Extracorporeal Membrane Oxygenation Cannula-Related Infections: Possible Interaction Between Prevention and Diagnosis
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Letters to the Editor Source Type: research
Extracorporeal Membrane Oxygenation Cannulae-related Infection: Diagnostic Difficulties and Potential Prevention
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Letters to the Editor Source Type: research
Progression Toward Decompensated Right Ventricular Failure in the Ovine Pulmonary Hypertension Model
Decompensated right ventricular failure (RVF) in patients with pulmonary hypertension (PH) is fatal, with limited treatment options. Novel mechanical circulatory support systems have therapeutic potential for RVF, but the development of these devices requires a large animal disease model that replicates the pathophysiology observed in humans. We previously reported an effective disease model of PH in sheep through ligation of the left pulmonary artery (PA) and progressive occlusion of the main PA. Herein, we report a case of acute decompensation with this model of chronic RVF. Gradual PA banding raised the RV pressure (max...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Favorable Hemocompatibility in HeartMate 3 May Prevent Thrombosis After Prolonged Pump Cessation
We present a 55-year-old man with a HeartMate 3 device who presented with heart failure symptoms, prolonged pump cessation for 7 days, and subtherapeutic anticoagulation therapy. Despite prolonged pump cessation and interrupted anticoagulation therapy, there was no evidence of pump thrombosis as determined by both laboratory and imaging studies. This case suggests favorable hemocompatibility of the HeartMate 3 device, which clinicians may consider in the management of patients needing advanced therapies. (Source: ASAIO Journal)
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Usefulness of Self-Expanding Drainage Cannula in Venovenous Extracorporeal Membrane Oxygenation: Tips, Tricks, and Results of an Early Experience
We present a retrospective series of selfexpanding venous cannula 430 or 530 mm in length in six consecutive patients undergoing venovenous (VV) ECMO. No vascular or cardiac iatrogenic injury was caused during implantation. Target flows were reached, and no clinically significant recirculation was described in any case. The use of selfexpanding drainage cannulas was safe, and efficient drainage was achieved with easy and definitive unique positioning during cannulation. (Source: ASAIO Journal)
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Case Reports Source Type: research
Direct Pull-Through Technique to Insert the Impella RP Device Without Using Fluoroscopy
We describe a technique for insertion of the Impella RP device that does not require fluoroscopy. Venous cannulation was performed via the superior vena cava and femoral vein percutaneously. After right atriotomy, the Impella RP is percutaneously inserted and advanced to the right atrium under transesophageal echocardiography guidance. Next, via a longitudinal 2 cm incision in the main pulmonary artery (PA), a large C-shaped clamp is advanced retrograde through the pulmonic and tricuspid valves into the right atrium. The pigtail portion is grasped, pulled through to the main PA, and the device is positioned in the PA und...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: How to do it Article Source Type: research
Hemodiafiltration Improves Low Levels of Health-Related Quality Of Life (Qol) and Nutritional Conditions of Hemodialysis Patients
We compared the effects on the nutritional condition and health-related quality of life (HR-QoL) of the treatment of patients with on-line hemodiafiltration (OL-HDF) and conventional hemodialysis (CHD) using a superflux dialyzer. In total, 47 maintenance (M) HD patients were treated by CHD with a high-flux dialyzer for the first 4 months (1st CHD) and were then switched to predilution OL-HDF for the next 4 months (OL-HDF), after which CHD was resumed for the last 4 months (2nd CHD). We assessed the clinical parameters, fat mass value, muscle mass value, and HR-QoL. In patients with low serum albumin levels, these levels si...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research
The Effect of Infectious Complications During Ventricular Assist Device Use on Outcomes of Pediatric Heart Transplantation
To describe the impact of infectious adverse events (IAEs) during ventricular assist device (VAD) support on graft loss, infection, and rejection after pediatric heart transplant (HT). Pedimacs data were linked to Pediatric Heart Transplant Society (PHTS) data for patients receiving a VAD followed by HT between September 2012 and December 2016. Linked patients were categorized into IAE on VAD (group A) and no IAE on VAD (group B). Infectious adverse event locations included nondevice, device (external or internal), and sepsis. Post-HT outcomes for analysis were graft loss, infection, and rejection. Time-dependent analysis ...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Ventilation Parameters Before Extracorporeal Membrane Oxygenator and In-Hospital Mortality in Children: A Review of the ELSO Registry
The aim of this study was to evaluate the impact of pre-extracorporeal membrane oxygenation (ECMO) ventilatory parameters with in-hospital mortality in children with pediatric acute respiratory distress syndrome undergoing ECMO for respiratory indication. In this retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry, all pediatric patients (≥29 days to ≤18 years) who required ECMO for respiratory indications were screened. The primary outcome was in-hospital mortality. From 2013 to 2017, 2,727 pediatric ECMO runs with a respiratory indication were reported to the ELSO registry. Overall ...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Protocol Associated with a Decrease in Complications
Extracorporeal membrane oxygenation (ECMO) in pediatrics has rapidly progressed in recent years; however, there continues to be considerable variation in anticoagulation practices. In 2016, we implemented a standardized anticoagulation protocol in effort to reduce clotting and bleeding complications. A single-center retrospective analysis of pediatric patients requiring ECMO between 2014 and 2018 was performed. One hundred one ECMO cases in 94 pediatric patients met eligibility criteria (preprotocol = 64 cases; postprotocol = 37 cases). Demographics, ECMO parameters, complications, laboratories, and blood product requireme...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Hemodynamic Response to Device Titration in the Shunted Single Ventricle Circulation: A Patient Cohort Modeling Study
Clinical outcomes of ventricular assist device (VAD) support for shunted single ventricle patients trail the larger population due in part to the challenges in optimizing VAD support and balancing systemic and pulmonary circulations. We sought to understand the response to VAD titration in the shunted circulation using a lumped-parameter network modeling six patient-specific clinical cases. Hemodynamic data from six patients (mean body surface area = 0.30 m2) with a systemic-to-pulmonary shunt was used to construct simulated cases of heart failure and hemodynamic response to increasing VAD flow from 5 to 10 L/min/m2. Wit...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
Extracorporeal Membrane Oxygenation for Septic Shock in Children
Extracorporeal membrane oxygenation (ECMO) is a rescue treatment used in children and adults with reversible cardiorespiratory failure. The role of ECMO is not fully established in pediatric sepsis. In this retrospective single-center study, we aimed to investigate risk factors and survival in pediatric septic shock supported with peripheral cannulation ECMO. All patients aged 30 days to 18 years treated between 2007 and 2016 with ECMO for septic shock were included. Of 158 screened patients, 31 were enrolled in the study. The P/F ratio was 48 ± 22 mm Hg, b-lactate 8.5 ± 6.6 mmol/L, p-procalcitonin 214 (IQR 19–294) Î...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
An External Validation of Scoring Systems in Mortality Prediction in Veno-Venous Extracorporeal Membrane Oxygenation
Veno-venous extracorporeal membrane oxygenation (VV ECMO) offers the last resort in the treatment of acute respiratory distress syndrome (ARDS). Various scoring systems have been established, yet external validation of these scoring systems in the Asian population remains scarce. We aim to identify factors associated with hospital mortality and to validate various scoring systems in the prediction of hospital mortality. A retrospective analysis of adults admitted to Pamela Youde Nethersole Eastern Hospital intensive care unit who received VV ECMO from January 1, 2010 to June 30, 2019 was performed. Demographics, ventilatio...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Clinical Critical Care Source Type: research
Neurologic Outcomes After Extracorporeal Cardiopulmonary Resuscitation: Recent Experience at a Single High-Volume Center
This study describes the recent ECPR experience at the University of Maryland Medical Center from 2016 through 2018, with attention to neurologic outcomes and predictors thereof. The primary outcome was dichotomized Cerebral Performance Category (≤2) at hospital discharge; secondary outcomes included rates of specific neurologic complications. From 429 ECMO runs over 3 years, 57 ECPR patients were identified, representing an increase in ECPR utilization compared with 41 cases over the previous 6 years. Fifty-two (91%) suffered in-hospital cardiac arrest, and 36 (63%) had an initial nonshockable rhythm. Median low-flow ti...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Clinical Critical Care Source Type: research
Impact of Venoarterial Extracorporeal Membrane Oxygenation Flow on Outcomes in Cardiogenic Shock
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is used to provide cardiopulmonary support in cardiogenic shock; however, high extracorporeal flow may increase left ventricular (LV) afterload leading to LV distention and intracardiac stasis. It is unclear how ECMO flow affects patient outcomes and complications related to ECMO. Retrospective review of patients at a single institution placed on VA ECMO from 2007 to 2018 was performed. Patients were divided into full flow (flow index> 2.2 L/min/m2) and partial flow (flow index (Source: ASAIO Journal)
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
