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Ecmo review

David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Stacy Pelekhaty, Jay Menaker
Prader-Willi Syndrome (PWS) is a genetic condition that results in a constellation of symptoms and typically results in hyperphagia and obesity in adulthood. Critically ill adults with PWS present a unique challenge to the nutrition professional, particularly when they require support modalities such as extracorporeal membrane oxygenation (ECMO). The purpose of this case study is to review the nutrition care of a critically ill adult patient with PWS who required venovenous ECMO. The patient was successfully managed with a hypocaloric, high-protein approach, which did not result in the diagnosis of malnutrition during his hospitalization...
March 12, 2018: Nutrition in Clinical Practice
Kate M Richmond, Katharine G Warburton, Simon J Finney, Sachin Shah, Benjamin A J Reddi
INTRODUCTION: Comprehensive clinical examination can be compromised in patients on veno-venous extracorporeal membrane oxygenation (VV-ECMO). Adjunctive diagnostic imaging strategies range from bedside imaging only to routine computed tomography (CT). The risk-benefit of either approach remains to be evaluated. Patients retrieved to the Royal Brompton Hospital (RBH) on VV-ECMO routinely undergo admission CT imaging of head, chest, abdomen and pelvis. This study aimed to identify how frequently changes in therapy or adverse events could be attributed to routine CT scanning...
March 1, 2018: Perfusion
Kristin C Greathouse, Kelly T Sakellaris, Dmitry Tumin, Jacob Katsnelson, Joseph D Tobias, Don Hayes, Andrew R Yates
INTRODUCTION: Pediatric data related to safety, tolerance, and outcomes of enteral nutrition (EN) for patients requiring extracorporeal membrane oxygenation (ECMO) are lacking. The objectives of this study were to evaluate early nutrition status and timing of EN initiation on survival during pediatric ECMO. METHODS: A single center institutional review board-approved retrospective chart review was performed on all pediatric patients requiring ECMO from October 2008 through December 2013...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Gemma Malpas, Orlando Hung, Ainslie Gilchrist, Chrison Wong, Blaine Kent, Gregory M Hirsch, Robert D Hart
While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management...
March 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
Sandeep M Patel, Jerry Lipinski, Sadeer G Al-Kindi, Toral Patel, Petar Saric, Jun Li, Fahd Nadeem, Thomas Ladas, Amer Alaiti, Ann Phillips, Benjamin Medalion, Salil Deo, Yakov Elgudin, Marco A Costa, Mohammed Najeeb Osman, Guilherme F Attizzani, Guilherme H Oliveira, Basar Sareyyupoglu, Hiram G Bezerra
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous left ventricular assist device (Impella) and VA-ECMO remains largely unknown. We retrospectively reviewed patients treated for refractory cardiogenic shock with VA-ECMO (2014-2016). The primary outcome was all-cause mortality within 30 days of VA-ECMO implantation. Secondary outcomes included duration of support, stroke, major bleeding, hemolysis, inotropic score, and cardiac recovery...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
Abigail White, Sabin J Bozso, Michael C Moon
PURPOSE: Thyrotoxicosis-induced cardiomyopathy (TCM) is a rare, potentially life-threatening complication requiring extracorporeal membrane oxygenation (ECMO) for temporary mechanical support while a euthyroid state is being achieved. MATERIALS AND METHODS: The current review searched Ovid Medline and PubMed for all relevant studies reported in English from January 1, 1970 to December 31, 2017. We included studies where patients were diagnosed with thyrotoxicosis, eventually deteriorating into TCM, requiring veno-arterial ECMO...
February 3, 2018: Journal of Critical Care
Chunli Liu, Wenqing Sun, Chunting Wang, Fenglin Liu, Mingxiang Zhou
OBJECTIVE: To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature. METHODS: Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza. RESULTS: A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus...
February 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
George Stoyle, Peter Fawcett, Ignacio Malagon
The purpose of this study is to determine the effect of illicit drug and alcohol dependencies on mortality, length of stay, and complications in patients who have been supported with veno-venous extracorporeal membrane oxygenation (VV-ECMO) following respiratory failure not responsive to conventional methods of ventilation. 584 VV-ECMO referrals received at Wythenshawe Hospital were reviewed for evidence of drug dependency. 13 patients were identified as being drug-dependent and having undergone treatment with VV-ECMO...
February 20, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Elin Öst, Björn Frenckner, Margret Nisell, Carmen Mesas Burgos, Maria Öjmyr-Joelsson
PURPOSE: The aim of this study was to examine health-related quality of life (HRQoL) in children born with congenital diaphragmatic hernia (CDH). METHODS: Between 1993 and 2003, a total of 102 children born with CDH were treated at Astrid Lindgren Children's hospital in Stockholm. In 2012, long-term survivors (n = 77) were asked to participate in the present study, which resulted in a 46% (n = 35) response rate. The KIDSCREEN-52 questionnaire was used for measuring HRQoL and a detailed review of medical records was performed...
February 16, 2018: Pediatric Surgery International
Sibghat Tul Llah, Sheema Mir, Sumaiya Sharif, Salman Khan, Mohammed A Mir
Hantavirus cardiopulmonary syndrome is characterized by pulmonary capillary leakage and alveolar flooding, resulting in 50% mortality due to fulminant hypoxic respiratory failure. In addition, depression of cardiac function ensues, which complicates the picture with cardiogenic shock. Early diagnosis and appropriate use of extracorporeal membrane oxygenation (ECMO) are amongst the lifesaving interventions in this fatal illness. However, a recent case report demonstrates that implementation of high volume continuous hemofilteration along with protective ventilation reverses the cardiogenic shock within few hours in hantavirus infected patients...
February 15, 2018: Journal of Medical Virology
Fabio Ius, Ruslan Natanov, Jawad Salman, Christian Kuehn, Wiebke Sommer, Murat Avsar, Thierry Siemeni, Dmitry Bobylev, Reza Poyanmehr, Dietmar Boethig, Joerg Optenhoefel, Nicolaus Schwerk, Axel Haverich, Gregor Warnecke, Igor Tudorache
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) has an important role in bridging patients to lung transplantation. In this study, we present our experience with pretransplant ECMO during the last 7 years and investigate its impact on graft outcomes. METHODS: Records of all lung-transplanted patients at our institution between January 2010 and April 2017 were retrospectively reviewed. Graft survival was compared between patients who required pretransplant ECMO (pre-Tx ECMO+) and patients who did not (pre-Tx ECMO-)...
February 12, 2018: European Journal of Cardio-thoracic Surgery
Jeremy W Cannon, Phillip E Mason, Andriy I Batchinsky
Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation (ECMO), review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense ECMO program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care...
February 13, 2018: Journal of Trauma and Acute Care Surgery
Maziar Khorsandi, Mark Davidson, Omar Bouamra, Andrew McLean, Kenneth MacArthur, Ida Torrance, Gillian Wylie, Ed Peng, Mark Danton
Introduction: Around 3.2%-8.4% of patients receive venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support after pediatric cardiac surgery. The desired outcome is "bridge-to-recovery" in most cases. There is no universally agreed protocol, and given the associated costs and complications rates, the decisions as of when and when not to institute VA ECMO are largely empirical. Methods: A retrospective review of the ECMO database at the Scottish Pediatric Cardiac Services (SPCS) was undertaken...
January 2018: Annals of Pediatric Cardiology
Yuexing Tu, Qi Jin, Renhua Sun, Qian Li
Extracorporeal membrane oxygenation (ECMO) provides rescue treatment for patients with severe acute respiratory distress syndrome (ARDS) when conventional management fails. The present study reported ECMO as a life-saving treatment for ARDS due to bilateral pulmonary contusion in a 24-year-old male multiple trauma patient. ECMO therapy lasted 7 days for the patient and was successively stopped without any complications. ECMO modality should be chosen according to the respiratory and circulatory condition of each individual...
February 2018: Experimental and Therapeutic Medicine
Antonio Rubino, Diego Costanzo, Daniel Stanszus, Kamen Valchanov, David Jenkins, Federico Sertic, Jo-Anne Fowles, Alain Vuylsteke
OBJECTIVES: Central veno-arterial extracorporeal membrane oxygenation (C-VA-ECMO) provides temporary cardiorespiratory support for patients in heart failure who cannot be weaned from cardiopulmonary bypass successfully. Outcomes are influenced by the reversibility of the initial insult and complications of the technique. METHODS: The authors reviewed their single-center experience over the last 8 years to inform future practice. The study included all patients supported with C-VA-ECMO after cardiothoracic surgery between January 2008 and July 2016...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions. METHODS: This retrospective study enrolled 36 adult trauma patients receiving ECMO due to advanced shock or respiratory failure in a level I trauma center between August 2006 and October 2014...
February 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
V Núñez, M Romo, J L Encinas, A Bueno, B Herrero, E Antolín, L Martínez, M López Santamaría
INTRODUCTION AND OBJECTIVES: Different echographic and fetal magnetic resonance (MRI) measurements have been described in the diagnosis of associated malformations and the prognosis of congenital diaphragmatic hernia (CDH). We have reviewed our experience searching for useful isolated or combined parameters and how MRI can complement ultrasound. MATERIAL AND METHODS: We evaluated 29 fetuses with CDH. We examined ultrasonography: Lung to Head (LHR o/e) and in MRI: ipsilateral lung volume (IPV) and total expressed as percentage of observed / expected lung volume (VPT o/e) and percentage of herniated liver (PHH)...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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