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ECMO

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https://www.readbyqxmd.com/read/27984228/new-innovations-in-circulatory-support-with-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-therapy
#1
Robert N Sladen
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28074818/cannulation-strategies-in-adult-veno-arterial-and-veno-venous-extracorporeal-membrane-oxygenation-techniques-limitations-and-special-considerations
#2
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/28063605/extracorporeal-membrane-oxygenation-in-massive-pulmonary-embolism
#3
Elena V Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
BACKGROUND: Extracorporeal Membrane Oxygenation (ECMO) has been suggested for cardiopulmonary support in patients with massive pulmonary embolism (PE) refractory to other treatment or as bridging to embolectomy. The survival benefit from ECMO in patients with massive PE remains unclear. METHODS: Here, we describe 5 cases in which ECMO was used as cardiopulmonary support following massive near-fatal pulmonary embolism. RESULTS: The overall mortality in patients with massive PE that received ECMO support was 40%...
January 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28054903/massive-pulmonary-embolism-treated-with-catheter-therapy-and-extracorporeal-membrane-oxygenation
#4
Nicholas R Teman, Jianzhou T Xiao, Curtis G Tribble
Massive pulmonary embolism (PE) is associated with significant morbidity and mortality.  Treatment for massive PE can include systemic thrombolysis and catheter-directed therapy. We present the case of a patient with massive PE successfully treated with catheter-directed therapy, using extracorporeal membrane oxygenation for hemodynamic support, and discuss some of the potential complications associated with this therapy.
21, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28043990/low-dose-bivalirudin-anticoagulation-for-lung-transplantation-with-extracorporeal-membrane-oxygenation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#5
Andreas Koster, Jost Niedermeyer, Jan Gummert, Andre Renner
A patient scheduled for lung transplantation needed veno-venous extracorporeal membrane oxygenation (ECMO) and developed acute heparin-induced thrombocytopenia (HIT). After 21 days on ECMO support, lung transplantation was successfully performed using veno-arterial ECMO with bivalirudin anticoagulation. The target activating clotting time values of 160-180 s resulted in low bivalirudin infusion rates of 0.1 mg/kg/h. Diffuse bleeding stopped quickly after ending the continuous bivalirudin infusion.
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28033607/extracorporeal-membrane-oxygenation-in-adults-variants-complications-during-therapy-and-the-role-of-radiological-imaging
#6
Laura Beck, Matthias C Burg, Walter Heindel, Christoph Schülke
Background Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) as respiratory and circulatory assist therapies are gaining in importance in the treatment of critically ill patients. Depending on the place of cannulation - veno-venous for ECMO and veno-arterial for ECLS - distinct changes in hemodynamics will occur. In this review we describe the different types of ECMO and ECLS systems, the typical cannula placement and frequent complications under therapy. The most suitable imaging modalities will be presented and typical hemodynamic pitfalls in contrast-enhanced computed tomography or angiography will be elucidated...
December 29, 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28030497/extra-corporeal-membrane-oxygenation-ecmo-following-traumatic-injury
#7
Sarwat Ahmad, Jay Menaker, Joseph Kufera, James O'Connor, Thomas M Scalea, Deborah M Stein
BACKGROUND: The use of ECMO for acute respiratory failure following injury is controversial and poorly described. METHODS: We reviewed our single-center experience with use of ECMO from January 2006 to November 2015 at a Level 1 primary adult resource center for trauma to determine the association of in-hospital mortality with patient demographics and clinical variables. RESULTS: 46 patients were treated with ECMO. Patients requiring venoarterial ECMO (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27993632/ecmo-cardio-pulmonary-resuscitation-ecpr-trends-in-survival-from-an-international-multicentre-cohort-study-over-12-years
#8
Alexander Sacha C Richardson, Matthieu Schmidt, Michael Bailey, Vincent A Pellegrino, Peter T Rycus, David V Pilcher
BACKGROUND: Use of Extracorporeal Membrane Oxygenation during cardiopulmonary resuscitation (ECPR) is increasingly being deployed as an adjunct to conventional CPR. It is unknown if this has been associated with improved outcomes. AIMS: To describe trends in survival and patient demographics for ECPR patients in the international Extracorporeal Life Support Organisation (ELSO) database over the past 12 years and identify factors associated with changes in survival...
December 16, 2016: Resuscitation
https://www.readbyqxmd.com/read/27994255/review-of-venoarterial-extracorporeal-membrane-oxygenation-and-development-of-intracardiac-thrombosis-in-adult-cardiothoracic-patients
#9
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/27986281/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-a-multicentre-experience
#10
Mark Dennis, Peter McCanny, Mario D'Souza, Paul Forrest, Brian Burns, David A Lowe, David Gattas, Sean Scott, Paul Bannon, Emily Granger, Roger Pye, Richard Totaro
AIM: To describe the ECPR experience of two Australian ECMO centres, with regards to survival and neurological outcome, their predictors and complications. METHODS: Retrospective observational study of prospectively collected data on all patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) at two academic ECMO referral centres in Sydney, Australia. MEASUREMENTS AND MAIN RESULTS: Thirty-seven patients underwent ECPR, 25 (68%) were for in-hospital cardiac arrests...
December 6, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27940495/extracorporeal-membrane-oxygenation-in-new-york-state-trends-outcomes-and-implications-for-patient-selection
#11
Jaya Batra, Nana Toyoda, Andrew B Goldstone, Shinobu Itagaki, Natalia N Egorova, Joanna Chikwe
BACKGROUND: Utilization of extracorporeal membrane oxygenation (ECMO) is expanding despite limited outcome data defining appropriate use. METHODS AND RESULTS: To quantify determinants of early and 1-year survival after ECMO in adult patients, we conducted a retrospective cohort analysis of 1286 patients aged ≥18 years who underwent ECMO in New York State from 2003 to 2014. Median follow-up time was 4.9 months (range, 0-12 months). ECMO utilization increased from 13 patients in 8 hospitals in 2003 to 330 patients in 30 hospitals in 2014...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27959313/-awake-extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplant
#12
Sara K Kearns, Omar O Hernandez
Mortality of patients awaiting lung transplant remains a significant problem as the number of patients on the waiting list far surpasses the number of donor organs available. Interest in the use of "awake" extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplant has emerged because this strategy offers several benefits over mechanical ventilation. This article provides a review of relevant literature and discusses indications and complications of awake ECMO therapy, cannulation strategies, and nursing considerations for this patient population...
July 2016: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/27913738/extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-replacement
#13
Elena Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
BACKGROUND: Patients undergoing transcatheter aortic valve replacement can experience severe perioperative complications leading to hemodynamic instability and death. Venoarterial extracorporeal membrane oxygenation can be used to provide cardiorespiratory support during this time. METHODS: From 2012 to 2015, of 247 patients who underwent transcatheter aortic valve replacement, 6 (2.42%) required extracorporeal membrane oxygenation support. Their mean age was 82 ± 7...
December 2, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27922880/investigation-of-key-circuit-constituents-affecting-drug-sequestration-during-extracorporeal-membrane-oxygenation-treatment
#14
Jiheum Park, Dong Ah Shin, Saram Lee, Young-Jae Cho, Sanghoon Jheon, Jung Chan Lee, Hee Chan Kim
We quantified the influence of the elements of the extracorporeal oxygenation (ECMO) circuit on drug sequestration by focusing on the interactions between materials and drugs. Tubing of three different brands (Tygon/Maquet/Terumo) and oxygenators of two different brands (Maquet/Terumo) were used. Drugs included dexmedetomidine, meropenem, and heparin which were dissolved in deionized water. Tubing was cut into ~7 cm sections and allowed drug solutions enclosed inside by clamping both ends. The oxygenator housing, gas membrane, and heat exchanger were dissected into ~1 g pieces and submerged into drug solutions...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27919283/outcomes-and-survival-prediction-models-for-severe-adult-acute-respiratory-distress-syndrome-treated-with-extracorporeal-membrane-oxygenation
#15
REVIEW
Sacha Rozencwajg, David Pilcher, Alain Combes, Matthieu Schmidt
Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) has known a growing interest over the last decades with promising results during the 2009 A(H1N1) influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance.Survival has steadily improved for a decade, reaching up to 65% at hospital discharge in the most recent cohorts. However, ECMO is still marred by frequent and significant complications such as bleeding and nosocomial infections...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#16
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#17
Alain Combes, Nicolas Bréchot, Charles-Edouard Luyt, Matthieu Schmidt
PURPOSE OF REVIEW: This article summarizes the results of past and more recent series on venovenous extracorporeal membrane oxygenation (VV-ECMO) and discusses its potential indications beyond the rescue of patients with lung failure refractory to conventional mechanical ventilation. RECENT FINDINGS: Successful VV-ECMO treatment in patients with extremely severe influenza A(H1N1)-associated acute respiratory distress syndrome (ARDS) and positive results of the CESAR trial have led to an exponential use of the technology in recent years...
February 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27866925/extracorporeal-membrane-oxygenation-support-and-post-heart-transplant-outcomes-among-united-states-adults
#18
Sandip Zalawadiya, Marat Fudim, Geetha Bhat, William Cotts, JoAnn Lindenfeld
BACKGROUND: Patients supported with extracorporeal membrane oxygenation (ECMO) are given priority listing status for heart transplant (HT). Data on post-HT outcomes for adults with ECMO support at the time of HT are limited. METHODS: We analyzed data from the United Network for Organ Registry (UNOS) registry for 157 ECMO-supported adults (age ≥ 18 years) undergoing HT after January 1, 2000. Data at the time of HT were examined for their association with post-transplant mortality using multivariable Cox proportional hazard analyses...
October 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#19
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#20
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
October 7, 2016: Journal of Heart and Lung Transplantation
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