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Ecmo review

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https://www.readbyqxmd.com/read/29351695/reasons-for-failure-of-systemic-to-pulmonary-artery-shunts-in-neonates
#1
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
BACKGROUND:  Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality. METHODS:  Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction...
January 19, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29350305/percutaneous-mechanical-circulatory-support-devices-for-high-risk-percutaneous-coronary-intervention
#2
REVIEW
Subrata Kar
PURPOSE OF REVIEW: Percutaneous mechanical circulatory support devices (PMCSD) consist of the intra-aortic balloon pump (IABP), Impella (Abiomed Inc., Danvers, Massachusetts), Tandem Heart (Cardiac Assist, Inc., Pittsburgh, Pennsylvania), or extracorporeal membranous oxygenation (ECMO). They augment cardiac output, cardiac index, and cardiac power which allow the operator to mitigate hemodynamic perturbations during high-risk percutaneous coronary intervention (HR-PCI). This review discusses PMCSD and their contemporary literature...
January 19, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29344952/a-weaning-protocol-for-venovenous-extracorporeal-membrane-oxygenation-with-a-review-of-the-literature
#3
April A Grant, Valerie J Hart, Edward B Lineen, Amit Badiye, Patricia M Byers, Amit Patel, Rodrigo Vianna, Michael M Koerner, Aly El Banayosy, Matthias Loebe, Ali Ghodsizad
Several articles have discussed the weaning process for venoarterial extracorporeal membrane oxygenation; however, there is no published report to outline a standardized approach for weaning a patient from venovenous extracorporeal membrane oxygenation (ECMO). This complex process requires an organized approach and a thorough understanding of ventilator management and ECMO physiology. The purpose of this article is to describe the venovenous ECMO weaning protocol used at our institution as well as provide a review of the literature...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#4
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29336834/an-overview-of-medical-ecmo-for-neonates
#5
REVIEW
Kathryn Fletcher, Rachel Chapman, Sarah Keene
Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer...
January 11, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29336832/anticoagulation-in-neonatal-ecmo
#6
REVIEW
Aditi Kamdar, Natalie Rintoul, Leslie Raffini
Despite advances made in technology and neonatal intensive care, the rate of hemorrhagic and thrombotic complications remains unacceptably high in patients undergoing extracorporeal membrane oxygenation (ECMO) and these complications negatively impact morbidity and mortality. Management of anticoagulation in neonates who have a developing hemostatic system is vastly different from adults and poses unique challenges. Variation in practice among ECMO centers regarding anticoagulation monitoring and titration reflects the lack of high-quality evidence...
January 11, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29316358/continuous-intravenous-sildenafil-as-an-early-treatment-in-neonates-with-congenital-diaphragmatic-hernia
#7
Florian Kipfmueller, Lukas Schroeder, Christoph Berg, Katrin Heindel, Peter Bartmann, Andreas Mueller
BACKGROUND: Pulmonary hypertension (PH) is an important contributor of morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). Treatment options are limited, but sildenafil might improve oxygenation and PH in neonates with CDH. OBJECTIVE: Aim of this study is to assess effects of intravenous sildenafil on oxygenation and PH in neonates with CDH. METHODS: A retrospective chart review was performed in all neonates with CDH born in our institution between September 2012 and December 2014...
January 5, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29315465/ventilation-strategy-and-anesthesia-management-in-patients-with-severe-tracheal-stenosis-undergoing-urgent-tracheal-stenting
#8
J-H Zhu, M Lei, E-G Chen, Q Qiao, T-D Zhong
BACKGROUND: Stenting of airway stenosis is a common procedure in specialized centers. The aim of this study was to summarize our clinical experience in ventilation strategy and anesthesia management of patients undergoing urgent tracheal stenting. METHODS: Clinical data of 22 patients with severe tracheal stenosis who underwent urgent endoscopic placement of a tracheal stent during a 2-year period were retrospectively reviewed. The efficacy and safety of different ventilation strategies and veno-arterial extracorporeal membrane oxygenation (ECMO), individualized based on the cause and location of tracheal narrowing, were evaluated...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29314296/successful-use-of-extracorporeal-membrane-oxygenation-support-in-severe-septic-shock-with-associated-acute-cardiomyopathy
#9
S Michelle Perdue, Brian J Poore, Ashok N Babu, W Kyle Stribling
A 24-year-old female presented with sepsis and cardiogenic shock 4 days after vaginal delivery. Veno-arterial extracorporeal membrane oxygenation (VA ECMO) therapy was used for cardiovascular support as a bridge for recovery. The use of VA ECMO in patients with cardiogenic shock secondary to sepsis is reviewed.
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29312713/outcomes-of-perioperative-extracorporeal-membrane-oxygenation-use-in-patients-undergoing-lung-transplantation
#10
Joo Han Song, Ji Eun Park, Jin Gu Lee, Chang Young Lee, Kyung Sik Nam, Jee Won Suh, Anes Kim, Seung Hyun Lee, Hyun Chel Joo, Young Nam Youn, Song Yee Kim, Moo Suk Park, Hyo Chae Paik
Background: The aim of this single-center study is to review the transplant outcomes of patients receiving lung transplantation (LTx) using intraoperative extracorporeal membrane oxygenation (ECMO) according to the perioperative use of ECMO. Methods: We retrospectively reviewed the transplant outcomes of 107 consecutive patients who underwent LTx using intraoperative ECMO between March 2013 and August 2016 at Severance Hospital of Yonsei University (Seoul, Korea)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29305226/extracorporeal-membrane-oxygenation-in-congenital-heart-disease
#11
REVIEW
Kiona Y Allen, Catherine K Allan, Lillian Su, Mary E McBride
This review article will discuss the indications for and outcomes of neonates with congenital heart disease who receive extracorporeal membrane oxygenation (ECMO) support. Most commonly, ECMO is used as a perioperative bridge to recovery or temporary support for those after cardiac arrest or near arrest in patients with congenital or acquired heart disease. What had historically been considered a contraindication to ECMO, is evolving and more of the sickest and most complicated babies are cared for on ECMO...
January 2, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29282441/platelet-transfusion-thresholds-among-children-admitted-to-a-pediatric-intensive-care-unit
#12
Batool Alsheikh, Madhuradhar Chegondi, Balagangadhar Totapally
Objective To evaluate the threshold for platelet transfusion in children admitted to a pediatric intensive care unit (PICU). This is a retrospective chart review study, conducted at our tertiary level PICU and is related to critically ill pediatric patients who required platelet transfusion. Methods We retrieved the target patient population data from our blood bank database. The patients were subdivided into four subgroups: hematologic (hematologic malignancies, bone marrow suppression, hemolytic anemia, and sickle cell disease), surgical (post-surgical, trauma and acute bleeding), the unstable fraction of inspired oxygen (FiO2 > 0...
October 24, 2017: Curēus
https://www.readbyqxmd.com/read/29274319/histopathologic-findings-in-lungs-of-patients-treated-with-extracorporeal-membrane-oxygenation
#13
Hee Eun Lee, Eunhee S Yi, Jeffrey T Rabatin, J Kyle Bohman, Anja C Roden
BACKGROUND: The outcome of extracorporeal membrane oxygenation (ECMO) might be influenced by its complications. Only limited information is available regarding the pathologic consequences of ECMO especially in the era of modern ECMO technology. METHODS: We studied the histopathologic findings in autopsy lungs of patients treated with ECMO as compared to those without ECMO. Autopsy files were queried for cases with ECMO. An age and gender-matched control group, comprised of patients who died in the Intensive Care Unit without acute respiratory distress syndrome, pneumonia, or ECMO, was compared with patients with ECMO for cardiac reason...
December 20, 2017: Chest
https://www.readbyqxmd.com/read/29236180/diagnosis-medical-treatment-and-stepwise-mechanical-circulatory-support-for-fulminat-myocarditis
#14
Shunsuke Saito, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Keitaro Domae, Yasumasa Tsukamoto, Yasushi Sakata, Yoshiki Sawa
Fulminant myocarditis is one of the most challenging diseases. We sought to examine the outcomes of our multidisciplinary treatment strategy for fulminant myocarditis. A retrospective review of consecutive 30 patients with fulminant myocarditis was conducted. Of the 30 patients, 25 required mechanical circulatory support (MCS). Percutaneous extracorporeal membrane oxygenation (ECMO) was the first-line therapy to rescue the patients and inserted in 23 of them. The other 2 were implanted with temporary ventricular assist device (t-VAD) with extracorporeal centrifugal pump(s)...
December 13, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29221484/the-impacts-of-baseline-ventilator-parameters-on-hospital-mortality-in-acute-respiratory-distress-syndrome-treated-with-venovenous-extracorporeal-membrane-oxygenation-a-retrospective-cohort-study
#15
Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a valuable life support in acute respiratory distress syndrome (ARDS) in adult patients. However, the success of VV-ECMO is known to be influenced by the baseline settings of mechanical ventilation (MV) before its institution. This study was aimed at identifying the baseline ventilator parameters which were independently associated with hospital mortality in non-trauma patients receiving VV-ECMO for severe ARDS. METHODS: This retrospective study included 106 non-trauma patients (mean age: 53 years) who received VV-ECMO for ARDS in a single medical center from 2007 to 2016...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29216952/-sepsis-induced-cardiomyopathy-complicated-with-cardiogenic-shock-patients-supported-with-extracorporeal-membrane-oxygenation
#16
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216679/the-role-of-extracorporeal-membrane-oxygenator-therapy-in-the-setting-of-type-a-aortic-dissection
#17
Ibrahim Sultan, Andreas Habertheuer, Tyler Wallen, Mary Siki, Wilson Szeto, Joseph E Bavaria, Matthew Williams, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Patients presenting with type A aortic dissection (TAAD) present with a wide clinical spectrum ranging from hemodynamic stability to multiorgan malperfusion with cardiovascular collapse. Extracorporeal membrane oxygenator (ECMO) therapy is increasingly being utilized as salvage therapy in patients with acute cardiopulmonary failure and for post-cardiotomy shock. We sought to determine the utility of ECMO implementation post-TAAD repair. METHODS: The Pennsylvania Health Care Cost Containment Council (PHC4) database, maintained by an independently functioning state agency, was retrospectively reviewed from 2004 to 2014...
December 7, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29209510/milrinone-in-congenital-diaphragmatic-hernia-a-randomized-pilot-trial-study-protocol-review-of-literature-and-survey-of-current-practices
#18
REVIEW
Satyan Lakshminrusimha, Martin Keszler, Haresh Kirpalani, Krisa Van Meurs, Patricia Chess, Namasivayam Ambalavanan, Bradley Yoder, Maria V Fraga, Holly Hedrick, Kevin P Lally, Leif Nelin, Michael Cotten, Jonathan Klein, Stephanie Guilford, Ashley Williams, Aasma Chaudhary, Marie Gantz, Jenna Gabrio, Dhuly Chowdhury, Kristin Zaterka-Baxter, Abhik Das, Rosemary D Higgins
Background: Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29203213/examining-the-role-of-extracorporeal-membrane-oxygenation-in-patients-following-suspected-or-confirmed-suicide-attempts-a-case-series
#19
Adeel Abbasi, Cynthia Devers, Christopher S Muratore, Colin Harrington, Corey E Ventetuolo
The decision to offer extracorporeal membrane oxygenation (ECMO) is based on a risk/benefit assessment and the likelihood of a treatable underlying condition or the feasibility of destination therapy (durable mechanical support or thoracic organ transplantation) should heart-lung function fail to improve. Patients who present following suspected suicide attempts who fail medical therapy may pose a dilemma for clinicians. An assessment to determine if a patient has a high likelihood of psychiatric recovery such that bridging with ECMO or ultimately destination therapy could or should be offered is not always feasible in the setting of critical illness...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29184987/ventilation-during-extracorporeal-support-why-and-how
#20
REVIEW
A Pesenti, E Carlesso, T Langer, T Mauri
The main target of extracorporeal support is to achieve viable gas exchange, while minimizing the risk of ventilator-induced lung injury, achieved through a decreased mechanical ventilation load on the natural lung. However, during veno-venous extracorporeal membrane oxygenation (ECMO), mechanical ventilation is still necessary in order to prevent lung collapse and/or if extracorporeal blood flow is not sufficient to guarantee adequate gas exchange. In this review, we will summarize the physiology of extracorporeal support and the rationale for continuing mechanical ventilation in this context...
November 28, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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