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Ecmo review

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https://www.readbyqxmd.com/read/29777285/insufficient-left-ventricular-unloading-after-extracorporeal-membrane-oxygenation-a-case-series-observational-study
#1
W Hu, J Zhou, L Chen, J Huang, W Hu, Y Zhu, T Yuan
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a method widely used to support circulation in patients with fulminant myocarditis (FM). However, a common complication associated with ECMO is left ventricular (LV) overload. METHODS: This case series observed the effects of intra-aortic balloon pump (IABP) and beta-blockers for the treatment of LV overload after ECMO. The cases of eight patients with FM who underwent ECMO from September 2009 to July 2016 were reviewed...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#2
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29753504/extracorporeal-life-support-for-adults-with-refractory-septic-shock
#3
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/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#4
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#5
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29744226/cerebral-pathophysiology-in-extracorporeal-membrane-oxygenation-pitfalls-in-daily-clinical-management
#6
REVIEW
Syed Omar Kazmi, Sanjeev Sivakumar, Dimitrios Karakitsos, Abdulrahman Alharthy, Christos Lazaridis
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that is widely being used in centers throughout the world. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO. Studies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical aspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological changes can lead to profound neurological complications...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29744220/principles-and-indications-of-extracorporeal-life-support-in-general-thoracic-surgery
#7
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/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#8
Olutosin J Akanni, Koji Takeda, Lauren K Truby, Paul A Kurlansky, Codruta Chiuzan, Jiho Han, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Jeffery W Moses, Yoshifumi Naka, A Reshad Garan, Ajay J Kirtane, Hiroo Takayama
Combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and a percutaneous microaxial left ventricular assist device (pLVAD), or "EC-VAD," has been reported in cases of left ventricular decompression with mixed results. We conducted a retrospective review of patients who received EC-VAD (n = 29) or isolated VA-ECMO therapy (ECMO-only; n = 196) for refractory cardiogenic shock between February 2011 and October 2014. Fourteen patients received VA-ECMO and then Impella pLVAD (E→EC-VAD), and 15 received the Impella pump then VA-ECMO (I→EC-VAD)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29732190/hybrid-extracorporeal-membrane-oxygenation
#9
REVIEW
Alexandre Brasseur, Sabino Scolletta, Roberto Lorusso, Fabio Silvio Taccone
Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732187/adjunctive-therapies-during-veno-venous-extracorporeal-membrane-oxygenation
#10
REVIEW
Federico Pappalardo, Andrea Montisci
Veno-venous extracorporeal membrane oxygenation (VV ECMO) restores gas exchanges in severely hypoxemic patients. The need for adjunctive therapies usually originates either from refractory hypoxemia during ECMO (defined as the persistence of low blood oxygen levels despite extracorporeal support) or from the attempt to give a specific therapy for acute respiratory distress syndrome (ARDS). In this review, therapeutic strategies to treat refractory and persistent hypoxemia during ECMO are evaluated. In the second part, therapies that can be added on top of VV ECMO to address inflammation and altered vascular permeability in ARDS are examined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732186/right-ventricular-dysfunction-during-acute-respiratory-distress-syndrome-and-veno-venous-extracorporeal-membrane-oxygenation
#11
REVIEW
Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers, Dinis Reis Miranda
Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732184/spontaneous-breathing-during-veno-venous-extracorporeal-membrane-oxygenation
#12
REVIEW
Stefania Crotti, Nicola Bottino, Elena Spinelli
Veno-venous extracorporeal membrane oxygenation (VV ECMO) has started to be applied in awake spontaneously breathing patients as an alternative to invasive mechanical ventilation. As the physiologic cardiorespiratory variability is increased in this condition, the dynamic interaction between patient respiratory activity and extracorporeal system function affects the clinical management. The effect of extracorporeal CO2 removal on patient respiratory drive is variable and not always predictable, with some patients responding to CO2 removal with a decrease in respiratory rate and effort and other patients demonstrating a persistently high work of breathing independent on CO2 unload...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732182/drugs-pharmacokinetics-during-veno-venous-extracorporeal-membrane-oxygenation-in-pediatrics
#13
REVIEW
Matteo Di Nardo, Enno Diederick Wildschut
Data evaluating pharmacokinetic/pharmacodynamic (PK/PD) aspect in the pediatric population are scarce especially regarding the pediatric intensive care unit. Dosing of frequently used drugs (sedatives, analgesics, antibiotics and cardiovascular drugs) are mainly based on non "pediatric intensive care unit (PICU)" patients, and sometimes are translated from adult patients. Among PICU patients, the most complex patients are the ones who are critically ill and are receiving mechanical circulatory/respiratory support for cardiac and/or respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732180/bicaval-dual-lumen-cannula-in-adult-veno-venous-extracorporeal-membrane-oxygenation-clinical-pearls-for-safe-cannulation
#14
REVIEW
Chun-Wai Ngai, Pauline Yeung Ng, Wai-Ching Sin
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been traditionally delivered with two independent cannulae at different venous insertion sites. The bicaval dual lumen cannula has gained popularity as a cannula for simultaneous venous drainage and reinfusion of blood via the internal jugular vein (IJV). Its insertion requires special attention to details to prevent the occurrence of serious complications. In this review, we discuss different techniques of cannula insertion and tips for troubleshooting...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29730125/triage-and-optimization-a-new-paradigm-in-the-treatment-of-massive-pulmonary-embolism
#15
Chetan Pasrija, Aakash Shah, Praveen George, Anthony Kronfli, Maxwell Raithel, Francesca Boulos, Mehrdad Ghoreishi, Gregory J Bittle, Michael A Mazzeffi, Lewis Rubinson, James S Gammie, Bartley P Griffith, Zachary N Kon
BACKGROUND: Massive pulmonary embolism (PE) remains a highly fatal condition. Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) and surgical pulmonary embolectomy in the management of massive PE have been reported previously, the outcomes remain less than ideal. We hypothesized that the institution of a protocolized approach of triage and optimization using VA-ECMO would result in improved outcomes compared with historical surgical management. METHODS: All patients with a massive PE referred to the cardiac surgery service between 2010 and 2017 were retrospectively reviewed...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29714432/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-center-experience-in-turkey
#16
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/29701338/arterial-vascular-complications-in-peripheral-venoarterial-extracorporeal-membrane-oxygenation-support
#17
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/29678433/clinical-outcomes-of-adult-patients-who-receive-extracorporeal-membrane-oxygenation-for-postcardiotomy-cardiogenic-shock-a-systematic-review-and-meta-analysis
#18
Liangshan Wang, Hong Wang, Xiaotong Hou
OBJECTIVE: To investigate the clinical outcomes of adult patients receiving extracorporeal membrane oxygenation (ECMO) for postcardiotomy cardiogenic shock (PCS). DESIGN: Meta-analysis of 20 observational studies. SETTING: Hospitals that perform cardiac surgery. PARTICIPANTS: The study included 2,877 PCS patients undergoing ECMO from 20 observational studies. INTERVENTIONS: ECMO use. MEASUREMENTS AND MAIN RESULTS: Twenty observational studies were selected for final analysis...
March 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29670870/adjunctive-therapies-during-extracorporeal-membrane-oxygenation-to-enhance-multiple-organ-support-in-critically-ill-children
#19
REVIEW
Marguerite Orsi Canter, Jessica Daniels, Brian C Bridges
Since the advent of extracorporeal membrane oxygenation (ECMO) over 40 years ago, there has been increasing interest in the use of the extracorporeal circuit as a platform for providing multiple organ support. In this review, we will examine the evidence for the use of continuous renal replacement therapy, therapeutic plasma exchange, leukopheresis, adsorptive therapies, and extracorporeal liver support in conjunction with ECMO.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29622277/the-role-of-extracorporeal-membrane-oxygenation-in-severe-pulmonary-coccidioidomycosis
#20
Alex Studemeister, Lucy Studemeister, Francisco Brun
BACKGROUND: Severe coccidioidal pneumonia with acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membrane oxygenation (ECMO) has been applied successfully to other severe fungal pneumonia associated with ARDS. We review our experience with the use of ECMO in severe coccidioidal ARDS. OBJECTIVES: To review indications and outcome of ECMO in severe pulmonary coccidioidomycosis. METHODS: Three cases of severe ARDS caused by coccidioidomycosis are presented...
May 2018: Heart & Lung: the Journal of Critical Care
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