Special Considerations for Durable Left Ventricular Assist Device Use in Small Patients
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Editorial Source Type: research
Extracorporeal Life Support Organization Guidelines for Fluid Overload, Acute Kidney Injury, and Electrolyte Management
Disclaimer:
This guideline for extracorporeal membrane oxygenation (ECMO) fluid and electrolyte management for all patient populations is intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS/ECMO, but these are not necessarily consensus recommendations. The aim of clinical guidelines is to help clinicians to make informed decisions about their patients. However, adherence to a guideline doe...
Source: ASAIO Journal - May 1, 2022 Category: Medical Devices Tags: Guidelines Source Type: research
IgA Vasculitis With Henoch-Schönlein Purpura as an Immune Complication Associated With Left Ventricle Assist Device Insertion
We present here the first observation of a peculiar immune complication associated with the implantation of an LVAD, characterized by an IgA vasculitis clinically manifested as Henoch-Schönlein purpura. The vasculitis was biologically associated with a significant increase of the plasma levels of C-X-C motif chemokine ligand (CXCL)13, a CXC motif chemokine produced by follicular dendritic cells, which targets CXCR5, a receptor primarily expressed by B lymphocytes, to promote their chemotaxis and expansion. Spontaneous resolution of the vasculitis occurred over time, concomitantly to a decrease of CXCL13 expression. These ...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Stress-Induced (Takotsubo) Cardiomyopathy After Liver Transplant Rescued with Venoarterial Extracorporeal Membrane Oxygenation
Here, we report the case of a 55 year old male patient without significant preexisting cardiovascular disease who received a deceased donor liver transplant. Intraoperatively, the patient developed cardiogenic shock secondary to stress-induced cardiomyopathy or Takotsubo syndrome (TTS), which was refractory to high-dose vasoactive, inotropic medical therapy. The patient was successfully managed with venoarterial extracorporeal membrane oxygenation (VA-ECMO) for 7 days, with complete recovery of cardiac function and maintenance of the hepatic graft. Given the anticipated need for only a short period of support and the expec...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Successful Heart Transplantation Recovered From a Brain-Dead Donor on Veno-Arterial Extracorporeal Membrane Oxygenation Support
We describe the successful transplantation of a brain-dead donor supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac arrest secondary to pulmonary embolism. The donor was a 50-year-old female who developed massive pulmonary embolism complicated by cardiac arrest requiring initiation of VA-ECMO. An initial echocardiogram revealed severe right ventricular dysfunction which recovered after 6 days of VA-ECMO confirmed by transthoracic echocardiogram and right heart catheterization. The heart was transplanted to a 56-year-old male on a left ventricular assist device. At 1-year posttransplant, ...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Extracorporeal Membrane Oxygenation in Trauma
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Invited Commentary Source Type: research
Use of Extracorporeal Membrane Oxygenation in Blunt Traumatic Injury Patients with Acute Respiratory Distress Syndrome
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Brief Communication Source Type: research
Soluble Triggering Receptor on Myeloid Cell-1 and its Predictive Factors in Patients With End-Stage Kidney Disease on Hemodialysis
Triggering receptor expressed on myeloid cells (TREM)-1 is a potent and early amplifier of the inflammatory response expressed on neutrophils and monocytes/macrophages. TREM-1, and its soluble form (sTREM-1), are increased in sepsis and other noninfectious inflammatory conditions. However, virtually no data are available in kidney disease. To determine serum sTREM-1 and its associated variables in patients on hemodialysis (HD), cross-sectional study including 264 HD patients and 148 controls. sTREM-1 was measured by quantitative sandwich enzyme immunoassay; soluble tumor necrosis factor receptor-1 (sTNF-R1), interleukin-6 ...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research
Effect of Intradialytic Aerobic Exercise on Relative Blood Volume in Patients Undergoing Maintenance Hemodialysis
The purpose of this study was to investigate changes in the relative blood volume because of intradialytic exercise. Twenty patients undergoing hemodialysis (HD) were assigned randomly to exercise or control sessions as a first test by simple randomization. All participants were crossed over and participated in both tests. In the exercise test, each patient underwent 30 minutes of exercise using a cycle ergometer from the initiation of HD. The control session consisted of routine HD without exercise. The blood volume (ΔBV) reduction in both types of sessions was calculated from the area under the curve of the ΔBV (ΔBVAU...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research
Sequestration of Dexmedetomidine in Ex Vivo Cardiopulmonary Bypass Circuits
This study aimed to evaluate the disposition of DEX after administration to the ex vivo CPB circuits following different bolus doses and continuous infusion of DEX, including the effect of circuit coating, temperature, and modified ultrafiltration (MUF). Cardiopulmonary bypass circuits were setup ex vivo and primed with reconstituted blood. Dexmedetomidine was administered to the circuit (as a single bolus or single bolus along with continuous infusion). The circuit was allowed to equilibrate during the first 5 minutes, blood samples were collected at multiple time points (5–240 minutes). Blood samples were processed to ...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Does Cardiac Catheterization Facilitate Hemodynamic Optimization of Pediatric Patients on Continuous-Flow Ventricular Assist Devices?
Understanding optimal ventricular assist device (VAD) parameters for pediatric patients is valuable given the inherent issue of patient-device size mismatch and heterogeneous cardiac anatomy in children. We evaluated our center’s experience of continuous-flow VAD (CF-VAD) optimization using cardiac catheterization. We performed a retrospective analysis of all patients on CF-VAD support who underwent hemodynamic heart catheterization from 2013 to 2018. Fifteen patients had 16 hemodynamic catheterizations performed. The indications for hemodynamic optimization by catheterization included clinical signs of heart failure whi...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
MILESTONE: More Than 1,200 Children Bridged to Heart Transplantation with Mechanical Circulatory Support
Pediatric mechanical circulatory support (MCS) has been successfully used to bridge numerous children to transplantation who otherwise would have been unlikely to survive on the waitlist and, in many cases, make them better transplant candidates. The purpose of this study was to analyze what the pediatric heart failure community has achieved over the last 15 years in reaching 1,200 cases of bridging children to heart transplantation. The United Network for Organ Sharing database was used to identify MCS patients ages 0–18 at the time of listing for heart transplantation between 2005 and 2019, divided into three eras: fir...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Extracorporeal Membrane Oxygenation Cannula–Related Infections: Epidemiology and Risk Factors
Although being a potential major source of infection in extracorporeal membrane oxygenation (ECMO) patients, data regarding cannula-related infections (CRI) remain scarce. We therefore aimed at describing the epidemiology of CRI among critically ill patients supported by ECMO. Between October 2017 and November 2019, adult patients supported by either venoarterial (VA), venopulmonary arterial, or venovenous (VV) ECMO for more than 24 hours were prospectively enrolled. When CRI was suspected, cannula swab and subcutaneous needle aspirate samples were obtained for microbiological culture. Cannula tips were systematically sent...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Clinical Critical Care Source Type: research
Cross-Circulation for Extracorporeal Liver Support in a Swine Model
Although machine perfusion has gained momentum as an organ preservation technique in liver transplantation, persistent organ shortages and high waitlist mortality highlight unmet needs for improved organ salvage strategies. Beyond preservation, extracorporeal organ support platforms can also aid the development and evaluation of novel therapeutics. Here, we report the use of veno-arterial-venous (V-AV) cross-circulation (XC) with a swine host to provide normothermic support to extracorporeal livers. Functional, biochemical, and morphological analyses of the extracorporeal livers and swine hosts were performed over 12 hours...
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Biomedical Engineering Source Type: research
Extracorporeal Membrane Oxygenation Support for Antineutrophil Cytoplasmic Antibody-associated Vasculitides: An ELSO Registry Analysis
In conclusion, venovenous ECMO should be considered as a supportive bridge to definitive diagnosis and treatment in (ANCA)-associated vasculitides, regardless if pulmonary hemorrhage is present. (Source: ASAIO Journal)
Source: ASAIO Journal - April 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
