly. At the same time, the indications for its use have also been broadened. In part, this trend has been supported by advances in circuit design and in cannulation techniques. Despite the widespread adoption of extracorporeal life support techniques, the use of ECMO remains associated with significant morbidity and mortality...
November 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27884211/plasma-glutamine-levels-before-cardiac-surgery-are-related-to-post-surgery-infections-an-observational-study
#6
Hanneke Buter, Matty Koopmans, Ramses Kemperman, Lilian Jekel, Christiaan Boerma
BACKGROUND: A low plasma glutamine level was found in 34% of patients after elective cardiothoracic surgery. This could be a result of the inflammation caused by surgical stress or the use of extracorporeal circulation (ECC). But it is also possible that plasma glutamine levels were already lowered before surgery and reflect an impaired metabolic state and a higher likelihood to develop complications. In the present study plasma glutamine levels were measured before and after cardiac surgery and we questioned whether there is a relation between plasma glutamine levels and duration of ECC and the occurrence of postoperative infections...
November 25, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27874962/analysis-of-risk-factors-of-type-a-aortic-dissection-taad-operation-of-frozen-elephant-trunk-and-total-arch-replacement
#7
W Shang, M Ma, Y-P Ge, N Liu, J-M Zhu, L-Z Sun
OBJECTIVE:  To investigate the incidence and risk factors of acute renal failure (ARF) after operation of frozen elephant trunk and total arch replacement for acute thoracic aortic aneurysm and dissection (TAAD) with mild hypothermic circulatory arrest (MHCA), and to analyze the long-term survival rate of the patients with ARF. PATIENTS AND METHODS: From February 2009 to March 2015, patients with acute TAAD accepted operation of frozen elephant trunk and total arch replacement were enrolled...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27862075/minimally-invasive-implantation-of-heartware-assist-device-and-simultaneous-tricuspid-valve-reconstruction-through-partial-upper-sternotomy
#8
Julia Hillebrand, Andreas Hoffmeier, Tonny Djie Tiong Tjan, Juergen R Sindermann, Christoph Schmidt, Sven Martens, Mirela Scherer
Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27860413/development-of-a-wearable-bioartificial-kidney-using-the-bioartificial-renal-epithelial-cell-system-brecs
#9
Kimberly A Johnston, Angela J Westover, Alvaro Rojas-Pena, Deborah A Buffington, Christopher J Pino, Peter L Smith, H David Humes
Cell therapy for the treatment of renal failure in the acute setting has proved successful, with therapeutic impact, yet development of a sustainable, portable bioartificial kidney for treatment of chronic renal failure has yet to be realized. Challenges in maintaining an anticoagulated blood circuit, the typical platform for solute clearance and support of the biological components, have posed a major hurdle in advancement of this technology. This group has developed a Bioartificial Renal Epithelial Cell System (BRECS) capable of differentiated renal cell function while sustained by body fluids other than blood...
November 18, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27859540/the-impact-of-citrate-concentration-on-adhesion-of-platelets-and-leukocytes-to-adsorbents-in-whole-blood-lipoprotein-apheresis
#10
René Weiss, Michael B Fischer, Viktoria Weber
Lipoprotein apheresis is applied to deplete low density lipoprotein and other apolipoprotein B containing lipoproteins in patients with severe familial hypercholesterolemia, hypertriglyceridemia associated pancreatitis, or lipoprotein (a)-hyperlipoproteinemia. Anticoagulation of the extracorporeal circuit may influence cellular activation, as evidenced by a reduction of inflammatory parameters during regional citrate anticoagulation with acid citrate dextrose A (ACD-A) commonly used in whole blood lipid apheresis...
November 17, 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/27858002/continuous-and-simultaneous-measurement-of-the-biophysical-properties-of-blood-in-a-microfluidic-environment
#11
Yang Jun Kang
The biophysical properties of blood have been considered as promising indices for effectively screening the cardiovascular diseases. In this study, a method for the continuous and simultaneous measurement of the biophysical properties of blood, including viscosity, viscoelasticity, and RBC (red blood cell) aggregation is suggested, using a microfluidic device. The microfluidic device has two inlets (A, B), two outlets (A, B), two identical side channels, and one bridge channel. To sequentially induce steady and transient flows of blood samples, a blood sample is carefully delivered into the inlet (A) at a pulsatile flow rate (Q) (Qmax = 1 mL h(-1), Qmin = 0 mL h(-1), T = 240 s)...
November 18, 2016: Analyst
https://www.readbyqxmd.com/read/27830023/over-expression-of-heat-shock-protein-70-protects-mice-against-lung-ischemia-reperfusion-injury-through-sirt1-ampk-enos-pathway
#12
Shumei Liu, Junping Xu, Chunfang Fang, Chunjing Shi, Xin Zhang, Bo Yu, Yantong Yin
Lung ischemia/reperfusion injury (LIRI) usually occurs during in lung transplantation and extracorporeal circulation operation and may develop into pulmonary infections, acute rejection and bronchiolitis obliterans syndrome. Recent studies have discovered the protective effect of heat shock protein 70 (HSP70) on various types of injuries. In the present study, we firstly explore the role of over-expressed HSP70 on the protection against LIRI. Lung Wet/Dry (W/D) ratio, biomarkers in the bronchoalveolar lavage fluid (BALF), lung histological changes and apoptosis markers, oxidative products and proinflammatory cytokines in the lung tissues were analyzed...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27820606/survival-rates-following-pediatric-in-hospital-cardiac-arrests-during-nights-and-weekends
#13
Farhan Bhanji, Alexis A Topjian, Vinay M Nadkarni, Amy H Praestgaard, Elizabeth A Hunt, Adam Cheng, Peter A Meaney, Robert A Berg
Importance: Nearly 6000 hospitalized children in the United States receive cardiopulmonary resuscitation (CPR) annually. Little is known about whether the survival of these children is influenced by the time of the event (eg, nighttime or weekends). Differences in survival could have important implications for hospital staffing, training, and resource allocation. Objective: To determine whether outcomes after pediatric in-hospital cardiac arrests differ during nights and weekends compared with days/evenings and weekdays...
November 7, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27819221/concealed-resuscitation-related-injuries-as-reversible-cause-of-recurrent-arrest-following-extracorporeal-cardiopulmonary-resuscitation
#14
Kap Su Han, Sung Woo Lee, Kwang Hoon Park, Jong Su Park, Jae Seung Jung, Cheol Woong Yu, Su Jin Kim
A life-threatening cardiopulmonary resuscitation (CPR)-related injury can cause recurrent arrest after return of circulation. Such injuries are difficult to identify during resuscitation, and their contribution to failed resuscitation can be missed given the limitations of conventional CPR. Extracorporeal cardiopulmonary resuscitation (ECPR), increasingly being considered for selected patients with potentially reversible etiology of arrest, may identify previously occult CPR-related injuries by restoring arterial pressure and flow...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27815579/extracorporeal-membrane-oxygenation-improves-coagulopathy-in-an-experimental-traumatic-hemorrhagic-model
#15
M Larsson, P Forsman, P Hedenqvist, A Östlund, J Hultman, A Wikman, L Riddez, B Frenckner, M Bottai, C-M Wahlgren
PURPOSE: Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation (ECMO) is an established treatment for patients with respiratory failure and has in recent years also been used in severely injured trauma patients with cardiopulmonary failure and coexisting bleeding shock. The aim of this study was to evaluate the effect of ECMO on hypothermia, acidosis, and coagulopathy in a traumatic hemorrhagic rabbit model...
November 4, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27815258/inflammation-and-lung-injury-in-an-ovine-model-of-extracorporeal-membrane-oxygenation-support
#16
Margaret Passmore, Yoke L Fung, Gabriela Simonova, Samuel R Foley, Kimble R Dunster, Sara D Diab, John-Paul Tung, Robyn M Minchinton, Charles I McDonald, Chris M Anstey, Kiran Shekar, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for patients with severe, refractory, cardiorespiratory failure. Exposure to the ECMO circuit is thought to trigger/exacerbate inflammation. Determining whether inflammation is due to the patients underlying pathologies or the ECMO circuit is difficult. To discern how different insults contribute to the inflammatory response we developed an ovine model of lung injury and ECMO to investigate the impact of smoke-induced lung injury and ECMO in isolation and cumulatively on pulmonary and circulating inflammatory cells, cytokines and tissue remodeling...
November 4, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27810996/annals-express-stability-of-ionized-calcium-measurements-at-concentrations-less-than-0-3-mmol-l-by-point-of-care-blood-gas-instruments-application-for-post-filter-calcium-quality-control-in-patients-with-citrate-anticoagulation-during-extracorporeal-circulation
#17
Maria Averina, Raymond Jakobsen
: BackgroundMeasurements of ionized calcium (Ca(2)(+)) at concentrations less than 0.3 mmol/L are required for post-filter control in patients that receive extracorporeal circulation with sodium citrate anticoagulation. This study evaluates the stability of the Ca(2)(+) measurements at such concentrations. MethodsThe stability of the Ca(2)(+) measurements was tested by measuring daily the external standard Qualicheck concentration 3 s7950, Radiometer (0.22-0.25 mmol/L) by blood gas instruments ABL800 and ABL90, Radiometer...
November 3, 2016: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27807630/-role-of-plasmapheresis-and-immunoadsorption-in-salvage-therapy-of-rheumatological-diseases
#18
M Boser, J T Kielstein
Many rheumatological diseases are either caused by specific known proteins, such as antibodies or mediated by a plethora of cytokines. Both the unspecific immunosuppressive therapy and the specific action of biologics usually require time to be effective; therefore, extracorporeal forms of treatment are increasingly being employed in severe forms of rheumatological diseases as well as in patients who cannot tolerate pharmacological treatment or where the risk of pharmacological treatment may outweigh the potential benefits...
December 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27801307/pregnancy-related-cardiovascular-complications-case-presentation-and-review-of-literature
#19
Hasan Baki Altinsoy, Ozkan Alatas, Salih Colak, Hakan Atalay, Omer Faruk Dogan
BACKGROUND: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. METHODS: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27801303/levosimendan-use-increases-cardiac-performance-after-coronary-artery-bypass-grafting-in-end-stage-renal-disease-patients
#20
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
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