Sterility and Oxygenator Function in Pre-Primed Extracorporeal Membrane Oxygenation: A Prospective Clinical Study

July 2, 2024 No Comments

This study explores the sterility and function of pre-primed extracorporeal membrane oxygenation (ECMO) circuits in a clinical setting. Conducted at Sahlgrenska University Hospital, the study assessed 107 ECMO circuits between 2019 and 2021, analyzing sterility through culture tests and oxygenator function through parameters like sweep gas flow and FiO2. Results indicated minimal bacterial growth and no significant impact of wet priming on oxygenator function, suggesting pre-priming is safe and effective for rapid ECMO initiation.

Quantifying Potential Fluid Transfused Through Pressure Monitoring and Circuit Flushes in Pediatric ECMO Patients

June 22, 2024 No Comments

This study investigates the fluid volume transfused to pediatric ECMO patients via pressure monitoring circuits, an area currently lacking published data or guidelines. Using in vitro experiments with Edwards True Wave transducers and pressure bags, the study measured fluid volumes from passive and active flushing methods. Results showed that maintaining patency with a pressurized IV bag can transfuse approximately 319.6 mL daily, close to a neonate’s total blood volume. Automated syringe pumps, however, significantly reduce this volume to 24 mL per day. The findings suggest the need for further research to establish best practices.

Clinician Prediction of Survival vs Calculated Prediction Scores in Patients Requiring Extracorporeal Membrane Oxygenation

June 9, 2024 No Comments

This study compared clinician predictions of survival to hospital discharge versus established ECMO survival prediction scores (RESP and SAVE). Conducted from January 2020 to November 2021, it involved interviews with nurses, perfusionists, and physicians within the first 24 hours of ECMO initiation. Results showed that clinicians, especially perfusionists and physicians, often had more accurate survival predictions than the RESP and SAVE scores. The study highlights the need for improved prediction tools.

Multimodal Neurologic Monitoring in Patients Undergoing Extracorporeal Membrane Oxygenation

June 5, 2024 No Comments

This study investigates the safety and feasibility of noninvasive multimodal neurologic monitoring (MNM) in patients undergoing extracorporeal membrane oxygenation (ECMO) at Baylor St. Luke’s Medical Center. The observational study spanned from January 2017 to February 2019 and included patients undergoing ECMO. Results showed that MNM was safe and feasible, with no adverse events reported. Specific EEG and transcranial Doppler (TCD) findings were identified that could help in early detection of neurologic deterioration. MNM may aid in monitoring, prognostication, and clinical decision-making for ECMO patients.

Psychological Safety in an ECMO Retrieval Team: A Qualitative Study to Inform Improvement

June 1, 2024 No Comments

This study explores psychological safety within an ECMO retrieval team at the Royal Brompton Hospital in London. By conducting semistructured interviews with consultants, nurses, and perfusionists, researchers identified factors influencing psychological safety. Key findings include the impact of the high-risk environment, structured team processes, and leadership behaviors on team communication and collaboration. Recommendations were made to enhance psychological safety by addressing these factors.

Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices

May 28, 2024 No Comments

The study examines hospital readmissions in patients with centrifugal-flow left ventricular assist devices (CF-LVADs), highlighting the commonality and impact on patient outcomes. Analyzing data from 204 patients, 67.7% experienced heart failure (HF)/LVAD-related readmissions, mainly due to major bleeding, infection, HF exacerbation, and neurological dysfunction. Using machine learning models, several pre-, intra-, and post-operative factors were identified as predictors of readmission risk, which can guide strategies to improve patient management and outcomes.

Complications During Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome

May 27, 2024 No Comments

This study compares complications in COVID-19 and non-COVID-19 patients with acute respiratory distress syndrome (ARDS) undergoing veno-venous extracorporeal membrane oxygenation (vv-ECMO). Retrospective analysis of 64 patients from March 2020 to March 2022 revealed higher pre-cannulation pneumothorax rates in COVID-19 patients. However, post-cannulation complications and clinical outcomes were similar between groups. Non-survivors showed a trend towards higher post-vv-ECMO complications.

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

May 8, 2024 No Comments

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.

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

May 6, 2024 No Comments

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.

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

May 2, 2024 No Comments

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.