Category: ECMO

Development of a CO₂ Sensor for Extracorporeal Life Support

Development of a CO₂ Sensor for Extracorporeal Life Support Applications

This study presents the development of a novel optical CO₂ sensor for use in extracorporeal life support (ECLS) systems such as ECMO and ECCO₂R. The sensor accurately measures CO₂ concentration in oxygenator exhaust gas and gas flow to determine CO₂ removal rates. A built-in heating system prevents condensation, and a temperature control algorithm ensures measurement accuracy. Laboratory and in vivo validations confirm its clinical suitability.

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Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

This study evaluates the impact of extracorporeal life support (ECLS) as a bridge to lung transplantation (BTT) for patients with idiopathic pulmonary arterial hypertension (iPAH). A comparison between two cohorts (1997–2005 and 2006–2010) shows that ECLS significantly reduced waiting list mortality (from 22% to 0%) while slightly increasing ICU stay. The findings suggest that aggressive ECLS management can improve survival rates for iPAH patients awaiting lung transplants.

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Staying in Place: In Vitro Comparison of Extracorporeal Membrane Oxygenation Cannula Fixation for Dislodgment Prevention

Staying in Place: In Vitro Comparison of Extracorporeal Membrane Oxygenation Cannula Fixation for Dislodgment Prevention

This study evaluates the effectiveness of different fixation methods for ECMO cannulas to prevent dislodgment. Using an in vitro porcine skin model, researchers compared traditional sutures with adhesive securement devices. Results showed that adhesive methods, particularly CathGrip, provided superior stability in micro-movements while maintaining comparable fixation strength to sutures. The study suggests that adhesive anchors may offer a viable alternative for improving ECMO cannula security.

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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

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.

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

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.

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Pediatric Cardiac Patients with Pulmonary Hemorrhage Supported on ECMO: An ELSO Registry Study

Pediatric Cardiac Patients with Pulmonary Hemorrhage Supported on ECMO: An ELSO Registry Study

This study examines pediatric cardiac patients with pulmonary hemorrhage (PH) supported on extracorporeal membrane oxygenation (ECMO) using data from the ELSO registry (2011–2020). Analyzing 161 cases, the study identifies high-frequency oscillatory ventilation (HFOV) before ECMO cannulation as a key predictor of survival. The absence of hemorrhagic and renal complications also improved outcomes. Findings suggest that optimized pre-ECMO ventilation strategies may enhance survival rates in these high-risk patients.

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Ukraine ECMO During Warime

Prolonged ECMO Support in a Pediatric Patient with Complex Cardiac Conditions During Wartime in Kyiv, Ukraine

This case report details the prolonged extracorporeal membrane oxygenation (ECMO) support of a 12-year-old girl with severe congenital heart disease and myocarditis in wartime Kyiv. Due to a lack of transplant options and supply shortages, alternative oxygenators were used despite suboptimal long-term performance. The patient underwent 259 days of ECMO support but ultimately succumbed to multi-organ dysfunction. The study highlights the urgent need for medical resource mobilization in conflict zones.

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Variability in Triggers for Mechanical Left Ventricular Unloading in VA-ECMO: A Literature Search

Variability in Triggers for Mechanical Left Ventricular Unloading in VA-ECMO: A Literature Search

VA-ECMO provides critical cardiopulmonary support but increases left ventricular afterload, potentially leading to left ventricular distension (LVD). This literature review explores various clinical, hemodynamic, and imaging-based triggers for mechanical LV unloading. Findings highlight significant variability in defining LVD and initiating mechanical unloading. The study underscores the need for standardized criteria to optimize patient outcomes while minimizing risks associated with invasive procedures.

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Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

This case study explores a neonate with congenital diaphragmatic hernia (CDH) who experienced a lethal myocardial infarction (MI) while on extracorporeal membrane oxygenation (ECMO). The patient developed a large thrombus extending from the arterial cannula into the left main coronary artery, leading to severe cardiac dysfunction. Despite anticoagulation efforts, the clot progressed, resulting in a fatal outcome. The study highlights the challenges of managing neonatal ECMO and intracardiac thrombosis.

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