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"Extracorporeal membrane oxygenation"

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https://www.readbyqxmd.com/read/29792775/a-narrative-review-of-the-technical-standards-for-extracorporeal-life-support-devices-pumps-and-oxygenators-in-europe
#1
Matteo Di Nardo, Leen Vercaemst, Justyna Swol, Nicholas Barret, Fabio S Taccone, Maximilian V Malfertheiner, Lars M Broman, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Margherita Lonero, Mirko Belliato
This review summarizes the European rules to control the market when introducing new products. In particular, it shows all the steps to achieve the European Conformity (CE Mark), a certification that all new medical products must achieve before being used in Europe. Extracorporeal membrane oxygenation (ECMO) devices are exposed to the same procedures. Hereby, we present some regulatory issues regarding pumps and oxygenators, providing technical details as released by the manufacturers on their websites and information charts...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29792571/extracorporeal-membrane-oxygenation-and-temperature-management-in-postresuscitation
#2
Hans Friberg, Jonathan Paul, Graham Nichol, Takahiro Nakashima
No abstract text is available yet for this article.
May 24, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29792513/cardiogenic-shock-complicating-peripartum-cardiomyopathy-importance-of-early-left-ventricular-unloading-and-bromocriptine-therapy
#3
Jan-Thorben Sieweke, Tobias Jonathan Pfeffer, Dominik Berliner, Tobias König, Maximiliane Hallbaum, L Christian Napp, Jörn Tongers, Christian Kühn, Jan D Schmitto, Denise Hilfiker-Kleiner, Andreas Schäfer, Johann Bauersachs
INTRODUCTION: Acute peripartum cardiomyopathy complicated by cardiogenic shock is a rare but life-threatening disease. A prolactin fragment is considered causal for the pathogenesis of peripartum cardiomyopathy. This analysis sought to investigate the role of early percutaneous mechanical circulatory support with micro-axial flow-pumps and/or veno-arterial extracorporeal membrane oxygenation in combination with the prolactin inhibitor bromocriptine in refractory cardiogenic shock complicating peripartum cardiomyopathy...
May 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29792510/in-reply-to-intra-aortic-balloon-pump-protects-against-hydrostatic-pulmonary-oedema-during-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#4
Jamie R Privratsky, Sebastian Diaz, Alina Nicoara, Mani A Daneshmand
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized life-saving measure. However, left-ventricular distention from inadequate left-ventricular off-loading can lead to unwanted pulmonary and cardiac complications. We are writing to indicate our agreement with a recent article by Brechot et al. published in the June 2017 issue where the authors demonstrated that intra-aortic balloon pump provides mechanical support to off-load the left ventricle during VA-ECMO, which prevents pulmonary edema...
May 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29792118/extracorporeal-membrane-oxygenation-support-in-individuals-with-thoracic-insufficiency
#5
Shelley Hancock, Curtis Froehlich, Veronica Armijo-Garcia, Andrew D Meyer
INTRODUCTION: Respiratory failure is the leading cause of mortality in individuals with congenital spine and rib deformities. We present a case report of a child with Jeune syndrome surviving respiratory failure using extracorporeal membrane oxygenation (ECMO). We also summarize thoracic insufficiency syndrome cases reported in the Extracorporeal Life Support Organization (ELSO) registry. CASE REPORT: A two-year-old male with a chest circumference less than a third percentile for age was admitted with influenza pneumonia developing a peak oxygenation index of 103...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29791822/extracorporeal-membrane-oxygenation-for-severe-acute-respiratory-distress-syndrome
#6
Alain Combes, David Hajage, Gilles Capellier, Alexandre Demoule, Sylvain Lavoué, Christophe Guervilly, Daniel Da Silva, Lara Zafrani, Patrice Tirot, Benoit Veber, Eric Maury, Bruno Levy, Yves Cohen, Christian Richard, Pierre Kalfon, Lila Bouadma, Hossein Mehdaoui, Gaëtan Beduneau, Guillaume Lebreton, Laurent Brochard, Niall D Ferguson, Eddy Fan, Arthur S Slutsky, Daniel Brodie, Alain Mercat
BACKGROUND: The efficacy of venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) remains controversial. METHODS: In an international clinical trial, we randomly assigned patients with very severe ARDS, as indicated by one of three criteria - a ratio of partial pressure of arterial oxygen (Pao2 ) to the fraction of inspired oxygen (Fio2 ) of less than 50 mm Hg for more than 3 hours; a Pao2 :Fio2 of less than 80 mm Hg for more than 6 hours; or an arterial blood pH of less than 7...
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29790824/addressing-the-challenges-of-ecmo-simulation
#7
Guillaume Alinier, Ibrahim Fawzy Hassan, Abdullah Alsalemi, Mohammed Al Disi, Ali Ait Hssain, Ahmed Labib, Yahya Alhomsi, Fayçal Bensaali, Abbes Amira, Abdulsalam Saif Ibrahim
INTRODUCTION/AIM: The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants' suspension of disbelief...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#8
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789779/outcomes-in-cardiogenic-shock-patients-with-extracorporeal-membrane-oxygenation-use-a-matched-cohort-study-in-hospitals-across-the-united-states
#9
Rayan El Sibai, Rana Bachir, Mazen El Sayed
Background: ECMO is increasingly used for patients with critical illnesses. This study examines ECMO use in patients with cardiogenic shock in US hospitals and associated outcomes (mortality, hospital length of stay, and total hospital charges). Methods: A matched cohort retrospective study was conducted using the 2013 Nationwide Emergency Department Sample. Cardiogenic shock visits were matched (1 : 1) and compared based on ECMO use. Results: Patients with ECMO ( N = 802) were compared to patients without ECMO ( N = 805)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29788844/the-first-five-years-of-neonatal-and-pediatric-transports-on-extracorporeal-membrane-oxygenation-in-the-center-and-south-of-italy-the-pediatric-branch-of-the-italian-rete-respira-network
#10
Matteo Di Nardo, Margherita Lonero, Elisabetta Pasotti, Federica Cancani, Daniela Perrotta, Corrado Cecchetti, Francesca Stoppa, Nicola Pirozzi, Ondina La Salvia, Antonella Nicolini, Antonio Amodeo, Nicolo' Patroniti, Antonio Pesenti
INTRODUCTION: Neonatal and pediatric ECMO is a high-risk procedure that should be performed only in expert centers. Children who are eligible for ECMO and are managed in hospitals without ECMO capabilities should be referred to the closest ECMO center before the severity of illness precludes safe conventional transport. When the clinical situation precludes safe conventional transport, ECMO should be provided on site with the patient transported on ECMO. METHODS: We retrospectively reviewed our institutional database of all ECMO transports for neonatal and pediatric respiratory failure from February 2013 to February 2018...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788843/effect-of-pump-type-on-outcomes-in-neonates-with-congenital-diaphragmatic-hernia-requiring-ecmo
#11
Patrick T Delaplain, Lishi Zhang, Danh V Nguyen, Amir H Ashrafi, Peter T Yu, Matteo Di Nardo, Yanjun Chen, Joanne Starr, Henri R Ford, Yigit S Guner
PURPOSE: With the exception of neonatal respiratory failure, most centers are now using centrifugal over roller-type pumps for the delivery of extracorporeal membrane oxygenation (ECMO). Evidence supporting the use of centrifugal pumps specifically in infants with congenital diaphragmatic hernia (CDH) remains lacking. We hypothesized that the use of centrifugal pumps in infants with CDH would not affect mortality or rates of severe neurologic injury (SNI). METHODS: Infants with CDH were identified within the ELSO registry (2000-2016)...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788842/veno-arterio-venous-ecmo-for-septic-cardiomyopathy-a-single-centre-experience
#12
Dominik J Vogel, Josie Murray, Adam Z Czapran, Luigi Camporota, Nicholas Ioannou, Chris I S Meadows, Peter B Sherren, Kathleen Daly, Nigel Gooby, Nicholas Barrett
INTRODUCTION: The role of extracorporeal support for patients with septic shock remains unclear. METHODS: We conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database. RESULTS: Twelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788841/heparin-induced-thrombocytopenia-complicating-extracorporeal-membrane-oxygenation-support-in-pediatric-patients-review-of-the-literature-and-alternative-anticoagulants
#13
Uri Pollak
Heparin-induced thrombocytopenia (HIT) is a prothrombotic, immune-mediated complication of unfractionated heparin (UFH) and low molecular weight heparin therapy. HIT is characterized by moderate thrombocytopenia 5-10 days after initial heparin exposure, detection of platelet-activating anti-platelet factor 4/heparin antibodies and an increased risk of venous and arterial thrombosis. Extracorporeal membrane oxygenation (ECMO) is a form of mechanical circulatory support used in critically ill patients with respiratory or cardiac failure...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788840/new-optimized-dual-lumen-cannula-for-veno-venous-ecmo
#14
Ludwig K von Segesser, Denis Berdajs, Saad Abdel-Sayed, Enrico Ferrari, Maximilian Halbe, Markus Wilhelm, Francesco Maisano
OBJECTIVE: The present study was designed to assess in vivo a new, optimized, virtually wall-less, dual-lumen, bi-caval cannula for veno-venous ECMO in comparison to a commercially available cannula. METHODS: Veno-venous extracorporeal membrane oxygenation (ECMO) was carried out in a bovine study (n=5, bodyweight 75±5kg). Following systemic heparinization, ECMO was established in a trans-jugular fashion through a calibrated 23F orifice, using a new, optimized, virtually wall-less, dual-lumen, bi-caval 24F cannula (Smartcanula LLC, Lausanne, Switzerland) versus a commercially available 23F bi-caval, dual-lumen control cannula (Avalon Elite® , Maquet, Rastatt, Germany) in a veno-venous ECMO setup...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788839/phenobarbital-pharmacokinetics-in-neonates-and-infants-during-extracorporeal-membrane-oxygenation
#15
Pavla Pokorná, Martin Šíma, Václav Vobruba, Dick Tibboel, Ondřej Slanař
INTRODUCTION: The disposition of drugs is potentially changed due to extracorporeal membrane oxygenation (ECMO) in neonates and infants. METHODS: The aim of the study was to evaluate the individual pharmacokinetics (PK) of phenobarbital and the effect of PK covariates in neonates and infants undergoing ECMO. Sixteen patients (7 neonates, 9 infants) treated with phenobarbital during ECMO (centrifugal-flow pump circuits) were enrolled in the PK study. Phenobarbital serum concentrations were measured using a fluorescence polarization immunoassay...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788838/in-vitro-and-in-vivo-assessment-of-oxygenator-blood-volume-for-the-prediction-of-clot-formation-in-an-ecmo-circuit-theory-and-validation
#16
Nikolai Krivitski, Gregory Galyanov, Deborah Cooper, Mariam M Said, Oswaldo Rivera, Gerald T Mikesell, Khodayar Rais-Bahrami
INTRODUCTION: Clotting is one of the major causes of mortality and morbidity during extracorporeal membrane oxygenation (ECMO). A large meta-analysis study suggests that 29% of patients require the oxygenator to be replaced during ECMO. As clots usually form in the oxygenator, the oxygenator blood volume (OXBV) decreases over time. The currently used pressure gradient as a predicator of clot formation is unreliable. OBJECTIVE: The aim of this study was to develop and validate ultrasound dilution technology in a quantitative assessment of clotting, using measurements of OXBV...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788836/intracranial-hemorrhage-in-adults-on-ecmo
#17
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788811/central-ecmo-for-circulatory-failure-following-pediatric-liver-transplantation
#18
John P Scott, Johnny C Hong, Nathan E Thompson, Ronald K Woods, George M Hoffman
We describe the case of a 4-year-old male with a past medical history significant for nephrotic syndrome, short-bowel syndrome and fulminant hepatic failure status post (s/p) liver transplant (LT) who developed early post-transplant allograft dysfunction (hyperbilirubinemia, coagulopathy) and septic shock requiring central extracorporeal membrane oxygenation (ECMO). He remained on ECMO for 85 hours before he was decannulated without event and later underwent repeat LT. This case highlights the potential of central ECMO to provide the circulatory output necessary to reverse distributive shock physiology in patients with sepsis and hepatic dysfunction following LT...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29783818/-continuous-renal-replacement-therapy-combined-with-extracorporeal-membrane-oxygenation-for-pediatric-cardiopulmonary-failure
#19
Y P Zhou, J Y Shi, F Wang, Y Cui, T T Xu, C X Wang, Y C Zhang
Objective: To explore the effectiveness and safety of continuous renal replacement therapy (CRRT) combined with extracorporeal membrane oxygenation (ECMO) on rescuing pediatric patients with cardiopulmonary failure. Methods: The medical records of patients treated with ECMO admitted to pediatric intensive care unit (PICU) in Shanghai Children's Hospital from December 2015 to November 2017 were retrospectively extracted. There were 14 patients treated with ECMO combined with CRRT (ECMO+ CRRT group) due to acute kidney injury (AKI) or fluid overload, while 11 cases treated with ECMO only...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29783816/-consensus-on-extracorporeal-membrane-oxygenation-support-for-neonatal-respiratory-failure
#20
(no author information available yet)
No abstract text is available yet for this article.
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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