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ECMO

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https://www.readbyqxmd.com/read/28546860/predictors-of-intracranial-hemorrhage-in-adult-patients-on-extracorporeal-membrane-oxygenation-an-observational-cohort-study
#1
Alexander Fletcher Sandersjöö, Jiri Bartek, Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman, Bo-Michael Bellander
BACKGROUND: Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH in this patient category are poorly understood. The purpose of this study was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who were treated with ECMO for less than 12 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28528989/infections-during-extracorporeal-membrane-oxygenation-epidemiology-risk-factors-pathogenesis-and-prevention
#2
REVIEW
Stefano Biffi, Stefano Di Bella, Vittorio Scaravilli, Anna Maria Peri, Giacomo Grasselli, Laura Alagna, Antonio Pesenti, Andrea Gori
Extracorporeal membrane oxygenation (ECMO) is a life support technique used in patients with respiratory and/or cardiac failure. The ECMO circuit consists of vascular cannulae, a pump and an artificial lung. Infections are among the most common complications associated with ECMO and have a significant impact on the mortality rate. Here we present a narrative literature review regarding the epidemiology, risk factors, pathogenesis and prevention of infectious complications during ECMO support. The prevalence of hospital-acquired infections during ECMO is 10-12% and their occurrence is likely to be more frequent compared with other critically ill patients...
May 18, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28523148/iabp-plus-ecmo-is-one-and-one-more-than-two
#3
EDITORIAL
Sebastian Nuding, Karl Werdan
No abstract text is available yet for this article.
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28525416/is-there-a-preinterventional-mechanical-ventilation-time-limit-for-candidates-of-adult-respiratory-extracorporeal-membrane-oxygenation
#4
Meng-Yu Wu, Chung-Chi Huang, Tzu-I Wu, Yu-Sheng Chang, Chin-Liang Wang, Pyng-Jing Lin
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#5
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28525550/long-term-survival-and-quality-of-life-after-extracorporeal-life-support-a-10-year-report%C3%A2
#6
Daniele Camboni, Alois Philipp, Verena Rottenkolber, Matthaeus Zerdzitzki, Andreas Holzamer, Bernhard Floerchinger, Dirk Lunz, Thomas Mueller, Christof Schmid, Claudius Diez
OBJECTIVES: Information is lacking about long-term survival and quality of life (QOL) after treating patients on extracorporeal life support. METHODS: Outcome data were assessed by phone interviews, a QOL analysis using the EuroQol 5-dimensions questionnaire and a retrospective inquiry of the Regensburg ECMO Registry database for the decade 2006-2015. A statistical analysis was obtained by comparing patients with a cardiosurgical intervention (CS = 189 patients) with those without (w/oCS = 307 patients)...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#7
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
May 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27234777/heart-transplantation-under-mechanical-circulatory-support-for-acute-fulminant-myocarditis-with-cardiogenic-shock-10%C3%A2-years-experience-of-a-single-center
#8
M Ting, C-H Wang, C-I Tsao, S-C Huang, N-H Chi, N-K Chou, Y-S Chen, S-S Wang
BACKGROUND: Acute fulminant myocarditis with intractable cardiogenic shock is a fatal condition; its only therapeutic option is mechanical circulatory support. The use of mechanical circulatory support, either extracorporeal membrane oxygenation (ECMO) or a ventricular assist device (VAD), serves as a bridge to recovery or as a bridge to transplantation. OBJECTIVES: The aim of this research was to advance our understanding of the outcome of heart transplantation under mechanical support for acute myocarditis...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/24420915/acute-mechanical-circulatory-support-for-fulminant-myocarditis-complicated-by-cardiogenic-shock
#9
Kanika P Mody, Hiroo Takayama, Elissa Landes, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Ulrich P Jorde, Nir Uriel
In fulminant myocarditis complicated by cardiogenic shock, early mechanical circulatory support (MCS) may prevent cardiomyopathy and death. We sought to examine the outcomes of patients with fulminant myocarditis supported with MCS. A retrospective review of patients with acute cardiogenic shock treated with MCS from 2007 to 2013 was conducted, and patients with a diagnosis of fulminant myocarditis were included in this series. At our center, 260 patients received MCS for acute cardiogenic shock, and 11 were implanted for fulminant myocarditis...
March 2014: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28499654/hybrid-extracorporeal-membrane-oxygenation-using-avalon-elite-double-lumen-cannula-ensures-adequate-heart-brain-oxygen-supply
#10
Ju Zhao, Dongfang Wang, Cherry Ballard-Croft, Jingkun Wang, Po-Lin Hsu, Matthew Bacchetta, Joseph B Zwischenberger
BACKGROUND: Differential hypoxia exists in peripheral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) patients with compromised lungs, causing hypoxic damage to heart or brain. We proposed an Avalon Elite (Maquet, Rastatt, Germany) double lumen cannula-based hybrid ECMO to add a venovenous (VV) blood flow into the pulmonary circulation onto the existing VA ECMO circuit to increase oxygen saturation in the left ventricle and ascending aorta, mitigating heart/brain hypoxia...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28500585/systematic-review-and-meta-analysis-of-complications-and-mortality-of-veno-venous-extracorporeal-membrane-oxygenation-for-refractory-acute-respiratory-distress-syndrome
#11
REVIEW
Sergi Vaquer, Candelaria de Haro, Paula Peruga, Joan Carles Oliva, Antonio Artigas
Veno-venous extracorporeal membrane oxygenation (ECMO) for refractory acute respiratory distress syndrome (ARDS) is a rapidly expanding technique. We performed a systematic review and meta-analysis of the most recent literature to analyse complications and hospital mortality associated with this technique. Using the PRISMA guidelines for systematic reviews and meta-analysis, MEDLINE and EMBASE were systematically searched for studies reporting complications and hospital mortality of adult patients receiving veno-venous ECMO for severe and refractory ARDS...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28497496/percutaneous-left-atrial-decompression-in-adults-with-refractory-cardiogenic-shock-supported-with-veno-arterial-extracorporeal-membrane-oxygenation
#12
Mosaad Alhussein, Mark Osten, Eric Horlick, Heather Ross, Eddy Fan, Vivek Rao, Filio Billia
BACKGROUND AND AIM OF THE STUDY: Left ventricular (LV) distention, a recognized complication in patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock, can lead to pulmonary edema, increased myocardial oxygen consumption, and LV thrombus formation. Atrial septostomy was examined as a management strategy for LV distension. METHODS: Of 72 patients supported with VA-ECMO, seven patients underwent atrial septostomy through a trans-septal approach...
May 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28499130/extracorporeal-membrane-oxygenation-ecmo-as-a-treatment-strategy-for-severe-acute-respiratory-distress-syndrome-ards-in-the-low-tidal-volume-era-a-systematic-review
#13
REVIEW
Bourke W Tillmann, Michelle L Klingel, Alla E Iansavichene, Ian M Ball, A Dave Nagpal
OBJECTIVE: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included...
April 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28470918/isolated-left-ventricular-failure-is-a-predictor-of-poor-outcome-in-patients-receiving-veno-arterial-extracorporeal-membrane-oxygenation
#14
Corstiaan A den Uil, Lucia S Jewbali, Martijn J Heeren, Alina A Constantinescu, Nicolas M Van Mieghem, Dinis Dos Reis Miranda
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470919/extra-corporeal-membrane-oxygenation-in-the-therapy-of-cardiogenic-shock-ecmo-cs-rationale-and-design-of-the-multicenter-randomized-trial
#15
Petr Ostadal, Richard Rokyta, Andreas Kruger, Dagmar Vondrakova, Marek Janotka, Ondrej Smíd, Jana Smalcova, Milan Hromadka, Ales Linhart, Jan Bělohlávek
AIMS: Extracorporeal membrane oxygenation (ECMO) in veno-arterial configuration represents an increasingly used method for circulatory support. ECMO in cardiogenic shock offers rapid improvement of circulatory status and significant increase in tissue perfusion. Current evidence on the use of ECMO in cardiogenic shock remains insufficient. The aim of the ECMO-CS trial is to compare two recognized therapeutic approaches in the management of severe cardiogenic shock: early conservative therapy and early implantation of veno-arterial ECMO on the background of standard care...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470921/tracheostomy-as-a-bridge-to-spontaneous-breathing-and-awake-ecmo-in-non-transplant-surgical-patients
#16
J Swol, J T Strauch, T A Schildhauer
AIMS: The tracheostomy is a frequently used procedure for the respiratory weaning of ventilated patients allows sedation free ECLS use in awake patient. The aim of this study is to assess the possibility and highlight the benefits of lowering the impact of sedation in surgical non-transplant patients on ECLS. The specific objective was to investigate the use of tracheostomy as a bridge to spontaneous breathing on ECLS. METHODS AND RESULTS: Of the 95 patients, 65 patients received a tracheostomy, and 5 patients were admitted with a tracheostoma...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470922/choosing-the-appropriate-configuration-and-cannulation-strategies-for-extracorporeal-membrane-oxygenation-the-potential-dynamic-process-of-organ-support-and-importance-of-hybrid-modes
#17
Vitaly Sorokin, Graeme MacLaren, Puwalani C Vidanapathirana, Thijs Delnoij, Roberto Lorusso
Extracorporeal membrane oxygenation (ECMO) is becoming a common procedure to support patients with severe cardio-circulatory or respiratory failure as well as in case of combined compromise of the two systems. Deciding which ECMO configuration and proceeding with an uneventful implantation, however, may present minor or major shortcomings. Cannulation techniques should be tailored to specific patient conditions to provide sufficient regional and systemic perfusion, both of which must be comprehensively monitored...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470925/modalities-and-effects-of-left-ventricle-unloading-on-extracorporeal-life-support-a-review-of-the-current-literature
#18
Paolo Meani, Sandro Gelsomino, Eshan Natour, Daniel M Johnson, Hans-Peter Brunner La Rocca, Federico Pappalardo, Elham Bidar, Maged Makhoul, Giuseppe Raffa, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Niels Sluijpers, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan Willem Sels, Marcel van de Poll, Paul Roekaerts, Thomas Poels, Eric Korver, Zaheer Babar, Jos Maessen, Roberto Lorusso
INTRODUCTION/AIM: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature. METHODS: A systematic literature search was performed in the PubMed database: 207 articles published between 1993 and 2016 were included...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28460592/anticoagulation-and-transfusions-management-in-veno-venous-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-assessment-of-factors-associated-with-transfusion-requirements-and-mortality
#19
Gennaro Martucci, Giovanna Panarello, Giovanna Occhipinti, Veronica Ferrazza, Fabio Tuzzolino, Diego Bellavia, Filippo Sanfilippo, Cristina Santonocito, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Antonio Arcadipane
PURPOSE: We describe an approach for anticoagulation and transfusions in veno-venous-extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. METHODS: Observational study on consecutive adults supported with VV-ECMO for acute respiratory distress syndrome (ARDS). We targeted an activated partial thromboplastin time of 40 to 50 seconds and a hematocrit of 24% to 30%. Univariate and multiple analyses were done to evaluate factors associated with transfusion requirements and the influence of increasing transfusions on mortality during ECMO...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28466601/adult-extracorporeal-membrane-oxygenation-an-international-survey-of-transfusion-and-anticoagulation-techniques
#20
S A Esper, I J Welsby, K Subramaniam, W John Wallisch, J H Levy, J H Waters, D J Triulzi, J W A Hayanga, G J Schears
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a non-endothelialized, artificial surface to blood inciting an inflammatory response which activates haemostatic pathways. Anticoagulation may complicate a pre-existing coagulopathy and/or inadequate surgical hemostasis of varying severity...
May 3, 2017: Vox Sanguinis
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