Cardiopulmonary Bypass Supporting High-Risk PCI and TAVR

Cardiopulmonary Bypass as Safe and Effective Support for Concomitant High-Risk Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement

February 28, 2026 No Comments

This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.

Seamless Transition: Single-Circuit ECMO to CPB in Pediatric Surgery

ECMO to CPB: A Single Circuit Approach

February 27, 2026 No Comments

This technique article describes a novel method for converting pediatric patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to cardiopulmonary bypass (CPB) using a single circuit with the addition of a cardiotomy reservoir. In seven patients (eight procedures), the approach preserved circulating blood volume, limited donor exposure, and maintained effective surgical support. All patients were successfully decannulated, demonstrating feasibility and safety in complex congenital heart surgery.

Comparative Efficacy and Safety of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Versus Impella for Cardiogenic Shock: A Systematic Review and Meta-Analysis

February 24, 2026 No Comments

This systematic review and meta-analysis of 10 observational studies (5,364 patients) compared Impella and VA-ECMO for cardiogenic shock. No significant difference in short-term mortality was found (RR 0.92). However, Impella was associated with lower risks of stroke, major bleeding, and limb ischemia. Evidence certainty was very low due to confounding bias. Device selection should be individualized pending randomized trials.

Elective Use of Intraoperative Extracorporeal Membrane Oxygenation in Patients With Pulmonary Fibrosis Reduces Primary Graft Dysfunction After Bilateral Lung Transplantation

February 23, 2026 No Comments

This single-center retrospective study evaluated 422 pulmonary fibrosis patients undergoing bilateral lung transplantation between 2012 and 2025. After adopting a more liberal elective intraoperative veno-arterial ECMO strategy in 2020, the incidence of severe primary graft dysfunction (PGD grade 3 at 72 hours) significantly decreased. Elective ECMO use was associated with shorter ventilation times, reduced dialysis rates, and a trend toward improved one-year graft survival without increasing major vascular complications.

AI-Powered ECMO Digital Twin in Virtual Reality Training

Building an Extracorporeal Membrane Oxygenation Digital Twin Using High-Resolution Patient Data: An Artificial Intelligence Model for Virtual Reality Simulation

February 22, 2026 No Comments

In this multicentre study of 335 ECMO patients, high-resolution device and electronic health record data were integrated to develop a two-stage artificial intelligence model capable of simulating ECMO circuit behavior and patient physiological responses. The digital twin was deployed in a virtual reality platform with real-time inference. Expert evaluation confirmed clinically coherent responses, supporting scalable, high-fidelity ECMO training without dedicated hardware.

The Evolving Role of the ECMO Perfusionist

Redefining the Role of Perfusionists in ECMO: From Technical Operators to Clinical Stakeholders

February 19, 2026 No Comments

This letter to the editor argues that perfusionists in ECMO programs should move beyond a narrowly defined technical role and be formally integrated as clinical stakeholders. The authors highlight perfusionists’ expertise in circuit management, anticoagulation, device troubleshooting, and physiology, advocating for their inclusion in ICU rounds, decision-making, quality improvement, and research. Greater integration could improve safety, efficiency, and patient outcomes in complex ECMO care.

Balancing Bleeding and Clotting: Anticoagulation Strategies During ECMO Support

Efficacy of Reduced-Intensity or No Heparin Versus Standard Heparin Anticoagulation in Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-AnalysiS

February 17, 2026 No Comments

This systematic review and meta-analysis of 11 studies (958 ECMO patients) compared reduced-intensity or no heparin anticoagulation with standard heparin strategies. Low/no heparin significantly reduced bleeding complications (OR 0.49) without increasing thrombotic events or in-hospital mortality. Transfusion requirements showed no significant difference. Findings support individualized anticoagulation strategies, though high-quality randomized trials remain needed.

Peripheral Versus Central Cannulation for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO): A Meta-Analysis of Bleeding and Vascular Complications

February 16, 2026 No Comments

This meta-analysis of 15 studies (2,913 patients) compares peripheral and central cannulation strategies for VA-ECMO in refractory cardiogenic shock. Peripheral access significantly reduced major bleeding risk but increased limb ischemia. No meaningful differences were observed in infection, renal replacement therapy, or stroke. Findings support individualized cannulation decisions balancing bleeding risk against vascular complications.

Incidence and Risk Factors of Limb Ischaemia in Adult Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

February 6, 2026 No Comments

Limb ischaemia is a serious complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO). This systematic review and meta-analysis of 17 studies involving 2,812 adults found a pooled limb ischaemia incidence of 16.9%. Peripheral arterial disease, unsuccessful percutaneous cannulation, and shorter patient height were significant risk factors, underscoring the need for early risk identification and preventive strategies in ECMO care.

Determination of Insensible Water Loss and Sodium Accumulation Behavior from the Medtronic Nautilus ECMO Oxygenator: An In Vitro Study

January 28, 2026 No Comments

This in vitro study examined insensible water loss and sodium accumulation in the Medtronic Nautilus ECMO oxygenator. Using varying sweep gas rates over 24 hours, researchers found a strong linear relationship between sweep gas flow and fluid loss. The rate was approximately 72.5 mL/day per 1 L/min sweep gas. Sodium accumulation was observed but not statistically confirmed due to sample size. These findings are critical for managing fluid balance and hypernatremia risk in ECMO patients.