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https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#1
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#2
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28497496/percutaneous-left-atrial-decompression-in-adults-with-refractory-cardiogenic-shock-supported-with-veno-arterial-extracorporeal-membrane-oxygenation
#3
Mosaad Alhussein, Mark Osten, Eric Horlick, Heather Ross, Eddy Fan, Vivek Rao, Filio Billia
BACKGROUND AND AIM OF THE STUDY: Left ventricular (LV) distention, a recognized complication in patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock, can lead to pulmonary edema, increased myocardial oxygen consumption, and LV thrombus formation. Atrial septostomy was examined as a management strategy for LV distension. METHODS: Of 72 patients supported with VA-ECMO, seven patients underwent atrial septostomy through a trans-septal approach...
May 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28496031/atrial-septostomy-for-left-atrial-decompression-during-extracorporeal-membrane-oxygenation-by-inoue-balloon-catheter
#4
Yen-Nien Lin, Yin-Huei Chen, Huang-Joe Wang, Jui-Sung Hung, Kuan-Cheng Chang, Ping-Han Lo
BACKGROUND: Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients.Methods and Results:We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014...
May 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28494178/suicide-attempt-with-self-made-taxus-baccata-leaf-capsules-survival-following-the-application-of-extracorporeal-membrane-oxygenation-for-ventricular-arrythmia-and-refractory-cardiogenic-shock
#5
Fanny Vardon Bounes, Elsa Tardif, Stéphanie Ruiz, Jean-Christophe Gallart, Jean-Marie Conil, Clément Delmas
CONTEXT: Yew intoxication has been known for many years; high dose ingestion of Taxus baccata leads to cardiac toxicity mediated by calcium and sodium channel blocking properties. We present a case report of a patient who attempted suicide after T. baccata ingestion, causing refractory cardiogenic shock requiring temporary circulatory assistance by veno-arterial extra corporeal membrane oxygenation (VA ECMO). CASE DETAILS: A 28-year-old man was admitted to the critical care unit of a university hospital for arrhythmia after ingestion of self-made T...
May 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28489648/clinical-experience-with-iv-angiotensin-ii-administration-a-systematic-review-of-safety
#6
Laurence W Busse, Xueyuan Shelly Wang, Divya M Chalikonda, Kevin W Finkel, Ashish K Khanna, Harold M Szerlip, David Yoo, Sharon L Dana, Lakhmir S Chawla
OBJECTIVE: Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II. DATA SOURCES: PubMed, Medline, Scopus, and Cochrane. STUDY SELECTION: Studies in which human subjects received IV angiotensin II were selected whether or not safety was discussed. DATA EXTRACTION: In total, 18,468 studies were screened by two reviewers and one arbiter...
May 9, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28482382/-application-of-improved-regional-citrate-anticoagulation-in-continuous-hemofiltration-in-children
#7
K Bai, C J Liu, Y Q Fu, F Xu
Objective: To investigate the application of regional citrate anticoagulation with calcium hemofiltration basic solution in continuous hemofiltration in children. Method: The clinical data of 18 patients with citrate anticoagulation in continuous hemofiltration in children, excluding the hepatic failure and septic shock cases, were analyzed retrospectively, from September 2015 to August 2016 in Intensive Care Unit of the Children's Hospital of Chongqing Medical University.The commercial calcium hemofiltration basic solution was used as displacement liquid ...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28472406/short-term-mechanical-circulatory-support-as-a-bridge-to-durable-left-ventricular-assist-device-implantation-in-refractory-cardiogenic-shock-a-systematic-review-and-meta-analysis
#8
Corstiaan A den Uil, Sakir Akin, Lucia S Jewbali, Dinis Dos Reis Miranda, Jasper J Brugts, Alina A Constantinescu, Arie Pieter Kappetein, Kadir Caliskan
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016...
May 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28470925/modalities-and-effects-of-left-ventricle-unloading-on-extracorporeal-life-support-a-review-of-the-current-literature
#9
Paolo Meani, Sandro Gelsomino, Eshan Natour, Daniel M Johnson, Hans-Peter Brunner La Rocca, Federico Pappalardo, Elham Bidar, Maged Makhoul, Giuseppe Raffa, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Niels Sluijpers, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan Willem Sels, Marcel van de Poll, Paul Roekaerts, Thomas Poels, Eric Korver, Zaheer Babar, Jos Maessen, Roberto Lorusso
INTRODUCTION/AIM: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature. METHODS: A systematic literature search was performed in the PubMed database: 207 articles published between 1993 and 2016 were included...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470920/a-rationale-for-early-extracorporeal-membrane-oxygenation-in-patients-with-postinfarction-ventricular-septal-rupture-complicated-by-cardiogenic-shock
#10
Daniel Rob, Rudolf Špunda, Jaroslav Lindner, Vilém Rohn, Jan Kunstýř, Martin Balík, Jan Rulíšek, Petr Kopecký, Michal Lipš, Ondřej Šmíd, Tomáš Kovárník, František Mlejnský, Aleš Linhart, Jan Bělohlávek
AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470918/isolated-left-ventricular-failure-is-a-predictor-of-poor-outcome-in-patients-receiving-veno-arterial-extracorporeal-membrane-oxygenation
#11
Corstiaan A den Uil, Lucia S Jewbali, Martijn J Heeren, Alina A Constantinescu, Nicolas M Van Mieghem, Dinis Dos Reis Miranda
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28469686/left-ventricular-mechanical-support-with-the-impella-during-extracorporeal-membrane-oxygenation
#12
Kasra Moazzami, Elena V Dolmatova, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
Background: Venoarterial extracorporeal membrane oxygenation (ECMO) provides systemic arterial support without directly unloading the left heart, which causes an elevated left ventricular (LV) pressure. The aim of the present study was to investigate the adjunctive application of the Impella device for LV unloading in patients during ECMO. Methods: This retrospective cohort study included patients who received Impella support in addition to venoarterial ECMO between April 2012 and December 2015. ECMO cannulation was performed peripherally or centrally, while the Impella device was surgically inserted into the femoral artery or the right axillary artery...
January 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28466294/-cardiac-support-and-replacement-systems
#13
REVIEW
T Graf, H Thiele
In recent years, the widespread use of partial mechanical cardiac support and even temporary complete replacement of cardiac function has been established in many intensive care units in the treatment of refractory cardiogenic shock. There is a difference between partial left-ventricular assist devices (LVAD) and the possibility of complete heart (and lung) replacement by extra corporeal life support (ECLS). Despite the use of mechanical support devices, the mortality of cardiogenic shock remains high. The consideration of using percutaneous LVAD and ECLS in cardiogenic shock should be considered in refractory cardiogenic shock patients in addition to support by catecholamines and after early revascularization in acute coronary syndromes...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28460808/emergency-department-septic-shock-patient-mortality-with-refractory-hypotension-vs-hyperlactatemia-a-retrospective-cohort-study
#14
Michael D April, Chase Donaldson, Lloyd I Tannenbaum, Tyler Moore, Jose Aguirre, Alexander Pingree, James H Lantry
BACKGROUND: Our objective was to compare in-hospital mortality among emergency department (ED) patients meeting trial-based criteria for septic shock based upon whether presenting with refractory hypotension (systolic blood pressure<90mmHg after 1L intravenous fluid bolus) versus hyperlactatemia (initial lactate≥4mmol/L). METHODS: We conducted a retrospective cohort analysis by chart review of ED patients admitted to an intensive care unit with suspected infection during 1 August 2012-28 February 2015...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28454472/hsp90-inhibitor-sy-016-induces-g2-m-arrest-and-apoptosis-in-paclitaxel-resistant-human-ovarian-cancer-cells
#15
Hyun Gyo Lee, Won Jin Park, So Jin Shin, Sang Hoon Kwon, Soon Do Cha, Young Ho Seo, Ju Hui Jeong, Ji Yoon Lee, Chi Heum Cho
The aim of the present study was to evaluate the in vitro effect of a heat shock protein (Hsp)90 inhibitor, SY-016, on the paclitaxel (PTX)-resistant human ovarian cancer cell line OVCAR-3PTX, and explore its mechanism of apoptosis. In the present study, SY-016 was used in combination with PTX to determine its effect on the cell proliferation and apoptosis of OVCAR-3PTX cells. The drug-resistant tumor cells were established in vitro by stepwise sequential exposure to increasing concentrations of PTX. The cell viability and cell cycle distribution were measured by MTT assay and flow cytometric analysis, respectively...
April 2017: Oncology Letters
https://www.readbyqxmd.com/read/28453594/-shock-as-an-adverse-reaction-to-rituximab-case-report
#16
Estefanía Palma, Vicente González, Daniela Grünholz, María Landaeta, María Mallea, José Pérez, Tomás Armstrong
Rituximab is a plausible alternative first-line treatment of ANCA-associated vasculitis. Adverse effects related to its infusion are common and usually have a benign course. However, there have been reports of refractory cardiogenic shock simulating septic shock. We report an 81-year-old male with the diagnosis of ANCA associated vasculitis. Rituximab 500 mg was administered intravenously for a relapse. The infusion proceeded without incident. However, 24 hours after its administration the patient began with fever, chills, coughing and strong malaise...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#17
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28425079/outcome-of-patients-with-septic-shock-and-high-dose-vasopressor-therapy
#18
Thomas Auchet, Marie-Alix Regnier, Nicolas Girerd, Bruno Levy
BACKGROUND: Despite the dissemination of international guidelines, mortality from septic shock remains high. Norepinephrine is recommended as first-line vasopressor therapy with a target mean arterial pressure of 65 mmHg. High-dose vasopressor (HDV) may also be required. This study aimed to assess survival in patients with septic shock requiring HDV. We conducted a retrospective study of patients admitted between January 2008 and December 2013 to a 13-bed ICU for septic shock and receiving high-dose vasopressor therapy (defined by a dose >1 µg/kg/min)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28419300/short-term-mechanical-circulatory-support-for-cardiogenic-shock-in-severe-peripartum-cardiomyopathy-la-piti%C3%A3-salp%C3%A3%C2%AAtri%C3%A3-re-experience
#19
Nadia Bouabdallaoui, Pierre Demondion, Pascal Leprince, Guillaume Lebreton
OBJECTIVES: Mechanical circulatory support (MCS) is a valuable option in the setting of cardiogenic shock (CS), although MCS use in severe forms of peripartum cardiomyopathy (PPCM) is underreported. We aimed to investigate maternal outcomes under MCS for refractory CS complicating PPCM. METHODS: We retrospectively reviewed 10 consecutive patients (2010-2015) meeting diagnosis criteria of PPCM that were managed with peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO) for severe CS...
April 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28416468/cardiac-transplantation-in-children-and-adolescents-with-long-qt-syndrome
#20
Angela M Kelle, J Martijn Bos, Susan P Etheridge, Bryan C Cannon, Randall M Bryant, Jonathan N Johnson, Michael J Ackerman
BACKGROUND: Long QT syndrome (LQTS) is a potentially lethal, yet highly treatable, cardiac channelopathy. Cardiac transplantation has been reported anecdotally for patients with severe LQTS refractory to standard therapies. OBJECTIVE: The purpose of this study was to evaluate the incidence of and risk factors for cardiac transplantation in children evaluated and treated in an LQTS specialty center. METHODS: This was a retrospective review of 349 children with LQTS (mean age at diagnosis, 8...
April 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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