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Ecmo cardiogenic shock

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https://www.readbyqxmd.com/read/29779449/continuous-cytokine-haemoadsorption-incorporated-into-a-venoarterial-ecmo-circuit-for-the-management-of-postcardiotomy-cardiogenic-and-septic-shock-a-case-report
#1
Endre Nemeth, Szabolcs Szigeti, Tamas Varga, Laszlo Daroczi, Zoltan Barati, Bela Merkely, Janos Gal
INTRODUCTION: The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. CASE REPORT: A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29776940/successful-treatment-of-fulminant-neonatal-enteroviral-myocarditis-in-monochorionic-diamniotic-twins-with-cardiopulmonary-support-intravenous-immunoglobulin-and-pocapavir
#2
Shahnawaz M Amdani, Hannah S Kim, Anthony Orvedahl, Audrey Odom John, Ahmed Said, Kathleen Simpson
Neonatal cardiogenic shock most commonly occurs due to critical congenital heart disease, sepsis, metabolic disorder or arrhythmias. In particular, enterovirus infections are common in the neonatal period, and patients can present with fulminant myocarditis. Early recognition is imperative due to its high morbidity and mortality without prompt and aggressive treatment. We present the successful treatment of fulminant neonatal enteroviral myocarditis in a pair of monochorionic diamniotic twins with cardiopulmonary support, intravenous immunoglobulin and pocapavir, an enteroviral capsid inhibitor...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29757498/clinical-determinants-of-successful-weaning-from-extracorporeal-membrane-oxygenation-in-patients-with-fulminant-myocarditis
#3
Manabu Matsumoto, Yasuhide Asaumi, Yuichi Nakamura, Takeshi Nakatani, Toshiyuki Nagai, Tomoaki Kanaya, Shoji Kawakami, Satoshi Honda, Yu Kataoka, Seiko Nakajima, Osamu Seguchi, Masanobu Yanase, Kunihiro Nishimura, Yoshihiro Miyamoto, Kengo Kusano, Toshihisa Anzai, Teruo Noguchi, Tomoyuki Fujita, Junjiro Kobayashi, Hatsue Ishibashi-Ueda, Hiroaki Shimokawa, Satoshi Yasuda
AIMS: Patients with fulminant myocarditis (FM) often present with cardiogenic shock and require mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist device (VAD) implantation. This study sought to clarify the determinants of successful weaning from ECMO in FM patients. METHODS AND RESULTS: We studied 37 consecutive FM patients supported by ECMO as the initial form of mechanical circulatory support between January 1995 and December 2014 in our hospital...
May 14, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29753504/extracorporeal-life-support-for-adults-with-refractory-septic-shock
#4
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/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#5
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
#6
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/29721682/-infarct-related-cardiogenic-shock-prognosis-and-treatment
#7
REVIEW
R Prondzinsky, H Lemm, A Geppert, M Buerke, M Russ, K Werdan
Patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) experience cardiogenic shock in about 6-10% of cases during the hospital treatment. In recent years, the incidence seems to be decreasing due to invasive diagnostics and therapy after myocardial infarction. Early diagnosis is important to initiate immediate revascularization using percutaneous coronary intervention (PCI) with stent implantation as part of cardiogenic shock treatment. Thus, a significant improvement in survival can be achieved...
May 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29721672/outcomes-of-patients-requiring-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-clinical-case-series
#8
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Itaru Takamisawa, Jun Shimizu, Nobuo Iguchi, Shuichiro Takanashi, Morimasa Takayama, Mitsuaki Isobe
Transcatheter aortic valve implantation (TAVI) has been established as a low-invasive therapy for aortic stenosis, but circulatory collapse necessitating mechanical circulatory support could occur during TAVI due to procedure itself or procedural complications. The purpose of this study is to describe the outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in TAVI. Among 384 consecutive patients undergoing TAVI from April 2010 to July 2017 in Sakakibara Heart Institute, we evaluated seven patients (1...
May 2, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29703012/successful-treatment-of-left-main-shock-syndrome-induced-by-thrombosed-coronary-artery-dissection-a-case-report
#9
Xiaojun Bai, Weiping Zhang, Zuyi Yuan
RATIONALE: Left main shock syndrome (LMSS) induced by thrombosed coronary artery dissection is very rare and has a fatal prognosis. Optimal treatment strategy includes early reperfusion and hemodynamic support to prevent cardiogenic shock. However, it involves the extension of technical difficulties under different conditions. PATIENT CONCERNS: A 49-year-old woman developed symptoms of left main shock syndrome. The main clinical manifestations were retrosternal pain radiating to his back and left shoulder, heavy sweating, palpitation and brachypnea...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701504/the-neutrophil-to-lymphocyte-ratio-in-patients-supported-with-extracorporeal-membrane-oxygenation
#10
Gardner Yost, Geetha Bhat, Patroklos Pappas, Antone Tatooles
INTRODUCTION: The neutrophil to lymphocyte ratio (NLR) has proven to be a robust predictor of mortality in a wide range of cardiovascular diseases. This study investigated the predictive value of the NLR in patients supported by extracorporeal membrane oxygenation (ECMO) systems. METHODS: This study included 107 patients who underwent ECMO implantation for cardiogenic shock. Median preoperative NLR was used to divide the cohort, with Group 1 NLR <14.2 and Group 2 with NLR ≥14...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#11
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
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
#12
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/29644151/trans-cranial-doppler-as-an-ancillary-study-supporting-irreversible-brain-injury-in-a-post-cardiac-arrest-patient-on-extracorporeal-membrane-oxygenation
#13
Naresh Mullaguri, Aarti Sarwal, Nakul Katyal, Premkumar Nattanamai, Pravin George, Christopher R Newey
Obtaining neuroimaging in patients on cardiopulmonary support devices such as extracorporeal membrane oxygenation (ECMO) can be challenging, given the complexities in monitoring, instrumentation, and associated hemodynamic lability. Transcranial Doppler (TCD) is used as an ancillary test for the assessment of cerebral circulatory arrest, but its use in non-pulsatile blood flow in venoarterial (VA) ECMO is not well described. We report the use of TCD in a patient on VA ECMO post-cardiac arrest for evaluation of death by neurological criteria...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29626610/health-related-quality-of-life-after-extracorporeal-cardiopulmonary-resuscitation-in-refractory-cardiac-arrest
#14
T Spangenberg, J Schewel, A Dreher, F Meincke, E Bahlmann, H van der Schalk, F Kreidel, C Frerker, M Stoeck, B Bein, K-H Kuck, A Ghanem
BACKGROUND: Recent data identifies extracorporeal cardio-pulmonary resuscitation (eCPR) as a potential addendum of conventional cardiopulmonary-resuscitation (cCPR) in highly specified circumstances and selected patients. However, consented criteria indicating eCPR are lacking. Therefore we provide first insights into the health-related quality of life (HRQoL) outcomes of patients treated with eCPR in a real world setting. METHODS: Retrospective single-center experience of 60 consecutive patients treated with eCPR between 01/2014 and 06/2016 providing 1-year survival- and HRQoL data obtained through the Short-Form 36 Survey (SF-36) after refractory out-of-hospital- (OHCA) and in-hospital cardiac arrest (IHCA) of presumed cardiac etiology...
April 4, 2018: Resuscitation
https://www.readbyqxmd.com/read/29624620/clinical-risk-factors-of-extracorporeal-membrane-oxygenation-support-in-older-adults
#15
Te-Chun Yeh, Hsiao-Huang Chang, Luo-Ping Ger, Ju-O Wang, Senyeong Kao, Shung-Tai Ho
BACKGROUND: The ageing population and the expected increase in the number of elderly patients make an evidence-based assessment of Extracorporeal Membrane Oxygenation (ECMO) therapy in old patients progressively more important. Veno-arterial (VA) ECMO results for patient aged <65 years is well known. However, the risk profile and in-hospital prognosis of advanced age patients with ECMO still need more investigation. The aim of this study was to identify risk factors that predicted the outcomes for elderly patients who received VA-ECMO...
2018: PloS One
https://www.readbyqxmd.com/read/29600725/overview-of-impella-and-mechanical-devices-in-cardiogenic-shock
#16
Hymie Habib Chera, Menachem Nagar, Nai-Lun Chang, Carlos Morales-Mangual, George Dous, Jonathan D Marmur, Muhammad Ihsan, Paul Madaj, Yitzhak Rosen
Cardiogenic shock (CS) is a life-threatening condition associated with significant morbidity and mortality. The Impella (Abiomed Inc.) is an axial flow pump on a pigtail catheter that is placed across the aortic valve to unload the left ventricle by delivering non-pulsatile blood flow to the ascending aorta. It is used for high-risk percutaneous coronary intervention and CS. Areas covered: Percutaneous mechanical support devices are placed in a minimally invasive manner and provide life-saving assistance. We review Impella and other percutaneous devices such as intra-aortic balloon pump, TandemHeart, and extracorporeal membrane oxygenation (ECMO) and the evidence supporting their use in the setting of CS...
April 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29559756/acute-bowel-ischemia-associated-with-left-ventricular-thrombus-and-arteriovenous-extracorporeal-membrane-oxygenation
#17
Mary Huerter, Dean Govostis, Martin Ellenby, Eduardo Smith-Singares
Indications for extra corporeal membrane oxygenation (ECMO) have expanded in recent years, and it has become an invaluable tool in the care of adult patients in severe cardiogenic shock or respiratory failure. Understanding the physiologic effect of ECMO has also further developed, allowing for improvements in the management of the potential morbidities associated with this technology. Here, we present a case of acute bowel ischemia that developed while the patient was on central venoarterial ECMO.
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29517515/left-ventricular-unloading-during-veno-arterial-ecmo-a-simulation-study
#18
Dirk W Donker, Daniel Brodie, José P S Henriques, Michael Broomé
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is widely used in cardiogenic shock. It provides systemic perfusion, but left ventricular (LV) unloading is suboptimal. Using a closed-loop, real-time computer model of the human cardiovascular system, cardiogenic shock supported by peripheral VA ECMO was simulated, and effects of various adjunct LV unloading interventions were quantified. After VA ECMO initiation (4 L/min) in cardiogenic shock (baseline), hemodynamics improved (increased to 85 mm Hg), while LV overload occurred (10% increase in end-diastolic volume [EDV], and 5 mm Hg increase in pulmonary capillary wedge pressure [PCWP])...
March 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29502890/issues-to-resolve-with-the-use-of-extracorporeal-membrane-oxygenation-during-interfacility-transportation
#19
P Burgueño, C González, A Sarralde, F Gordo
Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionalization could benefit patients of this kind, establishing ECMO reference centers and integrating a transportation network specialized in ECMO. This type of transportation is a challenge for healthcare systems and physicians, given its greater complexity, requiring a multidisciplinary and inter-territorial approach...
March 1, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29489461/simultaneous-venoarterial-extracorporeal-membrane-oxygenation-and-percutaneous-left-ventricular-decompression-therapy-with-impella-is-associated-with-improved-outcomes-in-refractory-cardiogenic-shock
#20
Sandeep M Patel, Jerry Lipinski, Sadeer G Al-Kindi, Toral Patel, Petar Saric, Jun Li, Fahd Nadeem, Thomas Ladas, Amer Alaiti, Ann Phillips, Benjamin Medalion, Salil Deo, Yakov Elgudin, Marco A Costa, Mohammed Najeeb Osman, Guilherme F Attizzani, Guilherme H Oliveira, Basar Sareyyupoglu, Hiram G Bezerra
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous left ventricular assist device (Impella) and VA-ECMO remains largely unknown. We retrospectively reviewed patients treated for refractory cardiogenic shock with VA-ECMO (2014-2016). The primary outcome was all-cause mortality within 30 days of VA-ECMO implantation. Secondary outcomes included duration of support, stroke, major bleeding, hemolysis, inotropic score, and cardiac recovery...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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