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Ecmo cardiogenic shock

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https://www.readbyqxmd.com/read/29134345/trends-in-mechanical-circulatory-support-use-and-hospital-mortality-among-patients-with-acute-myocardial-infarction-and-non-infarction-related-cardiogenic-shock-in-the-united-states
#1
Mahek Shah, Soumya Patnaik, Brijesh Patel, Pradhum Ram, Lohit Garg, Manyoo Agarwal, Sahil Agrawal, Shilpkumar Arora, Nilay Patel, Joyce Wald, Ulrich P Jorde
BACKGROUND: Recent trends on outcomes in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) suggest improvements in early survival. However, with the ever-changing landscape in management of CS, we sought to identify age-based trends in these outcomes and mechanical circulatory support (MCS) use among patients with both AMI and non-AMI associated shock. METHODS: We queried the 2005-2014 Nationwide Inpatient Sample databases to identify patients with a diagnosis of cardiogenic shock...
November 13, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29124458/pitfalls-of-cannulation-for-extracorporeal-life-support-review-of-the-literature-and-illustrative-case-presentation
#2
REVIEW
Martin Geyer, Bernhard Gohrbandt, Ingo Sagoschen, Thomas Hartmann, Felix Post, Christian-Friedrich Vahl, Thomas Münzel
Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) are an increasingly established advanced therapy for emerging severe lung and/or cardiocirculatory dysfunction or failure. Several reports have provided evidence for a potential benefit in prognosis by ECLS in cases of cardiogenic shock including cardiopulmonary resuscitation. Routine use in specialized centers reduces the incidence of negative side effects (e.g., vascular/ischemic, embolic, hemorrhagic, hemolytic and, furthermore, septic)...
November 9, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29079045/three-dimensional-echocardiography-derived-right-ventricular-ejection-fraction-correlates-with-success-of-decannulation-and-prognosis-in-patients-stabilized-by-venoarterial-extracorporeal-life-support
#3
Kuan-Chih Huang, Lian-Yu Lin, Yih-Sharng Chen, Chien-Heng Lai, Juey-Jen Hwang, Lung-Chun Lin
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been proved to effectively rescue patients from refractory cardiogenic shock. The role of the right ventricle in VA-ECMO has been emphasized, but quantitative right ventricular (RV) analysis in this population has been lacking. Three-dimensional echocardiography (3DE) is currently suggested for RV volumetric analysis. The aims of this study were to assess 3DE-derived RV ejection fraction (RVEF) in patients with refractory cardiogenic shock stabilized by VA-ECMO and to explore the association between 3DE-derived RVEF and weaning success as well as the prognosis after the first intent of decannulation...
October 24, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29073930/functional-evaluation-of-sublingual-microcirculation-indicates-successful-weaning-from-va-ecmo-in-cardiogenic-shock
#4
Sakir Akin, Dinis Dos Reis Miranda, Kadir Caliskan, Osama I Soliman, Goksel Guven, Ard Struijs, Robert J van Thiel, Lucia S Jewbali, Alexandre Lima, Diederik Gommers, Felix Zijlstra, Can Ince
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly adopted for the treatment of cardiogenic shock (CS). However, a marker of successful weaning remains largely unknown. Our hypothesis was that successful weaning is associated with sustained microcirculatory function during ECMO flow reduction. Therefore, we sought to test the usefulness of microcirculatory imaging in the same sublingual spot, using incident dark field (IDF) imaging in assessing successful weaning from VA-ECMO and compare IDF imaging with echocardiographic parameters...
October 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29054200/the-role-of-acute-circulatory-support-in-st-segment-elevation-myocardial-infarction-complicated-by-cardiogenic-shock
#5
REVIEW
Michele Esposito, Yousef Bader, Robert Pedicini, Catalina Breton, Andrew Mullin, Navin K Kapur
In the setting of ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock, three primary treatment objectives include providing circulatory support, ventricular unloading, and restoring myocardial perfusion. In addition to primary percutaneous coronary intervention, each of these three objectives can be achieved with appropriate use of an acute mechanical circulatory support (AMCS) pump. Over the past decade, utilization of percutaneously-delivered AMCS devices including the Impella axial-flow catheter, TandemHeart left atrial-to-femoral artery bypass system, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has grown exponentially...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29049834/percutaneous-left-atrial-unloading-to-prevent-pulmonary-oedema-and-to-facilitate-ventricular-recovery-under-extracorporeal-membrane-oxygenation-therapy
#6
Alexander M Bernhardt, Mathias Hillebrand, Yalin Yildirim, Samer Hakmi, Florian M Wagner, Stefan Blankenberg, Hermann Reichenspurner, Edith Lubos
OBJECTIVES: Left-sided unloading during extracorporeal membrane oxygenation (ECMO) therapy is crucial to prevent pulmonary oedema and facilitate ventricular recovery. We present the case of a 55-year-old man under ECMO therapy with pre-existing left ventricular (LV) thrombus formation and in need of ventricular unloading. METHODS: We implanted a 21-Fr TandemHeart Protek Solo trans-septal cannula into the left atrium using a trans-septal approach via the femoral vein...
September 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#7
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29037612/lung-ultrasound-for-cardiogenic-shock-in-va-ecmo
#8
Javier Rodríguez-Fanjul, Julio Moreno Hernando, Joan Sánchez-de-Toledo
No abstract text is available yet for this article.
October 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29033360/veno-arterial-ecmo-in-the-intensive-care-unit-from-technical-aspects-to-clinical-practice
#9
REVIEW
Arthur Le Gall, Arnaud Follin, Bernard Cholley, Jean Mantz, Nadia Aissaoui, Romain Pirracchio
The use of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28979045/left-ventricular-unloading-during-peripheral-extracorporeal-membrane-oxygenator-support-a-bridge-to-life-in-profound-cardiogenic-shock
#10
Paolo Centofanti, Matteo Attisani, Michele La Torre, Davide Ricci, Massimo Boffini, Andrea Baronetto, Erika Simonato, Alberto Clerici, Mauro Rinaldi
A limit of peripheral veno-arterial Extracorporeal Membrane Oxigenator (VA-ECMO) is the inadequate unloading of the left ventricle. The increase of end-diastolic pressure reduces the possibility of a recovery and may cause severe pulmonary edema. In this study, we evaluate our results after implantation of VA-ECMO and Transapical Left Ventricular Vent (TLVV) as a bridge to recovery, heart transplantation or long-term left ventricular assit devices (LVAD). From 2011 to 2014, 24 consecutive patients with profound cardiogenic shock were supported by peripheral VA-ECMO as bridge to decision...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28966321/veno-arterial-extracorporeal-membrane-oxygenation-with-conventional-anticoagulation-can-be-a-best-solution-for-shock-due-to-massive-pe
#11
Yusuke Watanabe, Kenichi Sakakura, Naoyuki Akashi, Mami Ishikawa, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Hideo Fujita, Shin-Ichi Momomura
While most of pulmonary thromboembolism (PE) cases can be managed by thrombolytic and anticoagulation therapy, massive PE remains a life-threatening disease. Although surgical embolectomy can be a curative therapy for massive PE, peri-operative mortality for hemodynamically collapsed PE is extremely high. We present a case of hemodynamically collapsed massive PE. We avoided either thrombolytic therapy or surgical embolectomy, because the patient had recent cerebral contusion. Therefore, we managed the patient with the combination of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and conventional anticoagulation, which dramatically improved the patient's hemodynamics...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28953198/ejection-fraction-may-not-reflect-contractility-example-in-veno-arterial-extracorporeal-membrane-oxygenation-for-heart-failure
#12
Philippe Morimont, Bernard Lambermont, Julien Guiot, Vincent Tchana Sato, Christophe Clotuche, Jonathan Goffoy, Jean-Olivier Defraigne
Precise assessment of left ventricular (LV) contractility during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is crucial. However, changes in loading conditions may mask changes in LV function when assessed with load-dependent parameters. We compared end-systolic elastance (Ees, mm Hg/ml), the reference load-independent parameter of LV contractility, with LV ejection fraction (LVEF) in two patients. The first patient was a 54-year-old patient supported with femoro-femoral VA-ECMO for a cardiogenic shock...
September 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28925084/extracorporeal-membrane-oxygenation-in-the-therapy-of-cardiogenic-shock-ecmo-cs-the%C3%A2-need-for-a-better-definition-of-refractory-cardiogenic-shock
#13
EDITORIAL
Sébastien Champion
No abstract text is available yet for this article.
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28918455/in-hospital-outcomes-of-acute-myocardial-infarction-with-cardiogenic-shock-caused-by-right-coronary-artery-occlusion-vs-left-coronary-artery-occlusion
#14
Yousuke Taniguchi, Kenichi Sakakura, Yusuke Adachi, Naoyuki Akashi, Yusuke Watanabe, Masamitsu Noguchi, Kei Yamamoto, Yusuke Ugata, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
In-hospital outcomes of acute myocardial infarction (AMI) with cardiogenic shock (CS) were still not satisfactory even in the primary percutaneous coronary intervention (PCI) era. The aim of this study was to compare in-hospital outcomes of AMI with CS caused by right coronary artery (RCA) occlusion vs. left coronary artery (LCA) occlusion. Consecutive 894 AMI patients from January 2010 to March 2015 were screened for inclusion. A total of 114 AMI patients with CS were included as the final study population, and were divided into the RCA group (n = 56) and LCA group (n = 58)...
September 16, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#15
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#16
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28887927/cardiac-support-emphasis-on-venoarterial-ecmo
#17
REVIEW
Christopher S King, Aviral Roy, Liam Ryan, Ramesh Singh
Major advances have been made in mechanical circulatory support in recent years. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) provides both pulmonary and circulatory support for critically ill patients with hemodynamic compromise, serving as a bridge to recovery or definitive therapy in the form of transplant or a durable ventricular assist device. In the past, VA ECMO support was used in cases of cardiogenic shock or failure to wean from cardiopulmonary bypass; however, the technology is now being applied to an ever-expanding list of conditions, including massive pulmonary embolism, cardiac arrest, drug overdose, and hypothermia...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28883715/impact-of-age-on-extracorporeal-membrane-oxygenation-survival-of-patients-with-cardiac-failure
#18
Su Nam Lee, Min Seop Jo, Ki-Dong Yoo
PURPOSE: Extracorporeal membrane oxygenation (ECMO) is used to treat patients in critical condition with cardiogenic shock. However, few studies have examined the effect of old age in ECMO survival. This study analyzed the impact of age on ECMO survival of patients with cardiac failure, and analyzed predictive factors for survival according to age. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 95 patients who required veno-arterial (V-A) ECMO between May 2009 and May 2016 at a single center...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28871334/role-of-percutaneous-veno-arterial-extracorporeal-membrane-oxygenation-as-bridge-to-left-ventricular-assist-device
#19
Koichi Toda, Tomoyuki Fujita, Osamu Seguchi, Masanobu Yanase, Takeshi Nakatani
Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides emergency circulatory support for cardiogenic shock patients and is used as a bridge to a left ventricular assist device (LVAD). The purpose of this study was to determine risk factors for LVAD implantation in patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. We retrospectively investigated 32 consecutive LVAD patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. Twenty-nine patients (91%) were intubated, and their serum creatinine and total bilirubin levels before LVAD implantation were 2...
September 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28846533/the-prognostic-risk-factors-of-ecmo-in-patients-with-cardiogenic-shock-a-retrospective-cohort-analysis
#20
Xiao-Zu Liao, Zhi-Bin Zhou, Zhou Cheng, Xiao-Yu Yang, Xue Zhou, Bin-Fei Li, Xia Feng
BACKGROUND: Advances in ECMO have rapidly progressed in recent years; however, the clinical mortality rate remains high. This study aimed to identify the risk factors of ECMO in patients with cardiogenic shock. METHODS: Data of patients with cardiogenic shock who received ECMO from January 2006 to August 2013 at the Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. All patients with cardiogenic shock were divided into two groups according to whether death occurred in the hospital...
August 28, 2017: Heart Surgery Forum
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