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Extracorporeal life support

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https://www.readbyqxmd.com/read/28229199/-coronary-artery-disease-interventional-and-operative-therapeutic-options-after-cardiac-arrest
#1
M Behnes, K Mashayekhi, M Borggrefe, I Akin
Coronary artery disease (CAD) represents a common structural cause for developing cardiac arrest in older patients, whereas in young adults cardiac arrest is more often caused by cardiomyopathies and cardiac channelopathies. A structural heart disease is known in almost 50% of patients prior to cardiac arrest. The present review outlines current interventional and operative therapeutic options for patients surviving cardiac arrest. The focus is on associations between epidemiological data on the incidence of malignant arrhythmias causing cardiac arrest depending on the presence or absence of CAD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28223051/functional-status-and-quality-of-life-in-survivors-of-extracorporeal-membrane-oxygenation-after-the-norwood-operation
#2
Joshua M Friedland-Little, Karen Uzark, Sunkyung Yu, Ray Lowery, Ranjit Aiyagari, Jennifer C Hirsch-Romano
BACKGROUND: Infants who require extracorporeal membrane oxygenation (ECMO) support after a Norwood operation are at increased risk for early and late death compared with patients who do not require ECMO post-Norwood. Little is known about the effect that ECMO post-Norwood has on functional status and quality of life among long-term survivors. METHODS: We prospectively evaluated functional status and health-related quality of life in 12 surviving patients (cases) and 19 corresponding patients (controls) from a previous retrospective case-control assessment of long-term survival in patients requiring ECMO post-Norwood...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#3
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28211131/congenital-diaphragmatic-hernia-outcomes-of-neonates-treated-at-mayo-clinic-with-and-without-extracorporeal-membrane-oxygenation
#4
Katarina Bojanić, Jason M Woodbury, Alexandre N Cavalcante, Ruža Grizelj, Garth F Asay, Christopher E Colby, William A Carey, Gregory J Schears, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare anomaly with high mortality and long-term comorbid conditions. AIMS: Our aim was to describe the presenting characteristics, treatment, and outcomes of consecutive patients with CDH treated at our institution. METHODS: We performed a retrospective cohort study and identified consecutive neonates treated for CDH from 2001 to 2015 at our institution. For all patients identified, we reviewed hospital and postdischarge data for neonatal, disease, and treatment characteristics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28196469/extracorporeal-membrane-oxygenation-for-avian-influenza-a-h7n9-patient-with-acute-respiratory-distress-syndrome-a-case-report-and-short-literature-review
#5
Qi Nie, Ding-Yu Zhang, Wen-Juan Wu, Chao-Lin Huang, Zheng-Yi Ni
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is performed as an acceptable life-saving bridging procedure in patients with severe acute respiratory distress syndrome (ARDS).To patients with avian influenza A (H7N9)-associated ARDS, ECMO could be adopted as a feasible therapeutic solution. We present our successful experience with ECMO utilized in a respiratory failure patient with H7N9 infection. CASE PRESENTATION: A 44 years-old female with H7N9-induced ARDS was admitted to intensive care unit (ICU) and was treated with veno-venous ECMO for six days, antiviral therapy, prolonged corticosteroid infusion and other therapies...
February 14, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28193535/the-utility-of-nurse-managed-extracorporeal-life-support-in-an-adult%C3%A2-cardiac-intensive-care-unit
#6
Amy E Hackmann, Luke M Wiggins, Glenn P Grimes, Richard M Fogel, Felicia A Schenkel, Mark L Barr, Michael E Bowdish, Mark J Cunningham, Vaughn A Starnes
BACKGROUND: The use of extracorporeal life support (ECLS) worldwide has increased exponentially since 2009. The patient requiring ECLS demands an investment of hospital resources, including personnel. Educating bedside nurses to manage ECLS circuits broadens the availability of trained providers. METHODS: Experienced cardiothoracic intensive care unit (CTICU) nurses underwent training to manage ECLS circuits, including volume assessment, treatment of arterial blood gas values, the physiology of ECLS, and recognition of common emergencies...
February 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28190548/venovenous-versus-venoarterial-extracorporeal-membrane-oxygenation-for-adult-patients-with-acute-respiratory-distress-syndrome-requiring-precannulation-hemodynamic-support-a-review-of-the-elso-registry
#7
Zachary N Kon, Gregory J Bittle, Chetan Pasrija, Si M Pham, Michael A Mazzeffi, Daniel L Herr, Pablo G Sanchez, Bartley P Griffith
BACKGROUND: In addition to severe hypoxia and hypercapnia, acute respiratory distress syndrome (ARDS) can present with substantial hemodynamic compromise, requiring inotropic or vasopressor support or both. Either venovenous (VV) or venoarterial (VA) extracorporeal membrane oxygenation (ECMO) can be offered in this situation. However, a contemporary comparison of these two cannulation strategies has yet to be well described. METHODS: The Extracorporeal Life Support Organization Registry was reviewed for all cases of adult ARDS in patients that required inotropic agents or vasopressors or both before ECMO initiation (2009 to 2013)...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28183395/swine-influenza-a-h1n1-virus-siv-infection-requiring-extracorporeal-life-support-in-an-immunocompetent-adult-patient-with-indirect-exposure-to-pigs-italy-october-2016
#8
Francesca Rovida, Antonio Piralla, Federico Capra Marzani, Ana Moreno, Giulia Campanini, Francesco Mojoli, Marco Pozzi, Alessia Girello, Chiara Chiapponi, Fausto Vezzoli, Paola Prati, Elena Percivalle, Anna Pavan, Maria Gramegna, Giorgio Antonio Iotti, Fausto Baldanti
We describe a case of severe swine influenza A(H1N1) virus infection in an immunocompetent middle-aged man in October 2016 in Italy who had only indirect exposure to pigs. The patient developed a severe acute distress respiratory syndrome which was successfully supported by extracorporeal membrane oxygenation and treated with antiviral therapy. The sole risk factor for influenza was a body mass index > 30 kg/m(2). After a month of hospitalisation, the patient was discharged in good health.
February 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28176223/transportation-of-patients-on-extracorporeal-membrane-oxygenation-a-tertiary-medical-center-experience-and-systematic-review-of-the-literature
#9
Pedro Vitale Mendes, Cesar de Albuquerque Gallo, Bruno Adler Maccagnan Pinheiro Besen, Adriana Sayuri Hirota, Raquel de Oliveira Nardi, Edzangela Vasconcelos Dos Santos, Ho Yeh Li, Daniel Joelsons, Eduardo Leite Vieira Costa, Flavia Krepel Foronda, Luciano Cesar Pontes Azevedo, Marcelo Park
BACKGROUND: Utilization of extracorporeal membrane oxygenation (ECMO) has increased worldwide, but its use remains restricted to severely ill patients, and few referral centers are properly structured to offer this support. Inter-hospital transfer of patients on ECMO support can be life-threatening. In this study, we report a single-center experience and a systematic review of the available published data on complications and mortality associated with ECMO transportation. METHODS: We reported single-center data regarding complications and mortality associated with the transportation of patients on ECMO support...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28175939/good-neurological-outcome-after-accidental-hyopthermia-presenting-with-asytole
#10
I Eckert, P Imboden, P Paal, J Koppenberg
A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming...
February 7, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#11
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28167019/treatment-of-bronchial-foreign-body-aspiration-with-extracorporeal-life-support-in-a-child-a-case-report-and-literature-review
#12
REVIEW
Li Deng, Baichun Wang, Yan Wang, Lifeng Xiao, Hongyu Liu
We present a case in which extracorporeal life support treatment of a 6-year-old girl asphyxiated by aspiration of an elliptic plastic ball is described. The attempts for extraction of the foreign body by conventional bronchoscopy under critically ill conditions had failed. Thus, a skin incision was made in the midline, and an emergency open-chest cardiopulmonary bypass (CPB) with aortic, superior vena cava and inferior vena cava cannulation was performed for circulatory support. Following tracheal extubation, a video-assisted rigid bronchoscope was inserted to clear the airway and remove the foreign body...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28166602/managing-the-precarious-hemostatic-balance-during-extracorporeal-life-support-implications-for-coagulation-laboratories
#13
Anne M Winkler
For the past four decades, extracorporeal life support (ECLS) has been used to treat critically ill adult and pediatric patients with cardiac and/or respiratory failure unresponsive to medical management, and there are increasing numbers of centers performing ECLS for numerous indications worldwide. Despite the progress with advancing technology, hemorrhagic and thrombotic complications occur frequently and are associated with worse outcomes, but the exact cause is often elusive or multifactorial. As a result of the interaction between blood and a nonendothelialized circuit, there is activation of coagulation, fibrinolysis, as well as an increased inflammatory response; thus, anticoagulation of the patient and circuit is necessary...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28159528/therapeutic-hypothermia-may-improve-neurological-outcomes-in-extracorporeal-life-support-for-adult-cardiac-arrest
#14
Philip Y K Pang, Gillian H L Wee, Ming Jie Huang, Anne E E Hoo, Ismail Mohamed Tahir Sheriff, See Lim Lim, Teing Ee Tan, Yee Jim Loh, Victor T T Chao, Jia Lin Soon, Ka Lee Kerk, Zakir Hussain Abdul Salam, Yoong Kong Sin, Chong Hee Lim
BACKGROUND: Limited data exists on patients receiving therapeutic hypothermia during extracorporeal life support (ECLS). We investigated outcomes and prognostic factors in these patients. METHODS: A retrospective review was conducted for 225 consecutive adult patients treated with ECLS between July 2003 and January 2016. Extracorporeal life support was initiated for refractory cardiac arrest (>10 mins) in 79 patients (35.1%). Patient demographics, ECLS-related complications, in-hospital mortality and neurological outcomes were analysed...
January 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28139304/development-and-implementation-of-a-comprehensive-multidisciplinary-emergency-department-extracorporeal-membrane-oxygenation-program
#15
Joseph E Tonna, Craig H Selzman, Michael P Mallin, Brigham R Smith, Scott T Youngquist, Antigoni Koliopoulou, Frederick Welt, Kathleen Diane Stoddard, Ram Nirula, Richard Barton, James Franklin Fair, James C Fang, Stephen McKellar
Despite advances in the medical and surgical management of cardiovascular disease, greater than 350,000 patients experience out-of-hospital cardiac arrest in the United States annually, with only a 12% neurologically favorable survival rate. Of these patients, 23% have an initial shockable rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), a marker of high probability of acute coronary ischemia (80%) as the precipitating factor. However, few patients (22%) will experience return of spontaneous circulation and sufficient hemodynamic stability to undergo cardiac catheterization and revascularization...
January 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28131429/venoarterial-extracorporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-in-elderly-patients-trends-in-application-and-outcome-from-the-extracorporeal-life-support-organization-elso-registry
#16
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Priya Mendiratta, Parthak Prodhan, Peter Rycus, Graeme MacLaren, Thomas V Brogan, Yih-Sharng Chen, Jos Maessen, Xiaotong Hou, Ravi R Thiagarajan
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock (RCS) is increasingly used in adult patients, but age represents a controversial factor in this setting. METHODS: Data from the Extracorporeal Life Support Organization registry was analyzed to assess in-hospital survival of elderly patients (≥70 years of age) undergoing VA-ECMO for RCS from 1992 to 2015. In-hospital survival and complications for elderly patients were compared with data in younger adults (≥18 to <70 years of age) supported with VA-ECMO during the same time period for similar indications...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28119778/long-term-efficacy-of-extracorporeal-shock-wave-therapy-eswt-for-treatment-of-refractory-chronic-abacterial-prostatitis
#17
Ghazi Mohammad Al Edwan, Muheilan Mustafa Muheilan, Omar Nabeeh M Atta
OBJECTIVE: To evaluate the effect and safety of extracorporeal shockwave therapy (ESWT) on chronic pelvic pain syndrome (CPPS)/chronic abacterial prostatitis after failure of most other modalities of treatment, the maintenance of the treatment effect for up to one year post treatment and whether the patients are in need for further sessions. MATERIALS AND METHODS: In a follow-up survey of 41 patients, the study inclusion criteria were CPPS patients who failed at least previously 3 modalities of treatment other than ESWT, who were treated by ESWT once a week for one month with a protocol of 2500 pulses at 1 bar over 13 min, Nonaddiction to drugs and narcotics...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28109366/lung-volume-reduction-surgery-on-extracorporeal-life-support
#18
Stefanos Tzafos, Stéphane Collaud, Markus Wilhelm, Stephan Wieser, Walter Weder, Ilhan Inci
Lung volume reduction surgery improves exercise tolerance, lung function, and quality of life for selected patients with emphysema. Lung volume reduction surgery is well established for patients in a highly elective setting. It is, however, contraindicated in cases of acute cardiorespiratory failure. We present the case of a patient with severe emphysema who had acute respiratory failure and decompensated cor pulmonale requiring life-saving venovenoarterial extracorporeal life support after admission to the emergency unit...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28105685/evolution-of-gas-permeable-membranes-for-extracorporeal-membrane-oxygenation
#19
REVIEW
Torin Yeager, Shuvo Roy
Gas permeable membranes are a vital component of extracorporeal membrane oxygenation systems. Over more than half a century, membrane fabrication and packaging technology have progressed to enable safer and longer duration use of respiratory life support. Current research efforts seek to improve membrane efficiency and hemocompatibility, with the aim of producing smaller and more robust systems for ambulatory use. This review explores past and present innovations in oxygenator technology, suggesting possible applications of state-of-the-art membrane fabrication methods to address shortcomings of earlier concepts...
January 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28096230/haemodialysis-in-acute-paracetamol-poisoning
#20
L Serjeant, J Evans, F Sampaziotis, W G Petchey
A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines...
January 17, 2017: BMJ Case Reports
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