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Ecmo cardiogenic shock

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https://www.readbyqxmd.com/read/28319524/combined-therapy-of-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-for-profound-acute-cardiopulmonary-failure
#1
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/28296034/emergency-valve-in-valve-transcatheter-aortic-valve-replacement-in-a-patient-with-degenerated-bioprosthetic-aortic-stenosis-and-cardiogenic-shock-on-veno-arterial-extracorporeal-membrane-oxygenation
#2
Matthew R Summers, Stephanie Mick, Samir R Kapadia, Amar Krishnaswamy
The use of transcatheter aortic valve replacement (TAVR) as an acute treatment in severe decompensated bioprosthetic aortic valve disease is not well documented. We describe herein a unique case in which valve-in-valve (ViV) TAVR was successfully used as both an emergency salvage therapy and a bridge to definitive fourth reoperative aortic valve replacement (AVR) in a young patient with cardiogenic shock secondary to bioprosthetic aortic valve stenosis who was dependent on veno-arterial extracorporeal membrane oxygenation (VA-ECMO)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291665/cardiac-arrest-in-acute-myocardial-infarction-concept-of-circulatory-support-with-mechanical-chest-compression-and-impella-to-facilitate-percutaneous-coronary-intervention
#3
Kaleab N Asrress, Maciej Marciniak, Natalia Briceno, Divaka Perera
Cardiogenic shock in the context of acute ST-elevation myocardial infarction (STEMI) remains a challenge to manage and results in significant mortality and morbidity, cardiac arrest in this setting even more so. The increase in myocardial oxygen demand and consumption with the use of inotropes is recognised as increasing mortality. Alternatives include the intra-aortic balloon pump (IABP), which has yet to be shown to improve outcomes, and extracorporeal membrane oxygenation (ECMO), which requires super-specialised techniques not widely available...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28285546/left-heart-decompression-in-acute-complicated-myocardial-infarction-during-extracorporeal-membrane-oxygenation
#4
Seok In Lee, So Young Lee, Chang Hyu Choi, Kook Yang Park, Chul-Hyun Park
Acute myocardial infarction (AMI) can progress to cardiogenic shock and mechanical complications. When extracorporeal membrane oxygenation (ECMO) is applied to a patient with AMI with cardiogenic shock and mechanical complications, left ventricular (LV) decompression is an important recovery factor because LV dilation increases myocardial wall stress and oxygen consumption. The authors present the case of a 72-year-old man with AMI and LV dilation who developed cardiogenic shock and papillary muscle rupture and who was treated successfully by ECMO with a left atrial venting...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#5
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28259366/mechanical-support-with-venoarterial-extracorporeal-membrane-oxygenation-ecmo-va-short-term-and-long-term-prognosis-after-a-successful-weaning
#6
R García-Gigorro, E Renes-Carreño, J L Pérez-Vela, H Marín-Mateos, J Gutiérrez, M A Corrés-Peiretti, J F Delgado, E Pérez-de la Sota, J M Cortina-Romero, J C Montejo-González
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) affords mechanical circulatory assistance associated to high mortality. However, weaning from such mechanical support may not imply improved short- or long-term survival. This study describes the characteristics and evolution of patients with refractory cardiogenic shock (RCS) subjected to venoarterial ECMO (VA-ECMO) in a hospital with a heart transplant program. DESIGN: A single-center, retrospective cohort study was carried out...
March 2, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28244284/nosocomial-infection-in-adult-patients-undergoing-veno-arterial-extracorporeal-membrane-oxygenation
#7
Gwan Sic Kim, Kyo Seon Lee, Choung Kyu Park, Seung Ku Kang, Do Wan Kim, Sang Gi Oh, Bong Suk Oh, Yochun Jung, Seok Kim, Ju Sik Yun, Sang Yun Song, Kook Joo Na, In Seok Jeong, Byoung Hee Ahn
Data on the frequency of nosocomial infections during extracorporeal membrane oxygenation (ECMO) in adult populations remain scarce. We investigated the risk factors for nosocomial infections in adult patients undergoing venoarterial ECMO (VA-ECMO) support. From January 2011 to December 2015, a total of 259 patients underwent ECMO. Of these, patients aged 17 years or less and patients undergoing ECMO for less than 48 hours were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28236098/use-of-extracorporeal-membrane-oxygenation-in-complicated-transcatheter-aortic-valve-replacement
#8
Kyokun Uehara, Kenji Minakata, Naritatsu Saito, Masao Imai, Hiroki Daijo, Taro Nakatsu, Kazuhisa Sakamoto, Kazuhiro Yamazaki, Takeshi Kimura, Ryuzo Sakata
OBJECTIVES: Although transcatheter aortic valve replacement (TAVR) is an excellent alternative procedure for high-risk patients with severe symptomatic aortic stenosis, it is often associated with life-threatening complications. We report on the emergency or elective use of veno-arterial extracorporeal membrane oxygenation (ECMO) to manage these complications. METHODS: Between December 2013 and February 2016, 46 patients underwent TAVR at our institution. Of these, 4 patients required emergency ECMO support and another 3 patients were electively placed on ECMO support at the start of the procedure...
February 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28176385/financial-and-clinical-outcomes-of-extracorporeal-mechanical-support
#9
Ryan Chiu, Eric Pillado, Sohail Sareh, Kim De La Cruz, Richard J Shemin, Peyman Benharash
BACKGROUND: Over the past decade, extracorporeal mechanical support (ECMO) has been increasingly utilized in respiratory failure and cardiogenic shock. There is a need for assessing clinical and financial outcomes of ECMO use. This study presents our institution's experience with veno-arterial ECMO (VA-ECMO) over a 9-year period. METHODS: A retrospective review of our institution's ECMO database identified patients undergoing VA-ECMO between 2005 and 2013 (N = 150)...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28154601/cardiac-resynchronization-therapy-device-implantation-in-a-patient-with-cardiogenic-shock-under-percutaneous-mechanical-circulatory-support
#10
Kyunghee Lim, Jin-Oh Choi, Jeong Hoon Yang, Seung-Jung Park, Sun Hwa Kim, Jiseok Kang, Hyun Sung Joh, Sun Hye Shin
65-year-old woman was admitted to our hospital with acute decompensated heart failure with reduced left ventricular ejection fraction and severe mitral regurgitation. Electrocardiography revealed a typical left bundle branch block and atrial fibrillation. Her condition deteriorated despite administering high-doses of inotropes and vasopressors. Pending a decision to therapy, venoarterial extracorporeal membrane oxygenation (ECMO) was performed when the patient underwent a cardiogenic shock. Although the hemodynamic status stabilized with ECMO support, weaning the patient from ECMO was not possible...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28134658/flow-rate-through-pigtail-catheter-used-for-left-heart-decompression-in-an-artificial-model-of-extracorporeal-membrane-oxygenation-circuit
#11
Won Ho Kim, Tae Hee Hong, Joung Hun Byun, Jong Woo Kim, Sung Hwan Kim, Sung Ho Moon, Hyun Oh Park, Jun Young Choi, Jun Ho Yang, In Seok Jang, Chung Eun Lee, Jeong Hee Yun
In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or LV cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. 1L saline bag with its pressure set to 20 mmHg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28131429/venoarterial-extracorporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-in-elderly-patients-trends-in-application-and-outcome-from-the-extracorporeal-life-support-organization-elso-registry
#12
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Priya Mendiratta, Parthak Prodhan, Peter Rycus, Graeme MacLaren, Thomas V Brogan, Yih-Sharng Chen, Jos Maessen, Xiaotong Hou, Ravi R Thiagarajan
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock (RCS) is increasingly used in adult patients, but age represents a controversial factor in this setting. METHODS: Data from the Extracorporeal Life Support Organization registry was analyzed to assess in-hospital survival of elderly patients (≥70 years of age) undergoing VA-ECMO for RCS from 1992 to 2015. In-hospital survival and complications for elderly patients were compared with data in younger adults (≥18 to <70 years of age) supported with VA-ECMO during the same time period for similar indications...
January 26, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28127638/ecmo-in-cardiac-arrest-and%C3%A2-cardiogenic-shock
#13
L C Napp, C Kühn, J Bauersachs
Cardiogenic shock is an acute emergency, which is classically managed by medical support with inotropes or vasopressors and frequently requires invasive ventilation. However, both catecholamines and ventilation are associated with a worse prognosis, and many patients deteriorate despite all efforts. Mechanical circulatory support is increasingly considered to allow for recovery or to bridge until making a decision or definite treatment. Of all devices, extracorporeal membrane oxygenation (ECMO) is the most widely used...
February 2017: Herz
https://www.readbyqxmd.com/read/28074818/cannulation-strategies-in-adult-veno-arterial-and-veno-venous-extracorporeal-membrane-oxygenation-techniques-limitations-and-special-considerations
#14
REVIEW
Arun L Jayaraman, Daniel Cormican, Pranav Shah, Harish Ramakrishna
Extracorporeal membrane oxygenation (ECMO) refers to specific mechanical devices used to temporarily support the failing heart and/or lung. Technological advances as well as growing collective knowledge and experience have resulted in increased ECMO use and improved outcomes. Veno-arterial (VA) ECMO is used in selected patients with various etiologies of cardiogenic shock and entails either central or peripheral cannulation. Central cannulation is frequently used in postcardiotomy cardiogenic shock and is associated with improved venous drainage and reduced concern for upper body hypoxemia as compared to peripheral cannulation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28040752/predictors-for-quality-of-life-of-patients-with-a-portable-out-of-centre-implanted-extracorporeal-membrane-oxygenation-device
#15
Florian Rückert, Thomas Steinke, Lilit Flöther, Michael Bucher, Dietrich Metz, Stefan Frantz, Efstratios I Charitos, Hendrik Treede, Christoph Raspé
OBJECTIVES: Despite progress in the treatment of cardiopulmonary organ failure, the mortality rate for patients with acute respiratory distress syndrome (ARDS) and cardiogenic shock remains high. Extracorporeal membrane oxygenation (ECMO) is a promising treatment option, but long-term outcomes and health-related quality of life (HRQOL) are unknown. METHODS: Detailed information related to pre- and post-device data and outcomes from a consecutive sample of 71 patients treated with ECMO was analysed...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040370/benefit-of-extracorporeal-membrane-oxygenation-in-major-burns-after-stun-grenade-explosion-experience-from-a-single-military-medical-center
#16
Po-Shun Hsu, Yi-Ting Tsai, Chih-Yuan Lin, Shyi-Gen Chen, Niann-Tzyy Dai, Cheng-Jung Chen, Jia-Lin Chen, Chien-Sung Tsai
INTRODUCTION: Explosion injury is very common on the battlefield and is associated with major burn and inhalation injuries and subsequent high mortality and morbidity rates. Here we report six victims who suffered from explosion injuries caused by stun grenade; all were treated with extracorporeal membrane oxygenation (ECMO) as salvage therapy. This study was aimed to evaluate the indications and efficacy of ECMO in acute and critically ill major burn patients. METHODS: This was a retrospective analysis of six patients from Tri-Service General Hospital, National Defense Medical Center in Taiwan...
December 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27998838/emergency-percutaneous-implantation-of-veno-arterial-extracorporeal-membrane-oxygenation-in-the-catheterisation-laboratory
#17
Tomaz Goslar, Rihard Knafelj, Peter Radsel, Misa Fister, Alenka Golicnik, Klemen Steblovnik, Vojka Gorjup, Marko Noc
AIMS: Our aim was to describe our protocol for emergency percutaneous implantation of femoral veno-arterial extracorporeal membrane oxygenation (VA ECMO) in the catheterisation laboratory and to compare its effectiveness and safety with implantation in the intensive care unit and the operating room. METHODS AND RESULTS: Our retrospective observational study enrolled 56 consecutive patients undergoing VA ECMO implantation in the catheterisation laboratory (n=23), the intensive care unit (n=8) and the operating room (n=25)...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27994255/review-of-venoarterial-extracorporeal-membrane-oxygenation-and-development-of-intracardiac-thrombosis-in-adult-cardiothoracic-patients
#18
REVIEW
Brittney Williams, Wendy Bernstein
Venoarterial extracorporeal membrane oxygenation (VA ECMO) has become an indispensable treatment option for adult cardiothoracic patients experiencing acute refractory cardiogenic shock. VA ECMO is not without inherent complications as in-hospital mortality has ranged from 45% to 65% (1-3). Intracardiac thrombosis (ICT) is a rare but life-threatening complication associated with VA ECMO. VA ECMO cases complicated by ICT were searched for using the MEDLINE (PubMed and OVID), Society of Cardiovascular Anesthesiology Headquarters, and Google Scholar databases...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27983541/effect-of-increasing-mean-arterial-blood-pressure-on-microcirculation-in-patients-with-cardiogenic-shock-supported-by-extracorporeal-membrane-oxygenation
#19
Zhongtao Du, Zaishen Jia, Jinhong Wang, Zhichen Xing, Chunjing Jiang, Bo Xu, Xiaofang Yang, Feng Yang, Na Miao, Jialin Xing, Hong Wang, Ming Jia, Xiaotong Hou
BACKGROUND: Little is known about the effect of mean arterial blood pressure (MAP) augmentation on the microcirculation in cardiogenic-shock patients with peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support. We investigated the effect of increasing MAP on the microcirculation in cardiogenic-shock patients with ECMO support. METHODS: A single-center prospective observational study under taken in ICU patients undergoing ECMO support for post-cardiotomy cardiogenic shock was carried out...
December 14, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27977615/total-revascularization-for-an-epsilon-right-coronary-artery-and-severe-left-main-disease-combined-with-profound-cardiogenic-shock-a-case-report
#20
Hsiu-Yu Fang, Wei-Chieh Lee, Chiung-Jen Wu
RATIONALE: Severe left main disease combined with right coronary artery occlusion was rarely encountered in our daily practice. Percutaneous coronary intervention in these patients was most challenging due to high probability of hemodynamic changes. PATIENT CONCERNS: Here, we report a 67-year-old man with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and profound cardiogenic shock and we attempted coronary intervention with total revisualization for severe left main (LM) disease and angulated epsilon right coronary artery total occlusion...
December 2016: Medicine (Baltimore)
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