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Extracorporeal circulation

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https://www.readbyqxmd.com/read/29917004/is-female-sex-an-independent-risk-factor-for-early-mortality-in-isolated-coronary-artery-bypass-graft-a-propensity-matched-analysis
#1
Andrea Garatti, Alessandro Parolari, Alberto Canziani, Eugenio Mossuto, Andrea Daprati, Ali Abu Farah, Daniele Brugnetti, Marco Ranucci, Lorenzo Menicanti
AIMS: Despite several studies reporting a higher mortality rate for women undergoing isolated coronary artery bypass graft (CABG) surgery, this issue has not been completely clarified. The aim of the current study was to determine if sex differences in CABG surgery affect adjusted operative results and operative mortality. METHODS: Between January 2005 and December 2012, 3756 consecutive patients (3009 men and 747 women) underwent isolated CABG at our institution...
June 16, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29915655/to-be-or-not-to-be-a-case-of-heparin-resistance
#2
Jibran Durrani, Faizan Malik, Naveed Ali, Syed Imran Mustafa Jafri
Heparin resistance can be defined as high doses of unfractionated heparin (UFH), greater than 35,000 IU/day, required to raise the activated partial thromboplastin time (aPTT) and activated coagulation time (ACT) to within therapeutically desired ranges or the impossibility of doing so. The most common pathology responsible is the deficiency of anti-thrombin III (ATIII) deficiency. Other clinically relevant conditions that can present with heparin resistance are congenital deficiencies; use of high doses of heparin during extracorporeal circulation, use of asparaginase therapy and disseminated intravascular coagulation (DIC)...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29907121/position-of-draining-venous-cannula-in-extracorporeal-membrane-oxygenation-for-respiratory-and-respiratory-circulatory-support-in-adult-patients
#3
B Frenckner, M Broman, M Broomé
Extracorporeal membrane oxygenation (ECMO) is used in critically ill patients with severe pulmonary and/or cardiac failure. Blood is drained from the venous system and pumped through a membrane oxygenator where it is oxygenated. For pulmonary support, the blood is returned to the patient via a vein (veno-venous ECMO) and for pulmonary/circulatory support it is returned via an artery (veno-arterial ECMO).Veno-venous ECMO can be performed either with a single dual-lumen cannula or with two separate single-lumen cannulas...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29904353/low-level-light-therapy-protects-red-blood-cells-against-oxidative-stress-and-hemolysis-during-extracorporeal-circulation
#4
Tomasz Walski, Anna Drohomirecka, Jolanta Bujok, Albert Czerski, Grzegorz Wąż, Natalia Trochanowska-Pauk, Michał Gorczykowski, Romuald Cichoń, Małgorzata Komorowska
Aim: An activation of non-specific inflammatory response, coagulation disorder, and blood morphotic elements damage are the main side effects of the extracorporeal circulation (ECC). Red-to-near-infrared radiation (R/NIR) is thought to be capable of stabilizing red blood cell (RBC) membrane through increasing its resistance to destructive factors. We focused on the development of a method using low-level light therapy (LLLT) in the spectral range of R/NIR which could reduce blood trauma caused by the heart-lung machine during surgery...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29902852/-rescue-of-a-thyroid-cancer-patient-with-subglottic-carcinoma-and-infringement-of-cervical-trachea-under-extracorporeal-circulation-a-case-report
#5
C Y Yao, Y H Liu, C B Gao
No abstract text is available yet for this article.
June 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29898152/aortic-valve-replacement-combined-with-ascending-aortic-aneurysmectomy-in-a-patient-with-sickle-cell-disease-a-case-report
#6
Lucas Molinari Veloso da Silveira, Ana Paula Tagliari, Ronaldo David da Costa, Cristiano Blaya Martins, Orlando Wender
Sickle cell anemia is a haematological disorder characterized by multiple vaso-occlusive complications, resulting in a reduced life expectancy. These patients are exposed to several triggering factors for sickle cell crises when they are submitted to cardiovascular surgeries with extracorporeal circulation. Therefore, meticulous care and perioperative management are required. This paper reports a successful case of combined cardiovascular surgery - aortic valve replacement and ascending aortic aneurysmectomy - with no serious post-operative complications...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29893677/prospective-randomized-un-blinded-three-arm-controlled-study-in-coronary-artery-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-miecc-surrogate-parameter-analysis-of-biocompatibility
#7
Arndt H Kiessling, Harald Keller, Anton Moritz
OBJECTIVES: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused by, the reduced priming volume and hemodilution, or the avoidance of blood-air contact and dispersion of mediastinal debris into the systemic circulation. The aim of the trial was the comparison of MiECC to an open ECC setup (openECC) or a system with reduced blood air and debris interaction (closeECC)...
May 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29877960/the-effects-of-vasoconstriction-and-volume-expansion-on-veno-arterial-ecmo-flow
#8
Per W Moller, Anisa Hana, Paul Philipp Heinisch, Shengchen Liu, Siamak Djafarzadeh, Matthias Haenggi, Andreas Bloch, Jukka Takala, Stephan M Jakob, David Berger
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is gaining widespread use in the treatment of severe cardiorespiratory failure. Blood volume expansion is commonly used to increase ECMO flow (QECMO), with risk of positive fluid balance and worsening prognosis. We studied the effects of vasoconstriction on recruitment of blood volume as an alternative for increasing QECMO, based on the concepts of venous return. METHODS: In a closed chest, centrally cannulated porcine preparation (n = 9) in ventricular fibrillation and VA-ECMO with vented left atrium, mean systemic filling pressure (MSFP) and venous return driving pressure (VRdP) were determined in Euvolemia, during Vasoconstriction (norepinephrine 0...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29863725/combination-of-aptamer-and-drug-for-reversible-anticoagulation-in-cardiopulmonary-bypass
#9
Ruwan Gunaratne, Shekhar Kumar, James W Frederiksen, Steven Stayrook, Jens L Lohrmann, Kay Perry, Kristin M Bompiani, Charlene V Chabata, Nabil K Thalji, Michelle D Ho, Gowthami Arepally, Rodney M Camire, Sriram Krishnaswamy, Bruce A Sullenger
Unfractionated heparin (UFH), the standard anticoagulant for cardiopulmonary bypass (CPB) surgery, carries a risk of post-operative bleeding and is potentially harmful in patients with heparin-induced thrombocytopenia-associated antibodies. To improve the activity of an alternative anticoagulant, the RNA aptamer 11F7t, we solved X-ray crystal structures of the aptamer bound to factor Xa (FXa). The finding that 11F7t did not bind the catalytic site suggested that it could complement small-molecule FXa inhibitors...
June 4, 2018: Nature Biotechnology
https://www.readbyqxmd.com/read/29860680/rapid-onset-plasma-leakage-of-extracorporeal-oxygenation-membranes-possibly-due-to-hyperbilirubinemia
#10
Yoshiko Kida, Shinichiro Ohshimo, Michihito Kyo, Yuko Tanabe, Kei Suzuki, Koji Hosokawa, Nobuaki Shime
Extracorporeal membrane oxygenation (ECMO) is an emerging tool for supporting cardiopulmonary function in patients with cardiorespiratory failure or arrest. The oxygenator of the ECMO circuit requires effective oxygenation and removal of carbon dioxide from the blood. Major problems that can occur with the oxygenator include plasma leakage, one of the late-onset serious complications necessitating device replacement. However, the rapid onset of plasma leakage is rare. We present a 1-year-old boy with acute respiratory failure due to Pneumocystis and Aspergillus pneumonia...
June 2, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29857945/epinephrine-administration-in-non-shockable-out-of-hospital-cardiac-arrest
#11
R Jouffroy, A Saade, P Alexandre, P Philippe, P Carli, B Vivien
BACKGROUND: Epinephrine is recommended for the treatment of non-shockable out of hospital cardiac arrest (OHCA) to obtain return of spontaneous circulation (ROSC). Epinephrine efficiency and safety remain under debate. OBJECTIVE: We propose to describe the association between the cumulative dose of epinephrine and the failure of ROSC during the first 30 min of advanced life support (ALS). METHODOLOGY: A retrospective observational cohort study using the Paris SAMU 75 registry including all non-traumatic OHCA...
May 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29850264/complex-recanalization-of-chronic-total-occluison-supported-by-minimal-extracorporeal-circulation-in-a-patient-with-an-aortic-valve-bioprothesis-in-extraanatomic-position
#12
Ruben Jansen, Brigitte Bathgate, Alexander Bufe, Jan-Erik Guelker
Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. This case describes a complex PCI of the left main coronary artery and of a CTO of the right coronary artery using a minimal extracorporeal circulation system (MECC) in a patient with an aortic valve bioprothesis in extraanatomic position. It illustrates that complex recanalization strategies can be solved combining it with mechanical circulatory support technologies.
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29798392/-preoperative-airway-management-and-perioperative-period-asphyxia-prevention-in-patients-with-tumors-invasion-in-the-cervical-tracheal
#13
Q Cai, Y H Liu, K L Wu, J Wu, Y Zhao, C Y Yao
Objective: To investigate the effect of preoperative airway treatment and postoperative asphyxiation preventive measures in patients with tumors invasion in the cervical tracheal. Method: The clinical date of 35 patients with different degree of tumors invasion in the cervical tracheal were analyzed retrospectively. Anesthesia including normal endotracheal intubation anesthesia, awake intubation anesthesia with visual laryngoscope assisted after topical anesthesia, intubation anesthesia with preoperative tracheotomy, intubation anesthesia after transection of trachea and anesthesia with extracoporeal circulation was selected according to the patient's situation such as whether exist forced position, or the extent of dyspnea, or the range of recurrent tumor...
December 5, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#14
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29780574/synchronous-nephrectomy-and-cavoatrial-tumor-thrombectomy-under-normothermic-extracorporeal-circulation-and-beating-heart
#15
Eleftheria Mavrigiannaki, Ioannis Fesatidis, Evgenia Kalogridaki, Ioannis-Petros Katralis, Dimitrios Filippou, Panagiotis Skandalakis, Dionisios Vrochides
Formation of tumor thrombus is an occasional manifestation of renal cell carcinoma (RCC). Intravascular invasion of the renal vein and thereafter the inferior vena cava (IVC) might in very rare cases extend into the cardiac chambers. The subtle course and symptoms of such cases alongside with the engagement of vital anatomical structures marks them as a diagnostic and therapeutic challenge. Aggressive surgical intervention has proven to be critical for survival rates in such cases; however total synchronous resection remains a challenge for the surgical team and a debate for the medical community...
May 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29779479/optimizing-antitumor-efficacy-and-adverse-effects-of-pegylated-liposomal-doxorubicin-by-scheduled-plasmapheresis-impact-of-timing-and-dosing
#16
Romeo Ngoune, Christine Contini, Michael Marcus Hoffmann, Dominik Elverfeldt, Karl Winkler, Gerhard Putz
BACKGROUND: Nanoscale drug delivery systems accumulate in solid tumors preferentially by the enhanced permeation and retention effect (EPR-effect). Nevertheless, only a miniscule fraction of a given dosage reaches the tumor, while >90% of the given drug ends up in otherwise healthy tissues, leading to the severe toxic reactions observed during chemotherapy. Once accumulation in tumor has reached its maximum, extracorporeal elimination of circulating nanoparticles by plasmapheresis can diminish toxicities...
May 18, 2018: Current Drug Delivery
https://www.readbyqxmd.com/read/29777285/insufficient-left-ventricular-unloading-after-extracorporeal-membrane-oxygenation-a-case-series-observational-study
#17
W Hu, J Zhou, L Chen, J Huang, W Hu, Y Zhu, T Yuan
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a method widely used to support circulation in patients with fulminant myocarditis (FM). However, a common complication associated with ECMO is left ventricular (LV) overload. METHODS: This case series observed the effects of intra-aortic balloon pump (IABP) and beta-blockers for the treatment of LV overload after ECMO. The cases of eight patients with FM who underwent ECMO from September 2009 to July 2016 were reviewed...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29774882/-sleep-wake-rhythm-after-extracorporeal-circulation-in-new-zealand-rabbits
#18
Kaiwei Wang, Jiaqiang Zhang
To evaluate the change of sleep-wake rhythm after extracorporeal circulation (ECC) in New Zealand rabbits, and to explore the role of clock genes in sleep-wake rhythm disorder by ECC.
 Methods: A total of 54 New Zealand rabbits were randomly divided into 3 groups: a normal group (Group N), a sham group (Group S) and a model group (Group ECC). Electrocorticogram (ECOG), electroophthalmogram (EOG) and electromyogram (EMG) were respectively recorded by multipurpose EEG recorder, and the sleep-wake rhythm was also recorded...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29774399/endothelial-dysfunction-following-coronary-artery-bypass-grafting-influence-of-patient-and-procedural-factors
#19
J Hadem, R Rossnick, B Hesse, M Herr, M Hansen, A Bergmann, G Kensah, C Maess, H Baraki, P Kümpers, A Lukasz, I Kutschka
BACKGROUND: Angiopoietin-2 (Angpt2) mediates endothelial dysfunction (ED) following coronary artery bypass grafting (CABG). Its triggers are, however, poorly understood. METHODS: We examined the time course of ED beyond the early phase of postoperative recovery in 75 patients following CABG with a special focus on different cardiopulmonary bypass (CPB) modes as potential triggers of Angpt2 release. RESULTS: Nine patients (12.0%) underwent off-pump coronary artery bypass (OPCAB), 31 patients (41...
May 17, 2018: Herz
https://www.readbyqxmd.com/read/29751986/delirium-after-cardiac-surgery-incidence-phenotypes-predisposing-and-precipitating-risk-factors-and-effects
#20
Gianfranco Sanson, Yuliya Khlopenyuk, Sara Milocco, Massimiliano Sartori, Lorella Dreas, Adam Fabiani
BACKGROUND: In cardiac surgical patients little is known about different phenotypes of delirium and how the symptoms fluctuate over time. OBJECTIVES: Evaluate risk factors, incidence, fluctuations, phenotypic characteristics and impact on patients' outcomes of delirium. METHODS: Prospective longitudinal study. In postoperative intensive care unit 199 patient were assessed three-times a day through an adapted versions of the Intensive Care Delirium Screening Checklist...
May 8, 2018: Heart & Lung: the Journal of Critical Care
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