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vent wean

Prashant Rao, Jarrod Mosier, Joshua Malo, Vicky Dotson, Christopher Mogan, Richard Smith, Roy Keller, Marvin Slepian, Zain Khalpey
Cardiogenic shock and cardiac arrest are life-threatening emergencies that result in high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via peripheral cannulation is an option for patients who do not respond to conventional therapies. Left ventricular (LV) distention is a major limitation with peripheral VA-ECMO and is thought to contribute to poor recovery and the inability to wean off VA-ECMO. We report on a novel technique that combines peripheral VA-ECMO with off-pump insertion of a trans-apical LV venting cannula and a right ventricular decompression cannula...
February 1, 2018: Perfusion
Markus Kredel, Steffen Kunzmann, Paul-Gerhardt Schlegel, Matthias Wölfl, Peter Nordbeck, Christoph Bühler, Christopher Lotz, Philipp M Lepper, Johannes Wirbelauer, Norbert Roewer, Ralf M Muellenbach
BACKGROUND The use of venoarterial extracorporeal membrane oxygenation (va-ECMO) via peripheral cannulation for septic shock is limited by blood flow and increased afterload for the left ventricle. CASE REPORT A 15-year-old girl with acute myelogenous leukemia, suffering from severe septic and cardiogenic shock, was treated by venoarterial extracorporeal membrane oxygenation (va-ECMO). Sufficient extracorporeal blood flow matching the required oxygen demand could only be achieved by peripheral cannulation of both femoral arteries...
June 28, 2017: American Journal of Case Reports
Ahmed M A Mohammed, Robert J Dennis
A patient with Prader-Willi Syndrome was admitted to the ICU with features of recurrent acute gastric dilatation, aspiration pneumonia and a massive pulmonary embolus. He was initially managed with intubation, assisted ventilation, intravenous fluids and anticoagulation. Decompression of the stomach was achieved with a nasogastric tube. After ventilator weaning, he did not tolerate the nasogastric intubation that led to a further episode of aspiration pneumonia as a result of non-resolving gastric dilatation...
2016: Journal of Surgical Case Reports
Tae Hee Hong, Joung Hun Byun, Byung Ha Yoo, Sang Won Hwang, Han Yong Kim, Jae Hong Park
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in patients with cardiogenic shock. Insufficient decompression of the left ventricle (LV) is considered a major factor preventing adequate LV recovery. A 40-year-old male was diagnosed with acute myocardial infarction, and revascularization was performed using percutaneous stenting. However, cardiogenic shock occurred, and VA ECMO was initiated. Severe LV failure developed, and percutaneous transaortic catheter venting (TACV) was incorporated into the venous circuit of VA ECMO under transthoracic echocardiography guidance...
June 2015: Korean Journal of Thoracic and Cardiovascular Surgery
Fabio Sangalli, Gianluca Greco, Lucia Galbiati, Francesco Formica, Serena Calcinati, Leonello Avalli
We present the case of a woman assisted with veno-arterial extracorporeal membrane oxygenation (v-a ECMO) for postischemic cardiogenic shock, who developed left ventricular thrombosis despite systemic anticoagulation and left ventricular apical venting. We successfully achieved local thrombolysis with tenecteplase administered through the venting cannula to obtain local thrombolysis while reducing systemic effects to a minimum. The procedure was effective with mild systemic bleeding and the patient was successfully weaned off the extracorporeal support a few days thereafter...
June 2015: Journal of Cardiac Surgery
Chilsung Kim, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang
Percutaneous extracorporeal life support (P-ECLS) is a useful modality for the management of refractory cardiac or pulmonary failure. However, venoarterial P-ECLS may result in a complication of left ventricular distension. In this case report, we discuss a patient with drug-induced dilated cardiomyopathy managed with venoarterial P-ECLS and a left atrial vent catheter. The venoarterial P-ECLS was modified to a paracorporeal left ventricular assist device (LVAD) by removing the femoral venous cannula. After 28 days of hospitalization, the patient was successfully weaned from the paracorporeal LVAD and discharged home from the hospital...
August 2014: Korean Journal of Thoracic and Cardiovascular Surgery
Zaccaria Ricci, Chiara Pezzella, Stefano Romagnoli, Francesca Iodice, Roberta Haiberger, Adriano Carotti, Paola Cogo
OBJECTIVES: Haemolysis is known to occur during surgery on cardiopulmonary bypass (CPB) and to be responsible for kidney injury. The aim of this study was to assess, in a cohort of infants, the reference levels of free haemoglobin (fHb) and their change over time postoperatively; the predicting variables of haemolysis in the intraoperative phase; and the association between fHb and renal function. METHODS: A retrospective analysis in infants undergoing surgery on CPB was conducted...
August 2014: Interactive Cardiovascular and Thoracic Surgery
Stany Sandrio, Wolfgang Springer, Matthias Karck, Matthias Gorenflo, Alexander Weymann, Arjang Ruhparwar, Tsvetomir Loukanov
BACKGROUND: The aim of this study was to evaluate our experience in central extracorporeal life support with an integrated left ventricular vent in children with cardiac failure. METHODS: Eight children acquired extracorporeal life support with a left ventricular vent, either after cardiac surgery (n = 4) or during an acute cardiac illness (n = 4). The ascending aorta and right atrium were cannulated. The left ventricular vent was inserted through the right superior pulmonary vein and connected to the venous line on the extracorporeal life support such that active left heart decompression was achieved...
August 2014: Cardiology in the Young
William J Vernick, E Andrew Ochroch, Jiri Horak, Mary Hammond, W Clark Hargrove
OBJECTIVE: To evaluate the accuracy of Doppler-derived transmitral valve gradients immediately after mitral valve repair by comparing them with near simultaneously obtained direct catheter gradients. DESIGN: A prospective study. SETTING: A tertiary care medical center. PARTICIPANTS: Twenty elective adult surgical patients presenting for mitral valve repair surgery. METHODS: Mitral valve surgery proceeded in standard fashion except for the use of a smaller than usual left ventricular vent catheter (Medtronic DLP 10 French left heart vent catheter)...
July 2013: Journal of Cardiac Surgery
D Bradford Sanders, Steven R Sowell, Brigham Willis, John Lane, Christopher Pierce, Stephen Pophal, Francisco A Arabia, John J Nigro
Acute myocardial failure associated with myocarditis is highly lethal. Left ventricular assist device support for these patients has been advocated to decompress the left ventricle and facilitate myocardial remodeling and recovery. Concerns exist regarding the ability of venoarterial (VA) extracorporeal life support (ECLS) to decompress the left ventricle and allow effective myocardial recovery. ECLS has several advantages, including availability, rapid deployment, and flexibility, as compared with contemporary ventricular assist devices...
December 2012: Journal of Extra-corporeal Technology
Mikko P Pakarinen, Annika Kurvinen, Antti I Koivusalo, Tarja Ruuska, Heikki Mäkisalo, Hannu Jalanko, Risto J Rintala
AIM: The aim of this study was to characterize outcomes of children with severe intestinal motility disorders (IMD) requiring parenteral nutrition (PN). METHODS: Twenty consecutive children with primary IMD requiring long-term PN between 1984 and 2010 were included. Median (interquartile range) follow-up was 13.1 (5.2-20.1) years. Treatment, PN dependence, growth, nutritional status, liver function, and survival were assessed. RESULTS: Underlying etiology included chronic intestinal pseudo obstruction (CIPO; n=8) and Hirschsprung disease with extensive aganglionosis (n=12)...
February 2013: Journal of Pediatric Surgery
Jonathan L Kraidin, Enrique J Pantin, Mark B Anderson, Bo-Lu Zhou, Alann R Solina
OBJECTIVE: The placement of epicardial pacing wires before weaning from bypass during port-access heart surgery can be difficult or impossible. Sometimes, it is necessary to pacing the patient to wean from bypass, and it is problematic to exchange the Edwards pulmonary vent (EndoVent) for a pace catheter under the drapes. Our objective was to devise an effective means of pacing the patient using the pulmonary vent catheter. METHODS: All patients having aortic valve minimally invasive port-access surgery have a pacing wire deployed through the Edwards EndoVent catheter...
July 2011: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Sten Samuelsson, Fanny Möller, Anders Franco-Cereceda, Jan Liska, Ulf Lockowandt
OBJECTIVE: Omitting ventricular decompression in resternotomy during cardiopulmonary bypass with deep hypothermia and circulatory arrest in patients with aortic regurgitation (AR) has recently been reported. The consequences of the dilated and non-dilated heart in conjunction with rapid and profound cooling were further studied in this randomized animal model. METHODS: In five pigs (group A) AR was induced before cooling to 15°C and circulatory arrest of 30 minutes without left ventricular decompression...
June 2011: Scandinavian Cardiovascular Journal: SCJ
Leonello Avalli, Elena Maggioni, Fabio Sangalli, Giorgio Favini, Francesco Formica, Roberto Fumagalli
Extracorporeal membrane oxygenation (ECMO) is often applied for acute cardiorespiratory failure. Left ventricular distension can compromise recovery of the failing heart. To overcome this complication, we describe a new technique to decompress the left heart through the insertion of a venting cannula in the pulmonary artery. A 43-year-old woman was connected to ECMO for refractory cardiogenic shock after left pneumonia and severe sepsis. Transesophageal echocardiography (TEE) revealed a large intraventricular clot...
January 2011: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
M J Bruins, M A M Vente-Spreeuwenberg, C H Smits, L G J Frenken
Enterotoxigenic Escherichia coli (ETEC) is a main cause of diarrhoea in humans and piglets. In vitro, black tea extract (BTE) has anti-pathogenic properties. Anti-diarrhoeal properties of BTE were assessed in a pig model of gastrointestinal infection. At weaning (day 0), piglets (n = 96) were randomly assigned to a diet containing 0% (control), 0.4% or 0.8% (wt/wt) BTE during 27 days. Piglets were orally infected with 6.4 × 10(6) cfu of ETEC on day 6. Faecal consistency, feed intake and body weight were measured...
June 2011: Journal of Animal Physiology and Animal Nutrition
Junfeng Song, Kenneth Palmer, Bo Sun
BACKGROUND: To improve survival from septic acute lung injury (ALI), extracorporeal life support (ECLS) is one of the ultimate solutions. We evaluated biochemical and pathological characteristics of recovery phase of septic ALI treated in acute phase by inhaled nitric oxide (NO) and surfactant with ECLS and hypothesized that this combination should exert better lung protective effects than that with conventional mechanical ventilation (CMV). METHODS: ALI was induced by i...
April 2010: Pulmonary Pharmacology & Therapeutics
J Michael Smith, William H Roberts, Jeffrey D Miller, Kimberly A Hasselfeld, Mary Pat Hendy
BACKGROUND: It has been shown that abrupt re-exposure of ischemic myocardium to oxygen can lead to increased peroxidative damage to myocytes (oxygen paradox). Controlled cardiac reoxygenation, as an adjunct to substrate-enhanced cardioplegia, has been shown to improve myocardial function and limit reperfusion injury when utilizing standardized hyperoxic cardiopulmonary bypass (CPB). The objective of our study was to evaluate the effect of controlled reoxygenation on myocardial function following global ischemia employing normoxic CPB...
2006: International Journal of Surgery
Hironobu Morimoto, K Tsuchiya, M Nakajima, O Akashi, K Kato
A 64-year-old man with a history of hypertension was admitted to another hospital, presenting with sudden chest pain. Although his symptoms resolved after admission, chest computed tomography (CT) revealed acute type A aortic dissection, and he was referred to our hospital for surgery. On arrival, his hemodynamic status was stable. Electrogram showed no ST-T change, and transthoracic echocardiography demonstrated pericardial effusion, mild aortic regurgitation and good left ventricular wall motion. We immediately decided on an emergency operation...
September 2006: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Phillip L Syracuse, Carolyn Yager, Nicholas Smedira, Robert M Savage
Increased use of left ventricular assist devices (LVAD) as bridges to transplant has revealed the need for short-term right heart support for deairing and right ventricular recovery. The two approaches described are implemented as the patient is weaned from regular cardiopulmonary bypass. Dependent on patient needs, the surgeon may select a high-flow or low-flow approach to what is essentially right heart bypass. Both methods use the existing venous drainage from the right side of the heart. The higher flow returns blood through a 0...
December 2005: Journal of Extra-corporeal Technology
Georg Nollert, Ina Schwabenland, Deniz Maktav, Felix Kur, Frank Christ, Peter Fraunberger, Bruno Reichart, Calin Vicol
PURPOSE: Inflammation and coagulation disturbances are common consequences of cardiopulmonary bypass (CPB). Recently, miniaturized closed CPB circuits without cardiotomy suction and venous reservoir have been proposed to reduce complication rates. We compared outcomes with conventional (CCPB) and miniaturized cardiopulmonary bypass (MCPB) after coronary artery bypass operations (CABG) with respect to inflammation and coagulation. DESCRIPTION: Thirty patients (23% female; aged 67...
December 2005: Annals of Thoracic Surgery
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