Hemolysis and Nonhemorrhagic Stroke During Venoarterial Extracorporeal Membrane Oxygenation

We examined the association of low-level hemolysis (LLH) and nonhemorrhagic stroke during venoarterial extracorporeal membrane oxygenation (VA ECMO) support.MethodsA single-center retrospective review of all adult patients placed on VA ECMO from January 2012 to September 2017 was conducted. To determine the association between LLH and nonhemorrhagic stroke, patients were categorized as those with and without LLH. LLH was defined by 48-hour plasma free hemoglobin (PFHb) of 11 to 50 mg/dL after VA ECMO implantation.ResultsOf 201 patients who underwent VA ECMO placement, 150 (75%) met inclusion criteria and comprised the study population. They were 55 ± 14 years of age and 50 (33%) were women. Sixty-two (41%) patients had LLH. Patients with LLH had a higher likelihood of incident nonhemorrhagic stroke during VA ECMO support (20 [32%] versus 4 [5%]; adjusted hazard ratio [HR], 7.6; 95% confidence interval [CI], 2.2 to 25.9; p = 0.001). The severity of LLH was associated with an incrementally higher likelihood of a nonhemorrhagic stroke (PFHb 26 to 50 mg/dL: HR, 11.3; 95% CI, 3.6 to 35.1; p = 0.001; PFHb 11 to 25 mg/dL: HR, 4.4; 95% CI, 1.36 to 14.85; p = 0.014) in comparison with no LLH. Those with LLH had a 2-fold greater increase in mean platelet volume after VA ECMO placement (0.98 ± 1.1 fL versus 0.49 ± 0.96 fL; p = 0.03). Patients with a nonhemorrhagic stroke had a higher operative mortality (20 [83%] versus 57 [45%]; adjusted HR, 3.1...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

Related Links:

CONCLUSIONS: The validity of self-reported disease was lower than expected, especially in those who reported having been diagnosed with MI. Proper consideration is needed when using these self-reported data in further studies. PMID: 31795614 [PubMed - in process]
Source: Journal of Preventive Medicine and Public Health - Category: International Medicine & Public Health Tags: J Prev Med Public Health Source Type: research
Publication date: Available online 4 December 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Zhihui Deng, John DavisAbstractThere is evidence of disrupted cerebral blood flow in patients with a skull defect due to decompressive craniectomy though the pathophysiologic mechanism is yet to be established. Here we report on a patient who suffered one episode of transient ischemic attack (TIA) when developing early stage sinking skin flap syndrome (SSFS) post decompressive craniectomy due to a severe traumatic brain injury. This case report of TIA as a clinical presentation of SSFS indicating a potentially increased risk ...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Conclusions: This pilot study demonstrated the feasibility of a metacognitive occupation-based telerehabilitation intervention and its potential benefits in activity performance, participation, and QoL for older adults coping with long-term disability following ABI.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03048708.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Our results suggest that in this community-dwelling population, a higher CAA score is related to cognitive impairment and a higher risk of stroke, dementia, and death. The composite CAA score can be used to practically quantify the severity of vascular brain injury.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
DiscussionThis review will be the first to report and summarise the risk for and incidence of PPC in adult patients with MetS undergoing surgery across a range of surgical specialities. The results have the potential to inform the development of evidenced-based interventions to improve the management of PPC in the surgical patient with MetS. Findings from this systematic review and meta-analysis will inform a subsequent Delphi study on priorities and responses to PPC in patients with MetS. We will also disseminate our results through publication in scientific peer-reviewed journals, conference presentations and promotion t...
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
Publication date: Available online 4 December 2019Source: Sensors and Actuators A: PhysicalAuthor(s): Yanling Tian, Yue Ma, Fujun Wang, Kangkang Lu, Dawei ZhangAbstractThis paper presents the design, modeling, and experimental validation of a novel XYZ micro/nano positioner driven by piezoelectric actuator (PEA). To achieve a large motion stroke, compact structure and good decoupling performance, a novel displacement amplifier including L-shape levers and half-bridge (LSLHB) is proposed. By utilizing a concave input mechanism for location restriction between PEA and flexible mechanism, the motion coupling caused by the inc...
Source: Sensors and Actuators A: Physical - Category: Physics Source Type: research
Conditions:   Stroke;   Stroke, Acute;   Stroke, Subacute;   Robotics Intervention:   Device: Use of the Atalante exoskeleton Sponsor:   Wandercraft Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Stroke Intervention:   Behavioral: augmented reality Sponsors:   University of Pittsburgh;   Northeastern University;   NSF Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Stroke Sequelae;   Brain Ischemia Intervention:   Other: EEG -BCI based Feedback for rehabilitation Sponsor:   University of Houston Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Stroke;   Stroke, Acute;   Stroke, Subacute;   Robotics Intervention:   Device: Use of the Atalante exoskeleton Sponsor:   Wandercraft Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
More News: Cardiovascular & Thoracic Surgery | Stroke | Study | Women