International Perfusion Association

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IPA

Category: ECMO

ECPR

Bleeding and Thrombosis in Patients With Out-of-Hospital Ventricular Tachycardia/Ventricular Fibrillation Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation

This study examines the incidence and predictors of bleeding and thrombosis in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) after out-of-hospital cardiac arrest due to ventricular tachycardia/fibrillation. Among 200 patients, 67.5% experienced major bleeding, primarily from CPR-related trauma. Decreased fibrinogen levels were linked to bleeding, but bleeding did not significantly affect in-hospital mortality. Thrombosis occurred in 23.5% of patients and was not associated with in-hospital death.

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May 8, 2024
ECMO Kidney

Long-Term Clinical Outcomes of Acute Kidney Disease in Patients Receiving Extracorporeal Membrane Oxygenation

This study investigates the long-term outcomes of acute kidney disease (AKD) in patients undergoing extracorporeal membrane oxygenation (ECMO). From a dataset of 395 patients, 40.5% developed AKD. Those with AKD had a higher risk of major adverse kidney events (MAKEs) and cardiovascular events (MACEs). The risk of readmissions due to infections or sepsis was also elevated in AKD survivors, emphasizing the long-term impact of AKD in ECMO patients.

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May 6, 2024
Myocardial Protection

Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass

This study investigates the effects of dexmedetomidine (Dex) pretreatment in patients undergoing cardiac valve replacement under cardiopulmonary bypass. In the Dex group, the time to the first rescue dose of propofol was longer, and the total propofol dosage was less than in the control group. Additionally, the Dex group showed reduced cardiac injury markers and inflammation, requiring less mechanical ventilation time than the control group. The findings suggest that Dex pretreatment offers myocardial protection and optimizes postoperative outcomes.

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May 2, 2024
Duck Injection

Injection Site Matters: A Comparative Analysis of Transpulmonary Thermodilution via Simultaneous Femoral and Jugular Indicator Injections under Veno-Venous Extracorporeal Membrane Oxygenation Therapy

This study assesses how injection sites affect hemodynamic monitoring in patients on vv-ECMO therapy using the PiCCO system. By comparing simultaneous jugular and femoral indicator injections, it was found that femoral injections overestimate key parameters like EVLWI, ITBVI, and GEDVI. The discrepancies are linked to variations in the mean transit time and downslope time, correlated with extracorporeal blood flow, suggesting the injection site significantly impacts measurement accuracy.

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April 30, 2024
ECMO 45

Mid-Term Outcome after Extracorporeal Life Support in Postcardiotomy Cardiogenic Shock: Recovery and Quality of Life

This study evaluates the mid-term outcomes of extracorporeal life support (ECLS) in patients with refractory postcardiotomy cardiogenic shock, identifying factors like preoperative EuroSCORE II, renal function, cardiopulmonary bypass duration, and lactate levels as predictors of mortality. Survival rates and health-related quality of life (HRQoL) were assessed, showing acceptable results in surviving patients with a considerable percentage free from moderate to severe disability.

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April 29, 2024
DRESS

Heparin-Induced DRESS Syndrome in a Pediatric Patient and Successful Anaesthetic Management in Cardiovascular Bypass Surgery: Case Report

This case report discusses a pediatric patient with heparin-induced DRESS Syndrome managed successfully during cardiovascular bypass surgery. An 11-year-old with native aortic valve endocarditis developed DRESS after receiving unfractionated heparin. The syndrome, characterized by fever, eosinophilia, and a pruritic rash, was initially managed with corticosteroids. A subsequent episode prompted a shift to bivalirudin and fondaparinux, avoiding further complications and stabilizing the patient’s condition. This case emphasizes the need for alternative anticoagulation strategies in hypersensitive patients to improve outcomes.

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April 28, 2024
ECMO AI

Machine Learning Based Predictive Modeling of Readmissions Following Extracorporeal Membrane Oxygenation Hospitalizations

This study developed and assessed machine learning models, particularly using XGBoost, to predict 90-day nonelective readmissions following extracorporeal membrane oxygenation (ECMO) hospitalizations. Analyzing data from the Nationwide Readmissions Database (2016-2020), the study found that the XGBoost model outperformed traditional logistic regression in prediction accuracy and calibration. Key factors influencing readmission rates included duration of hospital stay, heart/lung transplants, and type of insurance.

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April 28, 2024
CRRT Particles

Spallation and Particles Infusion into the Extracorporeal Circuit During CRRT: A Preventable Phenomenon

This study investigates the infusion of microparticles in CRRT circuits, identifying disposable components like tubing and bags as sources. It highlights the effective role of in-line filters in reducing these particles, demonstrating a decrease in microparticle concentration from 14 mg/mL to 11 mg/mL post-filter. The study suggests that using in-line filters can mitigate iatrogenic damage and improve patient outcomes during extracorporeal treatments in intensive care.

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April 25, 2024
Blue Legs

Evolution of Distal Limb Perfusion Management in Adult Peripheral Venoarterial Extracorporeal Membrane Oxygenation with Femoral Artery Cannulation

This narrative review explores the advancements in managing distal limb perfusion in venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. Initially, no specialized techniques like distal perfusion cannulae were used, leading to limb ischemia. Recent innovations include prophylactic measures, various cannulation methods, and improved venous drainage techniques to enhance limb perfusion and reduce ischemic complications. Advanced monitoring tools like near-infrared spectroscopy aid in decision-making and management.

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April 23, 2024
CytoSorb Drowning

Does Adjunctive Hemoadsorption Provide Benefit in the Management of Ischemia-Reperfusion Syndrome Following Near-Drowning? A Case Report

This case report examines the efficacy of adjunctive hemoadsorption using CytoSorb® in managing ischemia-reperfusion injury (IRI) following a near-drowning incident. Highlighting a critical case involving an adolescent, the study details the use of CytoSorb® alongside veno-venous extracorporeal membrane oxygenation (vvECMO) to address hyperinflammation triggered by reoxygenation after drowning. The intervention showed potential in mitigating the surge of pro-inflammatory mediators, suggesting a promising role for hemoadsorption in severe drowning cases.

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April 20, 2024
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