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ECMO injuried patients

Gabriella Di Lascio, Edvin Prifti, Elmi Messai, Adriano Peris, Guy Harmelin, Roland Xhaxho, Albana Fico, Guido Sani, Massimo Bonacchi
INTRODUCTION: Status asthmaticus is a life-threatening condition characterized by progressive respiratory failure due to asthma that is unresponsive to standard therapeutic measures. We used extracorporeal membrane oxygenation (ECMO) to treat patients with near-fatal status asthamticus who did not respond to aggressive medical therapies and mechanical ventilation under controlled permissive hypercapnia. MATERIALS AND METHODS: Between January 2011 and October 2015, we treated 16 adult patients with status asthmaticus (8 women, 8 men, mean age: 50...
October 6, 2016: Perfusion
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Charles Marinus Pedersen, Reinhold Jensen, Christian Lindskov
Extracorporeal membrane oxygenation (ECMO) can support gas exchange independently of mechanical ventilation in patients with severe acute respiratory failure. Veno-venous ECMO is a temporary technique for providing life support by pulmonary dysfunction. ECMO should be considered for patients with respiratory failure when they cannot survive with conventional therapy. ECMO may be used either as a rescue therapy or to prevent ventilator-associated lung injury. Exact criteria for ECMO are not available. Transportation while using ECMO is safe when a team from the management centre provides it...
September 19, 2016: Ugeskrift for Laeger
Amy Cheng, Feifei Williams, James Fortenberry, Catherine Preissig, Steven Salinas, Pradip Kamat
Ehrlichiosis, caused by transmission of Ehrlichia chaffeensis to humans through the bite of an infected lone star tick, can lead to secondary hemophagocytic lymphohistiocytosis (HLH), a life-threatening condition caused by uncontrolled activation of the cellular immune system. We describe a child with HLH secondary to ehrlichiosis who developed multiorgan failure and was successfully managed with extracorporeal membrane oxygenation (ECMO). A 9-year-old boy developed headaches, fever, and sore throat after suspected tick exposure...
September 15, 2016: Pediatrics
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
Joo Han Song, Won Ki Woo, Seung Hwan Song, Hyo Hyun Kim, Bong Joon Kim, Ha Eun Kim, Do Jung Kim, Jee Won Suh, Yu Rim Shin, Han Ki Park, Seung Hyun Lee, Hyun Chel Joo, Sak Lee, Byung Chul Chang, Kyung Jong Yoo, Young Sam Kim, Young Nam Youn
BACKGROUND: Cardiac surgery with cardiopulmonary bypass (CPB) is a known risk factor for acute respiratory distress syndrome (ARDS). We aimed to analyze the treatment outcome in patients who required veno-venous extracorporeal membrane oxygenation (VV-ECMO) for postcardiotomy ARDS despite other rescue modalities. METHODS: We retrospectively reviewed the outcomes in 13 patients (mean age, 54.7±5.9 years) who received VV-ECMO support for refractory ARDS after cardiac surgery between March 2013 and February 2016 at Severance Hospital, Yonsei University (Seoul, Korea)...
July 2016: Journal of Thoracic Disease
Pramod K Guru, Tarun D Singh, Melissa Passe, Kianoush B Kashani, Gregory J Schears, Rahul Kashyap
BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) in refractory cardiorespiratory failure is gaining momentum with recent advancements in technology. However, the need for dialysis modes such as continuous renal replacement therapy (CRRT) has also increased in the management for acute kidney injury. Establishing the exact timing of CRRT initiation in these patients from the electronic medical record is vital for automated data extraction for research and quality improvement efforts...
2016: Applied Clinical Informatics
Atsushi Sato, Kikuo Isoda, Yodo Gatate, Koji Akita, Hiroyuki Daida
A 69-year-old man was admitted to our hospital with cardiopulmonary arrest. Percutaneous cardio-pulmonary support (PCPS) using the right femoral artery and vein was initiated, because ventricular fibrillation continued. Although we succeeded in defibrillation after percutaneous coronary intervention (PCI), a chest radiograph indicated a pneumothorax in the right lung and a pulmonic contusion in the left lung caused by cardiopulmonary resuscitation. Two days after PCI, partial pressure of arterial oxygen (PaO2) from the right radial artery suddenly decreased, and his cardiac function showed improvement on an echocardiogram...
2016: Internal Medicine
Marlina E Lovett, Todd J Karsies
Independent lung ventilation is an infrequently used ventilation strategy in the Pediatric Intensive Care Unit, but can be beneficial in unique patient subsets, such as patients who have asymmetric pulmonary pathology. Independent lung ventilation allows for the independent delivery of the appropriate effective tidal volume to each lung based upon individual compliance and pathology. In theory, it may help avoid alveolar overdistension and ventilator induced lung injury in the non-diseased lung. In addition, it allows for targeted interventions...
July 15, 2016: Annals of the American Thoracic Society
Zi-Hao Yang, Bo-Tao Ning, Chen-Mei Zhang, Ru Lin, Sheng Ye, Tao Liu
BACKGROUND: This study aimed to discribe the experience in supporting children with refractory cardiopulmonary failure with extracorporeal membrane oxygenation (ECMO). METHODS: We retrospectively reviewed 12 children with refractory cardiopulmonary failure supported with ECMO from February 2009 to August 2015 in the Pediatric Intensive Care Unit (PICU), Children's Hospital, Zhejiang University School of Medicine. RESULTS: Seven of the 12 patients were weaned successfully from ECMO and dischaged from the hospital, with a survival rate of 58...
August 2016: World Journal of Pediatrics: WJP
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No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Davide Chiumello, Matteo Brioni
BACKGROUND: Acute respiratory distress syndrome (ARDS) is characterized by a noncardiogenic pulmonary edema with bilateral chest X-ray opacities and reduction in lung compliance, and the hallmark of the syndrome is hypoxemia refractory to oxygen therapy. Severe hypoxemia (PaO2/FiO2 < 100 mmHg), which defines severe ARDS, can be found in 20-30 % of the patients and is associated with the highest mortality rate. Although the standard supportive treatment remains mechanical ventilation (noninvasive and invasive), possible adjuvant therapies can be considered...
2016: Critical Care: the Official Journal of the Critical Care Forum
Lin Lyu, Cun Long, Feilong Hei, Bingyang Ji, Jinping Liu, Kun Yu, Liang Chen, Jingxin Yao, Qiang Hu, Jinxiao Hu, Guodong Gao
OBJECTIVE: Hemolysis is a common and severe complication during extracorporeal membrane oxygenation (ECMO). Increased plasma free hemoglobin (PFHb) is related to renal injury. The aim of this study was to investigate whether increased PFHb during adult venous-arterial ECMO was associated with acute renal failure (ARF). DESIGN: A retrospective, observational, single-center study. SETTING: Fuwai Hospital in Beijing, China. PARTICIPANTS: The study comprised 84 venous-arterial ECMO patients...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
S Lavoue, G Le Gac, A Gacouin, M Revest, L Sohier, J Mouline, S Jouneau, E Flecher, P Tattevin, J-M Tadié
OBJECTIVE: To describe two cases of Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) necrotizing pneumonia treated with ECMO, and complete pulmonary evaluation at six months. METHODS: Retrospective analysis of two patients presenting with severe PVL-SA pneumonia who both underwent complete respiratory function testing and chest CT scan six months after hospital discharge. RESULTS: Indications for ECMO were refractory hypoxia and left ventricular dysfunction associated with right ventricular dilatation...
September 2016: Médecine et Maladies Infectieuses
Bryan Boling, Donna R Dennis, Thomas A Tribble, Navin Rajagopalan, Charles W Hoopes
PURPOSE: Venovenous extracorporeal membrane oxygenation (VV ECMO) is an effective therapy in patients with acute lung injury and end-stage lung disease. Although immobility increases the risk of complications, ambulation of patients on VV ECMO is not the standard of care in many institutions. Staff concerns for patient safety remain a barrier to ambulation. In this case series, we present our experience utilizing a nurse-driven ambulatory VV ECMO process to safely rehabilitate patients...
June 2016: Progress in Transplantation
Chia-Hsuin Chang, Hsi-Chieh Chen, James L Caffrey, Jiun Hsu, Jou-Wei Lin, Mei-Shu Lai, Yih-Sharng Chen
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) provides circulatory and respiratory support for patients with severe acute cardiopulmonary failure. The objective of this study was to examine the survival outcomes for patients who received ECMO. METHODS AND RESULTS: Adult patients who received ECMO from September 1, 2002, to December 31, 2012, were identified from the Taiwan National Health Insurance Database associated with coronary artery bypass graft surgery, myocardial infarction/cardiogenic shock, injury, and infection/septic shock...
June 14, 2016: Circulation
Gianluca Villa, Nevin Katz, Claudio Ronco
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is an effective therapy for patients with reversible cardiac and/or respiratory failure. Acute kidney injury (AKI) often occurs in patients supported with ECMO; it frequently evolves into chronic kidney damage or end-stage renal disease and is associated with a reported 4-fold increase in mortality rate. Although AKI is generally due to the hemodynamic alterations associated with the baseline disease, ECMO itself may contribute to maintaining kidney dysfunction through several mechanisms...
December 2015: Cardiorenal Medicine
Xin Chang, Xin Li, Zhen Guo, Lingfeng Xu, Lin Sun, Dan Shi, Hua Xu
OBJECTIVE: To analyze the reason and treatment of the complications of 61 cases of extracorporeal membrane oxygenation (ECMO) in order to improve survival rate of ECMO treatment. METHODS: ECMO records from January 2007 to December 2014 in Shanghai Chest Hospital were investigated retrospectively focusing on complications. There were included 43 male and 18 female patients, age 3 to 66 years. Indications for ECMO included post-operative low cardiac output, viral myocarditis, bridge to heart transplantation, acute respiratory distress syndrome and myocardial infarction...
May 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Chia-Hsiung Liu, Shuenn-Wen Kuo, Li-Ming Hsu, Shu-Chien Huang, Chih-Hsien Wang, Pi-Ru Tsai, Yih-Sharng Chen, Tzuu-Shuh Jou, Wen-Je Ko
BACKGROUND: Extracellular peroxiredoxin 1 (Prdx1) has been implicated to play a pivotal role in regulating inflammation; however, its function in tissue hypoxia-induced inflammation, such as severe cardiogenic shock patients, has not yet been defined. Thus, the objective of this study was to test the hypothesis that Prdx1 possesses prognostic value and instigates systemic inflammatory response syndrome in cardiogenic shock patients undergoing extracorporeal membrane oxygenation (ECMO) support...
2016: Journal of Translational Medicine
Elio Antonucci, Irene Lamanna, David Fagnoul, Jean-Louis Vincent, Daniel De Backer, Fabio Silvio Taccone
Acute kidney injury (AKI) is common in patients treated with veno-arterial (VA-) or veno-venous (VV-) extracorporeal membrane oxygenation (ECMO). In this setting, the use of continuous renal replacement therapy (CRRT) can help to optimize fluid status but may also negatively impact on patients' outcome. In contrast, the relationship between AKI, CRRT, and survival in critically ill adult patients receiving ECMO is not well defined. The institutional ECMO database (n = 162) from November 2008 to December 2013, excluding patients with ICU survival <24 hours was reviewed...
August 2016: Artificial Organs
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