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Ecmo review

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https://www.readbyqxmd.com/read/28419300/short-term-mechanical-circulatory-support-for-cardiogenic-shock-in-severe-peripartum-cardiomyopathy-la-piti%C3%A3-salp%C3%A3%C2%AAtri%C3%A3-re-experience
#1
Nadia Bouabdallaoui, Pierre Demondion, Pascal Leprince, Guillaume Lebreton
OBJECTIVES: Mechanical circulatory support (MCS) is a valuable option in the setting of cardiogenic shock (CS), although MCS use in severe forms of peripartum cardiomyopathy (PPCM) is underreported. We aimed to investigate maternal outcomes under MCS for refractory CS complicating PPCM. METHODS: We retrospectively reviewed 10 consecutive patients (2010-2015) meeting diagnosis criteria of PPCM that were managed with peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO) for severe CS...
April 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28410786/the-use-of-ecmo-for-gastroschisis-and-omphalocele-two-decades-of-experience
#2
Joanne E Baerg, Arul Thirumoorthi, Andrew O Hopper, Edward P Tagge
PURPOSE: The aim was to review the respiratory failure causes and outcomes of infants with omphalocele or gastroschisis receiving ECMO and reported to the Extracorporeal Life Support Organization (ELSO). METHODS: Gastroschisis and omphalocele infants supported with ECMO and reported to the ELSO Registry between 1992 and 2015 were retrospectively reviewed. Clinical variables, diagnosis of respiratory failure (pulmonary hypertension (PHN), congenital heart defects (CHD), congenital diaphragmatic hernia (CDH), and sepsis), and outcomes were recorded...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28410641/a-comparative-analysis-of-survival-prediction-using-preserve-and-resp-scores
#3
Hye-Rin Kang, Dong Jung Kim, Jinwoo Lee, Young-Jae Cho, Jun Sung Kim, Sang-Min Lee, Jae-Ho Lee, Sanghoon Jheon, Choon-Taek Lee, Yeon Joo Lee
BACKGROUND: Venovenous (VV) extracorporeal membrane oxygenation (ECMO) can be a life-saving therapy for patients with severe acute lung failure refractory to conventional therapy. The respiratory ECMO survival prediction (RESP) score and the predicting death for severe acute respiratory distress syndrome on VV-ECMO (PRESERVE) score were created to predict survival at the time of initiation of ECMO. This study aimed to validate both of these scores externally and to compare their predictive accuracies in patients with non-Western acute respiratory distress syndrome (ARDS)...
April 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#4
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28387487/-how-i-treat-%C3%A2-severe-beta-blocker-poisoning-pharmacological-approaches-and-ecmo
#5
P Horward, B Lambermont, J-O Defraigne, C Gurdebeke, P Morimont
We report the case of a woman with severe beta-blocker poisoning who, after failure of pharmacological therapy, was supported with an ECMO (ExtraCorporeal Membrane Oxygenation) device. We discuss conventional pharmacological treatments and other approaches that have emerged over the past decade such as high dose insulin therapy and lipid emulsions. Major advance has been achieved in the field of ECMO devices and their management. ECMO is now the first line device for refractory acute cardiac and/or pulmonary failure...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28385427/percent-predicted-lung-volume-changes-on-fetal-magnetic-resonance-imaging-throughout-gestation-in-congenital-diaphragmatic-hernia
#6
Hester F Shieh, Carol E Barnewolt, Jay M Wilson, David Zurakowski, Susan A Connolly, Judy A Estroff, Jill Zalieckas, C Jason Smithers, Terry L Buchmiller
PURPOSE: Percent predicted lung volume (PPLV)<15% on fetal MRI predicts high-risk CDH. Potential changes in PPLV throughout gestation and impact on risk stratification are unknown. We reviewed CDH patients with serial fetal MRIs to follow PPLV and determine correlation with postnatal outcomes. METHODS: CDH patients with serial fetal MRIs from 2005 to 2015 were included. We recorded prenatal MRI gestational age (GA) and PPLV, postnatal ECMO use, and survival. Data were analyzed by logistic regression and Fisher's exact test...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#7
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28347320/life-threatening-massive-pulmonary-embolism-rescued-by-venoarterial-extracorporeal-membrane-oxygenation
#8
Fillipo Corsi, Guillaume Lebreton, Nicolas Bréchot, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Charles-Edouard Luyt, Pascal Leprince, Jean Chastre, Alain Combes, Matthieu Schmidt
BACKGROUND: Despite quick implementation of reperfusion therapies, a few patients with high-risk, acute, massive, pulmonary embolism (PE) remain highly hemodynamically unstable. Others have absolute contraindication to receive reperfusion therapies. Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) might lower their right ventricular overload, improve hemodynamic status, and restore tissue oxygenation. METHODS: ECMO-related complications and 90-day mortality were analyzed for 17 highly unstable, ECMO-treated, massive PE patients admitted to a tertiary-care center (2006-2015)...
March 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28343415/is-therapeutic-hypothermia-for-acute-respiratory-distress-syndrome-the-future
#9
Adam J Hayek, Heath D White, Shekhar Ghamande, Christopher Spradley, Alejandro C Arroliga
INTRODUCTION: Severe acute respiratory distress syndrome (ARDS) has a high mortality, and there is limited knowledge about management of severe ARDS refractory to standard therapy. Early evidence suggests that therapeutic hypothermia (TH) could be a viable treatment for acute respiratory failure. We present 2 cases where TH was successfully used to manage refractory ARDS on extracorporeal membrane oxygenation (ECMO) and a review of the literature around TH and acute respiratory failure...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28342510/arterial-protocol-including-prophylactic-distal-perfusion-catheter-decreases-limb-ischemia-complications-in-patients-undergoing-extracorporeal-membrane-oxygenation
#10
Kathleen M Lamb, Paul J DiMuzio, Adam Johnson, Philip Batista, Neil Moudgill, Megan McCullough, Joshua A Eisenberg, Hitoshi Hirose, Nicholas C Cavarocchi
OBJECTIVE: Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complications (10%-70%). This study evaluates the results of a distal limb perfusion arterial protocol designed to reduce associated complications. METHODS: We conducted a retrospective institutional review board-approved review of consecutive patients requiring ECMO via femoral cannulation (July 2010-January 2015)...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#11
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#12
REVIEW
Praveen Kumar Chandrasekharan, Munmun Rawat, Rajeshwari Madappa, David H Rothstein, Satyan Lakshminrusimha
Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28329232/mid-term-results-of-bilateral-lung-transplant-with-postoperatively-extended-intraoperative-extracorporeal-membrane-oxygenation-for-severe-pulmonary-hypertension%C3%A2
#13
Jawad Salman, Fabio Ius, Wiebke Sommer, Thierry Siemeni, Christian Kuehn, Murat Avsar, Dietmar Boethig, Ulrich Molitoris, Christoph Bara, Jens Gottlieb, Tobias Welte, Axel Haverich, Marius M Hoeper, Gregor Warnecke, Igor Tudorache
OBJECTIVES: In severe pulmonary hypertension, diastolic dysfunction of the left ventricle causes significant morbidity and mortality after lung transplantation, which may be successfully reversed using a protocol based on perioperative veno-arterial extracorporeal membrane oxygenation (ECMO) and early extubation. Here, we present echocardiographic data and mid-term outcomes. METHODS: The records of lung transplanted patients at our institution between May 2010 and January 2016 were retrospectively reviewed...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328555/association-of-pediatric-cardiac-surgical-volume-and-mortality-after-cardiac-ecmo
#14
Cindy S Barrett, Titus T Chan, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
Centers with higher surgical and ECMO volume have improved survival for children undergoing pediatric cardiac surgery and ECMO respectively. We examined the relationship between both cardiac surgical and cardiac ECMO volumes, with survival. Using data from the Pediatric Health Information System, we reviewed patients who underwent ECMO during the hospitalization for cardiac surgery or heart transplantation from January 2003- June 2014. Among 106,967 patients in 43 centers undergoing a Risk Adjustment for Congenital Heart Surgery-1 (RACHS) 1-6 procedure (n =104,951) and/or cardiac transplantation (n=2016), 2...
March 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319524/combined-therapy-of-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-for-profound-acute-cardiopulmonary-failure
#15
Kevin Fujita, Koji Takeda, Boyganzi Li, Christine Mauro, Paul Kurlansky, Sowmyashree Sreekanth, Jiho Han, Lauren K Truby, Reshad Garan, Veli Topkara, Melana Yuzefpolskaya, Paolo Colombo, Yoshifumi Naka, Hiroo Takayama
Short-term ventricular assist devices (ST-VAD) have been effective in treating patients with refractory cardiogenic shock. Membrane oxygenators (MO) can be added to the circuit for concomitant profound refractory hypoxia. This study reports outcomes of combined therapy in this portion of patients. This is a retrospective review of 166 patients who received an ST-biventricular assist device (BiVAD) or right ventricular assist device (RVAD) for cardiogenic shock between November 2007 and November 2014. An MO was added to the RVAD for profound hypoxia refractory to maximized ventilation...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28318620/factors-associated-with-mortality-risk-in-critical-care-patients-treated-with-veno-arterial-extracorporeal-membrane-oxygenation
#16
Sun Hee Lee, Dong-Soo Shin, Jong Ran Kim, Hyunjung Kim
OBJECTIVES: To identify factors associated with mortality in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and to validate the discrimination of the risk assessment tools to predict mortality. BACKGROUND: VA-ECMO is a rescue therapy for patients with life-threatening cardiac failure, but mortality remains high. METHODS: In this retrospective study, we reviewed the medical records of adult patients who underwent VA-ECMO in an intensive care unit of a university hospital, between 2009 and 2013...
March 16, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28298667/suspected-heparin-induced-thrombocytopenia-in-patients-receiving-extracorporeal-membrane-oxygenation
#17
Bhupinder Natt, Cameron Hypes, Robyn Basken, Joshua Malo, Toshinobu Kazui, Jarrod Mosier
Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management is critical in patients while on extracorporeal membrane oxygenation (ECMO) to prevent thromboembolism and for the optimal functioning of the circuit. We identified five patients with respiratory failure at our hospital managed with ECMO in the last 2 years that were treated for HIT. A brief clinical course and their management are discussed. We also briefly review the literature for best evidence for management of such patients...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28275619/extracorporeal-membrane-oxygenation-in-the-pre-and-post-lung-transplant-period
#18
REVIEW
Nirmal S Sharma, Mathew G Hartwig, Don Hayes
Evolution in technology has resulted in rapid increase in utilization of extracorporeal membrane oxygenation (ECMO) as a bridge to recovery and/or transplantation. Although there is limited evidence for the use of ECMO, recent improvements in ECMO technology, personnel training, ambulatory practices on ECMO and lung protective strategies have resulted in improved outcomes in patients bridged to lung transplantation. This review provides an insight into the current outcomes and best practices for utilization of ECMO in the pre- and post-lung transplantation period...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28267980/postoperative-extracorporeal-membrane-oxygenation-support-for-acute-type-a-aortic-dissection
#19
Ting-Wei Lin, Meng-Ta Tsai, Yu-Ning Hu, Wei-Hung Lin, Wei-Ming Wang, Chwan-Yau Luo, Jun-Neng Roan
BACKGROUND: Few studies have investigated the use of postoperative extracorporeal membrane oxygenation (ECMO) in acute type A aortic dissection (aTAAD). We identified aTAAD surgical patients at risk of ECMO implantation postoperatively and analyzed the prognosis of these patients. METHODS: We retrospectively reviewed 162 consecutive aTAAD patients undergoing operations from January 2008 to December 2015. Patient data were analyzed for risk factors leading to an ECMO requirement...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28257296/extracorporeal-circulation-during-lung-transplantation-procedures-a-meta-analysis
#20
Dominik J Hoechter, Yu-Ming Shen, Tobias Kammerer, Sabina Günther, Thomas Weig, René Schramm, Christian Hagl, Frank Born, Bruno Meiser, Gerhard Preissler, Hauke Winter, Stephan Czerner, Bernhard Zwissler, Mansmann Ulrich, Vera von Dossow
Extracorporeal circulation is an invaluable tool in lung transplantation. Over the past years, an increasing number of centers changed their standard for intraoperative extracorporeal circulation from cardiopulmonary bypass to extracorporeal membrane oxygenation - with differing results. This meta-analysis reviews the existing evidence.An online literature research on Medline, Embase, and Pubmed has been performed. Two persons independently judged the papers using the ACROBAT-NRSI tool of the Cochrane collaboration...
February 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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