Posts Tagged ‘ECLS’
41st Annual Cardiothoracic Surgery Symposium (CREF 2022)
The 41st Annual Cardiothoracic Surgery Symposium (CREF 2022) offers cutting-edge presentations, interactive discussions and debates, hands-on workshops, and extracurricular education on topics related to cardiac surgery, cardiopulmonary bypass, extracorporeal perfusion, and extracorporeal life support. It offers Category 1 CME and CEU credits, meeting the specific educational needs of CVOR and CVICU teams: cardiac anesthesiologists, cardiac…
Read MoreThrombosis in Extracorporeal Membrane Oxygenation (ECMO) Circuits
Examination of ECMO circuits after removal is a useful quality improvement tool that can elucidate the cause of circuit problems, indicate patients at increased risk of thrombosis, and suggest areas for possible improvements.
Read MoreCytokine Adsorption Therapy during Extracorporeal Membrane Oxygenation in Adult Patients with COVID-19
This case series aimed to contribute to the body of evidence substantiating CAT utilization in hyperinflammatory patients, namely, COVID-19 patients requiring ECMO rescue.
Read MoreCentral, Peripheral ECMO or CPB? Comparsion between Circulatory Support Methods Used during Lung Transplantation
The use of central extracorporeal membrane oxygenation should be favorized over peripheral cannulation or cardiopulmonary bypass. CPB should be no longer used during LuTx.
Read MoreVenoarterial Extracorporeal Membrane Oxygenation is A Viable Option as A Bridge to Heart Transplant
Recipients bridged with extracorporeal membrane oxygenation were estimated to survive 16.6 months less than nonmechanical circulatory support recipients. Bridge to heart transplant with extracorporeal membrane oxygenation is a viable option, and these patients should be considered transplant candidates.
Read MoreResearch Trends and Hotspots of Extracorporeal Membrane Oxygenation: A 10-Year Bibliometric Study and Visualization Analysis
Inter-regional and inter-institutional cooperation and exchanges should be carried out among ECMO research teams and institutions. The suggested research direction is to further broaden the application scope of ECMO, while determining the ways to reduce the incidence of complications and the cost, cultivate specialized team talents, and promote the application thereof.
Read MoreECMO Implantation Training: Needle Penetration in 3D Printable Materials and Porcine Aorta
Shore A 10 and 20 polymers have similar needle penetration properties compared to the porcine tissue. Significantly more force is needed to pierce through the material fully. The most similar tested material to porcine aorta for needle penetration and piercing in ECMO-implantation is the silicon Shore A 10 polymer. This silicon could be a 3D-printable material in surgical training for ECMO-implantation.
Read MoreTo Balloon or Not to Balloon? The Effects of an Intra-Aortic Balloon-Pump on Coronary Artery Flow during Extracorporeal Circulation Simulating Normal and Low Cardiac Output Syndromes
Based on our in vitro study results, combining ECMO and IABP in a heart failure setup further improves coronary blood flow. This effect was more pronounced at a lower heart rate and decreased with heart failure, which might positively impact recovery from cardiac failure.
Read MoreVery Low Blood Flow Carbon Dioxide Removal System is Not Effective in A Chronic Obstructive Pulmonary Disease Exacerbation Setting
The present retrospective study describes the first use of PrismaLung in severe COPD patients with acute exacerbation. When compared with a higher blood flow ECCO2R system, our results show that this novel, very low-flow device is not able to remove sufficient CO2, normalize pH or decrease respiratory rate.
Read MoreNoninvasive Optical Measurement of Microvascular Cerebral Hemodynamics and Autoregulation in the Neonatal ECMO Patient
Our pilot results suggest that systemic measures alone cannot distinguish impaired CA from intact CA during ECMO. Furthermore, optical neuromonitoring could help determine patient-specific ECMO pump flows for optimal CA integrity, thereby reducing risk of secondary brain injury.
Read MoreHuman Factors in ECLS – A Keystone for Safety and Quality – A Narrative Review for ECLS Providers
Expertise from other industries is extrapolated to improve patient safety through the application of simulation training to reduce error propagation and improve outcomes.
Read MorePregnant/Peripartum Women with COVID-19 High Survival with ECMO: An ELSO Registry Analysis
We investigated the survival and complications of pregnant/peripartum women with COVID19 supported with V-V ECMO reported to the Extracorporeal Life Support Organization (ELSO) Registry.
Read MoreExtracorporeal Membrane Oxygenation in the Forensic Setting: A Series of 19 Forensic Cases
As ECMO therapy has become increasingly available, it is of importance for medical examiners and death investigators to be familiar with the procedure as well as its limitations. Familiarity with ECMO and its sequelae allows for the proper documentation of postmortem findings and fosters an informed determination of the cause and manner of death.
Read MorePaving the Road for the Adoption of Normothermic Regional Perfusion in Canada
Here, we propose a research agenda that will allow this technology to be introduced within current Canadian organ donation frameworks.
Read MoreIntraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) is used to support patients with refractory cardiopulmonary failure. Given ECMO’s increased use in adults and the fact that many ECMO patients are cared for by anesthesiologists, the Society of Cardiovascular Anesthesiologists ECMO working group created an expert consensus statement that is intended to help anesthesiologists manage adult ECMO patients who are cared for in the operating room. In the first part of this 2-part series, technical aspects of ECMO are discussed, and related expert consensus statements are provided.
Read MoreIntraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists— Part II, Intraoperative Management and Troubleshooting
In the first stage of creating the expert consensus statement, topics related to intraoperative ECMO management were proposed by group members. A literature review for each topic was performed using MEDLINE, and articles published after 1980 were included at the discretion of group members. The specific search terms that were queried varied for each topic area.
Read MoreLimb Amputation Following Extracorporeal Membrane Oxygenation Therapy Among Survivors: A Nationwide Cohort Study from South Korea
In South Korea, 1.6% of ECMO survivors underwent limb amputation within 365 days after initiating ECMO therapy; however, it was not significantly associated with the 3-year all-cause mortality. Our findings warrant future studies on the impact on the quality of life and morbidity-related implications among patients who undergo limb amputation due to ECMO therapy.
Read MoreEarly Experience with Donation after Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion in The United States
DCD heart transplantation outcomes have been excellent. Our DCD protocol is adoptable for more widespread use and will increase donor heart availability in the United States.
Read MoreAdrenaline Improves Regional Cerebral Blood Flow, Cerebral Oxygenation and Cerebral Metabolism During CPR in A Porcine Cardiac Arrest Model Using Low-Flow Extracorporeal Support
This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.
Read MoreThe Use of Cerebral NIRS Monitoring to Identify Acute Brain Injury in Patients With VA-ECMO
Our results support that cerebral NIRS is a useful, real-time bedside neuromonitoring tool to detect ABI in VA-ECMO patients. A >25% drop from the baseline was sensitive in predicting ABI occurrence. Further research is needed to assess how to implement this knowledge to utilize NIRS in developing appropriate intervention strategy in VA-ECMO patients.
Read MoreLeft Heart Decompression on Veno-Arterial Extracorporeal Membrane Oxygenation in Children With Dilated Cardiomyopathy and Myocarditis: An Extracorporeal Life Support Organization Registry Review
Retrospective review of the Extracorporeal Life Support Organization registry revealed an association between left heart decompression and greater odds of survival in children with myocarditis and dilated cardiomyopathy on extracorporeal membrane oxygenation. When comparing patients with dilated cardiomyopathy against those with myocarditis, we could not exclude a three-fold greater odds of survival associated with the use of left heart decompression. This finding warrants further prospective evaluation.
Read MorePediatric ECMO: Unfavorable Outcomes Are Associated with Inflammation and Endothelial Activation
High levels of circulating inflammatory, endothelial activation, and fibrinolytic markers are associated with mortality and abnormal neuroimaging in children on ECMO.
Read MoreLeft Ventricular Assist Device Implants in Patients On Extracorporeal Membrane Oxygenation: Do We Need Cardiopulmonary Bypass?
Omitting CPB for an LVAD implant in patients on ECLS is safe and results in shorter operating time, less re-exploration for bleeding and fewer blood products. However, no survival benefit is observed.
Read MoreImpact of Arterial Carbon Dioxide and Oxygen Content on Cerebral Autoregulation Monitoring Among Children Supported by ECMO
We observed a complex relationship between PaCO2 and CA, influenced by the level of blood pressure. Hypercapnia seems to be globally protective in normotensive or hypertensive condition, while, in case of very low MAP, hypercapnia may disturb CA as it increases LLA. These data add additional arguments for very cautiously lower PaCO2, especially after ECMO start.
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