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Category: ECMO

ML ECMO

Utilizing Machine Learning to Predict Neurological Injury in Venovenous Extracorporeal Membrane Oxygenation Patients: An Extracorporeal Life Support Organization Registry Analysis

In a study analyzing 37,473 VV-ECMO patients, machine learning was used to predict acute brain injury (ABI), revealing a 7.1% incidence of ABI and identifying pre-ECMO cardiac arrest as the most significant risk factor. The study’s machine learning models, however, showed sub-optimal performance in predicting ABI, attributed to the low prevalence of ABI and the lack of standardized neuromonitoring and imaging protocols in the ELSO Registry data.

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January 12, 2024
COVID-19 Patient

Impact of the COVID-19 Pandemic on Prehospital and In-Hospital Treatment and Outcomes of Patients After Out-of-Hospital Cardiac Arrest: A Japanese Multicenter Cohort Study

This study compared prehospital care, in-hospital treatment, and outcomes among out-of-hospital cardiac arrest (OHCA) patients before and after the COVID-19 pandemic, revealing that survival rates and favorable outcomes at 1 month post-OHCA deteriorated in the post-pandemic period, with longer EMS response times and increased advanced airway management by EMS. Despite these changes, most prehospital and in-hospital treatments remained unchanged between the pre- and post-pandemic periods.

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January 11, 2024
Impella ECMO

ECMO and Impella Support Strategies as a Bridge to Surgical Repair of Post-Infarction Ventricular Septal Rupture

This review evaluates the use of Impella and venoarterial extracorporeal membranous oxygenation (VA-ECMO) as strategies to stabilize patients with post-infarct ventricular septal rupture (PIVSR) before surgical repair, based on a case report and a systematic literature review. While both Impella and VA-ECMO have shown better outcomes compared to traditional management, they present unique advantages and challenges; Impella effectively unloads the left ventricle but may cause shunt reversal, whereas VA-ECMO improves organ perfusion but has higher complication risks and may require additional ventricular unloading.

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January 9, 2024
VV ECMP

Post-COVID Changes in Lung Function 6 Months After Veno-Venous Extracorporeal Membrane Oxygenation: A Prospective Observational Clinical Trial

Six months after hospital discharge, patients with severe COVID-19 who received veno-venous extracorporeal membrane oxygenation (V-V ECMO) showed persistent impairments in small airway function and reduced respiratory tissue elasticity, compared to healthy controls. These findings indicate moderate but ongoing lung function impairment in severe acute COVID-19 cases, even after recovery from the critical phase of the infection.

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January 7, 2024
COVID-19 Cost

Inpatient Costs of Treating Patients With COVID-19

This study analyzed the mean cost of inpatient care for COVID-19 patients in the US from March 2020 to March 2022, finding an overall increase from $10,394 to $13,072, with higher costs for patients with comorbidities like obesity and coagulation deficiency. The significant rise in costs, over five times the rate of medical inflation, was partly attributed to increased use of treatments like extracorporeal membrane oxygenation (ECMO) over time.

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January 7, 2024
Abstract Kidney

Using Cardiohelp, Quadrox, and Nautilus Extracorporeal Membrane Oxygenators as Vascular Access for Hemodialysis, Continuous Renal Replacement Therapy, and Plasmapheresis: A Brief Technical Report

This technical report details methods for performing dialytic therapies, such as intermittent hemodialysis (iHD) and continuous renal replacement therapy (CRRT), safely and effectively through an ECMO circuit, eliminating the need for a separate dialysis catheter in patients with acute kidney injury (AKI) and end-stage renal disease (ESRD). It outlines the connection of these kidney replacement therapies to various oxygenators and discusses performing plasmapheresis alongside ECMO and iHD or CRRT, emphasizing the technique’s safety as it doesn’t require modifications to ECMO cannulas/tubing.

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January 2, 2024
Heart Failute

Test Bench for Right Ventricular Failure Reversibility: The Hybrid BiVAD Concept

Patients with biventricular cardiogenic shock, ineligible for heart transplantation, may benefit from a micro-invasive hybrid BiVAD approach, combining the ProtekDuo cannula and the Impella 5.5 trans-aortic pump. This strategy, beyond ECMO, allows for physiological circulation, biventricular unloading, and accurate evaluation of right ventricular function, leading to the possibility of transitioning to less invasive, durable left ventricular assist device (LVAD) implantation.

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December 29, 2023

Supervised Machine Learning Model to Predict Mortality in Patients Undergoing Venovenous Extracorporeal Membrane Oxygenation from a Nationwide Multicentre Registry

Machine learning models, specifically extreme gradient boosting and light gradient boosting, demonstrated higher accuracy than conventional models in predicting 90-day mortality for patients undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO). These advanced models, outperforming existing methods like RESP and PRESERVE, show potential for improving patient selection by identifying those less likely to benefit from VV-ECMO therapy.

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December 29, 2023

Extracorporeal Cardiopulmonary Resuscitation: Lifesaving for the Right Patient, at the Right Time and in the Right Place

Extracorporeal membrane oxygenation (ECMO), a life-saving technology for patients with cardiorespiratory failure unresponsive to standard treatments, has seen increased global use since the H1N1 pandemic in 2009, particularly for adult respiratory and cardiac failures. The most rapid expansion of its use has been in extracorporeal cardiopulmonary resuscitation (ECPR), which serves as a critical intervention in cases of refractory cardiac arrest, maintaining circulation and allowing time for potential reversal of the underlying cause.

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December 22, 2023

Meropenem Extraction by Ex Vivo Extracorporeal Life Support Circuits

The study investigates the impact of ECMO and CRRT circuits on meropenem pharmacokinetics, finding minimal extraction by ECMO components but rapid clearance during CRRT, indicating a need for adjusted meropenem dosing in critically ill patients on these therapies. Meropenem underwent significant degradation/metabolism in physiological conditions, informing clinicians on dosing strategies.

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December 22, 2023
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