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

April 28, 2024 No Comments

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.

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

April 25, 2024 No Comments

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.

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

April 23, 2024 No Comments

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.

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

April 20, 2024 No Comments

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.

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

April 18, 2024 No Comments

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.

Evolution of Cardiogenic Shock Management and Development of a Multidisciplinary Team-Based Approach: Ten Years Experience of a Single Center

April 16, 2024 No Comments

Background: The management of cardiogenic shock (CS) after ACS has evolved over time, and the development of a multidisciplinary team-based approach has been shown to

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

April 14, 2024 No Comments

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.

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

April 11, 2024 No Comments

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.

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

April 11, 2024 No Comments

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.

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

April 10, 2024 No Comments

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.