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Extracorporeal life support

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https://www.readbyqxmd.com/read/28433359/feasibility-of-profound-hypothermia-as-part-of-extracorporeal-life-support-in-a-pig-model
#1
Christoph Weiser, Wolfgang Weihs, Michael Holzer, Christoph Testori, Anne-Margarethe Kramer, Christoph Kment, Martin Stoiber, Michael Poppe, Christian Wallmüller, Peter Stratil, Michael Hoschitz, Anton Laggner, Fritz Sterz
OBJECTIVE: To investigate the feasibility of a refined aortic flush catheter and pump system to induce emergency preservation and resuscitation before extracorporeal cardiopulmonary resuscitation in a normovolemic cardiac arrest swine model simulating near real size/weight conditions of adults. METHODS: In this feasibility study, 8 female Large White breed pigs weighing 70 to 80 kg underwent ventricular fibrillation cardiac arrest for 15 minutes, followed by 4°C aortic flush (150 mL/kg for the brain; 50 mL/kg for the spine) via a new hardware ensued by resuscitation with extracorporeal cardiopulmonary resuscitation...
March 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#2
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28424884/principle-and-basic-property-of-the-sequential-flow-pump
#3
Shintaro Hara, Erina Maeno, Xinyang Li, Terumi Yurimoto, Takashi Isoyama, Itsuro Saito, Toshiya Ono, Yusuke Abe
In the emergency care field, early treatment of acute heart or respiratory failure has been a global concern. In severe cases, patients are frequently required to be on an extracorporeal membrane oxygenator (ECMO) life support. To make the ECMO system more compact and portable, we proposed a sequential flow-type centrifugal pump named the sequential flow pump (SFP). In this study, principle and basic properties of this novel blood pump were examined by computational fluid dynamic (CFD) analysis and an experimental model...
April 19, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28419300/short-term-mechanical-circulatory-support-for-cardiogenic-shock-in-severe-peripartum-cardiomyopathy-la-piti%C3%A3-salp%C3%A3%C2%AAtri%C3%A3-re-experience
#4
Nadia Bouabdallaoui, Pierre Demondion, Pascal Leprince, Guillaume Lebreton
OBJECTIVES: Mechanical circulatory support (MCS) is a valuable option in the setting of cardiogenic shock (CS), although MCS use in severe forms of peripartum cardiomyopathy (PPCM) is underreported. We aimed to investigate maternal outcomes under MCS for refractory CS complicating PPCM. METHODS: We retrospectively reviewed 10 consecutive patients (2010-2015) meeting diagnosis criteria of PPCM that were managed with peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO) for severe CS...
April 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#5
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28410786/the-use-of-ecmo-for-gastroschisis-and-omphalocele-two-decades-of-experience
#6
Joanne E Baerg, Arul Thirumoorthi, Andrew O Hopper, Edward P Tagge
PURPOSE: The aim was to review the respiratory failure causes and outcomes of infants with omphalocele or gastroschisis receiving ECMO and reported to the Extracorporeal Life Support Organization (ELSO). METHODS: Gastroschisis and omphalocele infants supported with ECMO and reported to the ELSO Registry between 1992 and 2015 were retrospectively reviewed. Clinical variables, diagnosis of respiratory failure (pulmonary hypertension (PHN), congenital heart defects (CHD), congenital diaphragmatic hernia (CDH), and sepsis), and outcomes were recorded...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28400684/early-prediction-of-3-month-survival-of-patients-in-refractory-cardiogenic-shock-and-cardiac-arrest-on-extracorporeal-life-support
#7
Clément Delmas, Jean-Marie Conil, Simon Sztajnic, Bernard Georges, Caroline Biendel, Camille Dambrin, Michel Galinier, Vincent Minville, Olivier Fourcade, Stein Silva, Bertrand Marcheix
BACKGROUND: Extracorporeal life support (ECLS) holds the promise of significant improvement of the survival of patient in refractory cardiogenic shock (CS) or cardiac arrest (CA). Nevertheless, it remains to be shown to which extent these highly invasive supportive techniques could improve long-term patient's outcome. METHODS: The outcomes of 82 adult ECLS patients at our institution between January 2012 and December 2013 were retrospectively analyzed. RESULTS: Patients were essentially men (64...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28397410/building-a-better-neonatal-extracorporeal-life-support-circuit-comparison-of-hemodynamic-performance-and-gaseous-microemboli-handling-in-different-pump-and-oxygenator-technologies
#8
Kristen Glass, Payal Trivedi, Shigang Wang, Karl Woitas, Allen R Kunselman, Akif Ündar
Neurologic complications during neonatal extracorporeal life support (ECLS) are associated with significant morbidity and mortality. Gaseous microemboli (GME) in the ECLS circuit may be a possible cause. Advances in neonatal circuitry may improve hemodynamic performance and GME handling leading to reduction in patient complications. This study compared hemodynamic performance and GME handling using two centrifugal pumps (Maquet RotaFlow and Medos Deltastream DP3) and polymethylpentene oxygenators (Maquet Quadrox-iD and Medos Hilite 800LT) in a neonatal ECLS circuit model...
April 2017: Artificial Organs
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#9
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#10
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28377296/mechanical-chest-compressions-improve-rate-of-return-of-spontaneous-circulation-and-allow-for-initiation-of-percutaneous-circulatory-support-during-cardiac-arrest-in-the-cardiac-catheterization-laboratory
#11
Joseph M Venturini, Elizabeth Retzer, J Raider Estrada, Janet Friant, David Beiser, Dana Edelson, Jonathan Paul, John Blair, Sandeep Nathan, Atman P Shah
BACKGROUND: Performing advanced cardiac life support (ACLS) in the cardiac catheterization laboratory (CCL) is challenging. Mechanical chest compression (MCC) devices deliver compressions in a small space, allowing for simultaneous percutaneous coronary intervention and reduced radiation exposure to rescuers. In refractory cases, MCC devices allow rescuers to initiate percutaneous mechanical circulatory support (MCS) and extracorporeal life support (ECLS) during resuscitation. This study sought to assess the efficacy and safety of MCC when compared to manual compressions in the CCL...
April 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28368919/a-national-perspective-on-ecmo-utilization-in-patients-with-burn-injury
#12
Lauren B Nosanov, Melissa M McLawhorn, Mariana Vigiola Cruz, Jason H Chen, Jeffrey W Shupp
Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28366715/twenty-years-of-anesthetic-and-perioperative-management-of-patients-with-tetralogy-of-fallot-with-absent-pulmonary-valve
#13
John D Jochman, Douglas B Atkinson, Luis G Quinonez, Morgan L Brown
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. DESIGN: Retrospective chart review. SETTING: Large academic children's hospital. PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. INTERVENTIONS: None...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28365109/pushing-the-boundaries-of-ecls-outcomes-in-34-week-ega-neonates
#14
Joseph T Church, Anne C Kim, Kimberly M Erickson, Ankur Rana, Robert Drongowski, Ronald B Hirschl, Robert H Bartlett, George B Mychaliska
PURPOSE: Extracorporeal life support (ECLS) is usually reserved for infants ≥34weeks estimated gestational age (EGA) owing to concerns about increased mortality and incidence of intracranial hemorrhage (ICH). We sought to characterize survival, rates of ICH, and complications in <34week EGA neonates placed on ECLS. METHODS: 752 neonates of EGA 29-34weeks were identified in the Extracorporeal Life Support Organization (ELSO) Registry (1976-2008). Data analyzed included birthweight, survival, pre-ECLS conditions, ventilatory parameters and complications (including ICH and other neurological outcomes)...
March 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28362356/severe-pneumonia-caused-by-influenza-a-h1n1-virus-successfully-managed-with-extracorporeal-life-support-in-a-comorbid-former-preterm-infant
#15
Genny Raffaeli, Giacomo Cavallaro, Lorenza Pugni, Ernesto Leva, Andrea Artoni, Simona Neri, Chiara Baracetti, Mauro Cotza, Valerio Gentilino, Leonardo Terranova, Susanna Esposito, Fabio Mosca
Influenza A (H1N1) virus infection is a global health burden, leading to significant pediatric morbidity and mortality. Prematurity, young age and comorbidities are important risk factors for unfavorable outcomes. Preventive strategies, such as healthcare workers and household contacts vaccination as well as the implementation of infection control practices during the epidemic season, are crucial to protect the most vulnerable populations. Early diagnosis, timely administration of antiviral drugs and supportive therapy are crucial to lead to a complete recovery...
March 31, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28361084/meta-analysis-on-extracorporeal-life-support-during-cardiac-arrest-do-not-compare-apples-and-oranges
#16
EDITORIAL
Sacha Rozencwajg, Matthieu Schmidt
No abstract text is available yet for this article.
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28361068/use-of-distal-perfusion-in-peripheral-extracorporeal-membrane-oxygenation
#17
George Makdisi, Tony Makdisi, I-Wen Wang
Extra corporeal membrane oxygenation (ECMO) is a life-saving technique to manage refractory cardiopulmonary failure. Its usage and indication continue to increase. Femoral venoarterial ECMO (VA ECMO) is relatively less invasive and the cardiac support may be more rapidly instituted in in these extremely tenuous patients. Vascular injuries and limb ischemia unfortunately occur in these emergent access settings. Here we will discuss the optimal techniques of preventing this complication which might affect patient survival and impact the patient quality of life...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28359588/centrifugal-pumps-and-hemolysis-in-pediatric-extracorporeal-membrane-oxygenation-ecmo-patients-an-analysis-of-extracorporeal-life-support-organization-elso-registry-data
#18
Ciaran O'Brien, Julie Monteagudo, Christine Schad, Eva Cheung, William Middlesworth
PURPOSE: It is currently unclear whether centrifugal pumps cause more hemolysis than roller pumps in extracorporeal membrane oxygenation (ECMO) circuits. The aim of this study was to help answer that question in pediatric patients. METHODS: A limited deidentified data set was extracted from the international multicenter Extracorporeal Life Support Organization (ELSO) registry comprising all reported ECMO runs for patients 18years or younger between 2010 and 2015...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28358849/extracorporeal-life-support-prior-to-left-ventricular-assist-device-implantation-leads-to-improvement-of-the-patients-intermacs-levels-and-outcome
#19
David Schibilsky, Christoph Haller, Bruno Lange, Barbara Schibilsky, Helene Haeberle, Peter Seizer, Meinrad Gawaz, Peter Rosenberger, Tobias Walker, Christian Schlensak
BACKGROUND: The objective of this study was to evaluate the outcome of left ventricular assist device (LVAD) implantation after initial extracorporeal life support (ECLS) in patients with cardiogenic shock and the incidence of post implantation right ventricular failure. METHODS & RESULTS: All patients on ECLS therapy for cardiogenic shock prior to LVAD implantation (n = 15) between October 2011 and January 2014 were analyzed. Baseline patient characteristics, as well as detailed pre-operative treatment and postoperative outcome data were collected retrospectively...
2017: PloS One
https://www.readbyqxmd.com/read/28349177/understanding-ethical-decisions-for-patients-on-extracorporeal-life-support
#20
Thomas Bein, Daniel Brodie
No abstract text is available yet for this article.
March 27, 2017: Intensive Care Medicine
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