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

January 9, 2024 No Comments

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.

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

January 7, 2024 No Comments

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.

Inpatient Costs of Treating Patients With COVID-19

January 7, 2024 No Comments

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.

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

January 2, 2024 No Comments

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.

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

December 29, 2023 No Comments

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.

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

December 29, 2023 No Comments

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.

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

December 22, 2023 No Comments

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.

Meropenem Extraction by Ex Vivo Extracorporeal Life Support Circuits

December 22, 2023 No Comments

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.

Direct and Continuous Dosing of Propofol can Saturate Ex vivo ECMO Circuit to Improve Propofol Recovery

December 21, 2023 No Comments

This study investigates the adsorption of propofol in extracorporeal membrane oxygenation (ECMO) circuits, noting that drugs prescribed to ECMO patients often lack optimized dosing strategies due to the circuit’s ability to adsorb drugs. It found that while only 27% of propofol was recovered after a bolus dose, more than 80% was recovered following a continuous infusion, suggesting direct dosing into ECMO circuits could mitigate altered drug exposure due to adsorption.

ECPR for Prolonged Pediatric Cardiac Arrest, an Autcome Without Major Neurological Compromise

December 21, 2023 No Comments

Pediatric in-hospital cardiac arrest (IHCA) occurs in 1-6% of pediatric ICU admissions, with survival rates improving from 9% to 35% over the past 25 years, partly due to the use of ECMO as a rescue strategy. A case is reported of a 4-month-old patient with ventricular and septal defects who underwent surgery, experienced complications leading to a prolonged cardiac arrest, and was successfully treated with ECMO.

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

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

Inpatient Costs of Treating Patients With COVID-19

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

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

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

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

Meropenem Extraction by Ex Vivo Extracorporeal Life Support Circuits

Direct and Continuous Dosing of Propofol can Saturate Ex vivo ECMO Circuit to Improve Propofol Recovery

ECPR for Prolonged Pediatric Cardiac Arrest, an Autcome Without Major Neurological Compromise

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