Posts by Bryan Lich
Myocardial Revascularization Surgery
Coronary artery bypass grafting (CABG) was introduced in the 1960s as the first procedure for direct coronary artery revascularization and rapidly became one of the most common surgical procedures worldwide, with an overall total of more than 20 million operations performed.
Read MoreCPB and ECMO Cannulation Survey
We are seeking input from clinical perfusionists, cardiac surgeons, and clinicians responsible for the care and placement of femoral cannula in patients’ requiring extracorporeal circulation
Read MoreEvaluation, Treatment, and Impact of Neurologic Injury in Adult Patients on Extracorporeal Membrane Oxygenation: a Review
Extracorporeal membrane oxygen (ECMO) is increasingly used as an advanced form of life support for cardiac and respiratory failure. Unfortunately, in infrequent instances, circulatory and/or respiratory recovery is overshadowed by neurologic injury that can occur in patients who require ECMO. As such, knowledge of ECMO and its implications on diagnosis and treatment of neurologic injuries is indispensable for intensivists and neurospecialists.
Read MoreEarly Outcomes After Lung Transplantation for Severe COVID-19: A Series of the First Consecutive Cases from Four Countries
We aimed to describe the course of disease and early post-transplantation outcomes in critically ill patients with COVID-19 who failed to show lung recovery despite optimal medical management and were deemed to be at imminent risk of dying due to pulmonary complications.
Read MoreInsight into ECMO, Mortality and ARDS: A Nationwide Analysis of 45,647 ECMO Runs
The choice of support mode depends largely on the indication. Patients with respiratory failure are predominantly treated with a venovenous (VV) approach. We hypothesized that mortality in Germany in ECLS therapy did not differ from previously reported literature
Read MoreImpact of the Influenza Vaccine on COVID-19 Infection Rates and Severity
With a unique influenza season occurring in the midst of a pandemic, there is interest in assessing the role of the influenza vaccine in COVID-19 susceptibility and severity.
Read MoreVenovenous Versus Venoarterial Extracorporeal Membranous Oxygenation in Inotrope Dependent Pediatric Patients With Respiratory Failure
This retrospective multicenter study compared outcomes for 103 pediatric patients, with hemodynamic compromise, placed on VV ECMO for respiratory failure to those placed on VA ECMO.
Read MoreEfficacy of Prophylactic Antibiotics during Extracorporeal Membrane Oxygenation: A Nationwide Cohort Study
Extracorporeal membrane oxygenation (ECMO) is widely used worldwide, and many hospitals consider using antibiotics to prevent nosocomial infection in ECMO patients. However, the efficacy of antimicrobial prophylaxis for patients receiving ECMO remains unclear.
Read MorePerioperative Management of COVID-19 Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass
The following report will recommend perioperative guidance in patient management to include safety precautions for the heart team, the conduct of extracorporeal circulation and related equipment, and covering the early period in intensive care in the context of the current pandemic.
Read MoreEssential role of Patient Blood Management in a Pandemic: A Call for Action
LivaNova is offering a live webcast on the topic of patient blood management during the COVID pandemic featuring Jonathan Waters, MD and Milan Milojevic, MD PhD.
Read MoreSynchronous Liver Resection, Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Liver and Peritoneal Metastases: A Systematic Review and Meta-analysis
Synchronous liver resection, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases has traditionally been contraindicated. More recent clinical practice has begun to promote this aggressive treatment in select patients.
Read MoreHemoadsorption Eliminates Remdesivir from the Circulation: Implications for the Treatment of COVID-19
Both antiviral treatment with remdesivir and hemoadsorption using a CytoSorb® adsorption device are applied in the treatment of severe COVID-19. The CytoSorb® adsorber consists of porous polymer beads that adsorb a broad range of molecules, including cytokines but also several therapeutic drugs. In this study, we evaluated whether remdesivir and its main active metabolite GS-441524 would be adsorbed by CytoSorb®.
Read MoreFraction of Expired Oxygen: An Additional Safety Approach to Monitor Oxygen Delivery to the Heart Lung Machine Oxygenator
Monitoring the FEO2 is a more reliable way to verify O2 delivery to an oxygenator. An alarm can be set on the FEO2 monitor to alert the perfusionist if the FEO2 falls below a predetermined threshold so any issue with O2 delivery will always be recognized.
Read MoreCardiopulmonary Bypass: Development of John Gibbon’s Heart-Lung Machine
Steady progress has been made in cardiopulmonary bypass in the decades since it was first conceived of by Gibbon. Despite the constant evolution of cardiopulmonary bypass techniques and attempts to minimize their complications, it is still essential that clinicians respect the particularities of each patient’s physiological function.
Read MoreEffect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial
Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days.
Read MoreOutcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome due to COVID-19: The Lessons Learned from the First Wave of COVID-19
Extracorporeal membrane oxygenation (ECMO) has been used as a refractory treatment for acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19), but there has been little evidence of its efficacy. We conducted this study to share our experience using ECMO as a bridge to recovery for ARDS due to COVID-19.
Read MoreIn Honor of Woman’s History Month – LivaNova Presents an Interview with Tami Rosenthal, CCP, MBA, FPP
In recognition of Women’s History Month, the LivaNova Cardiovascular team would like to take a moment to honor the contributions and accomplishments of influential women in the healthcare profession.
Read MoreIntegral Use of Thromboelastography With Platelet Mapping to Guide Appropriate Treatment, Avoid Complications, and Improve Survival of Patients With Coronavirus Disease 2019–Related Coagulopathy
The primary aim was to evaluate if algorithm-guided thromboelastography with platelet mapping could better characterize an individual’s coronavirus disease 2019-relatedcoagulopathic state and, secondarily, improve outcomes.
Read MoreExtracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome: How do we Expand Capacity in the COVID-19 Era?
Despite advances in medical technology, the mortality rate for severe acute respiratory distress syndrome (ARDS) remains high at around 40%. In recent years, multiple studies, systematic reviews, and meta-analyses, including the study in this issue of Heart, Lung and Circulation published by Wang and colleagues, have indicated that treatment with veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be associated with better outcomes in severe ARDS than conventional mechanical ventilation.
Read MoreThe “TIDE”-Algorithm for the Weaning of Patients With Cardiogenic Shock and Temporarily Mechanical Left Ventricular Support With Impella Devices
Mechanical circulatory support (MCS) is often required to stabilize therapy-refractory cardiogenic shock patients. We here propose a novel cardiovascular physiology-based weaning algorithm for MVS.
Read MoreProne Positioning during Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome. A Multicenter Cohort Study and Propensity-matched Analysis
The aim of the study was to assess the feasibility, safety, and effect on oxygenation and lung mechanics of PP during ECMO. As a secondary exploratory aim, we assessed the association between PP and hospital mortality.
Read MoreA Better Predictor of Acute Kidney Injury After Cardiac Surgery: The Largest Area Under the Curve Below the Oxygen Delivery Threshold During Cardiopulmonary Bypass
The aim of this study was to compare the predictive accuracy of acute kidney injury (AKI) after cardiac surgery using cardiopulmonary bypass for the largest area under the curve (AUC) below the oxygen delivery (DO2) threshold and the cumulative AUC below the DO2 threshold.
Read MoreImpact of CytoSorb on Kinetics of Vancomycin and Bivalirudin in Critically ill Patients
CytoSorb is effective in mitigating the systemic inflammatory response and safe with respect to vancomycin and bivalirudin administration. These preliminary data further support the use of CytoSorb as adjunct therapy in critically ill patients.
Read MoreOutcome Prediction in Patients with Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation-A Retrospective International Multicenter Study
In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival.
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