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ECMO injuried patients

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https://www.readbyqxmd.com/read/28643997/brain-monitoring-in-adult-and-pediatric-ecmo-patients-the-importance-of-early-and-late-assessments
#1
Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo DI Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote
Monitoring brain integrity and neuro-cognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643320/revised-protocol-of-extracorporeal-membrane-oxygenation-ecmo-therapy-in-severe-ards-recommendations-of-the-veno-venous-ecmo-expert-panel-appointed-in-february-2016-by-the-national-consultant-on-anesthesiology-and-intensive-care
#2
Romuald Lango, Zbigniew Szkulmowski, Dariusz Maciejewski, Andrzej Sosnowski, Krzysztof Kusza
Extracorporeal Membrane Oxygenation (ECMO) has become well established technique of the treatment of severe acute respiratory failure (Veno-Venous ECMO) or circulatory failure (Veno-Arterial ECMO) which enables effective blood oxygenation and carbon dioxide removal for several weeks. Veno-Venous ECMO (V-V ECMO ) is a lifesaving treatment of patients in whom severe ARDS makes artificial lung ventilation unlikely to provide satisfactory blood oxygenation for preventing further vital organs damage and progression to death...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28625238/-risk-factors-of-perioperative-intra-aortic-balloon-pump-complications-in-cardiac-surgery-a-12-year-single-institution-analysis
#3
Hongyan Zhou, Yonghui Zhang, Yu Du, Fangfang Cao, Ji Wang, Li Zhao, Yu Nie, Haitao Zhang
OBJECTIVE: To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. METHODS: The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#4
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28562568/rapid-improvement-of-thyroid-storm-related-hemodynamic-collapse-by-aggressive-anti-thyroid-therapy-including-steroid-pulse-a-case-report
#5
Hiroyuki Kiriyama, Eisuke Amiya, Masaru Hatano, Yumiko Hosoya, Hisataka Maki, Daisuke Nitta, Akihito Saito, Yasuyuki Shiraishi, Shun Minatsuki, Tatsuyuki Sato, Haruka Murakami, Masae Uehara, Katsunori Manaka, Noriko Makita, Masafumi Watanabe, Issei Komuro
RATIONALE: Heart failure is relatively common in patients with hyperthyroidism, but thyrotoxic cardiomyopathy with poor left ventricular (LV) systolic function is very rare. PATIENT CONCERNS: We experienced a representative case of a patient who presented with severe LV dysfunction related to thyroid storm and needed extracorporeal membrane oxygenation (ECMO) temporally. DIAGNOSIS: Thyrotoxic cardiomyopathy. INTERVENTIONS AND OUTCOMES: Aggressive antithyroid therapy, including steroid pulse to hyperthyroidism, leads to the dramatic improvement of cardiac function and she was successfully weaned from ECMO...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#6
John C Lin
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#7
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28497496/percutaneous-left-atrial-decompression-in-adults-with-refractory-cardiogenic-shock-supported-with-veno-arterial-extracorporeal-membrane-oxygenation
#8
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/28485315/assessment-of-1-year-outcomes-in-survivors-of-severe-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation-or-mechanical-ventilation-a-prospective-observational-study
#9
Zhi-Yong Wang, Tong Li, Chun-Ting Wang, Lei Xu, Xin-Jing Gao
BACKGROUND: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population. METHODS: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28470346/the-icm-research-agenda-on-extracorporeal-life-support
#10
REVIEW
Alain Combes, Dan Brodie, Yih-Sharng Chen, Eddy Fan, José P S Henriques, Carol Hodgson, Philipp M Lepper, Pascal Leprince, Kunihiko Maekawa, Thomas Muller, Sebastian Nuding, Dagmar M Ouweneel, Antoine Roch, Matthieu Schmidt, Hiroo Takayama, Alain Vuylsteke, Karl Werdan, Laurent Papazian
PURPOSE: This study aimed to concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to extracorporeal membrane oxygenation (ECMO). METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
May 3, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28469686/left-ventricular-mechanical-support-with-the-impella-during-extracorporeal-membrane-oxygenation
#11
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/28460592/anticoagulation-and-transfusions-management-in-veno-venous-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-assessment-of-factors-associated-with-transfusion-requirements-and-mortality
#12
Gennaro Martucci, Giovanna Panarello, Giovanna Occhipinti, Veronica Ferrazza, Fabio Tuzzolino, Diego Bellavia, Filippo Sanfilippo, Cristina Santonocito, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Antonio Arcadipane
PURPOSE: We describe an approach for anticoagulation and transfusions in veno-venous-extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. METHODS: Observational study on consecutive adults supported with VV-ECMO for acute respiratory distress syndrome (ARDS). We targeted an activated partial thromboplastin time of 40 to 50 seconds and a hematocrit of 24% to 30%. Univariate and multiple analyses were done to evaluate factors associated with transfusion requirements and the influence of increasing transfusions on mortality during ECMO...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28459322/fifty-years-of-research-in-ards-is-extracorporeal-circulation-the-future-of-acute-respiratory-distress-syndrome-management
#13
Alain Combes, Antonio Pesenti, V Marco Ranieri
Mechanical ventilation (MV) remains the cornerstone of acute respiratory distress syndrome (ARDS) management. It guarantees sufficient alveolar ventilation, high FiO2 concentration, and high positive end-expiratory pressure levels. However, experimental and clinical studies have accumulated, demonstrating that MV also contributes to the high mortality observed in patients with ARDS by creating ventilator-induced lung injury. Under these circumstances, extracorporeal lung support (ECLS) may be beneficial in two distinct clinical settings: to rescue patients from the high risk for death associated with severe hypoxemia, hypercapnia, or both not responding to maximized conventional MV, and to replace MV and minimize/abolish the harmful effects of ventilator-induced lung injury...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28416430/-extracorporeal-membrane-oxygenation-in-critically-ill-neonates-and-children
#14
J Rambaud, J Guilbert, I Guellec, S Jean, A Durandy, M Demoulin, A Amblard, R Carbajal, P-L Leger
Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest)...
June 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28394816/brain-mri-findings-in-pediatric-patients-post-ecmo
#15
Venessa L Pinto, Sumit Pruthi, Ashly C Westrick, Chevis N Shannon, Brian C Bridges, Truc M Le
Neurologic complications can occur with ECMO due to several factors. Prior studies identified neonates as having unique risk factors and neuro-imaging findings post-ECMO. The aim of this study is to describe brain MRI findings of pediatric patients treated with ECMO. We conducted a retrospective study of non-neonatal pediatric patients who underwent a comprehensive brain MRI after ECMO, between January 2000 and July 2015. We identified 47 pediatric patients in the study cohort with a median age of 8 months (IQR 3-170mo) and a median ECMO run duration of 7...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#16
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28368919/a-national-perspective-on-ecmo-utilization-in-patients-with-burn-injury
#17
Lauren B Nosanov, Melissa M McLawhorn, Mariana Vigiola Cruz, Jason H Chen, Jeffrey W Shupp
Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28361068/use-of-distal-perfusion-in-peripheral-extracorporeal-membrane-oxygenation
#18
George Makdisi, Tony Makdisi, I-Wen Wang
Extra corporeal membrane oxygenation (ECMO) is a life-saving technique to manage refractory cardiopulmonary failure. Its usage and indication continue to increase. Femoral venoarterial ECMO (VA ECMO) is relatively less invasive and the cardiac support may be more rapidly instituted in in these extremely tenuous patients. Vascular injuries and limb ischemia unfortunately occur in these emergent access settings. Here we will discuss the optimal techniques of preventing this complication which might affect patient survival and impact the patient quality of life...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28359588/centrifugal-pumps-and-hemolysis-in-pediatric-extracorporeal-membrane-oxygenation-ecmo-patients-an-analysis-of-extracorporeal-life-support-organization-elso-registry-data
#19
Ciaran O'Brien, Julie Monteagudo, Christine Schad, Eva Cheung, William Middlesworth
PURPOSE: It is currently unclear whether centrifugal pumps cause more hemolysis than roller pumps in extracorporeal membrane oxygenation (ECMO) circuits. The aim of this study was to help answer that question in pediatric patients. METHODS: A limited deidentified data set was extracted from the international multicenter Extracorporeal Life Support Organization (ELSO) registry comprising all reported ECMO runs for patients 18years or younger between 2010 and 2015...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28283699/opening-pressures-and-atelectrauma-in-acute-respiratory-distress-syndrome
#20
Massimo Cressoni, Davide Chiumello, Ilaria Algieri, Matteo Brioni, Chiara Chiurazzi, Andrea Colombo, Angelo Colombo, Francesco Crimella, Mariateresa Guanziroli, Ivan Tomic, Tommaso Tonetti, Giordano Luca Vergani, Eleonora Carlesso, Vladimir Gasparovic, Luciano Gattinoni
PURPOSE: Open lung strategy during ARDS aims to decrease the ventilator-induced lung injury by minimizing the atelectrauma and stress/strain maldistribution. We aim to assess how much of the lung is opened and kept open within the limits of mechanical ventilation considered safe (i.e., plateau pressure 30 cmH2O, PEEP 15 cmH2O). METHODS: Prospective study from two university hospitals. Thirty-three ARDS patients (5 mild, 10 moderate, 9 severe without extracorporeal support, ECMO, and 9 severe with it) underwent two low-dose end-expiratory CT scans at PEEP 5 and 15 cmH2O and four end-inspiratory CT scans (from 19 to 40 cmH2O)...
May 2017: Intensive Care Medicine
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