The intricate physiology of veno-venous extracorporeal membrane oxygenation: an overview for clinicians
Perfusion. 2024 Apr;39(1_suppl):49S-65S. doi: 10.1177/02676591241238156.ABSTRACTDuring veno-venous extracorporeal membrane oxygenation (V-V ECMO), blood is drained from the central venous circulation to be oxygenated and decarbonated by an artificial lung. It is then reinfused into the right heart and pulmonary circulation where further gas-exchange occurs. Each of these steps is characterized by a peculiar physiology that this manuscript analyses, with the aim of providing bedside tools for clinical care: we begin by describing the factors that affect the efficiency of blood drainage, such as patient and cannulae position...
Source: Perfusion - April 24, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Emilia Tomarchio Francesca Momigliano Lorenzo Giosa Patrick Duncan Collins Nicholas A Barrett Luigi Camporota Source Type: research
Mechanical ventilation during extracorporeal membrane oxygenation support - New trends and continuing challenges
CONCLUSION: Understanding the physiological principles of gas exchange during cardiac support on femoro-femoral V-A ECMO configuration and the interactions with native gas exchange and haemodynamics are essential for the safe applications of these techniques in clinical practice. Proning during ECMO remains to be discussed until further data is available from prospective, randomized trials implementing individualized PEEP titration during proning.PMID:38651573 | DOI:10.1177/02676591241232270 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Konstanty Szuldrzynski Mariusz Kowalewski Justyna Swol Source Type: research
EuroELSO 2024, Author Index
Perfusion. 2024 Apr;39(1_suppl):276S-288S. doi: 10.1177/02676591241248245.NO ABSTRACTPMID:38651574 | DOI:10.1177/02676591241248245 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Source Type: research
Left ventricular unloading in patients supported with veno-arterial extra corporeal membrane oxygenation; an international EuroELSO survey
CONCLUSIONS: Significant variation exists with respect to international practice of ventricular unloading. Further research is required that compares the efficacy of different unloading strategies and a randomized comparison of routine mechanical unloading versus unplanned unloading.PMID:38651575 | DOI:10.1177/02676591241229647 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Saad M Ezad Matthew Ryan Nicholas Barrett Luigi Camporota Justyna Swol Marta V Antonini Dirk W Donker Federico Pappalardo Navin K Kapur Louise Rose Divaka Perera Source Type: research
Agreement between the thromboelastography reaction time parameter using fresh and citrated whole blood during extracorporeal membrane oxygenation with Teg ®5000 and Teg®6s
CONCLUSIONS: Using citrated-recalcified blood to perform TEG might lead to underestimation of the effect of heparin.PMID:38651576 | DOI:10.1177/02676591231223085 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Stefano De Falco Andrea Meli Alessio Caccioppola Giacomo Grasselli Mauro Panigada Source Type: research
Rehabilitation for adult patients undergoing extracorporeal membrane oxygenation
CONCLUSION: Current practice focuses on rehabilitative protocols that incorporate exercise routines with progressive intensity, greater emphasis on out-of-bed activities, and a multidisciplinary approach to patient mobilization.PMID:38651577 | DOI:10.1177/02676591231226289 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Massimiliano Polastri Allaina Eden Justyna Swol Source Type: research
The role of inflammation and antithrombin supplementation on thromboelastographic parameters during veno-venous ECMO for respiratory failure
CONCLUSIONS: High concentrations of systemic cytokines correlated with longer reaction times and decreased angle and amplitude at TEG, suggesting that an increase in inflammation is related with hypocoagulability as revealed by thromboelastography.PMID:38651578 | DOI:10.1177/02676591241237637 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Andrea Meli Stefano De Falco Cristina Novembrino Massimo Boscolo Anzoletti Antonio Arcadipane Giovanna Panarello Giovanna Occhipinti Giacomo Grasselli Mauro Panigada Source Type: research
Extracorporeal membrane oxygenation from last resort to indispensable tool in the treatment of respiratory and/or circulatory failure
Perfusion. 2024 Apr;39(1_suppl):3S-4S. doi: 10.1177/02676591231226292.NO ABSTRACTPMID:38651579 | DOI:10.1177/02676591231226292 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Filip De Somer Justyna Swol Source Type: research
The physiology of venoarterial extracorporeal membrane oxygenation - A comprehensive clinical perspective
Perfusion. 2024 Apr;39(1_suppl):5S-12S. doi: 10.1177/02676591241237639.ABSTRACTVenoarterial extracorporeal membrane oxygenation (VA ECMO) has become a standard of care for severe cardiogenic shock, refractory cardiac arrest and related impending multiorgan failure. The widespread clinical use of this complex temporary circulatory support modality is still contrasted by a lack of formal scientific evidence in the current literature. This might at least in part be attributable to VA ECMO related complications, which may significantly impact on clinical outcome. In order to limit adverse effects of VA ECMO as much as possible...
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Libera Fresiello Jeannine A J Hermens Lara Pladet Christiaan L Meuwese Dirk W Donker Source Type: research
Clinical decision making for VA ECMO weaning in patients with cardiogenic shock A formative qualitative study
Perfusion. 2024 Apr;39(1_suppl):39S-48S. doi: 10.1177/02676591241236643.ABSTRACTWeaning and liberation from VA ECMO in cardiogenic shock patients comprises a complex process requiring a continuous trade off between multiple clinical parameters. In the absence of dedicated international guidelines, we hypothesized a great heterogeneity in weaning practices among ECMO centers due to a variety in local preferences, logistics, case load and individual professional experience. This qualitative study focused on the appraisal of clinicians' preferences in decision processes towards liberation from VA ECMO after cardiogenic shock ...
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: J A J Hermens J A van Til C L Meuwese D van Dijk D W Donker Source Type: research
The approach to extracorporeal cardiopulmonary resuscitation (ECPR) in children. A narrative review by the paediatric ECPR working group of EuroELSO
Perfusion. 2024 Apr;39(1_suppl):81S-94S. doi: 10.1177/02676591241236139.ABSTRACTExtracorporeal Cardiopulmonary Resuscitation (ECPR) has potential benefits compared to conventional Cardiopulmonary Resuscitation (CCPR) in children. Although no randomised trials for paediatric ECPR have been conducted, there is extensive literature on survival, neurological outcome and risk factors for survival. Based on current literature and guidelines, we suggest recommendations for deployment of paediatric ECPR emphasising the requirement for protocols, training, and timely intervention to enhance patient outcomes. Factors related to outc...
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: H A Mensink A Desai M Cvetkovic M Davidson A Hoskote M O'Callaghan T Thiruchelvam P P Roeleveld Source Type: research
What the pediatric nurse needs to know about the Impella cardiac assist device
Perfusion. 2024 Apr;39(1_suppl):95S-106S. doi: 10.1177/02676591241237761.ABSTRACTBackground: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and ...
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Giorgia Borrelli Ilaria Nittolo Chiara Bochicchio Laura Trainelli Valerio Confalone Tiziana Satta Federica Cancani Richard Kirk Antonio Amodeo Matteo Di Nardo Source Type: research
Evolution of distal limb perfusion management in adult peripheral venoarterial extracorporeal membrane oxygenation with femoral artery cannulation
Perfusion. 2024 Apr;39(1_suppl):23S-38S. doi: 10.1177/02676591241236650.ABSTRACTLimb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications. Multiple alternative cannulation techniques to the distal perfusion can...
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Jorik Simons Barend Mees Graeme MacLaren John F Fraser Akram M Zaaqoq Sung-Min Cho Bhavesh M Patel Daniel Brodie Jan B ělohlávek Mirko Belliato Jae-Seung Jung Leonardo Salazar Paolo Meani Silvia Mariani Michele Di Mauro Demetris Yannopoulos Lars Mikael Source Type: research
Individual patient data meta-analysis on awake pediatric extracorporeal life support: Feasibility and safety of analgesia, sedation and respiratory support weaning, and physiotherapy
CONCLUSION: Awake ECLS strategy with active physiotherapy can be applied in children from neonatal age. Ambulation is also possible in selected cases. Complications related to such management were limited. Further studies on aECLS are needed to evaluate safety and efficacy of early physiotherapy and define patient selection.PMID:38652693 | DOI:10.1177/02676591241240377 (Source: Perfusion)
Source: Perfusion - April 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Marta Cucchi Silvia Mariani Michal J Kawczynski Emma Shkurka Fabio Ius Giuseppe Comentale Aparna Hoskote Roberto Lorusso Source Type: research
Effect of geography on the use of ultrafiltration during cardiac surgery with cardiopulmonary bypass
CONCLUSIONS: Across the United States there is geographic variation on the use of UF. Further research is warranted to investigate why these practice variations exist and to better understand and determine their reasons for use.PMID:38647100 | DOI:10.1177/02676591241246080 (Source: Perfusion)
Source: Perfusion - April 22, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Kirti P Patel Alfred H Stammers Eric A Tesdahl Jeffrey Chores Scott R Beckmann Jennifer Baeza Craig M Petterson Ty Thompson Alexander Baginski Michael Firstenberg Jeffrey P Jacobs Source Type: research
