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Circulatory Support

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https://www.readbyqxmd.com/read/29226765/never-declared-brain-dead-potential-organ-donors-an-additional-source-of-donor-organs
#1
Patricia A Webster, Lori E Markham
CONTEXT: Patients never declared brain dead may represent an additional source of donor organs. OBJECTIVE: To determine the number of likely brain dead potential donors who are never declared brain dead and to compare them with brain dead and donation after cardiac death potential organ donors. DESIGN, SETTING, AND PARTICIPANTS: This study was a retrospective chart review of all catastrophically brain-injured patients referred to a single-organ procurement organization (OPO) over a 4-year period...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#2
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221320/bridging-to-lung-transplantation-with-extracorporeal-circulatory-support-when-or-when-not
#3
REVIEW
Gabriel Loor, Leo Simpson, Amit Parulekar
Patients with end-stage lung disease who are candidates for lung transplantation may acutely decompensate before a donor organ becomes available. In this scenario, extracorporeal life support (ECLS) may be considered as a bridge to transplant or as a bridge to decision. In the current chapter, we review the indications, techniques, and outcomes for bridging to lung transplantation with ECLS.
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217220/transaxillary-implantation-of-the-impella-cp-mechanical-circulatory-support-device-as-a-bridge-to-heart-transplant-first-experience-in-spain
#4
David Couto-Mallón, Francisco Estévez-Cid, Miguel Solla-Buceta, Carlos García-Velasco, María G Crespo-Leiro, José Joaquín Cuenca-Castillo
No abstract text is available yet for this article.
December 4, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29217152/advanced-cardiopulmonary-resuscitation-cpr-in-the-catheterization-laboratory-consensus-document-of-the-working-groups-of-1-cardiopulmonary-resuscitation-acute-cardiac-care-and-2-hemodynamic-and-interventional-cardiology-hellenic-cardiological-society
#5
George Latsios, George Mpompotis, Kostas Tsioufis, Kostas Toutouzas, Emmanouil Skalidis, Andreas Synetos, Dimosthenis Avramidis, Dimitris Tousoulis
The incidence of Cardiac (Cardio-Pulmonary) Arrest (CA) in the Catheterization Laboratory is not common. However, not only does it happen occasionally but its frequency tends to increase due to the increase in the overall number and complexity of interventions performed by interventional cardiologists. Therefore, certified knowledge and application of the ALS (Advanced Life Support) protocols by trained Catheterization Laboratory staff is imperative in many countries, by local Hospital standards and also by Law...
December 4, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29210774/liberal-right-ventricular-assist-device-extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-implantable-left-ventricular-assist-device-placement
#6
Quentin Fischer, Matthias Kirsch
Refractory right ventricular failure (RVF) after implantation of left ventricular assist device (LVAD) is a dramatic complication. The addition of right ventricular assist device (RVAD) may improve RV recovery and lead to improve outcomes. From February 2012 to September 2014, 44 patients received a HeartMate II. These patients were retrospectively compared in two groups according to early liberal implantation of an extracorporeal membrane oxygenation (ECMO) used as a RVAD established between a femoral vein and the pulmonary artery...
November 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29206731/enteral-feeding-practices-in-infants-with-congenital-heart-disease-across-european-picus-a-european-society-of-pediatric-and-neonatal-intensive-care-survey
#7
Lyvonne N Tume, Reinis Balmaks, Eduardo da Cruz, Lynne Latten, Sascha Verbruggen, Frédéric V Valla
OBJECTIVES: To describe enteral feeding practices in pre and postoperative infants with congenital heart disease in European PICUs. DESIGN: Cross-sectional electronic survey. SETTING: European PICUs that admit infants with congenital heart disease pre- and postoperatively. PARTICIPANTS: One senior PICU physician or designated person per unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-nine PICUs from 18 European countries responded to the survey...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206727/assessment-of-myocardial-function-and-injury-by-echocardiography-and-cardiac-biomarkers-in-african-children-with-severe-plasmodium-falciparum-malaria
#8
Simon Kotlyar, Peter Olupot-Olupot, Julius Nteziyaremye, Samuel O Akech, Sophie Uyoga, Rita Muhindo, Christopher L Moore, Kathryn Maitland
OBJECTIVES: Perturbed hemodynamic function complicates severe malaria. The Fluid Expansion as Supportive Therapy trial demonstrated that fluid resuscitation, involving children with severe malaria, was associated with increased mortality, primarily due to cardiovascular collapse, suggesting that myocardial dysfunction may have a role. The aim of this study was to characterize cardiac function in children with severe malaria. DESIGN: A prospective observational study with clinical, laboratory, and echocardiographic data collected at presentation (T0) and 24 hours (T1) in children with severe malaria...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29204773/circumstances-and-causes-of-sudden-circulatory-arrests-in-the-dutch-province-of-limburg-and-the-involvement-of-citizen-rescuers
#9
R W M Pijls, P J Nelemans, B M Rahel, A P M Gorgels
BACKGROUND: Recently we showed that a citizen volunteer system using text message alerts improves survival of out-of-hospital sudden circulatory arrest (OHCA). It is important to characterise the OHCA population encountered by the volunteers regarding circumstances and causes of the arrests. METHODS AND RESULTS: Eligible for this study were 968 OHCAs that occurred between April 2012 and April 2014 in the Dutch province of Limburg. The distribution of causes of OHCA, patient characteristics and resuscitation settings were compared between 492 arrests wherein volunteers were notified and 476 arrests where the dispatcher decided not to do so...
December 4, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#10
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29200072/tailored-holder-for-continuous-echocardiographic-monitoring
#11
Haibo Song, Shen Kou Tsai, Jin Liu
Hemodynamic monitoring is essential for prompt and effective interventions in intensive care unit patients. We developed a custom-made transthoracic echocardiography transducer holder consisting of transducer holder and skin patch attachment. This holder allowed continuous transthoracic echocardiography monitoring in 5 adult patients with circulatory failure due to shock, and 6 pediatric patients after successful percutaneous closure of a ventricular septal defect. One case of an unexpected hemopericardium was promptly diagnosed and pericardiocentesis was performed, and 1 patient required extracorporeal membrane oxygenation support...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198868/an-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs-analysis-of-hospitalization-functional-status-and-mortality-after-mechanical-circulatory-support-in-adults-with-congenital-heart-disease
#12
Ari Cedars, Christina Vanderpluym, Devin Koehl, Ryan Cantor, Shelby Kutty, James K Kirklin
BACKGROUND: Adult congenital heart disease (ACHD) prevalence is increasing worldwide, with advanced heart failure (HF) as a leading cause of death. Limited data are available on durable mechanical circulatory support (MCS) in ACHD patients. METHODS: ACHD patients from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database were identified and propensity matched with non-ACHD patients using risk factors from the INTERMACS Seventh Annual Report...
November 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29198667/donation-after-circulatory-arrest-in-pancreas-transplantation-a-report-of-10-cases
#13
J A Fridell, R S Mangus, C M Thomas, C A Kubal, J A Powelson
INTRODUCTION: Transplantation of pancreas allografts procured from donation after circulatory death (DCD) remains uncommon. This study reviews a series of pancreas transplants at a single center to assess the donor and recipient characteristics for DCD pancreas transplant and to compare clinical outcomes. METHODS: DCD procurement was performed with a 5-minute wait time from pronouncement of death to first incision. In 2 patients, tissue plasminogen activator was infused as a thrombolytic during the donor flush...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29196541/validation-of-the-grown-ups-with-congenital-heart-disease-score
#14
Jürgen Hörer, Régine Roussin, Emanuel LeBret, Mohamed Ly, Jarrah Abdullah, Rafaella Marzullo, Jelena Pabst von Ohain, Emre Belli
OBJECTIVES: Adults with congenital heart disease in need of heart surgery frequently present with significant comorbidity. Furthermore, additional technical difficulties often related to redo operations increase the risk for postoperative mortality and morbidity. Hence, next to the type of the procedure, additional procedure-dependent and procedure-independent factors have to be considered for risk evaluation. The recently proposed grown-ups with congenital heart disease (GUCH) mortality and morbidity scores account for these additional risk factors...
December 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29193160/multicenter-experience-with-mechanical-circulatory-support-using-a-new-diagonal-pump-in-233-children
#15
Brigitte Stiller, Robert Jan Houmes, André Rüffer, Matthias Kumpf, Andreas Müller, Florian Kipfmüller, Harald Köditz, Susanne Herber Jonat, Claudia Schmoor, Christoph Benk, Dick Tibboel, Thilo Fleck
Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients...
November 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29191299/implantable-cardioverter-defibrillators-in%C3%A2-patients-with-a-continuous-flow-left%C3%A2-ventricular-assist-device-an-analysis-of%C3%A2-the-intermacs-registry
#16
Kevin J Clerkin, Veli K Topkara, Ryan T Demmer, Jose M Dizon, Melana Yuzefpolskaya, Justin A Fried, Xingchen Mai, Donna M Mancini, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
OBJECTIVES: This study sought to determine if the presence of implantable cardioverter-defibrillators (ICD) provided a mortality benefit during continuous-flow left ventricular assist device (LVAD) support. BACKGROUND: An ICD decreases mortality in selected patients with advanced heart failure and have been associated with reduced mortality in patients with pulsatile LVAD. However, it is unclear whether that benefit extends to patients with a contemporary continuous-flow LVAD...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29191293/cardiac-transplantation-current-outcomes-and-contemporary-controversies
#17
REVIEW
Michelle M Kittleson, Jon A Kobashigawa
Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high, and many patients progress to end-stage heart failure. Over the last 5 decades, heart transplantation (HTx) has become the preferred therapy for select patients with end-stage heart disease. However, although HTx has become standard of care for the management of end-stage heart failure, challenges continue to exist. The number of patients with end-stage heart failure is increasing, whereas the number of donor organs remains constant and a limiting factor in HTx...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29189424/iphone-in-the-management-of-the-berlin-heart-excor-ventricular-assist-device
#18
Aditya Badheka, Veerajalandhar Allareddy
Berlin Heart Inc. EXCOR is an extracorporeal pneumatically pulsatile ventricular assist device approved for use in pediatric age group since 2011 in the United States. It is a well-established life-saving therapy for the bridge to heart transplant or to provide circulatory support in a transplanted patient. The most commonly reported problem was "membrane defect" in a postmarketing major device reporting. In general, the filling and emptying of the pump can be easily visualized, but the interobserver variability exist...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29189423/the-boy-in-the-bubble-and-the-baby-with-the-berlin-heart-the-dangers-of-bridge-to-decision-in-pediatric-mechanical-circulatory-support
#19
Seth A Hollander, Ethan J Hollander
On the day of his birth in 1971, David Vetter was "temporarily" placed in a sterile isolator to wait for a bone marrow donor who would cure his Severe Combined Immunodeficiency Syndrome. After enduring 12 years in isolation, David, now known to the world as "The Boy in the Bubble", received a bone marrow transplant from his unmatched sister and died 4 months later. Like Severe Combined Immunodeficiency Syndrome, pediatric heart failure is a rare and life-threatening condition for which organ transplantation is often the only option for survival...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29179956/extracorporeal-membrane-oxygenation-ecmo-during-pregnancy-and-postpartum
#20
REVIEW
Luis D Pacheco, George R Saade, Gary D V Hankins
Extracorporeal membrane oxygenation (ECMO) can provide respiratory support (VV-ECMO) or both respiratory and circulatory support (VA-ECMO). The use of ECMO has increased dramatically as a result of simpler technology. No level I evidence is yet available reflecting improved outcomes with ECMO. The use of this technology during pregnancy may be indicated in very select cases and should be delivered in centers with dedicated ECMO specialized units.
November 24, 2017: Seminars in Perinatology
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