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https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#1
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
September 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#2
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28638161/argatroban-for-heparin-induced-thrombocytopenia-during-venovenous-extracorporeal-membrane-oxygenation-with-continuous-venovenous-hemofiltration
#3
Jonathan H Sin, Natasha D Lopez
Patients receiving extracorporeal membrane oxygenation (ECMO) are at risk of circuit thrombosis due to constant contact between blood and the extracorporeal components. Unfractionated heparin has traditionally been used in this setting as a systemic form of anticoagulation to prevent thrombosis of the circuit. However, if a patient develops heparin-induced thrombocytopenia (HIT), an alternative anticoagulant would be required while the patient is maintained on ECMO. Unfortunately, the pharmacokinetic changes induced by ECMO and critical illness may potentially affect optimal drug dosing...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#4
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28470923/what-is-new-in-pediatric-ecmo-2016-a-year-in-review
#5
P P Roeleveld
With the increasing use of extracorporeal membrane oxygenation in children come increasing publications concerning pediatric ECMO. In 2016 important work was done in identifying modifiable risk-factors and possible predictors of mortality in cardiac and respiratory ECMO and risk-estimation scores have been developed for respiratory ECMO patients. Also, increasing important experience is published in the areas of neurodevelopmental follow-up of ECMO survivors. The most relevant publications of 2016 are summarized in this review...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28072699/prevention-preferable-to-treatment-3-case-reports-of-patients-experiencing-right-sided-heart-failure-after-ebstein-anomaly-correction
#6
Ming Luo, Jing Lin, Zhen Qin, Lei Du
RATIONALE: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. PATIENT CONCERNS: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28007059/current-status-of-pediatric-ventricular-assist-device-support
#7
REVIEW
Iki Adachi, Sarah Burki, Charles D Fraser
The last decade has witnessed significant advancement in the field of ventricular assist device (VAD) support. Although device options for pediatric patients were previously severely limited because of body size constraints, this frustrating situation has gradually been changing, owing to ongoing device miniaturization. Recognition of the superiority of VAD support compared with conventional extracorporeal membrane oxygenation support has spurred enthusiasm for VAD support in children. In this article, we discuss the current status of pediatric VAD support; where do we stand now and where will we be heading? Because this field is rapidly changing, it is anticipated that this article will provide a general overview of what is currently occurring in the field of pediatric VAD support...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#8
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
February 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27619972/extracorporeal-membrane-oxygenation-for-interstitial-lung-disease-what-is-on-the-other-side-of-the-bridge
#9
EDITORIAL
Sacha Rozencwajg, Matthieu Schmidt
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27493812/propofol-infusion-syndrome-in-refractory-status-epilepticus-a-case-report-and-topical-review
#10
Akil Walli, Troels Dirch Poulsen, Mette Dam, Jens Børglum
Propofol infusion syndrome (PRIS) is a fatal complication when doses of propofol administration exceed 4 mg/kg/h for more than 48 hours. Propofol overdosage is not uncommon in patients with refractory status epilepticus (RSE). We describe a case of refractory status epilepticus complicated by propofol infusion syndrome and collect from 5 databases all reports of refractory status epilepticus cases that were treated by propofol and developed the syndrome and outline whether refractory status epilepticus treatment with propofol is standardized according to international recommendations, compare it with alternative medications, and discuss how this syndrome can be treated and prevented...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27151155/idiopathic-bronchial-hemorrhage-a-rare-but-catastrophic-complication-in-cardiac-surgery
#11
Takeshi Uzuka, Masanori Nakamura, Tomohiro Nakajima, Shinichi Kusudoh, Hiroaki Usubuchi, Akihiko Tanaka, Noriyasu Watanabe
BACKGROUND: Hemoptysis is a common complication in all kinds of surgery. However, it is rarely critical because it resolves with or without intervention. CASE PRESENTATION: Here the authors present what is believed to be an unprecedented report of a case involving a fatal idiopathic bronchial hemorrhage complication during cardiac surgery. Eighty-five-year-old female with severe aorticvalve stenosis had elective aortic valve replacement. Subsequently, she developed diffuse bilateral severe idiopathic bronchial hemorrhage which required maximum intervention such as external bronchial ligation, V-A ECMO, coil embolization of bronchial artery and internal airway blockage by spigot...
May 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27113690/extracorporeal-membrane-oxygenation-what-the-nephrologist-needs-to-know
#12
REVIEW
Andres Oswaldo Razo-Vazquez, Kevin Thornton
Extracorporeal membrane oxygenation (ECMO) use in adults is rapidly increasing in its use for both cardiac and respiratory failure. ECMO exists in 2 primary configurations: veno-venous ECMO, used in the setting of isolated respiratory failure, and veno-arterial ECMO, which can be used in respiratory failure but is mandatory in the setting of cardiac failure. Acute kidney injury occurs frequently in patients on ECMO, and renal replacement therapy is often required. Continuous forms of renal replacement therapy predominate, but there is a high degree of variation in clinical practice among ECMO centers internationally...
May 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/26977974/what-is-ecmo
#13
REVIEW
(no author information available yet)
No abstract text is available yet for this article.
March 15, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26914772/challenges-in-individualizing-drug-dosage-for-intensive-care-unit-patients-is-augmented-renal-clearance-what-we-really-want-to-know-some-suggested-management-approaches-and-clinical-software-tools
#14
Roger Jelliffe
Acutely ill intensive care unit (ICU) patients often have large apparent volumes of distribution of drugs and, because of this, their drug clearance (CL) is usually also increased. 'Augmented renal Cl' is a current issue in the management of drug therapy for acutely ill and unstable ICU patients; however, Cl, the product of volume and the rate constant for excretion, describes only a theoretical volume of drug cleared per unit of time. Information of the actual rate of movement of the drug itself is obscured...
August 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/26769730/extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation-what-lessons-might-we-learn-from-volume-and-expertise
#15
COMPARATIVE STUDY
Jeremiah W Awori Hayanga, Alena Lira, Jonathan K Aboagye, Heather K Hayanga, Jonathan D'Cunha
OBJECTIVES: We sought to evaluate the effect of centre volume on survival when extracorporeal membrane oxygenation (ECMO) is used as a bridge to lung transplantation (LTx). METHODS: We performed a retrospective analysis of the United Network for Organ Sharing data on adult lung transplantations performed between 2000 and 2014. Centres were categorized based on volume of transplants into low-, medium- and high-volume centres (1-5, 6-15 and >15, respectively). Baseline characteristics were assessed and a Kaplan-Meier analysis was used to estimate survival with log-rank test...
April 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26689071/-successful-extracorporeal-membrane-oxygenation-for-a-patient-with-nearly-fatal-hypoxemia-induced-by-transfusion-related-acute-lung-injury
#16
Ayako Honda, Masato Morita, Akiko Taniguchi, Akihiko Tabuchi, Sadahiro Kubo
Transfusion-related acute lung injury (TRALI) is known to be the leading cause of transfusion-related mortality. A nearly fatal case of postoperative TRALI, successfully managed with extracorporeal membrane oxygenation (ECMO), is reported. The patient was a 70-year-old woman for whom laparoscopic nephrectomy was planned. She received several units of packed red blood cells and fresh-frozen plasma (FFP) intraoperatively due to massive bleeding. At the end of the operation, her PaO2/FIO2 ratio was 504, and she was extubated...
November 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26047606/extracorporeal-membranous-oxygenation-ecmo-in-polytrauma-what-the-radiologist-needs-to-know
#17
REVIEW
David Dreizin, Jay Menaker, Thomas M Scalea
The purpose of this article is to review the spectrum of severe traumatic injuries treatable with ECMO and their imaging features, considerations for cannula placement, and complications that may arise in polytraumatized patients on extracorporeal life support. Recent major advances in miniaturization and biocompatibility of ECMO devices have dramatically increased their safety profile and expanded the application of ECMO to patients with severe polytrauma.
October 2015: Emergency Radiology
https://www.readbyqxmd.com/read/25976146/innovation-in-surgical-technology-and-techniques-challenges-and-ethical-issues
#18
REVIEW
James D Geiger, Ronald B Hirschl
The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation...
June 2015: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/25789816/clinical-and-billing-review-of-extracorporeal-membrane-oxygenation
#19
REVIEW
James M Blum, William R Lynch, Craig M Coopersmith
Extracorporeal membrane oxygenation (ECMO) is a temporary technique for providing life support for cardiac dysfunction, pulmonary dysfunction, or both. The two forms of ECMO, veno-arterial (VA) and veno-venous (VV), are used to support cardiopulmonary and pulmonary dysfunction, respectively. Historically, ECMO was predominantly used in the neonatal and pediatric populations, as early adult studies failed to improve outcomes. ECMO has become far more common in the adult population because of positive results in published case series and clinical trials during the 2009 influenza A(H1N1) pandemic in 2009 to 2010...
June 2015: Chest
https://www.readbyqxmd.com/read/25711946/extracorporeal-membrane-oxygenation-a-radiologists-guide-to-who-what-and-where
#20
REVIEW
S R Hosmane, T Barrow, A Ashworth, E Smith
Extracorporeal membrane oxygenation (ECMO) is the short-term (days to weeks) support of patients with severe respiratory and/or cardiac failure. The use of these devices has been well established in paediatric and post-heart and lung transplantation patients; however, its use in patients with severe acute respiratory distress syndrome (ARDS) has gained acceptance as standard clinical practice over the past decade. The results of the CESAR trial (Conventional ventilation or ECMO for Severe Adult Respiratory failure) showed significant survival benefit for patients with ARDS undergoing ECMO...
May 2015: Clinical Radiology
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