-
Mashup Score: 15Vascular Complications After Venoarterial Extracorporeal... : Critical Care Medicine - 6 month(s) ago
tional cohort study. Setting: Two ICUs from a tertiary referral academic hospital. Patients: Adult patients who were successfully weaned from venoarterial ECMO between January 2021 and January 2022. Interventions: None. Primary outcome: Vascular complications frequency related to ECMO cannula. Measurements and Main Results: A total of 288 patients were implanted with venoarterial ECMO during the inclusion period. One hundred ninety-four patients were successfully weaned, and 109 underwent a CT examination to assess for vascular complications until 4 days after the weaning procedure. The median age of the cohort was 58 years (interquartile range [IQR], 46–64 yr), with a median duration of ECMO support of 7 days (IQR, 5–12 d). Vascular complications were observed in 88 patients (81%). The most frequent complication was thrombosis, either cannula-associated deep vein thrombosis (CaDVT) (n = 63, 58%) or arterial thrombosis (n = 36, 33%). Nonthrombotic arterial complications were observed i
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet
-
Mashup Score: 19Ultra-Low-Field Portable MRI and Extracorporeal Membrane... : Critical Care Explorations - 7 month(s) ago
acement and heating of ECMO cannulas and does not affect ECMO pump function. METHODS AND MODELS: ECMO cannulas in various sizes were tested ex vivo using phantom models to assess displacement force and heating according to the American Society for Testing and Materials criteria. ECMO pump function was assessed by pump flow and power consumption. In vivo studies involved five female domestic pigs (20–42 kg) undergoing different ECMO configurations (peripheral and central cannulation) and types of cannulas with an imaging protocol consisting of T2-weighted, T1-weighted, FLuid-Attenuated Inversion Recovery, and diffusion-weighted imaging sequences. RESULTS: Phantom models demonstrated that ECMO cannulas, both single lumen with various sizes (15–24-Fr) and double lumen cannula, had average displacement force less than gravitational force within 5 gauss safety line of ULF-pMRI and temperature changes less than 1°C over 15 minutes of scanning and ECMO pump maintained stable flow and power co
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet-
Portable MRI & #ECMO, preclinical safety testing: ☢️ cannulae: displacement force < gravitational force within 5 gauss safety line + temperature changes <1°C/15' ☢️ stable flow & power consumption ☢️ no visible motion of cannulas ☢️ stable hemodynamics 🔓 https://t.co/Ovk9he7QwO https://t.co/iPxNMVcm4F
-
-
Mashup Score: 13
s with multiple ECMO runs between 2010 and 2023 were included. A total of 70 (13%) patients required multiple ECMO runs. Of those, 56 (80%) died before discharge; late mortality was 89% at a median of 1.6 (1.0–3.9) years. A total of 47 (67%) patients had neurologic findings. Only one (1%) survivor had a normal neurodevelopmental follow-up. Duration of the first ECMO run (odds ratio [OR]: 2.63, 1.08–7.96), total duration on ECMO (OR: 4.72, 1.29–23.54), neurologic findings at any time (OR: 7.94, 1.46–43.24), need for renal replacement therapy (OR: 4.79, 1.06–25.58), and lactate values correlated with late mortality. All 19 (27%) patients with neurologic findings before the second run died. The frequency of multiple-run ECMOs increased within the study period. Outcomes in pediatric patients with multiple ECMO runs are disheartening. Given all patients in our cohort with neurological findings before the second ECMO run died, neurological findings should be taken into consideration when det
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet
-
Mashup Score: 18Ultra-Low-Field Portable MRI and Extracorporeal Membrane... : Critical Care Explorations - 7 month(s) ago
acement and heating of ECMO cannulas and does not affect ECMO pump function. METHODS AND MODELS: ECMO cannulas in various sizes were tested ex vivo using phantom models to assess displacement force and heating according to the American Society for Testing and Materials criteria. ECMO pump function was assessed by pump flow and power consumption. In vivo studies involved five female domestic pigs (20–42 kg) undergoing different ECMO configurations (peripheral and central cannulation) and types of cannulas with an imaging protocol consisting of T2-weighted, T1-weighted, FLuid-Attenuated Inversion Recovery, and diffusion-weighted imaging sequences. RESULTS: Phantom models demonstrated that ECMO cannulas, both single lumen with various sizes (15–24-Fr) and double lumen cannula, had average displacement force less than gravitational force within 5 gauss safety line of ULF-pMRI and temperature changes less than 1°C over 15 minutes of scanning and ECMO pump maintained stable flow and power co
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet-
Portable MRI & #ECMO, preclinical safety testing: ☢️ cannulae: displacement force < gravitational force within 5 gauss safety line + temperature changes <1°C/15' ☢️ stable flow & power consumption ☢️ no visible motion of cannulas ☢️ stable hemodynamics 🔓 https://t.co/Ovk9he7QwO https://t.co/iPxNMVcm4F
-
-
Mashup Score: 21Neurological monitoring and management for adult... : ASAIO Journal - 7 month(s) ago
port. Methods These guidelines are based on clinical practice consensus recommendations and scientific statements. We convened an international multidisciplinary consensus panel including 30 clinician-scientists with expertise in ECMO from all chapters of the Extracorporeal Life Support Organization (ELSO). We used a modified Delphi process with three rounds of voting and asked panelists to assess the recommendation levels. Results We identified five key clinical areas needing guidance: (1) neurological monitoring, (2) post-cannulation early physiological targets and ABI, (3) neurological therapy including medical and surgical intervention, (4) neurological prognostication, and (5) neurological follow-up and outcomes. The consensus produced 30 statements and recommendations regarding key clinical areas. We identified several knowledge gaps to shape future research efforts. Conclusions The impact of ABI on morbidity and mortality in ECMO patients is significant. Particularly, early dete
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet
-
Mashup Score: 18
Introduction Polymethylpentene (PMP) oxygenators serve as the primary oxygenator type utilized for ECMO. With the number of PMP oxygenators available, it has be…
Source: journals.sagepub.comCategories: General Medicine News, Critical CareTweet
-
Mashup Score: 21
tions in the Advanced Cardiac Therapies Improving Outcomes (ACTION) network. Multivariable Cox proportional-hazards modeled mortality after VAD implantation. A total of 1,022 patients were enrolled. The 1 year mortality was 19% (95% confidence interval [CI]: 16–23). The multivariable model was used to build the ACTION VADs risk stratification score with four components: ventilation, advanced organ support (dialysis or ECMO), diagnosis, and size (weight ≤5 kg). One point is added for each risk factor. Based on the sum of the risk factors, patients were classified into four classes: class 0—green (4% mortality at 1 year), class 1—yellow (16% mortality at 1 year), class 2—orange (21% mortality at 1 year), and class 3 or higher—red (42% mortality at 1 year). The score performed well, with area under the curve (AUC) of 0.72 and excellent calibration. The ACTION VADs score for mortality can be calculated easily and offers risk stratification and prognostic information for pediatric VAD candi
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet-
Novel MCS risk stratification tool for children including 🫁 ventilation 🩸organ support: dialysis/#ECMO 🩺 diagnosis ⚖️ size ≤5 kg ACTION VADs performed well, is easy (1 point for factor) & offers useful info for pediatric VAD candidates @asaiojournal 🖇️ https://t.co/S2XDPYmL4e https://t.co/SCsriKcGDH
-
-
Mashup Score: 16
eath, interrupting ischemia. Evidence is accumulating supporting the use of TA-NRP to improve the outcome of grafts from DCD donors. Thoracoabdominal normothermic regional perfusion may restore and maintain a near-physiological environment during procurement. Moreover, during TA-NRP it is feasible to evaluate the heart in situ. Thoracoabdominal normothermic regional perfusion could be performed through different cannulation techniques, central or peripheral, and, with different extracorporeal circuits. The use of conventional cardiopulmonary bypass and extracorporeal life support (ECLS) devices equipped with open circuits has been described. We report the use of a fully mobile, closed ECLS circuit to implement TA-NRP. The procedure was successfully performed in a peripheral center without a cardiac surgery program through a percutaneous cannulation approach. This strategy resulted in combined heart, liver, and kidney recovery despite a significantly prolonged functional warm ischemia t
Source: journals.lww.comCategories: General Medicine News, Critical CareTweet-
🫀TA-NRP using fully mobile, modified closed #ECMO circuit could be safe strategy to support combined thoracic/abdominal organs recovery also in peripheral centers without cardiac surgery program, contributing to expansion of DCD programs @asaiojournal 🔓 https://t.co/j3OInLU1Xx https://t.co/0DmuORF6BM
-
-
Mashup Score: 16Epidemiology of Seizures and Association With Mortality in Adult Patients Undergoing ECMO | Neurology - 9 month(s) ago
Background and ObjectivesExtracorporeal membrane oxygenation (ECMO) provides lifesaving support to patients with cardiopulmonary failure. Although seizures increase mortality risks among critically ill patients broadly, studies specific to adult ECMO …
Source: www.neurology.orgCategories: General Medicine News, NeurologyTweet
-
Mashup Score: 26
Intensive Care Medicine – Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an integral part of the management algorithm of patients with severe respiratory failure refractory to…
Source: link.springer.comCategories: General Medicine News, Hem/OncsTweet
Vascular complications after VA #ECMO: ☢️109 patients underwent CT until 4 days after after decannulation during the study period 🚧vascular complications common (81% patients), but not associated with in-hospital mortality 🩺 no risk factors identified 🔓 https://t.co/snv0YsqHWs https://t.co/xOL4gQ9yiG