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Venoarterial ecmo

Ilona Lálová, Lucie Filipovská, Hana Skalická, Ondřej Šmíd, Aleš Linhart, Helena Kollárová, Jan Bělohlávek
Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation: The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours...
2018: Case Reports in Medicine
Mary Huerter, Dean Govostis, Martin Ellenby, Eduardo Smith-Singares
Indications for extra corporeal membrane oxygenation (ECMO) have expanded in recent years, and it has become an invaluable tool in the care of adult patients in severe cardiogenic shock or respiratory failure. Understanding the physiologic effect of ECMO has also further developed, allowing for improvements in the management of the potential morbidities associated with this technology. Here, we present a case of acute bowel ischemia that developed while the patient was on central venoarterial ECMO.
March 2018: Journal of Extra-corporeal Technology
Iosif Gulkarov, James Schiffenhaus, Ivan Wong, Ashwad Afzal, Felix Khusid, Berhane Worku
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV...
March 2018: Journal of Extra-corporeal Technology
Maanasi S Mistry, Sara M Trucco, Timothy Maul, Mahesh S Sharma, Li Wang, Shawn West
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. METHODS: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
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...
February 10, 2018: Journal of Pediatric Surgery
Michele Di Mauro, Roberto Lorusso
No abstract text is available yet for this article.
February 23, 2018: Journal of Thoracic and Cardiovascular Surgery
Matthieu Schmidt, Hannah Wunsch, Daniel Brodie
No abstract text is available yet for this article.
March 12, 2018: Intensive Care Medicine
C Vignesh, Madhan Kumar, Ramesh Venkataraman, Senthilkumar Rajagopal, Nagarajan Ramakrishnan, Babu K Abraham
Overdose of cardiovascular medications such as beta blockers and calcium channel blockers cause impaired cardiac contractility, vasoplegia, and/or rhythm disturbances. In addition to conventional management of limiting absorption, increasing elimination and hemodynamic support intravenous (IV) calcium infusion, hyperinsulinemia-euglycemia therapy, glucagon infusion, and IV lipid emulsion have been tried. Extracorporeal circulatory assist device support has been reported as a rescue therapy in overdose refractory to maximal medical therapy...
February 2018: Indian Journal of Critical Care Medicine
Marian Urban, Karen Booth, John O'Sullivan, John Dark
We present a case of young female patient with end stage lung failure due to pulmonary arterial hypertension who was failing maximal medical therapy and was listed for a single sequential lung transplantation. The challenge of the case was a concomitant presence of a large atrial septal defect (ASD). The novelty of our approach was a device closure of ASD before performing a transplant with the use of intraoperative venoarterial extracorporeal membrane oxygenation (ECMO).
March 9, 2018: Annals of Thoracic Surgery
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Sandeep M Patel, Jerry Lipinski, Sadeer G Al-Kindi, Toral Patel, Petar Saric, Jun Li, Fahd Nadeem, Thomas Ladas, Amer Alaiti, Ann Phillips, Benjamin Medalion, Salil Deo, Yakov Elgudin, Marco A Costa, Mohammed Najeeb Osman, Guilherme F Attizzani, Guilherme H Oliveira, Basar Sareyyupoglu, Hiram G Bezerra
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous left ventricular assist device (Impella) and VA-ECMO remains largely unknown. We retrospectively reviewed patients treated for refractory cardiogenic shock with VA-ECMO (2014-2016). The primary outcome was all-cause mortality within 30 days of VA-ECMO implantation. Secondary outcomes included duration of support, stroke, major bleeding, hemolysis, inotropic score, and cardiac recovery...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
Rahatullah Muslem, Kadir Caliskan, Robert van Thiel, Usman Kashif, Sakir Akin, Ozcan Birim, Alina A Constantinescu, Jasper J Brugts, Jeroen J H Bunge, Jos A Bekkers, Frank W G Leebeek, Ad J J C Bogers
OBJECTIVES: Bleeding is a common complication following left ventricular assist device (LVAD) implantation. The goal of this study was to investigate the incidence, predictors and clinical outcome of early bleeding events in patients after LVAD implantation. METHODS: A total of 83 patients (age 50 ± 13 years, 76% men) had an LVAD implanted [77% HeartMate II, 19% HeartMate 3 (Abbott, Chicago, IL, USA)] over a period of 11 years. Patients were included consecutively...
February 22, 2018: European Journal of Cardio-thoracic Surgery
Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andre C Critsinelis, Suwei Wang, William E Cohn, Andrew B Civitello, O H Frazier, Jeffrey A Morgan
Implanting short-term mechanical circulatory support (MCS) devices as a bridge-to-decision is increasingly popular. However, outcomes have not been well studied in patients who receive short-term MCS before receiving long-term left ventricular assist device (LVAD) support. We analyzed outcomes in our single-center experience with long-term continuous-flow (CF)-LVAD recipients with pre-implantation short-term MCS. From November 2003 through March 2016, 526 patients (mean age, 54.7 ± 13.5 years) with chronic heart failure (mean ejection fraction, 21...
February 23, 2018: Artificial Organs
Brody Wehman, Michael Mazzeffi, Robert Chow, A Claire Watkins, Brittany Aicher, Si Pham, Whitney Burrows, Bradley Taylor
We report a patient with refractory electrical storm after coronary artery bypass grafting who was successfully treated with thoracoscopic sympathectomy. Cardiac arrest with ventricular tachycardia occurred on postoperative day 2, and the patient required emergency support with venoarterial extracorporeal membrane oxygenation. Frequent episodes of ventricular tachycardia prevented cardiac recovery and weaning from mechanical circulatory support. A percutaneous left stellate ganglion block initially demonstrated successful prevention of ventricular tachycardia, and definitive sympathetic denervation was achieved by a left thoracoscopic sympathectomy...
March 2018: Annals of Thoracic Surgery
Maziar Khorsandi, Mark Davidson, Omar Bouamra, Andrew McLean, Kenneth MacArthur, Ida Torrance, Gillian Wylie, Ed Peng, Mark Danton
Introduction: Around 3.2%-8.4% of patients receive venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support after pediatric cardiac surgery. The desired outcome is "bridge-to-recovery" in most cases. There is no universally agreed protocol, and given the associated costs and complications rates, the decisions as of when and when not to institute VA ECMO are largely empirical. Methods: A retrospective review of the ECMO database at the Scottish Pediatric Cardiac Services (SPCS) was undertaken...
January 2018: Annals of Pediatric Cardiology
Philipp M Lepper, Sabrina I Hörsch, Frederik Seiler, Annegret Kamp, Sören L Becker, Christian Lensch, Lars O Conzelmann, Hendrik Haake, Ralf M Muellenbach, Robert Bals, Markus Kredel, Frank Langer, Heinrike Wilkens, Franziska C Trudzinski
Right heart failure (RHF) because of pulmonary hypertension (PH) is a frequently encountered clinical problem with high mortality. The last resort, if pharmacological therapy fails, is mechanical circulatory support. There is a lack of percutaneous systems to support the right ventricle (RV). Venoarterial extracorporeal membrane oxygenation is widely used as a bailout in acute RHF in non-left ventricular assist device patients. Venoarterial extracorporeal membrane oxygenation does not unload the left ventricle and may cause failure of the left ventricle if used for a longer period of time...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Klaus Distelmaier, Dominik Wiedemann, Christina Binder, Thomas Haberl, Daniel Zimpfer, Gottfried Heinz, Herbert Koinig, Alessia Felli, Barbara Steinlechner, Alexander Niessner, Günther Laufer, Irene M Lang, Georg Goliasch
OBJECTIVE: The overall therapeutic goal of venoarterial extracorporeal membrane oxygenation (ECMO) in patients with postcardiotomy shock is bridging to myocardial recovery. However, in patients with irreversible myocardial damage prolonged ECMO treatment would cause a delay or even withholding of further permanent potentially life-saving therapeutic options. We therefore assessed the prognostic effect of duration of ECMO support on survival in adult patients after cardiovascular surgery...
December 26, 2017: Journal of Thoracic and Cardiovascular Surgery
Fabrice Sinnah, Marie-Amélie Dalloz, Eric Magalhaes, Ruben Wanono, Mathilde Neuville, Roland Smonig, Aguila Radjou, Bruno Mourvillier, Lila Bouadma, Jean-François Timsit, Marie-Pia d'Ortho, Any Rouvel-Tallec, Romain Sonneville
OBJECTIVES: We aimed to assess early electroencephalography findings in patients treated by venoarterial extracorporeal membrane oxygenation and their association with neurologic outcome. DESIGN: Single-center observational study. SETTING: Medical ICU of a university hospital. PATIENTS: An early standardized electroencephalography assessment, that is, standard electroencephalography followed by continuous electroencephalography, was performed in consecutive cardiogenic shock patients requiring venoarterial extracorporeal membrane oxygenation...
January 31, 2018: Critical Care Medicine
Viktor von Bahr, Håkan Kalzén, Jan Hultman, Björn Frenckner, Christin Andersson, Mikael Mosskin, Staffan Eksborg, Bernhard Holzgraefe
OBJECTIVES: To investigate the presence of cognitive dysfunction and brain lesions in long-term survivors after treatment with extracorporeal membrane oxygenation for severe respiratory failure, and to see whether patients with prolonged hypoxemia were at increased risk. DESIGN: A single-center retrospective cohort study. SETTING: Tertiary referral center for extracorporeal membrane oxygenation in Sweden. PATIENTS: Long-term survivors treated between 1995 and July 2009...
January 30, 2018: Critical Care Medicine
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