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642 papers 100 to 500 followers
Roberto Roncon-Albuquerque, Sérgio Gaião, Paulo Figueiredo, Nuno Príncipe, Carla Basílio, Paulo Mergulhão, Sofia Silva, Teresa Honrado, Francisco Cruz, Manuel Pestana, Gerardo Oliveira, Luis Meira, Ana França, João Paulo Almeida-Sousa, Fernando Araújo, José-Artur Paiva
AIM: To assess the feasibility of an integrated program of extracorporeal cardiopulmonary resuscitation (ECPR) and uncontrolled donation after circulatory determination of death (uDCDD) in refractory cardiac arrest (rCA). METHODS: Single center, prospective, observational study of selected patients with in-hospital (IHCA) and out-of-hospital (OHCA) rCA occurring in an urban area of ~1.5 million inhabitants, between October-2016 and May-2018. 65 year old or younger patients without significant bleeding or comorbidities with witnessed nonasystolic cardiac arrests were triaged to ECPR if they had a reversible cause and high quality CPR lasting < 60 min...
October 12, 2018: Resuscitation
Danielle E Bear, Elizabeth Smith, Nicholas A Barrett
The use of extracorporeal membrane oxygenation (ECMO) for both severe respiratory and cardiac failure is increasing. Because these patients are some of the sickest in the intensive care unit, a multidisciplinary approach to their treatment, including appropriate nutrition therapy, is warranted. Currently, limited data exist on the optimal timing, type, and amount of nutrition to be provided. This review focuses on describing the current nutrition practices in patients receiving ECMO, details research that is currently being undertaken, and lists important research questions that require exploration in this field...
October 15, 2018: Nutrition in Clinical Practice
Nicholas R Teman
No abstract text is available yet for this article.
October 9, 2018: Annals of Thoracic Surgery
Luke Masha, Shareez Peerbhai, David Boone, Fisayomi Shobayo, Aman Ghotra, Bindu Akkanti, Yelin Zhao, Igor Banjac, Igor D Gregoric, Biswajit Kar
Abnormalities in markers of liver injury after venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation are of unclear distribution and clinical significance. This study included all consecutive adult patients from a single institution who underwent VA-ECMO cannulation between May 2012 and September 2016 and had liver function panels drawn during their admission (n = 223). Data points include: age, sex, body mass index, diagnosis, duration of ECMO cannulation, duration of hospitalization, pre-ECMO cardiac arrest, central nervous system (CNS) injury, the presence of chronic kidney disease or acute renal failure, renal replacement therapy utilization, lactate levels, duration of pre-ECMO intubation, admission and peak bilirubin/aspartate aminotransferase (AST)/alanine aminotransferase (ALT)/alkaline phosphatase (ALP) levels, and time to peak bilirubin/AST/ALT/ALP in relation to cannulation...
October 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
A Reshad Garan, Waqas A Malick, Marlena Habal, Veli K Topkara, Justin Fried, Amirali Masoumi, Aws K Hasan, Dimitri Karmpaliotis, Ajay Kirtane, Melana Yuzefpolskaya, Maryjane Farr, Yoshifumi Naka, Dan Burkhoff, Paolo C Colombo, Paul Kurlansky, Hiroo Takayama, Koji Takeda
Chronic systolic heart failure (HF) with acute decompensation can result in cardiogenic shock (CS) requiring short-term mechanical circulatory support. We sought to identify predictors of survival for acute decompensated HF (ADHF) patients requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Patients >18 years old treated at our institution with VA-ECMO from 2009 to 2018 for ADHF with CS were studied. Demographic, hemodynamic, and echocardiographic data were collected. The primary outcome was survival to discharge...
October 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Raphaël Giraud, Carlo Banfi, Karim Bendjelid
No abstract text is available yet for this article.
October 10, 2018: European Heart Journal Cardiovascular Imaging
Jared Netley, James Roy, Joseph Greenlee, Shaun Hart, Michael Todt, Bryan Statz
Anticoagulation with unfractionated heparin during extracorporeal membrane oxygenation (ECMO) is common, but alternative agents are being evaluated for safety and efficacy. The objective of this analysis was to assess if a comprehensive bivalirudin dosing and monitoring protocol effectively guides dose adjustments and monitoring of bivalirudin in patients during ECMO. Our analysis included 11 patients who received bivalirudin during ECMO therapy and had dosing managed using our hospital derived protocol. Patients treated over a 1-year period were included in this retrospective analysis...
September 2018: Journal of Extra-corporeal Technology
Yongnan Li, Shujie Yan, Sizhe Gao, Mingyue Liu, Song Lou, Gang Liu, Bingyang Ji, Bingren Gao
An intra-aortic balloon pump (IABP) concomitant with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is frequently used to support patients with refractory cardiogenic shock (CS). Because of the lack of evidence of the adjunctive benefit, the goal of the study was to compare the effect of VA-ECMO plus IABP with that of VA-ECMO alone. Systematic searches were conducted to identify studies using PubMed, Embase, the Cochrane Library and the International Clinical Trials Registry Platform. Studies reporting on patients with adult CS treated with VA-ECMO plus IABP or VA-ECMO alone were identified and included...
September 24, 2018: European Journal of Cardio-thoracic Surgery
Yas Sanaiha, Katherine Bailey, Peter Downey, Young-Ji Seo, Esteban Aguayo, Vishal Dobaria, Richard J Shemin, Peyman Benharash
BACKGROUND: Extracorporeal membrane oxygenation is used as a life-sustaining measure in patients with acute or end-stage cardiac or respiratory failure. We analyzed national trends in extracorporeal membrane oxygenation use and outcomes and assessed the influence of hospital demographics. METHODS: Adult extracorporeal membrane oxygenation patients in the 2008-2014 National Inpatient Sample were evaluated. Patient and hospital characteristics, extracorporeal membrane oxygenation indication, mortality, and hospital costs were analyzed...
September 22, 2018: Surgery
Jin Hyuk Paek, Seohyun Park, Anna Lee, Seokwoo Park, Ho Jun Chin, Ki Young Na, Hajeong Lee, Jung Tak Park, Sejoong Kim
Background: Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy used in critically ill patients with severe cardiopulmonary dysfunction. Continuous renal replacement therapy (CRRT) is supplemented to treat fluid overload, acute kidney injury, and electrolyte disturbances during ECMO. However, the best time to initiate CRRT is not well-defined. We performed this study to identify the optimal timing of CRRT for ECMO. Methods: We conducted a multicenter retrospective cohort study of 296 patients over 12 years...
September 2018: Kidney Research and Clinical Practice
Yun Luo, Caroline Fritz, Nefissa Hammache, Daniel Grandmougin, Antoine Kimmoun, Sophie Orlowski, N'Guyen Tran, Eliane Albuisson, Bruno Levy
OBJECTIVE: This study was designed to assess the effect of two veno-arterial ExtraCorporeal Membrane Oxygenation (ECMO) blood-flow strategies in an experimental model of Extracorporeal Cardio-Pulmonary Resuscitation (ECPR) on macrocirculatory, metabolic and microcirculatory parameters in the first six hours of ECMO initiation. METHODS: Cardiac arrest was induced in 18 pigs by surgical ligature of the left descending coronary artery followed by a low-flow time of 40 min using internal cardiac massage...
September 20, 2018: Resuscitation
A Claire Watkins, Nathan L Maassel, Mehrdad Ghoreishi, Murtaza Y Dawood, Si M Pham, Zachary N Kon, Bradley S Taylor, Bartley P Griffith, James S Gammie
BACKGROUND: Cardiac surgery for structural heart disease has poor outcomes in the presence of cardiogenic shock or advanced heart failure. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients before high-risk cardiac operation. METHODS: Twelve patients with cardiogenic shock and end-organ failure were evaluated for cardiac surgery. The average Society of Thoracic Surgeons (STS) mortality risk was 24% (±13)...
September 17, 2018: Annals of Thoracic Surgery
Alexander Fletcher-Sandersjöö, Björn Frenckner, Mikael Broman
BACKGROUND: The dawning of the extracorporeal membrane oxygenation (ECMO)-2 era, with the potential of decentralizing ECMO treatment, has stressed the need for research into the safety of ECMO transportations. The aim of this study was to: 1) provide a comprehensive summary of transport arrangements and complications at a high-volume ECMO centre, 2) determine predictors of severe complications occurring during transport, and 3) determine transport-related predictors of mortality. METHODS: This was a retrospective population-based observational cohort study of all inter-hospital ECMO transports performed by the Karolinska University Hospital between 1996 and 2017...
September 18, 2018: Annals of Thoracic Surgery
Mateusz Puslecki, Marcin Ligowski, Michal Kiel, Marek Dabrowski, Sebastian Stefaniak, Maciej Sip, Adrian Maciejewski, Agata Dabrowska, Ilona Kiel-Puslecka, Tomasz Kłosiewicz, Marcin Misterski, Piotr Buczkowski, Lukasz Szarpak, Kurt Ruetzler, Bartlomiej Perek, Michael Czekajlo, Marek Jemielity
Background: Simulation is widely accepted as an important tool in training and educating healthcare providers. The first regional polish extracorporeal membrane oxygenation (ECMO) program called "ECMO for Greater Poland" was recently started. Methods: We present a prototype for ECMO prepared for high-fidelity medical simulation in extracorporeal life support. ECMO therapy is a complex, difficult and expensive therapy in patient care. We have constructed an advanced ECMO simulation prototype, which can be used as a training tool in scenarios that prepare for real-life experiences...
August 2018: Journal of Thoracic Disease
Tetsuya Nomura, Kenshi Ono, Yu Sakaue, Daisuke Ueno, Yusuke Hori, Kenichi Yoshioka, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
BACKGROUND As primary percutaneous coronary intervention (PCI) has been commonly performed for acute myocardial infarction (AMI), we rarely encounter ventricular septal rupture (VSR), which is one of the mechanical complications of AMI. However, the associated mortality rate is still very high unless treated appropriately. CASE REPORT We encountered a very rare case of VSR that was considered to have occurred during primary PCI for AMI. The manifestation of sudden coronary flow disturbance may correspond with the emergence of VSR...
September 18, 2018: American Journal of Case Reports
Patricia Yau, Yu Xia, Saadat Shariff, William A Jakobleff, Stephen Forest, Evan C Lipsitz, Larry A Scher, Karan Garg
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is an important life-saving modality for patients with cardiopulmonary failure. Vascular complications, including clinically significant limb ischemia, may occur as a result of femoral artery cannulation for venoarterial (VA) ECMO. This study examines our institutional experience with femoral VA ECMO and the development of ipsilateral limb ischemia. METHODS: We performed a retrospective review of all consecutive patients undergoing femoral VA ECMO between 2011 and 2016...
September 11, 2018: Annals of Vascular Surgery
Michael Y Mi, Michael A Matthay, Alan H Morris
New England Journal of Medicine, Volume 379, Issue 9, Page 884-887, August 2018.
August 30, 2018: New England Journal of Medicine
Kohei Hashimoto, Konrad Hoetzenecker, Jonathan C Yeung, Luke Jeagal, Laura Donahoe, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Thomas K Waddell, Shaf Keshavjee, Marcelo Cypel
BACKGROUND: Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is the preferred configuration for bridging respiratory failure patients while awaiting lung transplantation. However, there is no consensus on intraoperative extracorporeal cardiopulmonary support during lung transplantation in these patients. METHODS: The configuration of the intraoperative extracorporeal circuit after VV ECMO bridge was reviewed and correlated with clinical outcomes. This retrospective cohort study performed at our university hospital included 34 patients who were successfully bridged solely with VV ECMO to lung transplantation during the period 2007 to 2016...
September 5, 2018: Journal of Heart and Lung Transplantation
Michael Ried, Laura Sommerauer, Matthias Lubnow, Thomas Müller, Alois Philipp, Dirk Lunz, Hans-Stefan Hofmann
BACKGROUND: Patients with respiratory failure are treated more frequently with veno-venous extracorporeal membrane oxygenation (vv-ECMO). These patients are at risk for bleeding due to complex multifactorial coagulation disorders resulting from the extracorporeal circulation. METHODS: Retrospective analysis of prospectively collected data on all patients requiring vv-ECMO between December 2010 and December 2016. Endpoints were the incidence, consequence and in-hospital mortality of patients with thoracic bleeding complications...
September 4, 2018: Annals of Thoracic Surgery
Alireza Mahboub-Ahari, Fariba Heidari, Fatemeh Sadeghi-Ghyassi, Maryam Asadi
In recent years, there have been substantial advancements in the development of different technologies for extracorporeal membrane oxygenation (ECMO) for in-hospital and out of hospital applications. However the effectiveness of these devices is not clearly known. The objective of this study was to evaluate the cost-effectiveness of Cardiohelp compared to other portable ECMO devices. In this systematic review, we searched Medline (via Ovid), Embase, Pubmed, Cochrane Library, SCOPUS, CRD and NICE. Articles were assessed by two independent reviewers for eligibility and quality of the evidence...
September 5, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
2018-09-08 11:05:19
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