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Extracorporeal membrane

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https://www.readbyqxmd.com/read/28551923/-extracorporeal-membrane-oxygenation-in-israel-6-5-years-of-experience-at-the-largest-ecmo-treatment-center-in-israel
#1
Philip Biderman, Uri Carmi, Michael Fainblut, Oren Bachar, Benny Medallion, Dan Aravot
AIMS: The primary purpose of the study is to evaluate the characteristics of the population treated with ECMO at Beilinson Hospital, the treatment results and a comparison of results with ECMO centers in the world. The treatment outcomes relative to the experience of the team during the years 2008-2014 were also examined. The secondary purpose of this article is to increase the awareness of the medical staff to ECMO as a treatment option for patients with appropriate indications, where indications have increased in recent years...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28551379/review-of-1-000-consecutive-extracorporeal-membrane-oxygenation-runs-as-a-quality-initiative
#2
Harold N Lovvorn, Daphne C Hardison, Heidi Chen, Ashly C Westrick, Melissa E Danko, Brian C Bridges, William F Walsh, John B Pietsch
BACKGROUND: Extracorporeal membrane oxygenation is a resource-intensive mode of life-support potentially applicable when conventional therapies fail. Given the initial success of extracorporeal membrane oxygenation to support neonates and infants in the 1980s, indications have expanded to include adolescents, adults, and selected moribund patients during cardiopulmonary resuscitation. This single-institution analysis was conducted to evaluate programmatic growth, outcomes, and risk for death despite extracorporeal membrane oxygenation across all ages and diseases...
May 24, 2017: Surgery
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#3
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#4
Per Werner Moller, Berhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Martin Bloch, Soren Sondergaard, Stephan M Matthias Jakob, Jukka Takala, David Christian Berger
The relevance of right atrial pressure (RAP) as the back-pressure for venous return (QVR) and mean systemic filling pressure (MSFP) as up-stream pressure is controversial during dynamic changes of circulation. To examine the immediate response of QVR (sum of caval vein flows) to changes in RAP and pump function we used a closed chest, central cannulation, heart bypass porcine preparation (n=10) with veno-arterial extracorporeal membrane oxygenation (ECMO). MSFP was determined by clamping ECMO tubing with open or closed arterio-venous shunt at Euvolemia, Volume Expansion (9...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28546860/predictors-of-intracranial-hemorrhage-in-adult-patients-on-extracorporeal-membrane-oxygenation-an-observational-cohort-study
#5
Alexander Fletcher Sandersjöö, Jiri Bartek, Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman, Bo-Michael Bellander
BACKGROUND: Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH in this patient category are poorly understood. The purpose of this study was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who were treated with ECMO for less than 12 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#6
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#7
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/28546374/pediatric-ards
#8
Ira M Cheifetz
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28542046/elective-venovenous-extracorporeal-membrane-oxygenation-for-resection-of-endotracheal-tumor-a-case-report
#9
W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard
We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery...
May 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28538440/neurologic-injury-in-adults-supported-with-veno-venous-extracorporeal-membrane-oxygenation-for-respiratory-failure-findings-from-the-extracorporeal-life-support-organization-database
#10
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Michele Di Mauro, Fabio Barili, Gijs Geskes, Enrico Vizzardi, Peter T Rycus, Raf Muellenbach, Thomas Mueller, Antonio Pesenti, Alain Combes, Giles Peek, Bjorn Frenckner, Matteo Di Nardo, Justyna Swol, Jos Maessen, Ravi R Thiagarajan
OBJECTIVES: To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING: Data reported to Extracorporeal Life Support Organization from 350 international extracorporeal membrane oxygenation centers during 1992-2015. PATIENTS: Adults (≥ 18 yr old) supported with veno-venous extracorporeal membrane oxygenation for respiratory failure...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#11
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28536661/successful-use-of-extracorporeal-membrane-oxygenation-for-the-treatment-of-cardiogenic-shock-due-to-scorpion-envenomation
#12
Amine Tarmiz, Imene Mgarrech, Chokri Kortas, Sofiane Jerbi
Introduction. The occurrence of a cardiogenic shock is a rare presentation after scorpion envenomation. The treatment includes classically the use of inotropes and specific vasodilators. Case Presentation. We report a case of an 11-year-old boy presenting with cardiogenic shock and pulmonary edema after a scorpion sting. Despite adequate management at the emergency department and intensive care unit, the patient's hemodynamic status worsened rapidly, justifying his transfer to our department for ventricular mechanical assistance by venoarterial extracorporeal membrane oxygenation...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28536282/predicting-survival-after-extracorporeal-membrane-oxygenation-for-ards-an-external-validation-of-resp-and-preserve-scores
#13
Jennifer Brunet, Xavier Valette, Dimitrios Buklas, Philippe Lehoux, Pierre Verrier, Bertrand Sauneuf, Calin Ivascau, Yves Dalibert, Amélie Seguin, Nicolas Terzi, Gérard Babatasi, Damien du Cheyron, Jean-Jacques Parienti, Cédric Daubin
BACKGROUND: We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. METHODS: All consecutive patients treated with ECMO for refractory ARDS, regardless of cause, in the Caen University Hospital in northwestern France over the last decade were included in a retrospective cohort study. The receiver operating characteristic curves of each score were plotted, and the area under the curve was computed to assess their performance in predicting mortality (c-index)...
May 23, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28535518/extracorporeal-sorbent-technologies-basic-concepts-and-clinical-application
#14
William R Clark, Fiorenza Ferrari, Gaetano La Manna, Claudio Ronco
Limitations imposed by the characteristics of some solutes and the structure of dialysis membranes have spurred new interest in the use of mechanisms beyond diffusion and convection for extracorporeal solute removal. Sorbents have been utilized for more than 50 years in extracorporeal blood treatments for specific purposes, and better understanding of their basic aspects may further expand the potential for their clinical application. In this chapter, the basic principles applying to sorbents are discussed, including composition and structure, along with the fundamental mechanisms of solute removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535198/transcatheter-aortic-valve-implantation-for-recurrent-valsalva-sinus-re-dissection-and-severe-aortic-regurgitation-shortly-after-surgery-for-type-a-aortic-dissection
#15
Elena Caporali, Giovanni Pedrazzini, Stefanos Demertzis, Enrico Ferrari
Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#16
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#17
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528989/infections-during-extracorporeal-membrane-oxygenation-epidemiology-risk-factors-pathogenesis-and-prevention
#18
REVIEW
Stefano Biffi, Stefano Di Bella, Vittorio Scaravilli, Anna Maria Peri, Giacomo Grasselli, Laura Alagna, Antonio Pesenti, Andrea Gori
Extracorporeal membrane oxygenation (ECMO) is a life support technique used in patients with respiratory and/or cardiac failure. The ECMO circuit consists of vascular cannulae, a pump and an artificial lung. Infections are among the most common complications associated with ECMO and have a significant impact on the mortality rate. Here we present a narrative literature review regarding the epidemiology, risk factors, pathogenesis and prevention of infectious complications during ECMO support. The prevalence of hospital-acquired infections during ECMO is 10-12% and their occurrence is likely to be more frequent compared with other critically ill patients...
May 18, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28525615/embolic-foreign-material-in-the-central-nervous-system-of-pediatric-autopsy-patients-with-instrumented-heart-disease
#19
Matthew Torre, Mirna Lechpammer, Vera Paulson, Sanjay Prabhu, Audrey C Marshall, Amy L Juraszek, Robert F Padera, Elizabeth A Bundock, Sara O Vargas, Rebecca D Folkerth
Upon detection of foreign-body embolization to the central nervous system (CNS) following a specific invasive cardiovascular procedure in 1 autopsied child, we undertook a quality assurance analysis to determine whether other patients had had similar events. Autopsies of all infants and children with history of cardiac catheterization, heart surgery on cardiopulmonary bypass, and/or extracorporeal membrane oxygenation over a 5-year period at a single tertiary care institution were reviewed for light-microscopic evidence of foreign material...
May 19, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#20
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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