Publications by authors named "Binfei Li"

16 Publications

  • Page 1 of 1

Nomogram to predict survival outcome of patients with veno-arterial extracorporeal membrane oxygenation after refractory cardiogenic shock.

Postgrad Med 2021 May 20:1-10. Epub 2021 May 20.

Department of Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Gaozhou, Guangdong, China.

: This study aims to develop a nomogram model to predict the survival of refractory cardiogenic shock (RCS) patients that received veno-arterial extracorporeal membrane oxygenation (VA-ECMO).: A total of 235 and 209 RCS patients were supported with VA-ECMO from January 2018 to December 2019 in Guangdong Provincial People's Hospital, and from January 2020 to December 2020 in four third-grade and class-A hospitals were a development cohort (DC) and validation cohort (VC), respectively. Finally, 137 and 98 patients were included in the DC and VC. Multivariate logistic regression analysis was used to identify variables, and only these independent risk factors were used to establish the nomogram model. The receiver operating characteristic curve (ROC), calibration plot, decision curve, and clinical impact curves were used to evaluate the nomogram's discriminative ability, predictive accuracy, and clinical application value.: Pre-ECMO cardiogenic arrest (pre-ECA), lactate (Lac), inotropic score (IS), and modified nutrition risk in the critically ill score (mNUTRIC score) were incorporated into the nomogram. This showed good discrimination in the DC, with an area under ROC (AUROC) and a 95% confidence interval (CI) of 0.959 (0.911-0.986). The AUROC (95% CI) of the VC was 0.928 (0.858-0.971). The calibration plots of the DC and VC presented good calibration results. The decision curve and clinical impact curve of the nomogram provided improved benefits for RCS patients.: This study established a prediction nomogram composed of pre-ECA, Lac, IS, and mNUTRIC scores that could help clinicians to predict the survival probability at hospital discharge precisely and rapidly for RCS patients that received VA-ECMO.
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http://dx.doi.org/10.1080/00325481.2021.1925562DOI Listing
May 2021

A Case Report of Sedation Strategy for a Patient With Coronavirus Disease 2019 Supported by Extracorporeal Membrane Oxygenation After Cesarean Section.

Heart Surg Forum 2021 01 14;24(1):E019-E021. Epub 2021 Jan 14.

Department of Anesthesiology, Zhongshan City People's Hospital, Zhongshan, China.

Pneumonia caused by coronavirus disease 2019 (COVID-19) is a highly contagious disease. Unfortunately, research on extracorporeal membrane oxygenation (ECMO) assisted treatments for patients with COVID-19 infection is limited. In this case study, a patient who was in late pregnancy (35+2 weeks of pregnancy) and suffering from severe COVID-19 was extremely irritable during ECMO-assisted treatment after she underwent a cesarean section. Her Richmond Agitation Sedation Scale (RASS) score reached +3. Nevertheless, the patient successfully was treated with a continuous single/combined application of propofol, midazolam, dexmedetomidine, hibernation mixture, and other drugs for several days (maintaining RASS -2 to -4) and provided with anti-infection, mechanical ventilation, nutritional support, fluid balance under hemodynamic monitoring, liver support, and other organ function support treatments. ECMO-assisted sedation strategy for patients was introduced and discussed in this case to provide a certain reference for the clinical diagnosis and treatment of such patients.
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http://dx.doi.org/10.1532/hsf.3459DOI Listing
January 2021

First successful treatment of a COVID-19 pregnant woman with severe ARDS by combining early mechanical ventilation and ECMO.

Heart Lung 2021 Jan - Feb;50(1):33-36. Epub 2020 Aug 21.

Department of Cardiovascular Center, Zhongshan People's Hospital, Zhongshan 528403, PR China. Electronic address:

The novel coronavirus (COVID-19) has become a global pandemic outbreak. Patients with COVID-19 are prone to progress to acute respiratory distress syndrome (ARDS), and even severe ARDS with ineffective mechanical ventilation, and an extremely high mortality. Extracorporeal membrane oxygenation (ECMO) provides effective respiratory support and saves time for the treatment of severe COVID-19. The present study reports that a 31-year-old pregnant female infected by COVID-19, who suffered from fever, dyspnea, and rapid ARDS. The patient's pulmonary function gradually recovered by combining early mechanical ventilation and ECMO, and finally, this patient was successfully weaned from ECMO and the ventilator. No fibrosis lesions were found in the chest CT, and the patient recovered very well after leaving from the hospital for one month.
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http://dx.doi.org/10.1016/j.hrtlng.2020.08.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441876PMC
December 2020

Investigation of the Effect of Nanoparticle-Stabilized Foam on EOR: Nitrogen Foam and Methane Foam.

ACS Omega 2020 Aug 23;5(30):19092-19103. Epub 2020 Jul 23.

School of Petroleum Engineering, China University of Petroleum (East China), Qingdao 266580, China.

In recent years, studies conducted on foam stabilization have focused on nanoparticles by generating strong adsorption at the interface to stabilize the foam under harsh reservoir conditions. Meanwhile, the selection of a gas source is also of great importance for foam performance. In this study, a mixed system of surfactants was selected, and the foamability and foam stability of nitrogen and methane were evaluated according to the improved jet method. After adding modified SiO nanoparticles, the foam-related parameters were analyzed. The plugging abilities of the different foams were compared through core-flooding experiments, and the oil displacement effects of the different foams were compared through microfluidic experiments. The results show that the amphoteric surfactant betaine has an excellent synergistic effect on the anionic surfactant SDS. The methane foam produced using the jet method has a larger initial volume than the nitrogen foam, but its stability is poor. The half-life of the nitrogen foam is about two times that of the methane foam. After adding 1.0 wt % SiO nanoparticles to the surfactant solution, the viscosity and stability of the formed foam improve. However, the maximum viscosity of the surfactant nanoparticle foam (surfactant-NP foam) is 53 mPa·s higher than that of the surfactant foam. In the core-flooding experiment, the plugging performance of the methane foam was worse than that of the nitrogen foam, and in the microfluidic experiment, the oil displacement abilities of the methane foam and the nitrogen foam were similar. The plugging performance and the oil displacement effect of the foam are greatly improved by adding nanoparticles. The surfactant-NP foam flooding has a better oil displacement effect and can enhance the recovery factor by more than 30%. Under actual high-pressure reservoir conditions, although the stability of the methane foam is weaker than that of the nitrogen foam, some methane may be dissolved in the crude oil to decrease the viscosity after the foam collapses, which leads to the methane foam being the preferred method in oilfields.
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http://dx.doi.org/10.1021/acsomega.0c02434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408255PMC
August 2020

Vascular Complications of Lower Limb Ischemia in Patients with Femoral Venoarterial Extracorporeal Membrane Oxygenation.

Heart Surg Forum 2020 May 14;23(3):E305-E309. Epub 2020 May 14.

Department of Cardiology, Zhongshan City People's Hospital, Zhongshan, China.

Background: Lower limb ischemia in patients with extracorporeal membrane oxygenation (ECMO) via femoral artery catheterization negatively affects patient mortality and survivors' quality of life [Gulkarov 2020]. In this study, ECMO was established via femoral artery catheterization. This study aimed to identify the risk factors of lower limb ischemia to provide sufficient evidence for its prevention.

Methods: All patients with venoarterial (VA) ECMO via femoral artery catheterization in Zhongshan People's Hospital from January 2008 to November 2019 retrospectively were analyzed. Patients' general information and ECMO-related information were obtained, and the main outcome variables were survival and discharge and intubation-related adverse events (limb ischemia and incision bleeding). Logistic regression analysis was used to determine the independent risk factors of limb ischemia in patients with VA ECMO.

Results: A total of 179 (98 [54.7%] men and 81 [45.3%] women) eligible patients were included in this study. Moreover, a total of 90 patients (48.9%) had low cardiac output, 41 (22.3%) had acute myocardial infarction, and 33 (17.9%) had fulminant myocarditis. Eighty-six (48.04%) patients survived to hospital discharge, 36 (20.11%) had limb ischemia, and 42 (23.46%) had incision bleeding. Furthermore, the ECMO-assisted time was 114.23 ± 67.88 hours. There was no significant difference in age, sex, and Sequential Organ Failure Assessment score between the limb ischemia group and the non-limb ischemia group. Multivariate logistic regression analysis showed that peripheral artery disease (odds ratio, 27.12; 95% confidence interval, 5.614-130.96) was an independent risk factor of limb ischemia in patients with ECMO.

Conclusion: Limb ischemia is a common complication in patients with VA ECMO, and peripheral artery disease is an independent risk factor of limb ischemia in patients with VA ECMO via femoral artery catheterization.
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http://dx.doi.org/10.1532/hsf.2969DOI Listing
May 2020

Application of Extracorporeal Membrane Oxygenation in Patients with Scrub Typhus Complicated with Acute Respiratory Distress Syndrome.

Heart Surg Forum 2020 03 31;23(2):E183-E186. Epub 2020 Mar 31.

Department of Extracorporeal Membrane Oxygenation Laboratory, Zhongshan City People's Hospital, Zhongshan, China.

A 68-year-old woman was diagnosed with scrub typhus and acute pneumonia. Acute respiratory distress syndrome (ARDS) occurred on day 4 after admission and was treated with extracorporeal membrane oxygenation (ECMO). After 7 days of ECMO assistance, her respiratory condition gradually improved, and ECMO was removed. On day 20 after admission, she was discharged without any sequelae. The results suggest that ECMO should be considered as early as possible for patients with ARDS caused by scrub typhus.
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http://dx.doi.org/10.1532/hsf.2827DOI Listing
March 2020

Extracorporeal membrane oxygenation in patients with heart transplantation : A clinical prognosis analysis.

Herz 2020 Dec 13;45(8):739-744. Epub 2019 Aug 13.

Departments of Cardiology, Zhongshan City People's Hospital, Zhongshan, China.

Background: Extracorporeal membrane oxygenation (ECMO) is indicated for bridging to heart transplantation, graft failure, and right heart failure after heart transplantation. This study explored risk factors affecting the clinical prognosis of cardiac transplantation patients treated with ECMO during the perioperative period.

Methods: Data on 28 heart transplantation patients with ECMO obtained from January 2012 to January 2018 in the People's Hospital of Zhongshan City were retrospectively analyzed.

Results: A total of 25 patients (20 male and 5 female) were finally included. Heart transplantation was performed mainly due to cardiomyopathy (77.8%). Of the treated patients, 18 (72%) survived and were discharged, 4 were treated with cardiopulmonary resuscitation (CPR) before ECMO, and 3 died in hospital. There were no differences between the surviving and death group donors (N-terminal pro b‑type natriuretic peptide [NT-proBNP], creatine kinase-muscle/brain [CK-MB], warm ischemia time of donated heart, cold ischemia time of donated heart, total ischemia time of donated heart, and donor type). In univariate analysis, body mass index (BMI), length of stay in the intensive care unit (ICU), and CPR were relevant prognostic factors for heart transplantation patients with ECMO. Multi-factor logistic regression showed that CPR before ECMO (odds ratio, OR, 49.45; 95% confidence interval, CI, [1.37, 1781.6]; P = 0.033) is an independent risk factor influencing prognosis.

Conclusion: ECMO is an important life support method for patients before and after heart transplantation surgery. Obesity, poor preoperative cardiac function, and considerable intraoperative red blood cell transfusion may influence prognosis. Extracardiac compression before ECMO is an independent risk factor for prognosis.
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http://dx.doi.org/10.1007/s00059-019-04843-9DOI Listing
December 2020

[The first case of severe avian influenza A (H7N9) in Guangdong Province in 2018 successfully treated with extracorporeal membrane oxygenation].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Dec;30(12):1200-1201

Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan 528400, Guangdong, China. Corresponding author: Li Jianwei, Email:

Objective: Human infection with avian influenza A (H7N9) is easy to induce severe acute respiratory distress syndrome (ARDS), and traditional mechanical ventilation cannot correct hypoxemia, so patients may die from multiple organ failure (MOF) caused by persistent hypoxia. Extracorporeal membrane oxygenation (ECMO) can provide effective respiratory support and win time for the treatment of severe H7N9. The first case of severe H7N9 in Guangdong Province in 2018 was admitted to Zhongshan Hospital Affiliated to Sun Yat-sen University. The case was insult with severe ARDS caused by H7N9, the traditional mechanical ventilation could not correct hypoxemia, and the lung condition gradually improved with ECMO assistance. After 13 days of ECMO support, the patient was successfully weaned from ECMO and was transferred to a general ward after 55 days. After 102 days of rehabilitation, the patient was discharged from hospital and followed up for 2 months, who was in good health and had a good quality of life. This article states the diagnosis and treatment of severe H7N9 in details, providing experience for the treatment of severe H7N9 in the future.
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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2018.012.019DOI Listing
December 2018

Analysis of Nosocomial Infections in Post-Cardiac Surgery Extracorporeal Membrane Oxygenation Support Therapy.

Heart Surg Forum 2018 Sep 17;21(5):E387-E391. Epub 2018 Sep 17.

Department of Examination Medical Center, Zhongshan Affiliated Hospital, Sun Yat-sen University, Zhongshan, Guangdong, China.

Objectives: This study aims to analyze the nosocomial infection factors in post-cardiac surgery extracorporeal membrane oxygenation (ECMO) supportive treatment (pCS-ECMO).

Methods: The clinical data of the pCS-ECMO patients who obtained nosocomial infections (NI) were collected and analyzed retrospectively. Among the 74 pCS-ECMO patients, 30 occurred with NI, accounting for 40.5%; a total of 38 pathogens were isolated, including 22 strains of Gram-negative bacteria (57.9%), 15 strains of Gram-positive bacteria (39.5%), and 1 fungus (2.6%).

Results: Multidrug-resistant strains were highly concentrated, among which Acinetobacter baumannii and various coagulase-negative staphylococci were the main types; NI was related to mechanical ventilation time, intensive care unit (ICU) residence, ECMO duration, and total hospital stay, and the differences were statistically significant (P < .05). The binary logistic regression analysis indicated that ECMO duration was a potential independent risk factor (OR = 0.992, P = .045, 95.0% CI = 0.984-1.000).

Conclusions: There existed significant correlations between the secondary infections of pCS-ECMO and mechanical ventilation time, ICU residence, ECMO duration, and total hospital stay; therefore, hospitals should prepare appropriate preventive measures to reduce the incidence of ECMO secondary infections.
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http://dx.doi.org/10.1532/hsf.1789DOI Listing
September 2018

Analysis of the risk factors of acute kidney injury in patients receiving extracorporeal membrane oxygenation
.

Clin Nephrol 2018 Oct;90(4):270-275

Background: Acute kidney injury (AKI) during extracorporeal membrane oxygenation (ECMO) affects the prognosis of patients. In the present study, we explored the risk factors for AKI through a retrospective analysis of relevant data of patients undergoing ECMO with AKI.

Materials And Methods: Retrospective analysis was performed on patients with AKI who were receiving ECMO. Patient data, including preoperative basic conditions, related clinical conditions during ECMO, and complications, were collected. The patients were divided into two groups according to the occurrence of AKI. For the determination of the ECMO-independent risk factors of AKI, risk factors that may affect AKI and those that affected AKI were selected through single-factor analysis and logistic regression analysis, respectively.

Results: Of the 170 cases included in this study, 91 had AKI (53.5%) as indicated by the single-factor analysis results. CPR before ECMO, high lactic acid levels before ECMO, high inotropic equivalents, large amounts of red blood cells, plasma and platelet transfusion, high C-reactive protein levels, high brain natriuretic peptide levels during ECMO, and a long period of ECMO support were all associated with AKI patients. Multiple-factor analysis results revealed that high lactic acid levels before ECMO (OR 2.96, 95% CI (1.38, 6.34); p = 0.005) and high inotropic equivalents during ECMO (OR 3.17, 95% CI (1.52, 6.61); p = 0.002) were independent risk factors of AKI in patients with ECMO.

Conclusion: A high incidence of AKI was observed in patients with ECMO, and large doses of positive inotropic drugs and high lactic acid levels were independent risk factors of the disease in patients with ECMO.
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http://dx.doi.org/10.5414/CN109477DOI Listing
October 2018

Wall slipping behavior of foam with nanoparticle-armored bubbles and its flow resistance factor in cracks.

Sci Rep 2017 07 11;7(1):5063. Epub 2017 Jul 11.

College of Petroleum Engineering, China University of Petroleum, Qingdao, 266580, Shandong, China.

In this work, wall slipping behavior of foam with nanoparticle-armored bubbles was first studied in a capillary tube and the novel multiphase foam was characterized by a slipping law. A crack model with a cuboid geometry was then used to compare with the foam slipping results from the capillary tube and also to evaluate the flow resistance factor of the foam. The results showed that the slipping friction force F in the capillary tube significantly increased by addition of modified SiO nanoparticles, and an appropriate power law exponents by fitting F vs. Capillary number, Ca, was 1/2. The modified nanoparticles at the surface were bridged together and formed a dense particle "armor" surrounding the bubble, and the interconnected structures of the "armor" with strong steric integrity made the surface solid-like, which was in agreement with the slip regime associated with rigid surface. Moreover, as confirmed by 3D microscopy, the roughness of the bubble surface increased with nanoparticle concentration, which in turn increased the slipping friction force. Compared with pure SDBS foam, SDBS/SiO foam shows excellent stability and high flow resistance in visual crack. The resistance factor of SiO/SDBS foam increased as the wall surface roughness increased in core cracks.
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http://dx.doi.org/10.1038/s41598-017-05441-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506061PMC
July 2017

Risk factors for nosocomial infections in patients receiving extracorporeal membrane oxygenation supportive therapy.

Med Clin (Barc) 2017 Nov 22;149(10):423-428. Epub 2017 Jun 22.

Department of Examination Medical Center, Zhongshan Affiliated Hospital, Sun Yat-sen University, Zhongshan, Guangdong, China.

Background And Objective: The aim of this study was to analyze risk factors for nosocomial infection (NI) in patients receiving extracorporeal membrane oxygenation (ECMO) support.

Patients And Methods: Clinical NI data were collected from patients who received ECMO support therapy, and analyzed retrospectively.

Results: Among 75 ECMO patients, 20 were found to have developed NI (infection rate 26.7%); a total of 58 pathogens were isolated, including 43 strains of gram-negative bacteria (74.1%) and 15 strains of gram-positive bacteria (25.9%). Multi-drug resistant strains were highly concentrated and were mainly shown to be Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Incidence of NI was related to the duration of ECMO support therapy and the total length of hospital stay, and the differences were statistically significant (P<.05). A prolonged period of ECMO support extended the hospital stay, but it did not increase the mortality rate. However, an elevated level of lactic acid increased the mortality rate in this study population.

Conclusions: ECMO-associated secondary NIs correlated significantly with the length of hospital stay and with the duration of ECMO support. Therefore, to reduce the incidence of ECMO-associated NIs, preventive strategies that aim to shorten the duration of ECMO support therapy and avoid lengthy hospitalization should be applied, wherever possible.
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http://dx.doi.org/10.1016/j.medcli.2017.03.038DOI Listing
November 2017

Clinical Outcomes in Pediatric Patients Hospitalized with Fulminant Myocarditis Requiring Extracorporeal Membrane Oxygenation: A Meta-analysis.

Pediatr Cardiol 2017 Feb 23;38(2):209-214. Epub 2016 Nov 23.

Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.

We conducted a meta-analysis to provide the survival rates for pediatric patients hospitalized with fulminant myocarditis requiring ECMO. The literature search was conducted using Embase, PubMed, MEDLINE and Elsevier for studies published before April 1, 2016. We focus on survival rates for pediatric patients hospitalized with fulminant myocarditis requiring ECMO, and studies that reported only on adult patients were excluded. Summary of the survival rates was obtained using fixed-effect or random-effect meta-analysis which determined by I . Six studies were included in the analysis, encompassing 172 patients. The minimum and maximum reported rates of survival to hospital discharge were 53.8 and 83.3%, respectively. The cumulative rate was 107/172. The calculated Cochran Q value was 3.73, which was not significant for heterogeneity (P = 0.588). The I value was 0%. The pooled estimate rate was 62.9% with a 95% confidence interval of 55.3-69.8%. In pediatric patients with cardiac failure who have failed conventional therapies in FM, venoarterial ECMO should be considered. In total, 62.9% of patients with FM and either cardiogenic shock and/or cardiac arrest survived to hospital discharge with ECMO.
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http://dx.doi.org/10.1007/s00246-016-1517-1DOI Listing
February 2017

[Extracorporeal membrane oxygenation for treatment of fulminant myocarditis in patient suffering from dengue fever: a report of 1 case].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2015 Apr;27(4):317-8

Department of Critical Care Medicine, Zhongshan Hospital Affiliated to Zhongshan University, Zhongshan 528403, Guangdong, China.

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http://dx.doi.org/10.3760/cma. j. issn.2095-4352.2015.04.022DOI Listing
April 2015

[Suggestion of carrying out extracorporeal membrane oxygenation in China].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2014 Nov;26(11):769-72

Adult Chest Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2014.11.001DOI Listing
November 2014

[Effect of ulinastatin for hepatoprotection following extracorporeal membrane oxygenation].

Nan Fang Yi Ke Da Xue Xue Bao 2012 Oct;32(10):1511-2

Department of Anesthesiology, Zhongshan People's Hospital, Zhongshan, China.

Objective: To explore the effect of ulinastatin in hepatoprotection following extracorporeal membrane oxygenation (ECMO).

Methods: Forty patients with ECMO were randomized into two groups to receive ulinastatin treatment or not. Venous blood samples were collected to test ALT and AST levels following ECMO treatment for 12, 24 and 48 h.

Results: The two groups showed no significant difference in liver function indices before ECMO treatment. In both groups, the liver function worsened significantly after a 12-h ECMO treatment, but improved gradually after 24 h. The liver function damages were obviously lessened in ulinastatin group compared to those in patients without ulinastatin treatment (P<0.05). ECMO treatment significantly improved the liver function of the patients.

Conclusion: ECMO can significantly improve the liver function. The liver function damage reaches the peak level after a 12-h ECMO treatment, and ulinastatin can protect the liver function in patients undergoing ECMO.
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October 2012