Relatively Increased CO2 Delivered to the Brain From the Descending Aorta Leading to an Elevated Respiratory Rate Causing Differential Hypocapnia (RIDDLER or East-West Syndrome): New Pitfalls in Awake Peripheral V-A ECMO

This article describes a newly recognized physiological phenomenon, RIDDLER (East-West Syndrome), in patients on awake peripheral V-A ECMO. It occurs when CO2-rich blood from the ECMO circuit reaches the brain, triggering an increased respiratory rate despite paradoxically low CO2 levels in the right radial artery. This leads to a cycle of worsening hypercapnia, respiratory distress, and potential neurological injury. Proper CO2 monitoring strategies are needed to prevent mismanagement.

March 16, 2025

Thoracoabdominal Normothermic Regional Perfusion: Real-World Experience and Outcomes of DCD Liver Transplantation

This study evaluates the effectiveness of thoracoabdominal normothermic regional perfusion (TA-NRP) in liver transplantation from donation after circulatory death (DCD) donors. Compared to static cold storage (SCS), TA-NRP significantly reduces ischemic cholangiopathy (IC) at six months (1.2% vs. 9.5%, p = 0.03), despite higher-risk donor-recipient pairs. The findings suggest TA-NRP improves organ utilization and supports its integration into liver transplantation protocols.

March 16, 2025

Indications for Extracorporeal Membrane Oxygenation in Older Adult Patients with Accidental Hypothermia and Hemodynamic Instability

This study analyzes the efficacy of extracorporeal membrane oxygenation (ECMO) in older adults with accidental hypothermia (AH) and hemodynamic instability before cardiac arrest. A post-hoc analysis of the ICE-CRASH study (2019–2022) found no significant survival difference between ECMO and non-ECMO patients at 28 days. ECMO accelerated rewarming but increased bleeding complications. The study concludes ECMO may not benefit this patient group, challenging existing treatment criteria.

March 16, 2025

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

This study compares Buckberg (BS) and Del Nido (DNS) cardioplegia in isolated aortic valve replacement (AVR) through a two-center randomized trial with 311 patients. While postoperative creatine kinase and troponin levels showed no significant differences, the DNS group had better intraoperative glycemic control, higher spontaneous rhythm rates, and fewer cases of ventricular fibrillation requiring defibrillation. The study supports DNS as a viable alternative with workflow advantages.

March 16, 2025

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Day: March 16, 2025

Relatively Increased CO2 Delivered to the Brain From the Descending Aorta Leading to an Elevated Respiratory Rate Causing Differential Hypocapnia (RIDDLER or East-West Syndrome): New Pitfalls in Awake Peripheral V-A ECMO

Thoracoabdominal Normothermic Regional Perfusion: Real-World Experience and Outcomes of DCD Liver Transplantation

Indications for Extracorporeal Membrane Oxygenation in Older Adult Patients with Accidental Hypothermia and Hemodynamic Instability

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

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