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Extra-corporeal membrane oxygenation

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https://www.readbyqxmd.com/read/29768983/anticoagulation-monitoring-under-ecmo-support-a-comparative-study-between-the-activated-coagulation-time-and-the-anti-xa-activity-assay
#1
Clément Delmas, Aemilia Jacquemin, Fanny Vardon-Bounes, Bernard Georges, Felipe Guerrero, Nicolas Hernandez, Bertrand Marcheix, Thierry Seguin, Vincent Minville, Jean-Marie Conil, Stein Silva
PURPOSE: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)-a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#2
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29707826/pulmonary-hypertension-is-not-a-risk-factor-for-grade-3-primary-graft-dysfunction-after-lung-transplantation
#3
Silvia R Cottini, Giovanna Brandi, Alberto Pagnamenta, Walter Weder, Reto A Schuepbach, Markus Béchir, Lars C Huber, Christian Benden
Grade 3 primary graft dysfunction (PGD3) represents the most important risk factor for patient mortality during the first year after lung transplantation (LTX). We investigated whether pretransplant pulmonary hypertension (PH) is a risk factor for the development of PGD3. This retrospective, single-center cohort study included 96 candidates undergoing right heart catheterization (RHC) prior to being listed for LTX between March 2000 and October 2015. Based on their mean pulmonary artery pressure (mPAP) levels, the patients were classified into 3 groups: (1) <25 mm Hg, (2) 25-34 mm Hg and (3) ≥35 mm Hg...
April 6, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29703012/successful-treatment-of-left-main-shock-syndrome-induced-by-thrombosed-coronary-artery-dissection-a-case-report
#4
Xiaojun Bai, Weiping Zhang, Zuyi Yuan
RATIONALE: Left main shock syndrome (LMSS) induced by thrombosed coronary artery dissection is very rare and has a fatal prognosis. Optimal treatment strategy includes early reperfusion and hemodynamic support to prevent cardiogenic shock. However, it involves the extension of technical difficulties under different conditions. PATIENT CONCERNS: A 49-year-old woman developed symptoms of left main shock syndrome. The main clinical manifestations were retrosternal pain radiating to his back and left shoulder, heavy sweating, palpitation and brachypnea...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29559756/acute-bowel-ischemia-associated-with-left-ventricular-thrombus-and-arteriovenous-extracorporeal-membrane-oxygenation
#5
Mary Huerter, Dean Govostis, Martin Ellenby, Eduardo Smith-Singares
Indications for extra corporeal membrane oxygenation (ECMO) have expanded in recent years, and it has become an invaluable tool in the care of adult patients in severe cardiogenic shock or respiratory failure. Understanding the physiologic effect of ECMO has also further developed, allowing for improvements in the management of the potential morbidities associated with this technology. Here, we present a case of acute bowel ischemia that developed while the patient was on central venoarterial ECMO.
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29356392/transvenous-dual-chamber-pacemaker-after-paediatric-heart-transplantation-using-left-ventricle-pacing-through-the-coronary-sinus
#6
José Mario Baggio, Cristina Machado Camargo Afiune, Jorge Y Afiune, Alvaro V Sarabanda, Fernando A Atik
A 12-year-old child with end-stage heart failure due to restrictive cardiomyopathy was submitted to orthotopic heart transplantation. Primary graft dysfunction required venous arterial extra-corporeal membrane oxygenation. Heart function normalized, but complete atrioventricular block remained after 3 weeks. A dual-chamber pacing with transvenous left ventricle pacing through the coronary sinus was performed. At 5-year follow-up, the patient is stable with the same pacing system and with preserved ventricular function...
February 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29351695/reasons-for-failure-of-systemic-to-pulmonary-artery-shunts-in-neonates
#7
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
BACKGROUND:  Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality. METHODS:  Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction...
January 19, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29205886/ambulatory-central-va-ecmo-with-biventricular-decompression-for-acute-cardiogenic-shock
#8
Prashant Rao, Benjamin Alouidor, Richard Smith, Zain Khalpey
We describe the off-pump insertion of a biventricular assist device with extra-corporeal membrane oxygenation (ECMO): a novel technique that allows for ambulatory central veno-arterial (VA) ECMO with direct biventricular decompression.
December 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29194169/quality-of-life-of-adult-survivors-after-extra-corporeal-membrane-oxygenation-ecmo-a-quantitative-study
#9
Alessandro Galazzi, Alessandra Brambilla, Giacomo Grasselli, Antonio Pesenti, Roberto Fumagalli, Alberto Lucchini
INTRODUCTION: Extracorporeal Membrane Oxygenation (ECMO) is a technique used in the treatment of patients with severe respiratory failure. A lot of studies in the literature investigated the survival rate of patients treated with ECMO, but few are those that assess the long-term outcomes and the quality of life (QoL) of survivors. MATERIALS AND METHODS: A retrospective observational study with prospective QoL assessment through administration of the questionnaire EuroQol-5 Dimension was conducted in acute respiratory distress syndrome patients who h ad ECMO as a rescue therapy for reversible refractory hypoxemia from January 2013 until December 2015 in an Italian referral ECMO center...
January 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29174255/the-impact-of-severity-of-initial-illness-determined-by-sofa-score-and-presence-of-anemia-on-outcomes-among-patients-requiring-extra-corporal-membrane-oxygenation-ecmo-support-a-single-center-experience
#10
Wael Elabbassi, Farah Al Aila, Mohammed Andaleeb Chowdhury, Ahmed Najib, H Zaid, M Michelin, Arif Al Nooryani
INTRODUCTION: ECMO provides respiratory and circulatory support in critically ill patients. In our study, we report on a single center experience with ECMO and aim to identify the prognostic markers for survival to discharge from hospital. METHODS: A registry was maintained on all patients who underwent ECMO implantation from September 2012 till January 2016 at a single institution. The collected data was analyzed to identify baseline characteristics, outcomes including clinical variables predictive of poor outcome...
November 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#11
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
February 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29134345/trends-in-mechanical-circulatory-support-use-and-hospital-mortality-among-patients-with-acute-myocardial-infarction-and-non-infarction-related-cardiogenic-shock-in-the-united-states
#12
Mahek Shah, Soumya Patnaik, Brijesh Patel, Pradhum Ram, Lohit Garg, Manyoo Agarwal, Sahil Agrawal, Shilpkumar Arora, Nilay Patel, Joyce Wald, Ulrich P Jorde
BACKGROUND: Recent trends on outcomes in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) suggest improvements in early survival. However, with the ever-changing landscape in management of CS, we sought to identify age-based trends in these outcomes and mechanical circulatory support (MCS) use among patients with both AMI and non-AMI associated shock. METHODS: We queried the 2005-2014 Nationwide Inpatient Sample databases to identify patients with a diagnosis of cardiogenic shock...
November 13, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29125047/extra-corporeal-membrane-oxygenation-and-outcomes-in-massive-pulmonary-embolism-two-eras-at-an-urban-tertiary-care-hospital
#13
David L Ain, Mazen Albaghdadi, Jay Giri, Farhad Abtahian, Michael R Jaff, Kenneth Rosenfield, Nathalie Roy, Mauricio Villavicencio-Theoduloz, Thoralf Sundt, Ido Weinberg
Mortality associated with high-risk pulmonary embolism (PE) remains high. Extra-corporeal membrane oxygenation (ECMO) allows for acute hemodynamic stabilization and potentially for administration of other disease process altering therapies. We sought to compare two eras: pre-ECMO and post-ECMO in relation to high-risk PE treatment and mortality. A single-center retrospective chart review was conducted of high-risk PE patients. High-risk PE was defined as acute PE and cardiac arrest or shock. A total of 60 patients were identified, 31 in the pre-ECMO era and 29 in the post-ECMO era...
February 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29110799/acute-postoperative-management-after-lung-transplantation
#14
REVIEW
Christopher Potestio, Desmond Jordan, Bessie Kachulis
Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29094607/predictors-of-survival-and-ability-to-wean-from-short-term-mechanical-circulatory-support-device-following-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#15
A Reshad Garan, Christina Eckhardt, Koji Takeda, Veli K Topkara, Kevin Clerkin, Justin Fried, Amirali Masoumi, Ryan T Demmer, Pauline Trinh, Melana Yuzefpolskaya, Yoshifumi Naka, Dan Burkhoff, Ajay Kirtane, Paolo C Colombo, Hiroo Takayama
BACKGROUND: Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. METHODS: All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29081177/-outcome-determinants-in-cardiac-arrest-patients-secondary-to-acute-myocardial-infarction-receiving-extra-corporeal-membrane-oxygenation-combined-with-percutaneous-coronary-intervention-therapy
#16
H X Fu, J F Ma, M F Hu, Z N Zhao, Y Wang, L Miao
Objective: To investigate the clinical efficacy and outcome determinants in cardiac arrest patients secondary to acute myocardial infarction treated with extracorporeal membrane oxygenation (ECMO) and percutaneous coronary intervention (PCI). Methods: The clinical data of 27 patients hospitalized from January 2014 to March 2017 in 3 hospitals were retrospectively analyzed. The clinical data of the surviving group (12 cases) and the death group (15 cases) were compared and the outcome determinants were explored...
October 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29034035/surgical-embolectomy-for-acute-pulmonary-thromboembolism
#17
REVIEW
Ikuo Fukuda, Kazuyuki Daitoku
Acute pulmonary thromboembolism is a catastrophic event, especially for hospitalized patients. The prognosis of pulmonary thromboembolism depends on the degree of pulmonary arterial occlusion. The mortality of massive pulmonary embolism is reportedly as high as 25% without cardiopulmonary arrest and 65% with cardiopulmonary arrest. In patients with unstable hemodynamics due to pulmonary thromboembolism, surgical pulmonary embolectomy is indicated for patients with a contraindication to thrombolysis, failed catheter therapy, or failed thrombolysis...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29029712/advanced-cardiopulmonary-support-for-pulmonary-embolism
#18
REVIEW
Oren Friedman, James M Horowitz, Danny Ramzy
Management of high-risk pulmonary embolism (PE) requires an understanding of the pathophysiology of PE, options for rapid clot reduction, critical care interventions, and advanced cardiopulmonary support. PE can lead to rapid respiratory and hemodynamic collapse via a complex sequence of events leading to acute right ventricular failure. Importantly, reduction in pulmonary vascular resistance must be accomplished either by systemic thrombolytics, catheter directed thrombolytics, endovascular clot extraction, or surgical embolectomy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29017847/the-biomarkers-neuron-specific-enolase-and-s100b-measured-the-day-following-admission-for-severe-accidental-hypothermia-have-high-predictive-values-for-poor-outcome
#19
Sebastian Wiberg, Jesper Kjaergaard, Benedict Kjærgaard, Bjarne Møller, Bo Nørnberg, Anne Marie Sørensen, Christian Hassager, Michael Wanscher
AIM: The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. METHODS: Consecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO)...
December 2017: Resuscitation
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#20
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
November 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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