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Extracorporeal life support

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https://www.readbyqxmd.com/read/29780073/early-lvad-implantation-in-a-patient-with-left-ventricular-failure-after-aortic-dissection-with-left-main-stem-involvement
#1
Hazem El Beyrouti, Angela Kornberger, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Coronary involvement in aortic dissection heralds a poor outcome. Involvement of the left main stem may lead to left ventricular (LV) failure requiring mechanical circulatory support. CASE REPORT: A staged approach was applied in a 24-year-old female who suffered extensive infarction due to aortic dissection with left main stem involvement. After replacement of the ascending aorta and grafting of the left internal thoracic artery to the left anterior descending artery following a failed attempt at reconstruction of the left coronary ostium, she failed to wean from cardiopulmonary bypass (CPB) and underwent implantation of an extracorporeal life support (ECLS) system as a bridge to decision...
May 21, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779622/anticoagulation-during-ecmo-in-neonatal-and-paediatric-patients
#2
Rebecca Barton, Vera Ignjatovic, Paul Monagle
Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#3
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29774549/extracorporeal-membrane-oxygenation-characteristics-and-outcomes-in-adult-patients-with-down-syndrome
#4
Vicky Duffy, Daniel Gomez, Peter Rycus, Brian Rivera, Stephanie L Santoro, Carl H Backes, Clifford L Cua
Patients with Down syndrome (DS) may have multiple medical issues that place them at risk for requiring extracorporeal membrane oxygenation. Use of extracorporeal membrane oxygenation in pediatric patients with Down syndrome has been described, but minimal data exist for extracorporeal membrane oxygenation use in adults with Down syndrome. The goal of this study was to describe the clinical characteristics and to determine if there were differences between adult extracorporeal membrane oxygenation patients with Down syndrome that were alive (aDS) versus those that died (dDS) prior to hospital discharge...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29762934/rescue-tavi-for-aortic-regurgitation-after-left-ventricular-assist-device-implantation-following-preoperative-impella%C3%A2-support
#5
Florian E M Herrmann, Petra Wellmann, Vera von Dossow, Steffen Massberg, Christian Hagl, René Schramm, Maximilian Pichlmaier
A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29760471/bioinspired-detoxification-of-blood-the-efficient-removal-of-anthrax-toxin-protective-antigen-using-an-extracorporeal-macroporous-adsorbent-device
#6
Ganesh Ingavle, Les Baillie, Nathan Davies, Nigel Beaton, Yishan Zheng, Sergey Mikhalovsky, Susan Sandeman
Whilst various remedial human monoclonal antibodies have been developed to treat the potentially life-threatening systemic complications associated with anthrax infection, an optimal and universally effective administration route has yet to be established. In the later stages of infection when antibody administration by injection is more likely to fail one possible route to improve outcome is via the use of an antibody-bound, adsorbent haemoperfusion device. We report here the development of an adsorbent macroporous polymer column containing immobilised B...
May 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29757454/non-pharmacological-interventions-for-treating-chronic-prostatitis-chronic-pelvic-pain-syndrome
#7
REVIEW
Juan Va Franco, Tarek Turk, Jae Hung Jung, Yu-Tian Xiao, Stanislav Iakhno, Virginia Garrote, Valeria Vietto
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non-pharmacological interventions. The National Institute of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) score is a validated measure commonly used to measure CP/CPPS symptoms. OBJECTIVES: To assess the effects of non-pharmacological therapies for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)...
May 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29753504/extracorporeal-life-support-for-adults-with-refractory-septic-shock
#8
Sun Kyun Ro, Wan Kee Kim, Ju Yong Lim, Jae Suk Yoo, Sang-Bum Hong, Joon Bum Kim
OBJECTIVE: Although the use of extracorporeal membrane oxygenation (ECMO) in shock patients is increasing worldwide, studies concerning this treatment for adult septic shock are limited. This study aimed to analyze the outcome of venoarterial ECMO in adult patients with septic shock refractory to conventional treatment. METHODS: A total of 71 consecutive patients who presented with septic shock and underwent venoarterial ECMO were reviewed. Clinical parameters were compared between survivors and nonsurvivors...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29748076/comparison-of-levosimendan-and-milrinone-for-ecls-weaning-in-patients-after-cardiac-surgery-a-retrospective-before-and-after-study
#9
Annina Jacky, Alain Rudiger, Bernard Krüger, Markus J Wilhelm, Sebastian Paal, Burkhardt Seifert, Donat R Spahn, Dominique Bettex
OBJECTIVES: Pharmacodynamics suggests that levosimendan might be a valuable inotrope for weaning from extracorporeal life support (ECLS). As there is a paucity of evidence regarding the effectiveness and safety of such an approach, the aim was to report the authors' experiences in ECLS weaning before and after the implementation of levosimendan in clinical practice. DESIGN: Retrospective before-and-after study. SETTING: Cardiac intensive care unit of a university hospital...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29746522/changes-in-quality-of-life-and-health-status-in-patients-with-extracorporeal-life-support-a-prospective-longitudinal-study
#10
Kang-Hua Chen, Yu-Ting Chen, Shu-Ling Yeh, Li-Chueh Weng, Feng-Chun Tsai
BACKGROUND: Extracorporeal life support (ECLS) provides emergency pulmonary and cardiac assistance for patients in respiratory or cardiac failure. Most studies evaluate the success of ECLS based on patients' survival rate. However, the trajectory of health status and quality of life (QOL) should also be important considerations. The study's aim was to explore changes in health status and QOL in adult patients weaned from ECLS who survived to hospital discharge over a one-year period. STUDY DESIGN: A prospective longitudinal study was conducted from April 2012 to September 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29744220/principles-and-indications-of-extracorporeal-life-support-in-general-thoracic-surgery
#11
REVIEW
Karen McRae, Marc de Perrot
The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA® Novalung® , Heilbronn, Germany), and extracorporeal CO2 removal (ECCO2 R)...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29739630/extracorporeal-life-support-as-salvage-therapy-for-massive-pulmonary-embolus-and-cardiac-arrest-in-pregnancy
#12
Michael E Takacs, Kristina E Damisch
BACKGROUND: Massive pulmonary embolus (PE) with prolonged cardiac arrest in the setting of pregnancy has few treatment options. Selections are further restricted if there are contraindications to the standard therapies of embolectomy and thrombolysis. We report a case of extracorporeal life support (ECLS) used as salvage therapy for a critically ill pregnant patient. CASE REPORT: A 21-year-old woman presented to a small rural hospital with chest pain, dyspnea, hypoxia, and syncope...
May 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29732189/vv-extracorporeal-life-support-for-the-third-millennium-will-we-need-anticoagulation
#13
REVIEW
Danny Eytan, Yuval Bitterman, Gail M Annich
Since the late 1600's medicine and science have entertained the idea of extracorporeal circulation. With this technology to allow for cardiac and pulmonary support came the development of anticoagulation. Although this advanced the technology and capabilities of extracorporeal life support, it was not without complications and risks. The most common complications in extracorporeal life support (ECLS) present day are related to hemorrhage and thrombus due to the need for systemic anticoagulation and the challenges associated with it...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29726345/mortality-and-morbidity-in-acutely-ill-adults-treated-with-liberal-versus-conservative-oxygen-therapy-iota-a-systematic-review-and-meta-analysis
#14
Derek K Chu, Lisa H-Y Kim, Paul J Young, Nima Zamiri, Saleh A Almenawer, Roman Jaeschke, Wojciech Szczeklik, Holger J Schünemann, John D Neary, Waleed Alhazzani
BACKGROUND: Supplemental oxygen is often administered liberally to acutely ill adults, but the credibility of the evidence for this practice is unclear. We systematically reviewed the efficacy and safety of liberal versus conservative oxygen therapy in acutely ill adults. METHODS: In the Improving Oxygen Therapy in Acute-illness (IOTA) systematic review and meta-analysis, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, HealthSTAR, LILACS, PapersFirst, and the WHO International Clinical Trials Registry from inception to Oct 25, 2017, for randomised controlled trials comparing liberal and conservative oxygen therapy in acutely ill adults (aged ≥18 years)...
April 28, 2018: Lancet
https://www.readbyqxmd.com/read/29714432/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-center-experience-in-turkey
#15
Emel Okulu, F. Begüm Atasay, Gaffari Tunç, Hasan Akduman, Ömer Erdeve, Saadet Arsan, Zeynep Eyileten, Tayfun Uçar, H. Ercan Tutar
Background/aim: Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with respiratory failure, cardiac failure, or both. The aim of this study was to evaluate neonates supported with ECMO and report our experience as a Turkish neonatal intensive care unit. Materials and methods: We retrospectively reviewed 11 newborn infants treated with ECMO at Ankara University for respiratory and cardiac failure. We reported the demographic, diagnostic, laboratory, and clinical data of the patients...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29712611/the-development-of-extracorporeal-membrane-oxygenation
#16
Don K Nakayama
Evolving from the development of heart-lung machines for open-heart surgery, extracorporeal membrane oxygenation has reemerged as a rescue modality for patients with acute respiratory failure that cannot be supported by conventional modes of ventilation. The history of extracorporeal membrane oxygenation begins with the discovery of heparin, fundamental to the success of extracorporeal circulation and membrane lungs. Engineers and scientists created suitable artificial membranes that allowed gas exchange while keeping gas and blood phases separate...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29707342/aortic-arch-repair-under-moderate-hypothermic-circulatory-arrest-with-or-without-antegrade-cerebral-perfusion-based-on-the-extent-of-repair
#17
Sung Jun Park, Bo Bae Jeon, Hee Jung Kim, Joon Bum Kim
Background: For aortic-arch repair, moderate hypothermic circulatory arrest (HCA) have shown favorable outcomes over conventional deep HCA when coupled with antegrade cerebral perfusion (ACP); however, recent studies have shown that ACP may not be essential when circulatory arrest time is less than 30 minutes. This study aims to evaluate the stratified arch repair strategy of moderate HCA with or without ACP based on the extent of procedure. Methods: Consecutive 138 patients (63 female; mean age, 60...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701338/arterial-vascular-complications-in-peripheral-venoarterial-extracorporeal-membrane-oxygenation-support
#18
Rita Augusto, Marisa Passos Silva, Jacinta Campos, Andreia Coelho, Nuno Coelho, Ana Carolina Semião, Evelise Pinto, Daniel Brandão, Alexandra Canedo
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) has been evolved as a life-saving measure for patients requiring emergent support of respiratory and cardiac function.The femoral artery is the standard site for vascular access when initiating adult venoarterial (VA) ECMO.Cannulation-related complications are a known source of morbidity and it has been speculated that patients undergoing ECMO via femoral arterial cannulation are more likely to develop peripheral vascular complications (up to 70%)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#19
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29689088/electrocardiogram-synchronized-pulsatile-extracorporeal-life-support-preserves-left-ventricular-function-and-coronary-flow-in-a-porcine-model-of-cardiogenic-shock
#20
Petr Ostadal, Mikulas Mlcek, Holger Gorhan, Ivo Simundic, Svitlana Strunina, Matej Hrachovina, Andreas Krüger, Dagmar Vondrakova, Marek Janotka, Pavel Hala, Martin Mates, Martin Ostadal, James C Leiter, Otomar Kittnar, Petr Neuzil
INTRODUCTION: Veno-arterial extracorporeal life support (ECLS) is increasingly being used to treat rapidly progressing or severe cardiogenic shock. However, it has been repeatedly shown that increased afterload associated with ECLS significantly diminishes left ventricular (LV) performance. The objective of the present study was to compare LV function and coronary flow during standard continuous-flow ECLS support and electrocardiogram (ECG)-synchronized pulsatile ECLS flow in a porcine model of cardiogenic shock...
2018: PloS One
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