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Ecmo cardiogenic shock

Carlo Banfi, Matteo Pozzi, Marie-Eve Brunner, Fabio Rigamonti, Nicolas Murith, Damiano Mugnai, Jean-Francois Obadia, Karim Bendjelid, Raphaël Giraud
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has known a widespread application over the last decade and is now an effective and valuable therapeutic option in refractory cardiogenic shock of various etiologies. In this subgroup of critically ill and unstable patients in cardiogenic shock, VA-ECMO allows, on the one hand, temporary hemodynamic stabilization with improvement of end-organ function and, on the other hand, gives the time to perform complementary diagnostic exams and to decide the therapeutic strategy in these high-risk candidates for immediate long-term mechanical circulatory support (MCS) implantation...
September 2016: Journal of Thoracic Disease
Michael L Rigby
Major congenital or acquired heart disease in neonates presents with cyanosis, hypoxia, acute circulatory failure or cardiogenic shock. Antenatal diagnosis is made in up to 50% but heart disease is unanticipated in the remainder. The presence of significant heart disease in premature infants is also frequently not suspected at first; in general, whatever the underling cardiac anomaly, the clinical condition is worse, deteriorates more quickly and carries a poorer prognosis in premature and low birth weight infants...
October 13, 2016: Early Human Development
Federico Pappalardo, Christian Schulte, Marina Pieri, Benedikt Schrage, Rachele Contri, Gerold Soeffker, Teresa Greco, Rosalba Lembo, Kai Müllerleile, Antonio Colombo, Karsten Sydow, Michele De Bonis, Florian Wagner, Hermann Reichenspurner, Stefan Blankenberg, Alberto Zangrillo, Dirk Westermann
AIMS: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support stabilizes patients with cardiogenic shock. Despite improved oxygenation and peripheral circulation, LV unloading may be impeded due to the increased afterload, resulting in a failing static left ventricle and in high mortality. METHODS AND RESULTS: We describe for the first time a large series of patients treated with the combination of VA-ECMO and Impella(®) compared with patients with VA-ECMO only...
October 6, 2016: European Journal of Heart Failure
Shinya Unai, My-Le Nguyen, Daizo Tanaka, Nataliya Gorbachuk, Gregary D Marhefka, Hitoshi Hirose, Nicholas C Cavarocchi
BACKGROUND: Spontaneous echo contrast (SEC) is known to be a predisposition to thromboembolism and cerebrovascular accident. The aim of this study was to investigate the risk factors and the consequences of SEC in patients who were placed on venoarterial extracorporeal membrane oxygenation (VA-ECMO) because of cardiogenic shock. METHODS: Between January 2011 and December 2014, 98 patients underwent the insertion of VA-ECMO because of cardiogenic shock in our institution...
September 28, 2016: Annals of Thoracic Surgery
Marc Pineton de Chambrun, Nicolas Bréchot, Guillaume Lebreton, Matthieu Schmidt, Guillaume Hekimian, Pierre Demondion, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt
PURPOSE: To describe the characteristics, outcomes, and risk factors associated with poor outcome of venoarterial extracorporeal membrane oxygenation (VA-ECMO)-treated patients with refractory shock post-cardiac arrest. METHODS: We retrospectively analyzed data collected prospectively (March 2007-January 2015) in a 26-bed tertiary hospital intensive care unit. All patients implanted with VA-ECMO for refractory cardiogenic shock after successful resuscitation from cardiac arrest were included...
September 28, 2016: Intensive Care Medicine
Dmitry Esterov, Kiin Kim, Sara J Cuccurullo, Iqbal H Jafri
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Jintae Kwon, Donghyup Lee
BACKGROUND: Post infarction ventricular septal defect (VSD) is an uncommon but life threatening complication of acute myocardial infarction. CASE PRESENTATION: A 62-year-old woman was admitted with acute myocardial infarction (AMI). However, the day after angioplasty and stenting, Transthoracic echocardiography (TTE) showed post infarction VSD. We decided to insert an extracorporeal membrane oxygenation (ECMO) device for stabilization purposes before surgical repair...
September 26, 2016: Journal of Cardiothoracic Surgery
R Q Zhu, C Z Liu, J H Lu, Y P Su, S C Wen, G J Nie, Y Z Hu, L E Zuo
Objective: To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients. Methods: Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed. The clinical status before ECMO support, ECMO timing, complications and outcome were observed and analyzed.The hemodynamic data and the amount of vasoactive drugs at 2 hours before ECMO support and at 2, 6, 24 and 48 hours after ECMO support were collected and compared...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
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
Richard Cheng, Danny Ramzy, Babak Azarbal, Francisco A Arabia, Fardad Esmailian, Lawrence S Czer, Jon A Kobashigawa, Jaime D Moriguchi
For Interagency Registry for Mechanically Assisted Circulatory Support profiles 1 and 2 cardiogenic shock patients initially placed on extracorporeal membrane oxygenation (ECMO), whether crossover to more durable devices is associated with increased survival, and its optimal timing, are not established. Profiles 1 and 2 patients placed on mechanical support were prospectively registered. Survival and successful hospital discharge were compared between patients placed on ECMO only, ECMO with early crossover, and ECMO with delayed crossover...
September 23, 2016: Artificial Organs
Federico Pappalardo, Andrea Montisci
Cardiogenic shock (CS) is a state of systemic hypoperfusion, secondary to a deficit in cardiac contractile activity. Acute myocardial infarction (AMI) accounts for the majority of cases of CS, with a high mortality rate, despite the great improvements in revascularisation therapy. Nowadays, mechanical circulatory support (MCS) in CS often represents the only therapeutic approach able to restore systemic perfusion, determining a survival benefit. Recently, many efforts have been made to identify factors associated with mortality in patients receiving MCS devices...
August 2016: Journal of Thoracic Disease
Wei-Chieh Lee, Chih-Yuan Fang, Huang-Chung Chen, Chien-Jen Chen, Cheng-Hsu Yang, Chi-Ling Hang, Hon-Kan Yip, Hsiu-Yu Fang, Chiung-Jen Wu
BACKGROUND: Limited data are available regarding the role of percutaneous cardiopulmonary support for the treatment of ST segment elevation myocardial infarction (STEMI) with profound cardiogenic shock (CS). The aim of this study is to identify the determinant factors for survival of patients with STEMI who underwent extracorporeal membrane oxygenation (ECMO) support. METHOD: From January 2005 to December 2013, 192 patients experienced STEMI with CS needed intra-aortic balloon pumping and support with vasoactive agents at our hospital...
September 3, 2016: Heart & Lung: the Journal of Critical Care
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
Vikas Singh, Abdulla A Damluji, Rodrigo Mendirichaga, Carlos E Alfonso, Claudia A Martinez, Donald Williams, Alan W Heldman, Eduardo J de Marchena, William W O'Neill, Mauricio G Cohen
OBJECTIVE: Evaluate the use of mechanical circulatory support (MCS) devices in high-risk patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: The use of MCS devices in elderly patients with multiple comorbidities undergoing TAVR is underexplored. METHODS: All patients undergoing TAVR at a single tertiary academic center who required MCS during index procedure between 2008 and 2015 were included in a prospective database...
October 2016: Journal of Interventional Cardiology
Sheng-Ying Chung, Meng-Shen Tong, Jiunn-Jye Sheu, Fan-Yen Lee, Pei-Hsun Sung, Chien-Jen Chen, Cheng-Hsu Yang, Chiung-Jen Wu, Hon-Kan Yip
BACKGROUND: This study investigated the 30-day and long-term prognostic outcomes in patients with ST-segment elevation myocardial infarction (STEMI) complicated with profound cardiogenic shock (CS) undergoing early routine extracorporeal membrane oxygenator (ECMO)-assisted primary percutaneous coronary intervention (PCI). METHODS: Between December 2005 and December 2014, 65 consecutive STEMI patients with profound CS underwent routine ECMO-supported primary PCI...
November 15, 2016: International Journal of Cardiology
Felix Schoenrath, Dennis Hoch, Francesco Maisano, Christoph T Starck, Burkhardt Seifert, Urs Wenger, Frank Ruschitzka, Markus J Wilhelm
BACKGROUND: Mechanical circulatory support is increasingly used in acute cardiogenic shock. OBJECTIVE: To assess treatment strategies for cardiogenic shock. METHODS: Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​ RESULTS: Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6...
September 2016: Heart & Lung: the Journal of Critical Care
Matteo Pozzi, Carlo Banfi, Daniel Grinberg, Catherine Koffel, Karim Bendjelid, Jacques Robin, Raphaël Giraud, Jean François Obadia
Myocarditis is an inflammatory disease of the heart muscle with established histological, immunological and immunohistochemical diagnostic criteria. Different triggers could be advocated as possible etiologies of myocarditis such as viral and non-viral infections, medications, systemic autoimmune diseases and toxic reactions. The spectrum of clinical presentations of myocarditis is broad and varies from subclinical asymptomatic courses to refractory cardiogenic shock. The prognosis of patients with myocarditis depends mainly on the severity of clinical presentation...
July 2016: Journal of Thoracic Disease
Konstantinos Karatolios, Georgios Chatzis, Birgit Markus, Ulrich Luesebrink, Anette Richter, Bernhard Schieffer
BACKGROUND: Cardiogenic shock remains a clinical challenge with high mortality rate. Mechanical circulatory support (MCS) devices have become an integral component of the therapeutic armamentarium expanding the treatment options for refractory cardiogenic shock (RCS). METHODS: We included all consecutive patients with biventricular unloading with Impella-2.5 and VA-ECMO admitted for RCS between October 2013 and March 2015. Outcome data included survival to discharge, bridging to VAD and 28-day mortality...
November 1, 2016: International Journal of Cardiology
Yoshihisa Morimoto, Takaki Sugimoto, Fumiya Haba, Hideki Sakahira
INTRODUCTION: There are many publications reporting the use of TachoSil sheets for sutureless repair. Trauma doctors have recently reported that chitosan-based sheets can efficiently achieve hemostasis for active bleeding. PRESENTATION OF CASE: An 85-year-old man was diagnosed with left ventricle free wall rupture that caused cardiac tamponade and cardiogenic shock. Extracorporeal membrane oxygenator (ECMO) was started immediately and surgical repair was planned...
2016: International Journal of Surgery Case Reports
Fabrice Vanhuyse, Nicolas Ducrocq, Huguette Louis, Narimane Al Kattani, Nicolas Laurent, Frédérique Joineau-Groubatch, Aude Falanga, Juan-Pablo Maureira, Antoine Kimmoun, Nicolas Girerd, Nguyen Tran, Bruno Levy
Cardiogenic shock (CS) patients treated with ECMO have severe cardiac failure, associated with ischemia-reperfusion. The use of moderate hypothermia during ischemia-reperfusion syndrome is supported by experimental data. We therefore studied the effects of moderate hypothermia on cardiac and vascular function in pig ischemic CS treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Cardiogenic shock was induced in 12 anesthetized pigs by coronary ligation. After one hour of CS, VA-ECMO was initiated and pigs were randomized to normothermia (38°C) or moderate hypothermia (34°C) during 8 hours...
August 2, 2016: Shock
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