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Category: ECMO

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

This study examines risk factors affecting survival in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) treated with extracorporeal membrane oxygenation (ECMO). Analyzing 63 cases from 2020–2023, findings indicate that elevated arterial blood lactate, prolonged time to PCI, and higher vasoactive-inotropic scores (VIS) are key predictors of poor prognosis. Early intervention, including timely PCI and metabolic stabilization, is crucial to improving survival outcomes.

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February 22, 2025
Crazy ECMO

Survival After Endocarditis Surgery Needing Venoarterial Extracorporeal Membrane Oxygenation Support: Results from the Netherlands Heart Registration

This study analyzes venoarterial extracorporeal membrane oxygenation (VA-ECMO) use after infective endocarditis (IE) surgery using Netherlands Heart Registration data (2013–2022). Among 3,468 cases, 1.4% required VA-ECMO, with 49% in-hospital mortality and 60.9% one-year mortality. Despite increased risk factors and complications, VA-ECMO outcomes were comparable to non-IE postcardiotomy VA-ECMO cases, challenging the exclusion of IE patients based on high anticipated mortality.

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February 17, 2025
Outcomes in Children Who Undergo Postcardiotomy Extracorporeal Membrane Oxygenation

Outcomes in Children Who Undergo Postcardiotomy Extracorporeal Membrane Oxygenation: A Report From the STS-CHSD

This study evaluates survival outcomes in children who undergo postcardiotomy extracorporeal membrane oxygenation (ECMO) following congenital heart surgery. Using data from the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD), the study found that ECMO initiation over 48 hours post-surgery correlated with the poorest outcomes. Postoperative septicemia, cardiac arrest, and neurological injury were strongly linked to mortality, while reintubation and unplanned noncardiac reoperation improved survival.

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February 8, 2025
Robot

Perioperative Mechanical Circulatory Support: Transitioning from Sequential to Parallel Recovery

This editorial explores the evolution of mechanical circulatory support (MCS) in perioperative cardiac care. It discusses advancements in venoarterial extracorporeal membrane oxygenation (VA-ECMO) and micro-axial flow pumps, highlighting the shift from sequential to parallel recovery. The article emphasizes early MCS intervention, left ventricular unloading, and minimizing adverse events. Insights from the DanGer Shock trial suggest improved survival with early MCS use, but further research is needed for perioperative applications.

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February 7, 2025
The Superiority of Veno-Arterial Over Veno-Venous Extracorporeal Membrane Oxygenation for Operative Support of Lung Transplantation

The Superiority of Veno-Arterial Over Veno-Venous Extracorporeal Membrane Oxygenation for Operative Support of Lung Transplantation

This study compares the effectiveness of veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) in lung transplantation. Analyzing 62 patients over eight years, results show that V-A ECMO provides superior pulmonary circulatory unloading and improved survival outcomes. Patients on V-A ECMO had lower pulmonary artery pressure, better oxygenation, and reduced pulmonary edema compared to V-V ECMO. Findings suggest V-A ECMO should be the preferred choice when clinically appropriate.

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January 23, 2025
Predictive Value of Trendelenburg Position

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

This study evaluates the effectiveness of Trendelenburg position and carotid ultrasound in predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Findings reveal that carotid corrected flow time (FTcBaseline) and stroke volume index variation (ΔSVITrend) are accurate and non-invasive predictors. These methods outperform traditional markers like pulse pressure variation, enhancing fluid management strategies in critical care.

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January 2, 2025
Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

This review explores fluid management in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). It highlights the lack of evidence for optimal fluid strategies, comparing liberal vs. restrictive approaches, or types like crystalloids and albumin. Fluid overload negatively affects survival and kidney outcomes, emphasizing the need for precise strategies. The study calls for rigorous research to determine effective fluid resuscitation approaches and improve clinical outcomes.

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December 24, 2024
Lung ECMO

Enhancing Lung Transplantation with ECMO: A Comprehensive Review of Mechanisms, Outcomes, and Future Considerations

Lung transplantation (LTx) is a transformative solution for patients with end-stage lung disease, but it comes with significant challenges, including limited donor availability and severe post-operative complications. This review focuses on the role of Extracorporeal Membrane Oxygenation (ECMO) in overcoming these hurdles and improving patient outcomes across all phases of the transplant process.

ECMO, initially developed for cardiac surgery, has become an essential tool in lung transplantation, particularly for its ability to provide cardiopulmonary support. Its applications span the preoperative, intraoperative, and postoperative stages, making it integral to modern LTx practices.

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December 22, 2024
Milrinone

Interaction of Milrinone with Extracorporeal Life Support

This study investigates the interactions between milrinone, a phosphodiesterase inhibitor used in critically ill patients, and extracorporeal life support (ECLS) systems, specifically extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Ex vivo experiments demonstrated that milrinone exhibits negligible interaction with ECMO circuits but is rapidly cleared (99% within two hours) by CRRT circuits. These findings suggest that while ECMO dosing adjustments are unnecessary, CRRT requires tailored dosing. Future studies incorporating patient physiology are recommended to refine dosing strategies.

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December 22, 2024
ECMO Lung

Intraoperative Extracorporeal Support for Lung Transplant: A Systematic Review and Network Meta-Analysis

This systematic review and network meta-analysis investigates the comparative effectiveness of veno-arterial extracorporeal membrane oxygenation (V-A ECMO), cardiopulmonary bypass (CPB), and OffPump strategies for lung transplantation (LT). Based on 27 observational studies with 6113 patients, the study finds that OffPump approaches outperform both ECMO and CPB in all major outcomes, including reduced ICU stay, mechanical ventilation duration, and mortality. Among extracorporeal supports, V-A ECMO showed better performance than CPB. Factors such as age, gender, and BMI significantly influenced postoperative outcomes.

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December 20, 2024
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