Limiting the Gamble: Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

March 11, 2025 No Comments

This study investigates risk factors for renal replacement therapy (RRT) in patients receiving mechanical circulatory support (MCS). A retrospective analysis of 129 patients revealed an RRT incidence of 36%. Key risk factors include prior immunologic therapy and the presence of pacemakers or internal cardiac defibrillators. Unfractionated heparin showed minimal protection against RRT. Findings suggest systemic inflammation plays a role, emphasizing the need for alternative anticoagulation strategies.

Perfusion Instability During Hyperthermic Intraperitoneal Chemotherapy: The Utility of a Problem-solving Flowchart

March 6, 2025 No Comments

This study examines perfusion instability (PI) during hyperthermic intraperitoneal chemotherapy (HIPEC), where maintaining proper flow and temperature is crucial. A retrospective review of 208 HIPEC cases found a 10.1% incidence of PI. A step-by-step problem-solving flowchart was implemented, significantly improving perfusion stability. The study concludes that structured interventions can mitigate PI, though further research is needed to refine perfusion techniques.

Kidney Injury Under Diminished Pulsatile Flow Induced by V-A ECMO in Sheep

February 25, 2025 No Comments

Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention used for critically ill patients, yet it is frequently associated with high incidences of kidney injury. This

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

February 22, 2025 No Comments

This study examines risk factors affecting survival in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) treated with extracorporeal membrane oxygenation (ECMO). Analyzing 63 cases from 2020–2023, findings indicate that elevated arterial blood lactate, prolonged time to PCI, and higher vasoactive-inotropic scores (VIS) are key predictors of poor prognosis. Early intervention, including timely PCI and metabolic stabilization, is crucial to improving survival outcomes.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

February 6, 2025 No Comments

This expert consensus document from the American Association for Thoracic Surgery outlines standardized best practices for donor lung procurement and preservation. It highlights significant variability in existing techniques and emphasizes the role of ex vivo lung perfusion (EVLP), cold storage, and normothermic regional perfusion. The document provides 34 evidence-based recommendations aimed at improving organ utilization and lung transplant outcomes.

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

January 2, 2025 No Comments

This study evaluates the effectiveness of Trendelenburg position and carotid ultrasound in predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Findings reveal that carotid corrected flow time (FTcBaseline) and stroke volume index variation (ΔSVITrend) are accurate and non-invasive predictors. These methods outperform traditional markers like pulse pressure variation, enhancing fluid management strategies in critical care.

A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma

December 28, 2024 No Comments

This article presents a rare case of a 33-year-old woman with a left atrial myxoma, a benign cardiac tumor, causing bilateral lower limb ischemia due to systemic embolization. The patient’s myxoma, identified as the source of emboli, was successfully excised through open-heart surgery. The case underscores the critical need for timely surgical intervention to prevent potentially fatal complications such as stroke. Postoperative outcomes were excellent, with the patient resuming normal activities.

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

December 21, 2024 No Comments

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

December 3, 2024 No Comments

A conceptual representation of the “Five Pillars” framework for aRHF therapy. The image shows five pillars, each labeled with key aspects: Etiological Treatment, Hemodynamic Support, Ventilation, Fluid Optimization, and Mechanical Support. A heart is balanced on top of these pillars, symbolizing stability. The design is clean and professional, with subtle arrows indicating the interconnectedness of the pillars.

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Limiting the Gamble: Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

Perfusion Instability During Hyperthermic Intraperitoneal Chemotherapy: The Utility of a Problem-solving Flowchart

Kidney Injury Under Diminished Pulsatile Flow Induced by V-A ECMO in Sheep

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

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