International Perfusion Association

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IPA

Category: ECMO

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
Transplant Heart

Novel Portable Hypothermic Machine Perfusion Preservation Device Enhances Cardiac Viability of Donated Human Hearts

This study investigates a novel portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE®, designed to extend preservation times for donated human hearts. Utilizing hearts from 11 brain-dead donors, the research compared the efficacy of preservation across different durations (4, 6, and 8 hours) against standard static cold storage (SCS). Findings indicate that the VP.S ENCORE® significantly maintains cardiac viability and function, matching levels observed in healthy hearts, particularly in 6-hour perfusion scenarios which showed improved ventricular relaxation and reduced inflammation marker expression.

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April 18, 2024
ECMO Hero

Comparative Analysis of Therapeutic Strategies in Post-Cardiotomy Cardiogenic Shock: Insight into a High-Volume Cardiac Surgery Center

This study compares treatment outcomes for post-cardiotomy cardiogenic shock (PCCS) at a high-volume center. It retrospectively analyzes 220 patients (3% of 7028) from 2018 to 2022, assessing outcomes between conservative treatments and additional mechanical support with ECMO. Findings show ECMO patients had lower in-hospital mortality (60% vs. 85%) and better end-organ recovery, despite higher complications like dialysis and myocardial infarction, suggesting ECMO’s potential to improve critical patient outcomes.

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April 14, 2024
ECMO Nexk

Alternative Venous Access Sites for Dual-Lumen Extracorporeal Membrane Oxygenation Cannulation

This multicenter case series examines the safety and feasibility of using alternative venous access sites for dual-lumen cannulas in veno-venous (VV) extracorporeal membrane oxygenation (ECMO) when the right internal jugular vein (RIJV) is inaccessible. Data from three high-volume ECMO centers were analyzed, involving 20 patients who required alternative access due to inaccessible RIJV. The study found no procedural complications with alternative sites, which included the left internal jugular, subclavian, and femoral veins. The outcomes were promising with half of the patients successfully bridged to lung transplantation or recovery, highlighting the viability of these alternative sites for critical ECMO support.

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April 11, 2024
ECMO Hat

Impact of Center Volume on In-Hospital Mortality in Adult Patients with Out-of-Hospital Cardiac Arrest Resuscitated Using Extracorporeal Cardiopulmonary Resuscitation: A Secondary Analysis of the SAVE-J II Study

This secondary analysis of the SAVE-J II study evaluates the correlation between center volume and in-hospital mortality for patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR). Analyzing data from 36 Japanese centers, the study categorizes centers into three groups based on ECPR volume. Findings reveal that high-volume centers (≥21 sessions/year) show a significantly higher survival rate at discharge (33.4%) compared to medium (24.1%) and low-volume (26.8%) centers. Adjusted analysis suggests that patients at high-volume centers are more likely to survive, indicating a positive correlation between center volume and ECPR success.

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April 11, 2024
ECMO Tan Logo

Comparison of Conventional Methods with Pump-Controlled Retrograde Trial off for Weaning Adults with Cardiogenic Shock from Veno-Arterial Extracorporeal Membrane Oxygenation

This retrospective study evaluates the effectiveness of pump-controlled retrograde trial off (PCRTO) versus conventional weaning methods from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in adults with cardiogenic shock. It found that the PCRTO method significantly improves survival rates to discharge compared to non-PCRTO methods (90% vs. 72%) and reduces the incidence of cardiogenic shock post-weaning (5% vs. 16%). PCRTO, offering a safe and reversible weaning process, emerges as a useful predictor for successful VA-ECMO weaning through a preload stress test, suggesting its viability as a preferred approach in clinical practice.

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April 10, 2024
Coronary ECMO

The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment

The Jena Method introduces a revolutionary approach to deploying extracorporeal membrane oxygenation (ECMO) rapidly in emergency situations, without needing a perfusionist on hand. By maintaining a wet-primed ECMO system ready for immediate use, this method significantly reduces the initiation time for life-support procedures. Sterility and functionality of the ECMO components are maintained up to 14 days, ensuring patient safety. Training staff for independent ECMO setup and a pictorial guide facilitate quick and efficient deployment. Since its implementation in 2015, this method has demonstrated feasibility, safety, and the potential for widespread adoption in critical care settings, providing a significant advancement in emergency cardiac care.

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April 10, 2024
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