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https://www.readbyqxmd.com/read/27904968/outcome-measures-of-extracorporeal-life-support-ecls-in-trauma-patients-versus-patients-without-trauma-a-7-year-single-center-retrospective-cohort-study
#1
Christopher Ull, Thomas A Schildhauer, Justus T Strauch, Justyna Swol
This single-center retrospective study included a total of 99 extracorporeal life support (ECLS) cannulated patients assigned to a traumatic extracorporeal life-support cohort (TECLS) or a non-traumatic extracorporeal life-support cohort (NTECLS). Forty-nine TECLS patients and 50 NTECLS patients were compared. The TECLS patients were significantly younger [49.9 years 16.6-86.2 vs. 57.1 (21.4-78.6); p = 0.007] and had lower body mass indices (BMIs) [27.7 kg/m(2) (20-37) vs. 32.5 (19-88.5); p = 0.001] than the NTECLS patients...
November 30, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation-case-series-and-literature-review
#2
Minhyeok Lee, Seulgi Kim, Oh Jung Kwon, Ji Hye Kim, Inbeom Jeong, Ji Woong Son, Moon Jun Na, Yoo Sang Yoon, Hyun Woong Park, Sun Jung Kwon
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir...
November 30, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27903392/-resuscitation-efficacy-of-extracorporeal-membrane-oxygenation-in-non-postcardiotomy-adult-patients-with-cardiac-arrest
#3
L Huang, Y W Liu, T Li, X M Hu, D W Duan, P Wu
Objective: To evaluate the resuscitation efficacy of extracorporeal membrane oxygenation (ECMO) for non-postcardiotomy cardiac arrest adult patients post failed conventional cardiopulmonary resuscitation (CCPR). Methods: We retrospectively analyzed the clinical data of a total of 25 consecutive adults who suffered from non-postcardiotomy cardiac arrest and were treated with ECMO post failed CCPR in our hospital between January 2010 and January 2015. Inclusion criteria included: 18 to 75 years old; the duration from cardiac arrest to CCPR initiation<5 minutes; no recovery of spontaneous circulation within 10 min after implementation of standard CCPR, and the length of CCPR <90 minutes...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#4
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903207/direct-cerebral-perfusion-and-cooling-in-experimental-cardiac-arrest
#5
Rinaldo Bellomo, Bruno Marino, Peter Angelopoulos, Scott Carson, Glenn Eastwood, Junko Kosaka, Naoya Iguchi, Andrew Hilton, Clive May
BACKGROUND: Cerebral protection is a key priority during cardiac arrest (CA). However, current approaches are suboptimal. OBJECTIVE: To test whether direct perfusion and cooling of the anterior cerebral circulation by means of cerebral vessel cannulation and extracorporeal membrane oxygenation (ECMO) increases cerebral oxygenation and induces cerebral hypothermia during CA. METHODS: We performed proof-of-concept animal experiments in sheep...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903204/service-delivery-model-of-extracorporeal-membrane-oxygenation-in-an-australian-regional-hospital
#6
Joe McCaffrey, Neil R Orford, Nicholas Simpson, Jill Lamb Jenkins, Christopher Morley, Vin Pellegrino
BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) for adults in regional centres with low numbers of patients receiving ECMO is unclear. A robust service delivery model may assist in the quality provision of ECMO. OBJECTIVE: To describe a novel ECMO service delivery model in a regional Australian hospital, reporting on patient characteristics and outcomes before and after its implementation. METHODS: An observational cohort study of all patients receiving ECMO at the University Hospital Geelong intensive care unit before and after implementation of a new ECMO clinical service model...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#7
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27902647/extracorporeal-membrane-oxygenation-associated-bloodstream-infections-in-children
#8
David F Butler, Brian Lee, Erica Molitor-Kirsch, Jason G Newland
This was a case-control study of extracorporeal membrane oxygenation (ECMO) cases spanning five years. Bloodstream infection (BSI) occurred in 12/207 subjects, with Candida sp.-4, Pseudomonas sp.-2, and Staphylococcal sp.-2 being predominant. No risk factors for BSI were identified. Exposure to broad spectrum antibiotics was common in both BSI and control patients. Prophylactic antimicrobials did not decrease risk for BSI.
November 28, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27902621/total-laparoscopic-right-hemicolectomy-with-3-step-stapled-intracorporeal-isoperistaltic-ileocolic-anastomosis-for-colon-cancer-an-evaluation-of-short-term-outcomes
#9
Tu Jian-Cheng, Wang Shu-Sheng, Zhang Bo, Fang Jian, Zhou Liang
Laparoscopic right hemicolectomy with extracorporeal anastomosis is a widely used procedure; several authors have published their approach to intracorporeal anastomosis. In this paper, we present an approach developed by us and compare short-term outcomes with those of extracorporeal anastomosis in colon cancer patients.Retrospective review of colon cancer patients treated with laparoscopic right hemicolectomy either with intracorporeal anastomosis (TLG group) or extracorporeal anastomosis (LG group) at the Zhangjiagang Hospital Affiliated to Soochow University between January 2011 and October 2015...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27901553/a-prediction-and-simulation-model-for-target-oriented-regional-citrate-calcium-anticoagulation-in-extracorporeal-blood-purification
#10
Martin Brandl, Karlheinz Kellner
AIMS: Regional citrate-calcium anticoagulation is becoming more and more attractive for extracorporeal treatments in the clinical routine. METHODS: A prediction and simulation tool for the safe application of RCA during extracorporeal treatments was introduced. The model predicts the course of the ionized calcium level in the patient and the current anticoagulation status in the extracorporeal circuit based on the actual settings of the dialysis machine. RESULTS: The simulation tool delivers areas in which the blood and dialysate flow can be adjusted to reach the desired target values for RCA and predicts the time course of several parameters during treatment...
November 29, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#11
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899041/electromagnetic-and-electrohydraulic-shock-wave-lithotripsy-induced-urothelial-damage-is-there-a-difference
#12
Mahmoud Mustafa, Honood Aburas, Fatema Helo, Laila Qarawi
PURPOSE: To evaluate and compare the acute effect of electromagnetic and electrohydraulic extracorporeal shock wave lithotripsy (SWL) on the urothelial layers of kidney and ureter. MATERIALS AND METHODS: Fifty patients (29 males (58%), 21 females (42%), with average age 51.68 years (range: 37-70) who underwent SWL application in two different centers were included. Twenty-eight patients (56%) were treated with electrohydraulic and 22 (44%) were treated with electromagnetic lithotripsy...
November 29, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#13
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#14
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#15
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#16
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27897967/an-observational-study-of-donor-ex-vivo-lung-perfusion-in-uk-lung-transplantation-develop-uk
#17
Andrew Fisher, Anders Andreasson, Alexandros Chrysos, Joanne Lally, Chrysovalanto Mamasoula, Catherine Exley, Jennifer Wilkinson, Jessica Qian, Gillian Watson, Oli Lewington, Thomas Chadwick, Elaine McColl, Mark Pearce, Kay Mann, Nicola McMeekin, Luke Vale, Steven Tsui, Nizar Yonan, Andre Simon, Nandor Marczin, Jorge Mascaro, John Dark
BACKGROUND: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. OBJECTIVE: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. DESIGN: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27896819/extracorporeal-membrane-oxygenation-outcomes-after-the-comprehensive-stage-ii-procedure-in-patients-with-single-ventricles
#18
Daniel Gomez, Vicky Duffy, Diane Hersey, Carl Backes, Peter Rycus, Patrick McConnell, Jordan Voss, Mark Galantowicz, Clifford L Cua
Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with single ventricle physiology (SVP) undergoing cavopulmonary connection (Glenn procedure). An alternative surgical pathway for patients with SVP consists of an initial hybrid procedure followed by a comprehensive Stage II procedure. No data exist describing the outcomes of patients requiring ECMO after the comprehensive Stage II procedure. The goal of this study is to describe the outcomes for patients who required ECMO after the comprehensive Stage II procedure...
November 29, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27896787/extracorporeal-membrane-oxygenation-for-pheochromocytoma-induced-cardiogenic-shock
#19
Guillaume Hekimian, Fatima Kharcha, Nicolas Bréchot, Matthieu Schmidt, Cécile Ghander, Guillaume Lebreton, Xavier Girerd, Christophe Tresallet, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt
BACKGROUND: Pheochromocytoma, a rare catecholamine-producing tumor, might provoke stress-induced Takotsubo-like cardiomyopathy and severe cardiogenic shock. Because venoarterial-extracorporeal membrane oxygenation (VA-ECMO) rescue of pheochromocytoma-induced refractory cardiogenic shock has rarely been reported, we reviewed our ICU patients' presentations and outcomes. METHODS: All pheochromocytoma-induced refractory cardiogenic shock cases managed with VA-ECMO (January 2007-March 2015) were prospectively included and reviewed...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27896375/-extracorporeal-co2-removal-as-an-alternative-to-tracheotomy-in-a%C3%A2-patient-with-extubation-failure
#20
A Redel, M Ritzka, S Kraus, A Philipp, H-J Schlitt, B Graf, T Bein
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours...
November 28, 2016: Der Anaesthesist
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