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ECMO and renal failure

Patrick Vollmar, Matthias Lubnow, Michaela Simon, Thomas Müller, Tobias Bergler, Philipp Alois, Bryan R Thoma, Sandra Essbauer
In Germany Puumala virus (PUUV), known to cause mild forms of hemorrhagic fever with renal syndrome (HFRS), is the predominating endemic hantavirus. We herein describe an unusually severe case of a PUUV infection that occurred in summer 2015 in South Eastern Germany in a region known to be endemic for PUUV since over ten years. A 54-year-old female gardener was admitted to hospital with fever, cough and dyspnea. Within 48hours the patient developed a rapid progressive adult respiratory distress syndrome (ARDS) with circulatory failure and required ECMO (extracorporeal membrane oxygenation) treatment...
October 4, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
R Wang, B Sun, X Y Li, H Y He, X Tang, Q Y Zhan, Z H Tong
OBJECTIVE: To investigate the predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO). METHODS: Forty-two patients with severe ARF supported by VV-ECMO were enrolled from November 2009 to July 2015.There were 25 males and 17 females. The mean age was (44±18) years (rang 18-69 years). Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ⅲ, Ⅳ, Simplified Acute Physiology Score Ⅱ (SAPS) Ⅱ, Sequential Organ Failure Assessment (SOFA), ECMO net, PRedicting dEath for SEvere ARDS on VVECMO (PRESERVE), and Respiratory ECMO Survival Prediction (RESP) scores were collected within 6 hours before VV-ECMO support...
September 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
Fabrice Vanhuyse, Nicolas Ducrocq, Huguette Louis, Narimane Al Kattani, Nicolas Laurent, Frédérique Joineau-Groubatch, Aude Falanga, Juan-Pablo Maureira, Antoine Kimmoun, Nicolas Girerd, Nguyen Tran, Bruno Levy
Cardiogenic shock (CS) patients treated with ECMO have severe cardiac failure, associated with ischemia-reperfusion. The use of moderate hypothermia during ischemia-reperfusion syndrome is supported by experimental data. We therefore studied the effects of moderate hypothermia on cardiac and vascular function in pig ischemic CS treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Cardiogenic shock was induced in 12 anesthetized pigs by coronary ligation. After one hour of CS, VA-ECMO was initiated and pigs were randomized to normothermia (38°C) or moderate hypothermia (34°C) during 8 hours...
August 2, 2016: Shock
Xiaoli Fan, Zhiquan Chen, David Nasralla, Xianpeng Zeng, Jing Yang, Shaojun Ye, Yi Zhang, Guizhu Peng, Yanfeng Wang, Qifa Ye
Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes...
October 2016: Clinical Transplantation
Pramod K Guru, Tarun D Singh, Melissa Passe, Kianoush B Kashani, Gregory J Schears, Rahul Kashyap
BACKGROUND: The role of extracorporeal membrane oxygenation (ECMO) in refractory cardiorespiratory failure is gaining momentum with recent advancements in technology. However, the need for dialysis modes such as continuous renal replacement therapy (CRRT) has also increased in the management for acute kidney injury. Establishing the exact timing of CRRT initiation in these patients from the electronic medical record is vital for automated data extraction for research and quality improvement efforts...
2016: Applied Clinical Informatics
Benjamin Acheampong, Jonathan N Johnson, John M Stulak, Joseph A Dearani, Sudhir S Kushwaha, Richard C Daly, Dawit T Haile, Gregory J Schears
BACKGROUND: Cardiac operations in high-risk adult congenital heart disease (ACHD) patients may require mechanical circulatory support (MCS), such as extracorporeal membrane oxygenation (ECMO) or intraaortic balloon pump (IABP), to allow the cardiopulmonary system to recover. METHODS: We reviewed records for all ACHD patients who required MCS following cardiotomy at our institution from 1/2001 to 12/2013. RESULTS: During the study period, 2264 (mean age 39...
July 20, 2016: Congenital Heart Disease
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No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Lin Lyu, Cun Long, Feilong Hei, Bingyang Ji, Jinping Liu, Kun Yu, Liang Chen, Jingxin Yao, Qiang Hu, Jinxiao Hu, Guodong Gao
OBJECTIVE: Hemolysis is a common and severe complication during extracorporeal membrane oxygenation (ECMO). Increased plasma free hemoglobin (PFHb) is related to renal injury. The aim of this study was to investigate whether increased PFHb during adult venous-arterial ECMO was associated with acute renal failure (ARF). DESIGN: A retrospective, observational, single-center study. SETTING: Fuwai Hospital in Beijing, China. PARTICIPANTS: The study comprised 84 venous-arterial ECMO patients...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Gianluca Villa, Nevin Katz, Claudio Ronco
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is an effective therapy for patients with reversible cardiac and/or respiratory failure. Acute kidney injury (AKI) often occurs in patients supported with ECMO; it frequently evolves into chronic kidney damage or end-stage renal disease and is associated with a reported 4-fold increase in mortality rate. Although AKI is generally due to the hemodynamic alterations associated with the baseline disease, ECMO itself may contribute to maintaining kidney dysfunction through several mechanisms...
December 2015: Cardiorenal Medicine
Mohammed Quader, Damien J LaPar, Luke Wolfe, Gorav Ailawadi, Jeffrey Rich, Alan Speir, Clifford Fonner, Vigneshwar Kasirajan
Patient and institutional factors predictive of delayed sternal closure (DSC) practice and its impact on clinical and cost outcomes when compared with primary sternal closure (PSC) following continuous-flow left ventricular assist device (CF-LVAD) implantation were examined. Statewide Society of Thoracic Surgeons and hospital cost data on CF-LVADs implanted were analyzed. Between January 2007 and December 2013, 558 CF-LVADs were implanted (PSC = 464, 83.2%; DSC = 94, 16.8%). Among the six institutions implanting CF-LVADs, DSC practice ranged from 3...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Elio Antonucci, Irene Lamanna, David Fagnoul, Jean-Louis Vincent, Daniel De Backer, Fabio Silvio Taccone
Acute kidney injury (AKI) is common in patients treated with veno-arterial (VA-) or veno-venous (VV-) extracorporeal membrane oxygenation (ECMO). In this setting, the use of continuous renal replacement therapy (CRRT) can help to optimize fluid status but may also negatively impact on patients' outcome. In contrast, the relationship between AKI, CRRT, and survival in critically ill adult patients receiving ECMO is not well defined. The institutional ECMO database (n = 162) from November 2008 to December 2013, excluding patients with ICU survival <24 hours was reviewed...
August 2016: Artificial Organs
Caroline Der Nigoghossian, Amy L Dzierba, Joshua Etheridge, Russel Roberts, Justin Muir, Daniel Brodie, Greg Schumaker, Matthew Bacchetta, Robin Ruthazer, John W Devlin
STUDY OBJECTIVES: To compare sedative dose requirements during the 6-hour period when they are greatest in patients with severe acute respiratory distress syndrome (ARDS), as well as the time from severe ARDS onset to reach this maximum sedation exposure, between patients with severe ARDS who were managed either with or without extracorporeal membrane oxygenation (ECMO). Also, to explore factors other than ECMO use that may influence sedation requirements during this period of maximum sedation...
June 2016: Pharmacotherapy
Andres Oswaldo Razo-Vazquez, Kevin Thornton
Extracorporeal membrane oxygenation (ECMO) use in adults is rapidly increasing in its use for both cardiac and respiratory failure. ECMO exists in 2 primary configurations: veno-venous ECMO, used in the setting of isolated respiratory failure, and veno-arterial ECMO, which can be used in respiratory failure but is mandatory in the setting of cardiac failure. Acute kidney injury occurs frequently in patients on ECMO, and renal replacement therapy is often required. Continuous forms of renal replacement therapy predominate, but there is a high degree of variation in clinical practice among ECMO centers internationally...
May 2016: Advances in Chronic Kidney Disease
Sandeep Chauhan, Kamal P Sharma, Akshay K Bisoi, Raju Pangeni, Karan Madan, Yogendra S Chauhan
Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by accumulation of excessive lung surfactant in the alveoli leading to restrictive lung functions and impaired gas exchange. Whole lung lavage (WLL) is the treatment modality of choice, which is usually performed using double lumen endobronchial tube insertion under general anesthesia and alternating unilateral lung ventilation and washing with normal saline. It may be difficult to perform WLL in patients with severe hypoxemia wherein patients do not tolerate single lung ventilation...
April 2016: Annals of Cardiac Anaesthesia
Charles-Edouard Luyt, Nicolas Bréchot, Pierre Demondion, Tamara Jovanovic, Guillaume Hékimian, Guillaume Lebreton, Ania Nieszkowska, Matthieu Schmidt, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes
PURPOSE: The frequency of neurological events and their impact on patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) are unknown. We therefore study the epidemiology, risk factors, and impact of cerebral complications occurring in VV-ECMO patients. METHODS: Observational study conducted in a tertiary referral center (2006-2012) on patients developing a neurological complication (ischemic stroke or intracranial bleeding) while on VV-ECMO versus those who did not, and a systematic review on this topic...
May 2016: Intensive Care Medicine
Maziar Khorsandi, Kasra Shaikhrezai, Sai Prasad, Renzo Pessotto, William Walker, Geoffrey Berg, Vipin Zamvar
BACKGROUND: Post-cardiotomy cardiogenic shock (PCCS) has an incidence of 2-6 % after routine adult cardiac surgery. 0.5-1.5 % are refractory to inotropic and intra-aortic balloon pump (IABP) support. Advanced mechanical circulatory support (AMCS) can be used to salvage carefully selected number of such patients. High costs and major complication rates have lead to centralization and limited funding for such devices in the UK. We have looked the outcomes of such devices in a non-transplant, intermediate-size adult cardiothoracic surgery unit...
2016: Journal of Cardiothoracic Surgery
Mariusz Kuśmierczyk, Mateusz Kuć, Jarosław Szymański, Andrzej Juraszek, Piotr Kołsut, Krzysztof Kuśmierski, Tomasz Zieliński, Małgorzata Sobieszczańska-Małek, Ewa Sitkowska-Rysiak
INTRODUCTION: Mechanical circulatory support (MCS) is a recognised method of treatment for patients with end-stage chronic or acute heart failure. The POLCAS pulsatile-flow system has been used in our institution for 15 years. Currently, it is being widely replaced by continuous-flow mechanical circulatory support equipment of the second and third generations (HeartMateII, HeartWare). The MCS presented in this study is associated with a significant risk of complications and its use is increasingly considered controversial...
September 2015: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Sang Yoon Kim, Sungkyu Cho, Eunseok Choi, Woong-Han Kim
Mixing of autologous blood with priming volume has relatively significant effects on blood composition, especially in low-bodyweight neonates. In an effort to reduce these effects, mini-volume priming (MP) has been applied in cardiopulmonary bypass (CPB). The present study was designed to examine the effect of MP on clinical outcomes of low-bodyweight neonates undergoing open heart surgery.We retrospectively reviewed medical records of low-bodyweight (2.5 kg or less) neonates who underwent open heart surgery in our center from January 2000 to December 2014...
January 2016: Artificial Organs
Lin Lv, Cun Long, Jinping Liu, Feilong Hei, Bingyang Ji, Kun Yu, Qiang Hu, Jinxiao Hu, Yuan Yuan, Guodong Gao
Acute renal failure (ARF) is associated with increased mortality in pediatric extracorporeal membrane oxygenation (ECMO). The aim of this study was to identify predictors of ARF during ECMO in pediatric patients after cardiac surgery. A retrospective study analyzed 42 children (≤15 years) after cardiac surgery requiring venous-arterial ECMO between December 2008 and December 2014 at Fuwai Hospital. ARF was defined as ≥300% rise in serum creatinine (SCr) concentration from baseline or application of dialysis...
May 2016: Artificial Organs
Norihiro Kuroki, Daisuke Abe, Toru Iwama, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe, Kazutaka Aonuma, Akira Sato
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can improve survival in patients with cardiogenic shock or cardiac arrest. We investigated the association between initial renal function and clinical outcome in patients undergoing VA-ECMO for cardiogenic shock and cardiac arrest. METHODS: This was a single-center, retrospective cohort study of 287 patients who underwent ECMO at our hospital from January 2005 to December 2014. We excluded 70 patients with non-cardiogenic events...
November 20, 2015: Journal of Cardiology
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