Reperfusion strategies in patients with high-risk acute pulmonary embolism needing extracorporeal membrane oxygenation support: A systematic review

Extracorporeal membrane oxygenation (ECMO) could theoretically be useful in patients with high-risk pulmonary embolism (PE). Current European Society of Cardiology give a low-grade recommendation for ECMO implantation in patients with circulatory collapse or cardiac arrest, reporting that it may be considered (class IIb – level of evidence C) in combination with surgical embolectomy or catheter-based treatment.1 Caution is given regarding the use of ECMO in combination with systemic thrombolysis or as a stand-alone technique due to excessive risk of bleeding in one case and controversial efficacy in the other.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research

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Abstract PURPOSE: Clinical equipoise exists with the use of novel reperfusion therapies such as catheter-directed thrombolysis in the management of patients presenting to hospital with high risk pulmonary embolism (PE). Therapeutic options rely on clinical presentation, patient factors, physician preference, and institutional availability. We established a Pulmonary Embolism Response Team (PERT) to provide urgent assessment and multidisciplinary care for patients presenting to our institution with high-risk PE. METHODS: Data were retrospectively collected from PERT activations between January 2016 and Decembe...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Conclusions: Combinations of biomarkers and thromboelastometry results can be helpful in the future to decide which therapeutic strategy might be most appropriate in individual critically ill COVID-19 patients. This would be an important step to establish precision medicine in this high-risk patient population. PMID: 32773727 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT) and pulmonary embolism (PE), it accounts for approximately 10% of annual hospital deaths [1]. The latest guidelines of the American College of Chest Physicians (ACCP) emphasis VTE prophylaxis in all patients undergoing major surgical procedures including thyroid operations regardless of anesthesia type [2]. However, previous researchers have described that VTE prophylaxis might increase the bleeding risk [3], postoperative bleeding is uncommon in thyroid surgery, but sometimes is lethal, the complication is the main concern for head and neck surgeons.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to ...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
ConclusionsDVT was prevented with bemiparin, without significant bleeding increase nor adverse events; moreover, the cost of bemiparin is lower than enoxaparin. Bemiparin can be considered as alternative drug for DVT chemoprophylaxis in PRSx procedures.Level of Evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authorswww.springer.com/00266.
Source: Aesthetic Plastic Surgery - Category: Cosmetic Surgery Source Type: research
ConclusionIn this large observational study using a national clinical database, obese patients undergoing PD for head of pancreas cancer had increased risk of postoperative complications and mortality in comparison to controls.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
ConclusionsThe study is designed to identify a TxA dose with maximal efficacy and minimal complications. We hypothesize that the high dose has superior efficacy and non-inferior safety to the low dose.
Source: American Heart Journal - Category: Cardiology Source Type: research
ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
r M Abstract OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
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