In-Hospital Mortality in Patients With Cardiogenic Shock Requiring Veno-Arterial Extracorporeal Membrane Oxygenation With Concomitant Use of Impella vs. Intra-Aortic Balloon Pump – A Retrospective Cohort Study Using a Japanese Claims-Based Database

January 26, 2024 No Comments

In a study comparing the effectiveness of Impella and intra-aortic balloon pump (IABP) in patients with refractory cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO), no significant difference in in-hospital mortality was found between the two groups. However, the Impella group experienced longer mechanical ventilation support and hospital stays, and incurred higher medical costs than the IABP group, suggesting a need for further research to optimize the use of Impella in such clinical scenarios.

Outcomes of ECMO Support with Polypropylene Membrane During Pandemic Times: A Retrospective Cohort Study

January 25, 2024 No Comments

During the SARS-CoV-2 pandemic, a study compared clinical outcomes of patients on ECMO support using polypropylene (PP) oxygenation membranes versus poly-methylpentene (PMP) membranes. It found that PP membranes required more changes and had a higher frequency of renal replacement therapy as a complication, yet were a feasible alternative during supply shortages, without significant differences in mortality.

Predicting Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation Patients with Tree-Based Machine Learning: Analysis of the Extracorporeal Life Support Organization Registry

January 24, 2024 No Comments

This study utilized machine learning algorithms to predict acute brain injury (ABI) in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO), analyzing data from the Extracorporeal Life Support Organization Registry. It found that longer ECMO duration and higher 24-hour pump flow were associated with ABI in both non-ECPR and ECPR VA-ECMO patient groups, highlighting key risk factors for neurological complications in these patients.

Intraoperative Extracorporeal Support during Lung Transplantation: Not Just for the High-Risk Patient

January 19, 2024 No Comments

In lung transplantation, the use of intraoperative mechanical support, particularly cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), has evolved over time due to their respective advantages and disadvantages. While CPB was traditionally preferred for its full hemodynamic support, it poses risks like systemic inflammation and coagulopathy; ECMO, on the other hand, offers many benefits of CPB with fewer risks, leading to better outcomes such as reduced primary graft dysfunction and overall improved survival, suggesting its potential as a standard protocol in lung transplants.

Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis

January 15, 2024 No Comments

This systematic review and meta-analysis of 39 studies involving 6409 patients reveal that more than 50% of patients with high-risk pulmonary embolism (HRPE) treated with extracorporeal membrane oxygenation (ECMO) survive, with mortality significantly lower in those receiving ECMO combined with catheter-directed therapy compared to systemic thrombolysis. Factors like cardiac arrest prior to ECMO and pre-ECMO heart rate are associated with mortality, highlighting the need for further research to compare ECMO with non-ECMO therapies.

Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice

January 15, 2024 No Comments

This study surveys clinicians across seven U.S. hospitals to understand the informed consent process for Extracorporeal Membrane Oxygenation (ECMO) and ethical complexities in its application. Results reveal variability in the time spent on obtaining consent, use of exclusion criteria for ECMO, and differences in approaches to withdrawing ECMO, highlighting significant ethical challenges and inconsistencies in practice.

Multi-Method Investigation of Blood Damage Induced by Blood Pumps in Different Clinical Support Modes

January 14, 2024 No Comments

This study investigates the impact of different operational modes of an extracorporeal blood pump (CentriMag) on blood flow patterns and the associated risks of bleeding, thrombosis, and hemolysis using computational fluid dynamics and hemocompatibility models. It finds that venous-arterial (V-A) ECMO mode results in the highest risk of these complications, with heart failure (HF) mode being the least risky, largely due to variations in flow patterns affecting cell and protein functions.

Development and Validation of a Robust and Interpretable Early Triaging Support System for Patients Hospitalized With COVID-19: Predictive Algorithm Modeling and Interpretation Study

January 13, 2024 No Comments

The study developed and validated RIETS, a machine learning-based system using 11 routine clinical and laboratory biomarkers to predict COVID-19 severity upon hospitalization, showing high accuracy and low bias risk. RIETS demonstrated excellent predictive performance, including during the Omicron variant period, and provided interpretable data for clinical use, suggesting its potential for improving patient triaging and resource allocation in hospitals.

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

January 12, 2024 No Comments

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.

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

January 11, 2024 No Comments

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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In-Hospital Mortality in Patients With Cardiogenic Shock Requiring Veno-Arterial Extracorporeal Membrane Oxygenation With Concomitant Use of Impella vs. Intra-Aortic Balloon Pump – A Retrospective Cohort Study Using a Japanese Claims-Based Database

Outcomes of ECMO Support with Polypropylene Membrane During Pandemic Times: A Retrospective Cohort Study

Predicting Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation Patients with Tree-Based Machine Learning: Analysis of the Extracorporeal Life Support Organization Registry

Intraoperative Extracorporeal Support during Lung Transplantation: Not Just for the High-Risk Patient

Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis

Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice

Multi-Method Investigation of Blood Damage Induced by Blood Pumps in Different Clinical Support Modes

Development and Validation of a Robust and Interpretable Early Triaging Support System for Patients Hospitalized With COVID-19: Predictive Algorithm Modeling and Interpretation Study

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

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

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