17,040 results match your criteria Extracorporeal Membrane Oxygenation

Clinical value of electrical impedance tomography (EIT) in the management of patients with acute respiratory failure: a single centre experience.

Physiol Meas 2021 Jun 24. Epub 2021 Jun 24.

Universita degli Studi di Milano-Bicocca, Milano, Lombardia, ITALY.

to describe our clinical experience using Electrical Impedance Tomography (EIT) in the management of mechanical ventilation in patients with acute respiratory failure and to determine to which extent EIT-guided PEEP setting differed from clinically set values.a retrospective, observational cohort study performed in a hub centre for the treatment of acute respiratory failure and veno-venous Extracorporeal Membrane Oxygenation (ECMO).between January 2017 and December 2019, EIT was performed 54 times in 41 patients, not feasible only in one case because of signal instability. Read More

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Achieving Safe Liberation During Weaning from VV-ECMO in Patients with Severe ARDS: The role of Tidal Volume and Inspiratory Effort.

Chest 2021 Jun 16. Epub 2021 Jun 16.

Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada; Extracorporeal Life Support Program, Toronto General Hospital, Canada. Electronic address:

Background: Weaning from venovenous extracorporeal membrane oxygenation (VV-ECMO) is not well studied. VV-ECMO can be discontinued when patients tolerate non-injurious mechanical ventilation (MV) during a sweep gas off trial (SGOT). However, predictors of safe liberation are unknown. Read More

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Safety and Feasibility of a Protocolized Daily Assessment of Readiness for Liberation from Venovenous Extracorporeal Membrane Oxygenation.

Chest 2021 Jun 16. Epub 2021 Jun 16.

Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center.

Background: Decannulation from venovenous extracorporeal membrane oxygenation (VV-ECMO) at the earliest and safest possible time may improve outcomes and reduce cost. Yet, there are no prospective studies comparing weaning strategies for liberation from ECMO.

Research Question: Is a protocolized daily assessment of readiness to liberate from VV-ECMO safe and feasible?

Study Design And Methods: We conducted a prospective, single-arm, safety and feasibility study of a protocol for daily assessment of readiness to liberate from VV-ECMO among consecutive adult patients receiving VV-ECMO across four intensive care units at a single center between June 20, 2020 and November 24, 2020. Read More

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Impact of early nutrition route in patients on extracorporeal membrane oxygenation: A retrospective cohort study.

JPEN J Parenter Enteral Nutr 2021 Jun 24. Epub 2021 Jun 24.

Intensive Care Unit of Cardiothoracic Surgery, Anesthesia and Critical Care Department, Hôpital Nord Laennec, Centre Hospitalier Universitaire de Nantes, Nantes, France.

Background: Early nutritional management in patients on extracorporeal membrane oxygenation (ECMO) remains controversial. Despite its potentially beneficial effect, enteral nutrition (EN) could be associated with gastrointestinal (GI) complications. Total daily energy (TDE) requirements remain difficult to achieve with ECMO support. Read More

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Successful Treatment of a Critically Ill COVID-19 Patient Using Continuous Renal Replacement Therapy With Enhanced Cytokine Removal and Tocilizumab: A Case Report.

Front Med (Lausanne) 2021 7;8:649583. Epub 2021 Jun 7.

Division of Nephrology, University of Alabama, Birmingham, AL, United States.

The COVID-19 pandemic has caused multiple deaths worldwide. Since no specific therapies are currently available, treatment for critically ill patients with COVID-19 is supportive. The most severe patients need sustained life support for recovery. Read More

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One-Lung Ventilation in a Patient With Necrotizing Pneumonia Complicated by a Bronchopleural Fistula.

Cureus 2021 May 20;13(5):e15138. Epub 2021 May 20.

Internal Medicine, Westside Regional Medical Center, Plantation, USA.

A 32-year-old male with morbid obesity presented to the emergency department with a one-week history of shortness of breath and productive cough. This patient had previously been evaluated at an urgent care facility, diagnosed with pneumonia, and prescribed oral antibiotics. This patient's worsening shortness of breath and productive cough led this patient to seek further care at the emergency department. Read More

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Combined Liver-Lung-Kidney Transplant in a Patient with Cystic Fibrosis.

Am J Case Rep 2021 Jun 24;22:e930867. Epub 2021 Jun 24.

Department of Medicine, Columbia University Irving Medical Center, New York City, NY, USA.

BACKGROUND Individuals with cystic fibrosis (CF) constituted approximately 10% of organ transplants in 2019, with the majority of transplants consisting of bilateral lung transplant. Multiorgan transplantation in individuals with cystic fibrosis (CF) is rare, and usually involves the liver and lung combined. Since kidney disease is not a common sequela of CF, the need for renal transplant in individuals who have not previously undergone lung transplant is uncommon. Read More

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Critical care management of hydrofluoric acid burns with a negative outcome.

BMJ Case Rep 2021 Jun 23;14(6). Epub 2021 Jun 23.

Critical Care Medicine, Peterborough City Hospital, Peterborough, UK.

Hydrofluoric acid is a highly corrosive acid widely used in various industries. When in contact with skin it causes local and systemic reactions due to the generation of fluoride ions. Severe burns are associated with high mortality rates, approaching 100%. Read More

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First case of extracorporeal membrane oxygenation in cardiorespiratory arrest in an emergency room in Brasil: a possible reality?

Rev Assoc Med Bras (1992) 2021 Jan;67(1):29-32

Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo - São Paulo (SP), Brasil.

The extracorporeal membrane oxygenation (ECMO) is a procedure that has been used for a long time in reference centers worldwide. Its fundamental precept is to serve as a bridge to a definitive treatment in patients with severe, but potentially reversible, clinical conditions. Despite this, its use in cardiopulmonary arrest (ECPR) is still a matter of debate, especially when indicated in the emergency department. Read More

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January 2021

Anesthetic management of lung transplantation in a patient with end-stage COVID-19 pneumonia: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26468

Department of Anaesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.

Rationale: The COVID-19 pandemic is spreading around the world and the leading cause of death is rapidly progressive respiratory failure because of lung damage and consolidation. Lung transplantation is the last line of treatment for chronic end-stage lung diseases. There were several cases of lung transplantation reported in patients with COVID-19 pneumonia. Read More

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Utility of echocardiographic right ventricular subcostal strain in critical care.

Eur Heart J Cardiovasc Imaging 2021 Jun 23. Epub 2021 Jun 23.

Department of Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.

Aims: Right ventricular (RV) strain is a known predictor of outcomes in various heart and lung pathologies but has been considered too technically challenging for routine use in critical care. We examined whether RV strain acquired from the subcostal view, frequently more accessible in the critically ill, is an alternative to conventionally derived RV strain in intensive care.

Methods And Results: RV strain data were acquired from apical and subcostal views on transthoracic echocardiography (TTE) in 94 patients (35% female), mean age 50. Read More

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The Ethics of Extracorporeal Membrane Oxygenation: Revisiting the Principles of Clinical Bioethics.

Ann Thorac Surg 2021 Jul 24;112(1):61-66. Epub 2020 Oct 24.

Department of Surgery, Johns Hopkins University, Baltimore, Maryland. Electronic address:

Background: Extracorporeal life support has become accepted as a rescue therapy for cardiopulmonary shock, and there have been over 100,000 extracorporeal membrane oxygenation (ECMO) cases since 1987. Rapid growth has presented ethical challenges and concerns. Here, we discuss core principles of bioethics in an attempt to more thoroughly appreciate the ethical concerns and considerations raised by use of this technology. Read More

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Bronchoscopic interventions for plastic bronchitis in children without structural heart disease.

Eur J Pediatr 2021 Jun 23. Epub 2021 Jun 23.

Division of Pulmonology, Allergy/Immunology, Cystic Fibrosis and Sleep (PACS), Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.

Plastic bronchitis (PB) is a rare and life-threatening complication encountered in several disease states that leads to airway obstruction by branching casts. PB is most often reported in children with cyanotic congenital heart disease where recurrence is common, and mortality is high. There is limited data on optimal management strategies or recurrence of non-structural heart disease-related PB in children. Read More

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Successful treatment of intravenous drug abuser with refractory vasoplegic syndrome after mitral valve repair for infective endocarditis.

SAGE Open Med Case Rep 2021 3;9:2050313X211019788. Epub 2021 Jun 3.

Division of Cardiovascular and Thoracic Anesthesiology, West Virginia University, Morgantown, WV, USA.

Vasoplegic syndrome, a possible complication of cardiopulmonary bypass, is a critical state of unregulated systemic vasodilation with decreased vascular resistance and a pathological insensitivity to conventional inotropes and vasoconstrictors. This case demonstrates the use of methylene blue and hydroxocobalamin as medications in the treatment of refractory vasoplegic syndrome in the context of cardiac surgery due to their differences in mechanism of action. A 24-year-old female with history of intravenous drug abuse and hepatitis C infection underwent mitral valve repair for infective endocarditis. Read More

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Comparison of Surgical Embolectomy and Veno-arterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism.

Semin Thorac Cardiovasc Surg 2021 Jun 19. Epub 2021 Jun 19.

Section of Cardiothoracic Surgery, Westchester Medical Center, New York Medical College.

Massive pulmonary embolism (MPE) is associated with a 20-50% mortality rate with guideline directed therapy. MPE treatment with surgical embolectomy (SE) or venoarterial extracorporeal membrane oxygenation (VA-ECMO) have shown promising results. In the context of a surgical management strategy for MPE, a comparison of outcomes associated with VA-ECMO or SE was performed. Read More

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Implementation of new ECMO centers during the COVID-19 pandemic: experience and results from the Middle East and India.

Intensive Care Med 2021 Jun 22. Epub 2021 Jun 22.

Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

Purpose: Extracorporeal membrane oxygenation (ECMO) use for severe coronavirus disease 2019 (COVID-19) patients has increased during the course of the pandemic. As uncertainty existed regarding patient's outcomes, early guidelines recommended against establishing new ECMO centers. We aimed to explore the epidemiology and outcomes of ECMO for COVID-19 related cardiopulmonary failure in five countries in the Middle East and India and to evaluate the results of ECMO in 5 new centers. Read More

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Extracorporeal Membrane Oxygenation for Septic Shock in Children.

ASAIO J 2021 May 10. Epub 2021 May 10.

From the *ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden †Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

Extracorporeal membrane oxygenation (ECMO) is a rescue treatment used in children and adults with reversible cardiorespiratory failure. The role of ECMO is not fully established in pediatric sepsis. In this retrospective single-center study, we aimed to investigate risk factors and survival in pediatric septic shock supported with peripheral cannulation ECMO. Read More

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Tracheostomy and Long-Term Mechanical Ventilation in Children after Veno-Venous Extracorporeal Membrane Oxygenation.

Pediatr Pulmonol 2021 Jun 22. Epub 2021 Jun 22.

Division of Pediatric Critical Care, Riley Hospital for Children, Indiana University, Indianapolis, IN.

Objective: Our objective is to characterize the incidence of tracheostomy placement and of new requirement for long-term mechanical ventilation after extracorporeal membrane oxygenation (ECMO) among children with acute respiratory failure. We examine whether an association exists between demographics, pre-ECMO and ECMO clinical factors, and the placement of a tracheostomy or need for long-term mechanical ventilation.

Methods: A retrospective multicenter cohort study was conducted at 10 quaternary care pediatric academic centers, including children supported with veno-venous (V-V) ECMO from 2011 to 2016. Read More

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Ankle-brachial index to monitor limb perfusion in patients with femoral venoarterial extracorporeal membrane oxygenation.

J Card Surg 2021 Jun 21. Epub 2021 Jun 21.

Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: Limb ischemia is a major complication of femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO). Use of ankle-brachial index (ABI) to monitor limb perfusion in VA-ECMO has not been described. We report our experience monitoring femoral VA-ECMO patients with serial ABI and the relationships between ABI and near infrared spectroscopy (NIRS). Read More

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The Implementation and Outcomes of a Nurse-Run Extracorporeal Membrane Oxygenation Program, a Retrospective Single-Center Study.

Crit Care Explor 2021 Jun 15;3(6):e0449. Epub 2021 Jun 15.

Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, CA.

Due to a shortage of perfusionists and increasing utilization of extracorporeal membrane oxygenation in the United States, many programs are training nurses as bedside extracorporeal membrane oxygenation specialists (i.e., nurse-run extracorporeal membrane oxygenation). Read More

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Prone position nursing combined with ECMO intervention prevent patients with severe pneumonia from complications and improve cardiopulmonary function.

Am J Transl Res 2021 15;13(5):4969-4977. Epub 2021 May 15.

2A ICU, Shanghai General Hospital Shanghai 201620, China.

Objective: To study the application value of prone nursing combined with extracorporeal membrane oxygenation (ECMO) in patients with severe pneumonia.

Methods: Altogether 96 patients with severe pneumonia from December 2016 to June 2018 were selected as the research participants, and 48 patients were included in the observation group (OG) to receive prone nursing with ECMO, while the other 48 patients were included in the control group (CG) to receive routine nursing with ECMO. Complications, cardiopulmonary function, VAS, SAS, SDS, MMAS-8 scores and nursing satisfaction were compared. Read More

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Extracorporeal membrane oxygenation (ECMO) for acute exacerbations of chronic obstructive pulmonary disease: care modalities, experience, and precautions.

Am J Transl Res 2021 15;13(5):4922-4927. Epub 2021 May 15.

The First Department of Respiratory Medicine, The First People's Hospital of Wenling Wenling 317000, Zhejiang Province, China.

Purpose: The aim of this study was to summarize the care modalities, experiences, and corresponding precautions of ECMO for acute exacerbations of chronic obstructive pulmonary disease (COPD).

Methods: Seventy-three patients with acute exacerbations of COPD were enrolled, of whom 38 were treated with ECMO (experimental group) and 35 received conventional low-flow oxygen therapy, management of metabolic acidosis, infection control, bronchodilators for quick relief from severe spasms, and glucocorticoid-mediated suppression of inflammation (control group). The improvement in the patient's pulmonary ventilation and the incidence of complications were recorded. Read More

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What Are the Best Echocardiographic Parameters to Predict Successful Liberation From Venoarterial Extracorporeal Membrane Oxygenation?

JACC Cardiovasc Imaging 2021 Jun 9. Epub 2021 Jun 9.

Department of Cardiovascular Medicine, Kaufman Center for Heart Failure and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

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Management of high-risk pulmonary embolism in pregnancy.

Thromb Res 2021 Jun 7;204:57-65. Epub 2021 Jun 7.

Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

Pregnancy-associated high-risk pulmonary embolism (PE) is among the most frequent causes of maternal mortality in the Western world, by causing hemodynamic instability and circulatory failure through a large thrombotic pulmonary obstruction. The very challenging management of these dramatic situations comprises the need to quickly select a therapy of pulmonary reperfusion or hemodynamic replacement, while taking into account both maternal and fetal risks. In this review, we discuss the role of risk stratification in pregnancy-associated PE and the available evidence to support the use of thrombolysis, catheter-directed thrombectomy/thrombolysis, surgical embolectomy and extracorporeal membrane oxygenation. Read More

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Extracorporeal membrane oxygenation for COVID-19 during first and second waves.

Lancet Respir Med 2021 Jun 16. Epub 2021 Jun 16.

Cardio‑Thoracic Surgery Department, Maastricht University Medical Centre, Maastricht, Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.

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Levosimendan in venoarterial ECMO weaning. Rational and design of a randomized double blind multicentre trial.

ESC Heart Fail 2021 Jun 18. Epub 2021 Jun 18.

Department of Anesthesia and Critical Care, University Hospital of Dijon, Dijon, France.

Aims: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used in circulatory failure. The main indications are cardiogenic shock, post-cardiotomy cardiac failure, and refractory cardiac arrest. However, VA-ECMO weaning is particularly challenging, and weaning failure is reported to be as high as 50%, with increased related mortality. Read More

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Comparison of in-hospital outcomes of patients with vs. without ischaemic cardiomyopathy undergoing veno-arterial-extracorporeal membrane oxygenation.

ESC Heart Fail 2021 Jun 18. Epub 2021 Jun 18.

Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.

Aims: This study aimed to investigate differences in baseline and treatment characteristics, and in-hospital mortality according to the aetiologies of cardiogenic shock in patients undergoing veno-arterial-extracorporeal membrane oxygenation (VA-ECMO).

Methods And Results: The RESCUE registry is a multicentre, observational cohort that includes 1247 patients with cardiogenic shock from 12 centres. A total of 496 patients requiring VA-ECMO were finally selected, and the study population was stratified by cardiogenic shock aetiology [ischaemic cardiomyopathy (ICM, n = 342) and non-ICM (NICM, n = 154)]. Read More

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Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):84-91

Al Khezam Dialysis Center, Al Adan Hospital, Hadiya, Kuwait.

Patients with more severe cases of coronavirus disease-19 (COVID-19) may be at greater risk for developing acute kidney injury (AKI). The aim of our study was to analyze incidence and outcomes of AKI in critically ill patients with COVID-19. Our study prospectively followed about 198 patients with COVID-19 admitted to intensive care unit (ICU), Al Adan Hospital, Kuwait, for developing AKI and outcomes. Read More

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Six-month mortality in patients with COVID-19 and non-COVID-19 viral pneumonitis managed with veno-venous extracorporeal membrane oxygenation.

ASAIO J 2021 Jun 18. Epub 2021 Jun 18.

Department of Adult Intensive Care, Royal Brompton & Harefield Hospitals, part of Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom Division of Anaesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, United Kingdom Department of Anaesthesia, Royal Brompton & Harefield Hospitals, part of Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom Department of Haematology, Royal Brompton & Harefield Hospitals, part of Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom Imperial College Healthcare NHS Foundation Trust, DuCane Road, London, W12 0HS National Heart and Lung Institute, Imperial College London, London, United Kingdom Department of Cardiac Surgery, Royal Brompton & Harefield Hospitals, part of Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom.

A significant proportion of patients with COVID-19 develop acute respiratory distress syndrome (ARDS) with high risk of death. The efficacy of veno-venous extra-corporeal membrane oxygenation (VV-ECMO) for COVID-19 on longer term outcomes, unlike in other viral pneumonias, is unknown. In this study we aimed to compare the 6-month mortality of patients receiving VV-ECMO support for COVID-19 with a historical viral ARDS cohort. Read More

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