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ECMO injuried patients

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https://www.readbyqxmd.com/read/29783818/-continuous-renal-replacement-therapy-combined-with-extracorporeal-membrane-oxygenation-for-pediatric-cardiopulmonary-failure
#1
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/29766320/weaning-from-prolonged-veno-venous-extracorporeal-membrane-oxygenation-ecmo-after-transfer-to-a-specialized-center-a-retrospective-study
#2
Frederik Seiler, Franziska C Trudzinski, Sabrina I Hörsch, Annegret Kamp, Carlos Metz, Monika Flaig, Mohammad Alqudrah, Holger Wehrfritz, Markus Kredel, Ralf M Muellenbach, Hendrik Haake, Robert Bals, Philipp M Lepper
Veno-venous extracorporeal membrane oxygenation (vvECMO) is increasingly used as rescue therapy in severe respiratory failure. In patients with pre-existent lung diseases or persistent lung injury weaning from vvECMO can be challenging. This study sought to investigate outcomes of patients transferred to a specialized ECMO center after prolonged ECMO therapy. We performed a retrospective analysis of all patients admitted to our medical intensive care unit (ICU) between 01/2013 and 12/2016 who were transferred from an external ICU after > 8 days on vvECMO...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29762229/what-is-the-optimal-blood-pressure-on-veno-arterial-extracorporeal-membrane-oxygenation-impact-of-mean-arterial-pressure-on-survival
#3
Daizo Tanaka, Shogo Shimada, Megan Mullin, Kristin Kreitler, Nicholas Cavarocchi, Hitoshi Hirose
Blood pressure management is crucial for patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Lower pressure can lead to end-organ malperfusion, whereas higher pressure may compete with ECMO flow and cardiac output. The impact of mean arterial pressure (MAP) on outcomes of patients on VA ECMO was evaluated. Patients who were supported on VA ECMO from September 2010 to March 2016 were retrospectively analyzed for average MAP throughout their course on ECMO, excluding the first and last day...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29757498/clinical-determinants-of-successful-weaning-from-extracorporeal-membrane-oxygenation-in-patients-with-fulminant-myocarditis
#4
Manabu Matsumoto, Yasuhide Asaumi, Yuichi Nakamura, Takeshi Nakatani, Toshiyuki Nagai, Tomoaki Kanaya, Shoji Kawakami, Satoshi Honda, Yu Kataoka, Seiko Nakajima, Osamu Seguchi, Masanobu Yanase, Kunihiro Nishimura, Yoshihiro Miyamoto, Kengo Kusano, Toshihisa Anzai, Teruo Noguchi, Tomoyuki Fujita, Junjiro Kobayashi, Hatsue Ishibashi-Ueda, Hiroaki Shimokawa, Satoshi Yasuda
AIMS: Patients with fulminant myocarditis (FM) often present with cardiogenic shock and require mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist device (VAD) implantation. This study sought to clarify the determinants of successful weaning from ECMO in FM patients. METHODS AND RESULTS: We studied 37 consecutive FM patients supported by ECMO as the initial form of mechanical circulatory support between January 1995 and December 2014 in our hospital...
May 14, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29750039/impact-of-an-inline-extracorporeal-membrane-oxygenation-hemofilter-system-in-neonatal-acute-kidney-injury
#5
Mohammed Azar, Abdulrahman Alamir, Abdullah Thabet Al Qahtani, Al Mokali Khamisa, Khalid Alfakeeh
Extracorporeal membrane oxygenation (ECMO) is considered a recognized lifesaving support for patients with cardiorespiratory failure. Acute kidney injury (AKI) and fluid overload are significant morbidity factors resulting in serious complications. The inline hemofilter system (IHS) and the continuous renal replacement therapy (CRRT) machine are different methods of renal replacement therapy for patients with ECMO. IHS is the alternate, safe dialysis modality of choice because it is user-friendly, inexpensive, and efficiently removes fluid overload and renal diffusive clearance...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#6
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29732184/spontaneous-breathing-during-veno-venous-extracorporeal-membrane-oxygenation
#7
REVIEW
Stefania Crotti, Nicola Bottino, Elena Spinelli
Veno-venous extracorporeal membrane oxygenation (VV ECMO) has started to be applied in awake spontaneously breathing patients as an alternative to invasive mechanical ventilation. As the physiologic cardiorespiratory variability is increased in this condition, the dynamic interaction between patient respiratory activity and extracorporeal system function affects the clinical management. The effect of extracorporeal CO2 removal on patient respiratory drive is variable and not always predictable, with some patients responding to CO2 removal with a decrease in respiratory rate and effort and other patients demonstrating a persistently high work of breathing independent on CO2 unload...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29730351/traumatically-brain-injured-donors-and-the-impact-on-lung-transplant-survival
#8
Todd C Crawford, Cecillia Lui, J Trent Magruder, Alejandro Suarez-Pierre, Jinny S Ha, Robert S Higgins, Stephen R Broderick, Christian A Merlo, Bo S Kim, Errol L Bush
BACKGROUND: Concern has been raised over inferior lung transplant survival associated with traumatic brain injury (TBI) organ donors. Our purpose was to explore the relationship between TBI donors and lung transplant survival in the lung allocation score (LAS) era. METHODS: We queried the UNOS Scientific Registry of Transplant Recipients and identified all adult (≥18 years) lung transplants performed from May 4, 2005 to December 31, 2015. Recipients were dichotomized based on donor cause of death, TBI versus non-TBI, propensity scored across eight variables (final LAS, pre-transplant ICU admission, pre-transplant ECMO, donor age ≥50 years, CMV antibody recipient-/donor+, ischemia time, annual center transplant volume, single versus double lung transplant), and matched 1:1 without replacement...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29714432/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-center-experience-in-turkey
#9
Emel Okulu, F. Begüm Atasay, Gaffari Tunç, Hasan Akduman, Ömer Erdeve, Saadet Arsan, Zeynep Eyileten, Tayfun Uçar, H. Ercan Tutar
Background/aim: Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with respiratory failure, cardiac failure, or both. The aim of this study was to evaluate neonates supported with ECMO and report our experience as a Turkish neonatal intensive care unit. Materials and methods: We retrospectively reviewed 11 newborn infants treated with ECMO at Ankara University for respiratory and cardiac failure. We reported the demographic, diagnostic, laboratory, and clinical data of the patients...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#10
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29644151/trans-cranial-doppler-as-an-ancillary-study-supporting-irreversible-brain-injury-in-a-post-cardiac-arrest-patient-on-extracorporeal-membrane-oxygenation
#11
Naresh Mullaguri, Aarti Sarwal, Nakul Katyal, Premkumar Nattanamai, Pravin George, Christopher R Newey
Obtaining neuroimaging in patients on cardiopulmonary support devices such as extracorporeal membrane oxygenation (ECMO) can be challenging, given the complexities in monitoring, instrumentation, and associated hemodynamic lability. Transcranial Doppler (TCD) is used as an ancillary test for the assessment of cerebral circulatory arrest, but its use in non-pulsatile blood flow in venoarterial (VA) ECMO is not well described. We report the use of TCD in a patient on VA ECMO post-cardiac arrest for evaluation of death by neurological criteria...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29566407/intracranial-hemorrhage-and-early-mortality-in-patients-receiving-extracorporeal-membrane-oxygenation-for-severe-respiratory-failure
#12
Deepa R J Arachchillage, Maurizio Passariello, Michael Laffan, T C Aw, Leah Owen, Winston Banya, Richard Trimlett, Cliff Morgan, Brijesh V Patel, John Pepper, Stephane Ledot
Intracranial hemorrhage (ICH) is a serious complication in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) and is associated with high mortality. It is unknown whether ICH may be a consequence of the ECMO or of an underlying disease. The authors first aimed to assess the incidence of ICH at initiation and during the course of VV-ECMO and its associated mortality. The second aim was to identify clinical and laboratory measures that could predict the development of ICH in severe respiratory failure...
March 22, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29551243/evaluating-quality-of-life-of-extracorporeal-membrane-oxygenation-survivors-using-the-pediatric-quality-of-life-inventory-survey
#13
Yangyang R Yu, Jennifer L Carpenter, Annalyn S DeMello, Sundeep G Keswani, Darrell L Cass, Oluyinka O Olutoye, Adam M Vogel, James A Thomas, Cole Burgman, Caraciolo J Fernandes, Timothy C Lee
PURPOSE: This study assesses the impact of extracorporeal membrane oxygenation (ECMO) associated morbidities on long-term quality of life (QOL) outcomes. METHODS: A single center, retrospective review of neonatal and pediatric non-cardiac ECMO survivors from 1/2005-7/2016 was performed. The 2012 Pediatric Quality of Life Inventory™ (PedsQL™) survey was administered. Clinical outcomes and QOL scores between groups were compared. RESULTS: Of 74 patients eligible, 64% (35 NICU, 12 PICU) completed the survey...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29500117/extracorporeal-membrane-oxygenation-in-severe-respiratory-failure-resulting-from-burns-and-smoke-inhalation-injury
#14
Lajos Szentgyorgyi, Chloe Shepherd, Ken W Dunn, Peter Fawcett, Julian M Barker, Paul Exton, Marc O Maybauer
Extracorporeal membrane oxygenation (ECMO) is one of the most frequent forms of extracorporeal life support (ECLS) and can be used as rescue therapy in patients with severe respiratory failure resulting from burns and/or smoke inhalation injury. Experience and literature on this treatment option is still very limited, consequently results are varied. We report a retrospective analysis of our experience with veno-venous (VV) ECMO in burn patients. All five patients, three male and two female (age: 28-37 years) had flame type burns and smoke inhalation injury...
February 27, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29497534/intravenous-immunoglobulin-fails-to-improve-ards-in-patients-undergoing-ecmo-therapy
#15
Stefanie Prohaska, Andrea Schirner, Albina Bashota, Andreas Körner, Gunnar Blumenstock, Helene A Haeberle
Background: Acute respiratory distress syndrome (ARDS) is associated with high mortality rates. ARDS patients suffer from severe hypoxemia, and extracorporeal membrane oxygenation (ECMO) therapy may be necessary to ensure oxygenation. ARDS has various etiologies, including trauma, ischemia-reperfusion injury or infections of various origins, and the associated immunological responses may vary. To support the immunological response in this patient collective, we used intravenous IgM immunoglobulin therapy to enhance the likelihood of pulmonary recovery...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#16
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29422067/predictors-of-hospital-mortality-in-adult-trauma-patients-receiving-extracorporeal-membrane-oxygenation-for-advanced-life-support-a-retrospective-cohort-study
#17
Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions. METHODS: This retrospective study enrolled 36 adult trauma patients receiving ECMO due to advanced shock or respiratory failure in a level I trauma center between August 2006 and October 2014...
February 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29397959/neuromonitoring-in-the-neonatal-ecmo-patient
#18
REVIEW
Nan Lin, John Flibotte, Daniel J Licht
Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to advances in medical and surgical management, overall mortality has decreased. However, short and long-term neurological morbidity has remained high. Therefore, increasing attention has been focused on multimodal neuromonitoring to track and optimally, minimize or prevent intracranial injury...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29360002/does-acute-kidney-injury-affect-survival-in-adults-with-acute-respiratory-distress-syndrome-requiring-extracorporeal-membrane-oxygenation
#19
Richard Devasagayaraj, Nicholas C Cavarocchi, Hitoshi Hirose
INTRODUCTION: Patients who develop severe acute respiratory distress syndrome (ARDS) despite full medical management may require veno-venous extracorporeal membrane oxygenation (VV ECMO) to support respiratory function. Survival outcomes remain unclear in those who develop acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) during VV ECMO for isolated severe respiratory failure in adult populations. METHODS: A retrospective chart review (2010-2016) of patients who underwent VV ECMO for ARDS was conducted with university institutional review board (IRB) approval...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29340723/veno-venous-extracorporeal-membrane-oxygenation-vv-ecmo-for-acute-respiratory-failure-following-injury-outcomes-in-a-high-volume-adult-trauma-center-with-a-dedicated-unit-for-vv-ecmo
#20
Jay Menaker, Ronald B Tesoriero, Ali Tabatabai, Ronald P Rabinowitz, Christopher Cornachione, Terence Lonergan, Katelyn Dolly, Raymond Rector, James V O'Connor, Deborah M Stein, Thomas M Scalea
INTRODUCTION: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) has increased over the past decade. The purpose of this study was to evaluate outcomes in adult trauma patients requiring VV ECMO. METHODS: Data were collected on adult trauma patients admitted between January 1, 2015, and November 1, 2016. Demographics, injury-specific data, ECMO data, and survival to discharge were recorded. Medians [interquartile range (IQR)] were reported. A p value ≤0...
January 16, 2018: World Journal of Surgery
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