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ASAIO J 2022 May 20. Epub 2022 May 20.

Neurocritical Care Division, Departments of Neurology, Neurosurgery, and Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Extracorporeal membrane oxygenation (ECMO) is an increasingly utilized intervention for cardiopulmonary failure. Analgosedation during ECMO support is essential to ensure adequate pain and agitation control and ventilator synchrony, optimize ECMO support, facilitate patient assessment, and minimize adverse events. Although the principles of analgosedation are likely similar for all critically ill patients, ECMO circuitry alters medication pharmacodynamics and pharmacokinetics. Read More

ASAIO J 2022 May 20. Epub 2022 May 20.

Division of Cardiac Surgery, Associate Professor, Northern Ontario School of Medicine; Health Sciences North, Sudbury, Ontario, P3E 5J1.

Intra-aortic balloon pump (IABP) technology is an established treatment modality for patients with acute cardiac failure. Advances in IABP technology have simplified use and reliability such that electromechanical malfunctions are relatively rare. We present a case of an unanticipated pressure output signal from a powered off Cardiosave IABP console resulting in an erroneous mean arterial blood pressure waveform being displayed during cardiopulmonary bypass. Read More

ASAIO J 2022 May 20. Epub 2022 May 20.

Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

ASAIO J 2022 May 16. Epub 2022 May 16.

From the Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia.

Veno-venous extracorporeal membrane oxygenation (ECMO) support surged during the COVID-19 pandemic. Our program changed the model of care pursuing to protect the multidisciplinary team from the risk of infection and to serve as many patients as possible. Patient-healthcare interactions were restricted, and the ECMO bed capacity was increased by reducing the ECMO specialist-patient ratio to 1:4 with non-ECMO trained nurses support. Read More

ASAIO J 2022 May 13. Epub 2022 May 13.

Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain.

ASAIO J 2022 May 7. Epub 2022 May 7.

Section of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.

Predicting outcomes in open-heart surgery can be challenging. Unexpected readmissions, long hospital stays, and mortality have economic implications. In this study, we investigated machine learning (ML) performance in data visualization and predicting patient outcomes associated with open-heart surgery. Read More

ASAIO J 2022 May 7. Epub 2022 May 7.

UCMC Department of Anesthesia and Critical Care.

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, Kentucky.

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Biomarkers of cardiac dysfunction may aid in decision making about organ recovery and optimal timing of separation from extracorporeal membrane oxygenation (ECMO). We conducted a prospective observational study of children from 0 to <18 years who underwent ECMO between 7/2010 and 6/2015 in a single center. In this pilot study, we aimed to determine whether Suppression of tumorigenicity 2 (ST2), N-terminal pro-B-type natriuretic peptide (NT-proBNP), galectin-3, and endostatin were associated with ability to separate from ECMO. Read More

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Patients undergoing explantation of left ventricular assist devices (LVADs) after improvement of myocardial function remain a minority. Nevertheless, considering the growing population of LVAD patients, increasing demand for new explantation strategies is expected. Herein, we present a retrospective review of seven patients undergoing HeartMate3 explantation with the use of a custom-made apical ring plug in four medical centers. Read More

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Heart Failure and Transplant Unit, Cardiology Department, St Vincent's Hospital, Sydney, Australia.

Durable continuous-flow left ventricular assist devices (cfLVADs) demonstrate superior survival, cardiac functional status, and overall quality of life compared to medical therapy alone in advanced heart failure. Previous studies have not considered the impact arterial compliance may have on pump performance or developed arterial pressure. This study assessed the impact of alterations in arterial compliance, preload, and afterload on continuous-flow pump function and measured hemodynamics using an in-vitro pulsatile mock circulatory loop. Read More

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Department of Cardiac Surgery, Cedars-Sinai Medical Center.

In patients with severe cardiogenic shock, temporary mechanical circulatory support has become a viable strategy to bridge patients to heart transplantation. However, end-stage heart failure is often associated with progressive organ dysfunction of the liver or kidney. This can require a dual organ transplant for definitive management (combined heart-liver [HL] or heart-kidney [HK] transplantation). Read More

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Anesthesia and Intensive Care Unit, Bufalini Hospital - AUSL della Romagna, Cesena, Italy.

ASAIO J 2022 May 7. Epub 2022 May 7.

From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Coronavirus disease 2019 (COVID-19) has increased the demand for extracorporeal membrane oxygenation (ECMO) and introduced distinct challenges to patient selection for ECMO. Standardized processes for patient selection amidst resource limitations are lacking, and data on ECMO consults are underreported. We retrospectively reviewed consecutive adult ECMO consults for acute respiratory failure received at a single academic medical center from April 1, 2020, to February 28, 2021, and evaluated the implementation of a multidisciplinary selection committee (ECMO Council) and standardized framework for patient selection for ECMO. Read More

ASAIO J 2022 Feb 1. Epub 2022 Feb 1.

New York Proton Center, New York, New York, U.S.A.

ASAIO J 2022 May 5. Epub 2022 May 5.

From the Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Refractory hypoxemia despite the use of extracorporeal membrane oxygenation (ECMO) for coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome remains a challenging problem. A single ECMO circuit may not provide adequate physiologic support in the setting of an elevated cardiac output, physiologic demand, and impaired gas exchange. In select patients with refractory hypoxemia, addition of a second ECMO circuit in parallel can improve oxygenation, facilitate lung protective ventilation, awakening, and physical rehabilitation. Read More

ASAIO J 2022 May 6;68(5):e84-e86. Epub 2021 May 6.

Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.

A 77 year old man previously implanted with a HeartMate II left ventricular assist device (LVAD) as destination therapy and an implantable cardioverter defibrillator presented with a left upper lobe squamous cell lung cancer. Oncology determined that proton beam therapy was indicated for treatment, and a multidisciplinary team of radiation physicists, radiation oncologists, and LVAD providers developed a protocol to proceed safely. He was successfully treated with combined proton beam radiation therapy and reduced dose chemotherapy. Read More

ASAIO J 2022 May 6;68(5):e73-e76. Epub 2021 May 6.

Department of Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut.

ASAIO J 2022 May 16;68(5):654. Epub 2021 Aug 16.

ASAIO J 2022 Apr 29. Epub 2022 Apr 29.

Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York.

ASAIO J 2022 Apr 21. Epub 2022 Apr 21.

From the Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany.

Isolated right ventricular failure presents a rare pathology and heart transplantation remains the treatment of choice. Because of the shortage of donor organs, alternative treatment options are required. However, current continuous-flow ventricular assist devices are designed and approved only for left ventricular support and right ventricular implantation usually presents a procedure of last resort. Read More

ASAIO J 2022 05 26;68(5):730-731. Epub 2022 Apr 26.

From the Department Cardiovascular and Thoracic Surgery, University of Louisville.

ASAIO J 2022 Apr 21. Epub 2022 Apr 21.

Marmara University Pendik Training and Research Hospital, Department of Cardiovascular Surgery.

Hypoxemic arrests due to severe traumatic pulmonary injury may not respond to usual medical support. Extracorporeal life support (ECLS) can be life-saving; adequate flows are needed in this setting along with a careful choice of anticoagulation strategies to minimize bleeding. A 44-month-old child, who presented with severe blunt chest trauma after being run over by a truck was resuscitated with active compressions and code medications 7 times before arrival to the intensive care unit. Read More

ASAIO J 2022 Apr 22. Epub 2022 Apr 22.

From the Department of Pediatric Critical Care, Harbor-UCLA Medical Center, Torrance, California.

Both overfeeding and underfeeding critically ill children are problematic. This prospective pilot study evaluated the resting energy expenditure in infants and children requiring extracorporeal membrane oxygenation (ECMO) support. An indirect calorimeter was used to measure oxygen consumption (VO2) and carbon dioxide production (VCO2) from the mechanical ventilator. Read More

ASAIO J 2022 Apr 21. Epub 2022 Apr 21.

Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada.

Extracorporeal life support (ECLS) is a high-risk, lifesaving medical treatment that is typically limited to centers that can support a comprehensive ECLS program. Rescue programs can bridge the gap in care between ECLS centers and other tertiary pediatric centers without cardiac surgical and comprehensive ECLS support. We describe how our pediatric center without cardiac surgery successfully partnered with an established ECLS center to develop a Rescue ECLS Cannulation Program. Read More

ASAIO J 2022 Apr 21. Epub 2022 Apr 21.

Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.

Extracorporeal membrane oxygenation (ECMO) in acute respiratory distress syndrome (ARDS) is used to achieve oxygenation and protect lung ventilation. Near infrared spectroscopy (NIRS) measures cerebral regional tissue oxygenation (rSO2) and may contribute to patient safety during interhospital transport under ECMO support. We evaluated 16 adult ARDS patients undergoing interhospital ECMO transport by measuring cerebral rSO2 before and after initiation of ECMO support and continuously during transport. Read More

ASAIO J 2022 May 22;68(Suppl 1):1-64. Epub 2022 Apr 22.

ASAIO J 2022 Apr 15. Epub 2022 Apr 15.

From the Division of Pediatric Critical Care Medicine, Washington University School of Medicine, St Louis, Missouri.

ASAIO J 2022 Apr 15. Epub 2022 Apr 15.

From the Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Histiocytoid cardiomyopathy (HICMP) is a rare mitochondrial cardiomyopathy associated with recurrent life-threatening arrhythmias and variable degrees of systolic dysfunction. Successful heart transplantation for HICMP has been described, but there has been no published experience with biventricular assist device (BiVAD) support for intractable arrhythmias in HICMP. We report a 13 month old girl with left ventricular noncompaction and preserved systolic function who presented in cardiogenic shock secondary to incessant ventricular arrhythmias. Read More

ASAIO J 2022 Apr 15. Epub 2022 Apr 15.

Department of Anesthesiology, Oklahoma University College of Medicine, Oklahoma City, OK USA.