Swans in Swine: Cardiac Output Monitoring in Pigs Supported on Venovenous Extracorporeal Membrane Oxygenation
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Invited Commentary Source Type: research
Extracorporeal Membrane Oxygenation Blood Flow and Blood Recirculation Compromise Thermodilution-Based Measurements of Cardiac Output
The contribution of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) to systemic oxygen delivery is determined by the ratio of total extracorporeal blood flow () to cardiac output (). Thermodilution-based measurements of may be compromised by blood recirculating through the ECMO (recirculation fraction; Rf). We measured the effects of and Rf on classic thermodilution-based measurements of in six anesthetized pigs. An ultrasound flow probe measured total aortic blood flow () at the aortic root. Rf was quantified with the ultrasound dilution technique. was set to 0–125% of and was measured using a pulmonary arte...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Clinical Critical Care Source Type: research
Safety and Feasibility of an Early Mobilization Protocol for Patients with Femoral Intra-Aortic Balloon Pumps as Bridge to Heart Transplant
Intra-aortic balloon pumps (IABPs) can be used to provide hemodynamic support in patients with end-stage heart failure as a bridge to transplantation (BTT). The IABP is commonly inserted via the common femoral artery, which can limit patients’ mobility. The Ramsey protocol, developed by a critical care physical therapist, allows patients with femoral IABPs to ambulate with the assistance of a tilt table. The aim of this study was to determine the safety and feasibility of a modified Ramsey protocol for early mobilization of patients with femoral IABPs as BTT. This is a retrospective single-center review of patients with ...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research
Hemorheological Approach to Improve Perfusion of Red Blood Cells with Reduced Deformability Using Drag-Reducing Polymer (In Vitro Study)
This study examines the ability of DRPs to alter the traffic of mixtures of normal and less-deformable red blood cells (RBCs) through branched microchannels and is intended to support and expand upon previous experiments within straight capillary tubes to promote DRPs for future clinical use. Branched polydimethylsiloxane microchannels were perfused with a mixture of normal bovine RBCs also containing heat-treated less-deformable RBCs at a hematocrit of 30% with 10 ppm of the DRP poly(ethylene oxide) (MW 4M Da). Suspensions were driven by syringe pump, collected at outlets, and RBC dimensions measured while subject to sh...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Biomedical Engineering Source Type: research
Toward a Servoregulation Controller to Automate CO2 Removal in Wearable Artificial Lungs
A laptop-driven, benchtop control system that automatically adjusts carbon dioxide (CO2) removal in artificial lungs (ALs) is described. The proportional-integral-derivative (PID) feedback controller modulates pump-driven air sweep gas flow through an AL to achieve a desired exhaust gas CO2 partial pressure (EGCO2). When EGCO2 increases, the servoregulator automatically and rapidly increases sweep flow to remove more CO2. If EGCO2 decreases, the sweep flow decreases to reduce CO2 removal. System operation was tested for 6 hours in vitro using bovine blood and in vivo in three proof-of-concept sheep experiments. In all stud...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Biomedical Engineering Source Type: research
Predictors and Long-Term Impact of De Novo Aortic Regurgitation in Continuous Flow Left Ventricular Assist Devices Using Vena Contracta
The aim of this study was to identify the optimal echocardiographic measurement of aortic regurgitation (AR) in continuous flow left ventricular assist devices (LVAD) and determine risk factors and clinical implications of de novo AR. Echocardiographic images from consecutive patients who underwent LVAD implantation from February 2007 to March 2017 were reviewed. Severity of de novo AR was determined by vena contracta (VC). Preimplant clinical characteristics, LVAD settings at discharge, and outcomes including heart failure hospitalizations, all-cause mortality, and ventricular arrhythmias of patients with greater than or ...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Applications and Outcomes of Extracorporeal Life Support Use in Adult Liver Transplantation: A Case Series and Review of Literature
The use of extracorporeal life support (ECLS) is increasingly reported in adult liver transplantation (LT). However, neither the role of ECLS in the perioperative setting for LT nor its outcomes has been well defined. We performed a retrospective chart review of all adult LT patients at our institution who received ECLS from 2004 to 2021. We also conducted a comprehensive literature search for adult LT cases that involved perioperative ECLS for respiratory or cardiac failure. Over the study period, 11 LT patients required ECLS at our institution, two for respiratory and nine for cardiac failure. Both patients with respirat...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Incidence and Diagnostic Challenges of Bowel Ischemia after Continuous-flow Left Ventricular Assist Device Therapy
Long-term continuous-flow left ventricular assist device (CFLVAD) therapy is limited by complications. Compared with stroke and renal dysfunction, post-CFLVAD bowel ischemia is poorly characterized. Adult patients who underwent first-time durable CFLVAD implantation at our institution between 2008 and 2018 were identified and screened for bowel ischemia using Current Procedural Terminology codes for abdominal surgical exploration and International Classification of Disease codes for intestinal vascular insufficiency. Patients who developed biopsy-proven bowel ischemia (cases) were matched to controls (1:1, nearest neighbor...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Intra-aortic Balloon Pump Use With Extra Corporeal Membrane Oxygenation—A Mock Circulation Loop Study
This study demonstrates the need for careful IABP selection concomitant with ECMO. (Source: ASAIO Journal)
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
The Role of Serial Right Heart Catheterization Survey in Patients Awaiting Heart Transplant on Ventricular Assist Device
Current guidelines recommend serial right heart catheterization (RHC) to survey pulmonary hypertension in patients awaiting heart transplant. However, the role and impact of this surveillance is unclear in patients with a left ventricular assist device (LVAD). We reviewed our surveillance RHC protocol to determine whether useful data were obtained to justify the risks of serial invasive procedures (i.e., excessive bleeding). Between January 2015 and December 2018, 78 patients who received an LVAD as bridge-to-transplant (BTT) were included in this study. Routine RHC surveillance was performed every 6 months. Hemodynamic va...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Total Artificial Heart Computational Fluid Dynamics: Modeling of Stator Bore Design Effects on Journal-Bearing Performance
Cleveland Clinic’s continuous-flow total artificial heart (CFTAH) is a double-ended centrifugal blood pump that has a single rotating assembly with an embedded magnet, which is axially and radially suspended by a balance of magnetic and hydrodynamic forces. The key to the radial suspension is a radial offset between the stator bearing bore and the magnet’s steel laminations. This offset applies a radial magnetic force, which is balanced by a hydrodynamic force as the rotating assembly moves to a “force-balanced” radial position. The journal-bearing blood passage is a narrow flow path between the left and right impe...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Meet the Authors
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Meet the Authors Source Type: research
Risk of Renal Dysfunction Following Heart Transplantation in Patients Bridged with a Left Ventricular Assist Device
We examined the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry for heart transplant patients between January 2000 and June 2015. We compared patients bridged with durable continuous-flow LVAD to those without LVAD support. Primary outcomes were ARF requiring HD before discharge following HT and CKD (defined as creatinine>2.5 mg/dl, permanent dialysis, or renal transplant) within 3 years. There were 18,738 patients, with 4,535 (24%) bridged with LVAD support. Left ventricular assist device patients had higher incidence of ARF requiring HD and CKD at 1 year, but no significant...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Premature and Extracorporeal Life Support: Is it Time? A Systematic Review
Early preterm birth (Source: ASAIO Journal)
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Reviews Source Type: research
Surface Coatings for Rotary Ventricular Assist Devices: A Systematic Review
Rotary ventricular assist devices (VADs) are frequently used to provide mechanical circulatory support to patients suffering from end-stage heart failure. Therefore, these devices and especially their pump impeller and housing components have stringent requirements on wear resistance and hemocompatibility. Various surface coatings have been investigated to improve the wear resistance or hemocompatibility of these devices. The aim of the present systematic review was to build a comprehensive understanding of these coatings and provide potential future research directions. A Boolean search for peer-reviewed studies was condu...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Reviews Source Type: research
