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Ecmo review

Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Myung Jin Choi, Sang Ook Ha, Hyoung Soo Kim, Sunghoon Park, Sang Jin Han, Sun Hee Lee
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) for patients with septic shock is controversial. The outcomes are favorable in children but heterogeneous in adults. The present study aimed to analyze the outcomes of adult patients who underwent ECMO for septic shock, and to determine the factors associated with prognosis. METHODS: We respectively reviewed the medical records of patients who underwent ECMO for septic shock between January 2007 and December 2013...
October 12, 2016: Annals of Thoracic Surgery
Alban-Elouen Baruteau, Thomas Barnetche, Luc Morin, Zakaria Jalal, Nicholas S Boscamp, Emmanuel Le Bret, Jean-Benoit Thambo, Julie A Vincent, Alain Fraisse, Alejandro J Torres
BACKGROUND: Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aimed to assess whether balloon atrioseptostomy (BAS) is a safe and efficient strategy. METHODS: All patients who underwent percutaneous static BAS under VA-ECMO at four tertiary institutions were retrospectively reviewed. RESULTS: From 2000 to 2014, BAS was performed in 64 patients (32 adults and 32 children)...
October 14, 2016: European Heart Journal. Acute Cardiovascular Care
Wan-Ting Hung, Shu-Chien Huang, Dania El Mazloum, Wen-Hsi Lin, Hui-Hsin Yang, Hung-Chieh Chou, En-Ting Wu, Chien-Yi Chen, Po-Nien Tsao, Wu-Shiun Hsieh, Wen-Ming Hsu, Yih-Sharng Chen, Hong-Shiee Lai
BACKGROUND/PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a treatment option for stabilizing neonates with congenital diaphragmatic hernia (CDH) in a critical condition when standard therapy fails. However, the use of this approach in Taiwan has not been previously reported. METHODS: The charts of all neonates with CDH treated in our institute during the period 2007-2014 were reviewed. After 2010, patients who could not be stabilized with conventional treatment were candidates for ECMO...
October 7, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Eiji Hirakawa, Satoshi Ibara, Takuya Tokuhisa, Yoshinobu Maede, Takako Kuwahara, Chie Ishihara, Hiroyuki Noguchi, Yoshiki Naitou, Masakatsu Yamamoto, Masaya Kibe, Tsuyoshi Yamamoto, Tomonori Kurimoto, Masato Kamitomo, Kazutoshi Cho, Hisanori Minakami
BACKGROUND: There have been few reports regarding outcomes after extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. METHODS: A review of 61 neonates with ECMO through January 1995 at a single center was performed. ECMO was used in neonates with oxygenation index > 20 after conventional treatments. Background factors, such as etiology, vascular access mode (veno-venous [VV] or veno-arterial [VA]), number of days with ECMO, and early ECMO (within 24 hours after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD)...
October 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Michael C Sklar, Eric Sy, Laurance Lequier, Eddy Fan, Hussein D Kanji
BACKGROUND: The optimal anticoagulation strategy for venovenous extracorporeal membrane oxygenation (VV-ECMO) is not known. OBJECTIVE: To evaluate the safety of anticoagulation strategies and monitoring during VV-ECMO for respiratory failure. DATA SOURCES: We conducted a systematic review to evaluate the association between anticoagulation strategies during VV-ECMO and pre-specified outcomes including major bleeding episodes, thrombotic events, and in-hospital mortality...
October 3, 2016: Annals of the American Thoracic Society
Adambeke Nwozuzu, Manuel L Fontes, Robert B Schonberger
OBJECTIVE: To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers. DESIGN: A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: "extracorporeal membrane transport," "mobile ECMO," and "interhospital transport." SETTING: MEDLINE review of articles...
June 8, 2016: Journal of Cardiothoracic and Vascular Anesthesia
George Makdisi, Peter B Makdisi, I-Wen Wang
The superiority of transcatheter aortic valve replacement (TAVR) compared with medical therapy for patients with aortic stenosis (AS) who are not suitable candidates for surgery had been proven. Cardiopulmonary bypass (CPB) is rarely used in TAVR. Reports of early use of extracorporeal membranous oxygenator (ECMO) have promising outcomes. ECMO offers the option of cardiac support rescue in case of intraoperative hemodynamic instability and can be instituted in advance when hemodynamic instability is expected...
August 2016: Annals of Translational Medicine
Jialin Mao, Subroto Paul, Art Sedrakyan
INTRODUCTION: To compare characteristics and outcomes of patients receiving extracorporeal membrane oxygenation (ECMO) therapy as well as medical research activities related to ECMO before and after release of preliminary results of the CESAR trial. METHODS: We assessed trends in EMCO use among adults, patient and institutional characteristics, in-hospital mortality, peri-procedural complications and resource use before and after first quarter of 2008 in Nationwide Inpatient Sample Database...
September 30, 2016: International Journal of Surgery
Yoon Sang Chung, Dai Yun Cho, Dong Suep Sohn, Wang Soo Lee, Hoyoun Won, Dong Hoon Lee, Hyun Kang, Joonhwa Hong
Anticoagulation treatment during extracorporeal membrane oxygenation (ECMO) treatment is unavoidable. However, discontinuation of heparin infusion is necessary when challenges associated with the use of heparin, such as bleeding and thrombocytopenia, are encountered. The medical records of 94 adult (age ≥ 18 years) patients treated with ECMO from January 2011 to March 2015, at Chung-Ang University Hospital, Seoul, Korea, were reviewed. Among the 94 patients, 55 patients underwent ECMO treatment for 3 or more days...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kevin Ergle, Parham Parto, Selim R Krim
BACKGROUND: Despite recent advances in the management of heart failure, cardiogenic shock remains a challenging and devastating condition with significant morbidity and mortality. METHODS: We review currently available percutaneous mechanical circulatory support (MCS) devices and address each device's characteristics, mechanism of action, specific clinical indications, and contraindications. RESULTS: Four types of percutaneous MCS devices are currently available: the intraaortic balloon pump (IABP), Impella devices, the TandemHeart, and extracorporal membrane oxygenation (ECMO)...
2016: Ochsner Journal
Amy Cheng, Feifei Williams, James Fortenberry, Catherine Preissig, Steven Salinas, Pradip Kamat
Ehrlichiosis, caused by transmission of Ehrlichia chaffeensis to humans through the bite of an infected lone star tick, can lead to secondary hemophagocytic lymphohistiocytosis (HLH), a life-threatening condition caused by uncontrolled activation of the cellular immune system. We describe a child with HLH secondary to ehrlichiosis who developed multiorgan failure and was successfully managed with extracorporeal membrane oxygenation (ECMO). A 9-year-old boy developed headaches, fever, and sore throat after suspected tick exposure...
September 15, 2016: Pediatrics
Katrina L Weaver, Joanne E Baerg, Manabu Okawada, Go Miyano, Katherine A Barsness, Martin Lacher, Dani O Gonzalez, Peter C Minneci, Lena Perger, Shawn D St Peter
INTRODUCTION: Thoracoscopic repair of a congenital diaphragmatic hernia (CDH) in the neonate is controversial due to reports of increased hernia recurrence. A multicenter review on thoracoscopic CDH repair was conducted to evaluate outcomes and to identify factors that are associated with recurrence. METHODS: A multicenter retrospective review was conducted from 2009 to 2015 in neonates who were treated for CDH with thoracoscopic repair. Demographics, preoperative, intraoperative, including repair techniques, and postoperative variables were analyzed by using descriptive statistics...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
G F Yan, C M Zhang, X Y Hong, Y Wang, C F Liu, P F Zhang, L Xiang, G F Wen, Z H Yang, X Xu, S Y Qian, G P Lu
OBJECTIVE: To review the use of non-open chest extracorporeal membrane oxygenation (ECMO) in pediatric intensive care unit (PICU) in China. METHOD: The survey was conducted in 28 tertiary hospitals in China mainland from March to October 2015. All children <18 years of age have been supported with non-open chest ECMO in PICU were reviewed.Patient demographics, diagnosis, indication for ECMO, details of ECMO support, complications, and patient survival were analyzed...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Tsung-Yu Tsai, Feng-Chun Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Chan-Yu Lin, Wei-Wen Chang, Shen-Yang Lee, Hsiang-Hao Hsu, Ya-Chung Tian, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
Patients on extracorporeal membrane oxygenation (ECMO) usually have high mortality rate and poor outcome. Age, Creatinine, and Left Ventricular Ejection Fraction (ACEF) score is an easy-calculating score and provides good performance on mortality prediction in patients undergoing cardiac operations or percutaneous coronary intervention, but it has not been applied to patients on ECMO before. In this study, we aimed to use ACEF score obtained within 1 week of ECMO support for in-hospital mortality prediction in patients on ECMO due to severe myocardial failure...
September 1, 2016: Artificial Organs
Tapan Kavi, Megan Esch, Brenda Rinsky, Axel Rosengart, Shouri Lahiri, Patrick D Lyden
BACKGROUND: Transcranial Doppler (TCD) has significant implications for neurovascular assessment in patients being treated with venoarterial-extracorporeal membrane oxygenation (VA-ECMO). However, there have been no studies demonstrating the changes in pulsatility indices (PIs) seen in these patients. Nonpulsatile waveforms are seen during on-pump coronary artery bypass graft, but low or low-normal PIs have never been reported. It is important to be aware of these changes, as they can be misinterpreted as cerebral vasodilation, vasoconstriction, increased intracranial pressures (ICPs), or cerebral circulatory arrest...
August 26, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tyler H Harris, Jeffrey G Gossett
Care of adults with coronary artery disease focuses on troponins to rapidly move patients to catheterization. Troponins are increasingly drawn in children, but emergent catheterization may not be indicted. We sought to establish etiologies of troponin elevation and ascertain the yield of diagnostic tests, in this population. Retrospective review of patients from January 1, 2002, to December 31, 2011, who had any elevated troponin during the study period. Patients were excluded for recent cardiac surgery, "significant" congenital heart disease, if they were neonates in the NICU or were on ECMO...
August 29, 2016: Pediatric Cardiology
J-K Baek, J S Lee, T H Kim, Y H Kim, D J Han, S K Hong
BACKGROUND: Kidney transplant (KT) recipients are vulnerable to infections because of their immunosuppressive treatments, and they occasionally exhibit serious acute cardiopulmonary dysfunction. The purpose of this study was to report the clinical outcomes of using extracorporeal membrane oxygenation (ECMO) in KT recipients and to identify risk factors for ECMO weaning failure. METHODS: We retrospectively reviewed the electronic medical records of KT patients who experienced severe cardiopulmonary dysfunction refractory to conventional therapy and received ECMO at the Asan Medical Center Surgical Intensive Care Unit between December 2010 and December 2014...
July 2016: Transplantation Proceedings
Jiawei Qiu, Shoujun Li, Jun Yan, Qiang Wang, Yunhu Song, Hansong Sun, Dianyuan Li
BACKGROUND: Anomalous origin of coronary artery from the pulmonary artery (ACAPA) is a rare congenital coronary malformation with a high mortality whether in infants or adult patients. This study reviews 20years of surgical treatment in a single center and aims to establish the optimal surgical strategies for this rare pathology. METHODS AND RESULTS: From April 1994 to March 2015, 96 consecutive patients aged from 3months to 60years underwent coronary repair surgery...
November 15, 2016: International Journal of Cardiology
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
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