14,567 results match your criteria Extracorporeal Membrane Oxygenation


Venous Thromboembolism Events Following Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Syndrome Coronavirus 2 Based on CT Scans.

Crit Care Med 2020 Jun 26. Epub 2020 Jun 26.

Médecine Intensive Réanimation Détresses Respiratoires et Infection Sévères, AP-HM, CHU Nord, Marseille, France.

Objectives: The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagulation variables in patients requiring venovenous extracorporeal membrane oxygenation according to the pathogen.

Design: Retrospective observational analysis at a single center. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCM.0000000000004504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328443PMC

Extracorporeal Membrane Oxygenation During the Coronavirus Disease 2019 Pandemic.

Crit Care Med 2020 Jun 26. Epub 2020 Jun 26.

Department of Medicine; and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA Department of Anesthesia Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCM.0000000000004507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328442PMC

Elevated Venous to Arterial Carbon Dioxide Gap and Anion Gap Are Associated with Poor Outcome in Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation Support.

ASAIO J 2020 Jun 30. Epub 2020 Jun 30.

Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Queensland, Australia.

Optimal management of cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO) is still an evolving area in which assessment and optimization of the microcirculation may be critically important. We hypothesized that the venous arterial carbon dioxide gap (P(v-a)CO2 gap); the ratio of this gap to arterio-venous oxygen content (P(v-a)CO2/C(a-v)O2 ratio) and the anion gap would be early indicators of microcirculatory status and useful parameters for outcome prediction during ECMO support. We retrospectively reviewed 31 cardiogenic shock patients requiring veno-arterial ECMO, calculating P(v-a)CO2 gap and P(v-a)CO2/C(a-v)O2 ratios in the first 36 hours and the final 24 hours of ECMO support. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MAT.0000000000001215DOI Listing

The Covid-19 pandemic seen from the frontline.

Int Braz J Urol 2020 Jun 5;46. Epub 2020 Jun 5.

Emergency Service, Sierrallana Hospital, Cantabria, Spain.

COVID-19 disease caused by infection with the SARS-CoV-2 virus produces respiratory symptoms, predominantly of the upper airways, which can progress to pneumonia after 7 days with persistent fever, cough and dyspnea, and even develop a syndrome of acute respiratory distress (ARDS), multi-organ failure and death. Since COVID-19 disease was declared by the WHO there has been a redistribution of the healthcare system for these types of patients, especially in the front line, which is, in primary care, emergencies and in intensive care units (ICU). In primary care, the fundamental role is the diagnosis of the suspected patients, follow-up mainly by telemedicine (specially telephone calls) to detect warning signs in case of worsening and subsequent referral to the emergency department; as well as explaining home isolation measures. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1590/S1677-5538.IBJU.2020.S123DOI Listing

Mitral valve bio-prosthesis and annuloplasty thrombosis during extracorporeal membrane oxygenation: case series.

Eur Heart J Case Rep 2020 Jun 24;4(3):1-6. Epub 2020 Apr 24.

Department of Cardiology, The Prince Charles Hospital, Chermside, 4032 Brisbane, Australia.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a well-recognized form of haemodynamic support for patients with refractory cardiogenic shock, who are unable to be weaned off cardiopulmonary bypass. Thrombosis or bleeding from cannula sites or surgical wounds are the leading cause of morbidity and mortality in these patients, and presents a delicate balance of anticoagulation during management of patients undergoing circulatory support.

Case Summary: In this case series, we discuss three cases of patients undergoing mitral valve replacements or repair with thrombosis of their new bio-prosthesis in the immediate post-operative setting. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjcr/ytaa085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319831PMC

Massive Pulmonary Embolism as a Cause of Cardiac Arrest: Navigating Unknowns in Life After Death.

Cureus 2020 May 30;12(5):e8361. Epub 2020 May 30.

Physical Medicine and Rehabilitation, Memorial Regional Hospital / Nova Southeastern University-Dr. Kiran C. Patel College of Osteopathic Medicine (KPCOM), Hollywood, USA.

Pulmonary embolism (PE) is a common diagnosis with a low associated mortality rate. More critical variants, such as massive PE, also known as fulminant PE, are characterized by severe hemodynamic instability and have a markedly higher mortality rate. These variants can later develop in previously low to intermediate-risk patients and precipitate cardiac arrest within hours of symptom onset. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.8361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325409PMC

E-cigarette, or vaping, product use-associated lung injury (EVALI) treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO) and ultra-protective ventilator settings.

BMJ Case Rep 2020 Jul 2;13(7). Epub 2020 Jul 2.

Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, USA.

A 19-year-old man vaping with tetrahydrocannabinol presented with dyspnoea and right pneumothorax. History, imaging and negative infectious workup were consistent with E-cigarette, or vaping, product use-associated lung injury (EVALI). Treated with systemic steroids, he developed acute respiratory distress syndrome and was intubated requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO) by hospital day 3. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2020-234771DOI Listing

Virtual reality device training for extracorporeal membrane oxygenation.

Crit Care 2020 Jul 2;24(1):390. Epub 2020 Jul 2.

Division of Cardiology, Pulmonology and Vascular Medicine, Department of Internal Medicine, Medical Faculty, Heinrich-Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13054-020-03095-yDOI Listing

Cost-Utility of Sildenafil for Persistent Pulmonary Hypertension of the Newborn.

Am J Perinatol 2020 Jul 2. Epub 2020 Jul 2.

Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Objective:  While advanced therapies for severe persistent pulmonary hypertension of the newborn (PPHN) such as inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) are standard treatments in high-income countries, these therapies are often unavailable in resource-limited settings such as middle-income countries. However, there are small clinical trials illustrating the efficacy of sildenafil at reducing mortality in PPHN. This analysis sought to determine the cost-utility of enteral sildenafil for the treatment of severe PPHN. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0040-1713819DOI Listing

Enhanced vascular assessment by ultrasound using microbubble contrast after percutaneous decannulation of peripheral veno-arterial extracorporeal membrane oxygenation.

J Vasc Access 2020 Jul 2:1129729820932414. Epub 2020 Jul 2.

Department of Intensive Care, Queen Elizabeth Hospital, Hong Kong SAR.

Termination of peripheral veno-arterial extracorporeal membrane oxygenation support by managing the arteriotomy wound using a percutaneous closure device was reported successful and effective. However, careful assessment by clinical examination and also ultrasound Doppler assessment of the lower limb vasculature after closure is of paramount importance. Complications including pseudoaneurysm, arterial stenosis, and acute thrombosis are not uncommon. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/1129729820932414DOI Listing

Thromboelastography-guided management of coagulopathy in neonates with congenital diaphragmatic hernia supported by extracorporeal membrane oxygenation.

Pediatr Surg Int 2020 Jun 30. Epub 2020 Jun 30.

Department of Surgery, Division of Pediatric Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Purpose: Congenital diaphragmatic hernia (CDH) can cause severe hemodynamic deterioration requiring support with extracorporeal membrane oxygenation (ECMO). ECMO is associated with hemorrhagic and thromboembolic complications. In 2015, we standardized anti-coagulation management on ECMO, incorporating thromboelastography (TEG) as an adjunct to manage hemostasis of CDH patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00383-020-04694-0DOI Listing

Curriculum to Introduce Critical Care Nurses to Extracorporeal Membrane Oxygenation.

Am J Crit Care 2020 Jul;29(4):262-269

Matthew Bacchetta is an attending physician in the Department of Thoracic Surgery and co-director of the ECMO program at Vanderbilt University Medical Center.

Background: Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses.

Objectives: To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions.

Methods: An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4037/ajcc2020739DOI Listing

Large intracardiac thrombus in a COVID-19 patient treated with prolonged extracorporeal membrane oxygenation implantation.

Eur Heart J 2020 Jun 30. Epub 2020 Jun 30.

Department of Respiratory Medicine, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, Hubei, 430070, China.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurheartj/ehaa524DOI Listing

Extracorporeal Membrane Oxygenation Does Not Necessarily Mean Easier Breathing.

Respir Care 2020 Jul;65(7):1057-1058

Division of Pediatric Critical Care MedicineDuke Children's HospitalDurham, North Carolina.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.08085DOI Listing

Impella versus extracorporeal membrane oxygenation for acute myocardial infarction cardiogenic shock.

Cardiovasc Revasc Med 2020 May 30. Epub 2020 May 30.

Department of Cardiology, Henry Ford Hospital, Detroit, MI, United States of America.

Background: Percutaneous ventricular assist devices and extracorporeal membrane oxygenation (ECMO) are increasingly used for mechanical circulatory support (MCS) in patients with acute myocardial infarction with cardiogenic shock (AMI-CS) in hospitals throughout the United States.

Methods: Using the National Inpatient Sample from October 2015 to December 2017, we identified hospital admissions that underwent percutaneous coronary intervention (PCI) and non-elective Impella or ECMO placement for AMI-CS using ICD-10 codes. Propensity-score matching was performed to compare both groups for primary and secondary outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carrev.2020.05.042DOI Listing

Ex utero intrapartum treatment to extracorporeal membrane oxygenation: lifesaving management of a giant cervical teratoma.

J Laryngol Otol 2020 Jul 1:1-4. Epub 2020 Jul 1.

Department of Otolaryngology - Head and Neck Surgery, Loma Linda University School of Medicine, California, USA.

Background: Ex utero intrapartum treatment ('EXIT' procedure) is a well described method for maintaining maternal-fetal circulation in the setting of airway obstruction from compressive neck masses. When ex utero intrapartum treatment to airway is not feasible, ex utero intrapartum treatment to extracorporeal membrane oxygenation ('ECMO') has been described in fetal cardiopulmonary abnormalities.

Objective: This paper presents the case of a massively compressive midline neck teratoma managed with ex utero intrapartum treatment to extracorporeal membrane oxygenation, allowing for neonatal survival, with controlled airway management and subsequent resection. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0022215120001206DOI Listing

Acute exacerbations of COPD versus IPF in patients with combined pulmonary fibrosis and emphysema.

Respir Res 2020 Jun 30;21(1):164. Epub 2020 Jun 30.

Departments of Thoracic Medicine and Surgery, the Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA.

Rationale: Patients with combined pulmonary fibrosis and emphysema (CPFE) may develop acute exacerbations of IPF (AE-IPF) or COPD (AE-COPD). The incidence and the characteristics of exacerbations in patients with CPFE (e.g. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12931-020-01432-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325151PMC

Development of a CO Sensor for Extracorporeal Life Support Applications.

Sensors (Basel) 2020 Jun 27;20(13). Epub 2020 Jun 27.

Laboratory of Bioengineering, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy.

Measurement of carbon dioxide (CO) in medical applications is a well-established method for monitoring patient's pulmonary function in a noninvasive way widely used in emergency, intensive care, and during anesthesia. Even in extracorporeal-life support applications, such as Extracorporeal Carbon Dioxide Removal (ECCOR), Extracorporeal Membrane Oxygenation (ECMO), and cardiopulmonary by-pass (CPB), measurement of the CO concentration in the membrane oxygenator exhaust gas is proven to be useful to evaluate the treatment progress as well as the performance of the membrane oxygenator. In this paper, we present a new optical sensor specifically designed for the measurement of CO concentration in oxygenator exhaust gas. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3390/s20133613DOI Listing

Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers.

ASAIO J 2020 Jul;66(7):707-721

The Alfred, Melbourne, Victoria, Australia.

Disclaimer: The Extracorporeal Life Support Organization (ELSO) Coronavirus Disease 2019 (COVID-19) Guidelines have been developed to assist existing extracorporeal membrane oxygenation (ECMO) centers to prepare and plan provision of ECMO during the ongoing pandemic. The recommendations have been put together by a team of interdisciplinary ECMO providers from around the world. Recommendations are based on available evidence, existing best practice guidelines, ethical principles, and expert opinion. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MAT.0000000000001193DOI Listing

Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study.

J Int Med Res 2020 Jun;48(6):300060520935704

Division of Respiratory Disease, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010.

Methods: This retrospective cohort study enrolled adults with severe ARDS (PaO/FiO ratio of <100 with FiO of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0300060520935704DOI Listing

Simple and Reversible Venoarterial Extracorporeal Membrane Oxygenation Wean-Off Simulation Using Inflow-Outflow Bridging.

J Cardiothorac Vasc Anesth 2020 Jun 7. Epub 2020 Jun 7.

Cardiac Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2020.06.001DOI Listing

Giant Retroperitoneal Hematoma During Extracorporeal Membrane Oxygenation in a Patient With Coronavirus Disease-2019 Pneumonia.

J Cardiothorac Vasc Anesth 2020 Jun 3. Epub 2020 Jun 3.

Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2020.05.039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267793PMC

Prognostic Impact of Active Mechanical Circulatory Support in Cardiogenic Shock Complicating Acute Myocardial Infarction, Results from the Culprit-Shock Trial.

J Clin Med 2020 Jun 24;9(6). Epub 2020 Jun 24.

Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, 04289 Leipzig, Germany.

Objectives: To analyze the use and prognostic impact of active mechanical circulatory support (MCS) devices in a large prospective contemporary cohort of patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).

Background: Although increasingly used in clinical practice, data on the efficacy and safety of active MCS devices in patients with CS complicating AMI are limited.

Methods: This is a predefined subanalysis of the CULPRIT-SHOCK randomized trial and prospective registry. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm9061976DOI Listing

TRANSFUSION THRESHOLDS FOR ADULT RESPIRATORY EXTRACORPOREAL LIFE SUPPORT: AN EXPERT CONSENSUS DOCUMENT.

Can J Cardiol 2020 Jun 26. Epub 2020 Jun 26.

Department of Critical Care Medicine, Cumming School of Medicine - Alberta Health Services and University of Calgary and Libin Cardiovascular Institute of Alberta, University of Calgary.

Severe acute respiratory distress syndrome (ARDS) can complicate novel pandemic coronavirus disease (COVID-19). Extracorporeal life support (ECLS) represents the final possible rescue strategy. Variations in practice, combined with a paucity of rigorous guidelines, may complicate blood product resource availability and allocation during a pandemic. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cjca.2020.06.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319637PMC

The use of extracorporeal membrane oxygenation postcardiotomy-A systematic review.

J Card Surg 2020 Jun 29. Epub 2020 Jun 29.

Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.

Objectives: The use of extracorporeal membrane oxygenation (ECMO) in cardiac surgery has been established in cases of postcardiotomy cardiogenic shock, which is refractory to conventional therapy with inotropes and intra-aortic balloon pulsation support. We sought to examine the literature in a systematic review manner on the outcomes of using ECMO postcardiac surgery.

Methods: A comprehensive electronic literature search was done to identify all the articles that have discussed the use of ECMO postcardiac surgery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocs.14694DOI Listing

Veno-venous Extracorporeal Membrane Oxygenation Support in COVID-19 Respiratory Distress Syndrome: Initial Experience.

ASAIO J 2020 Jul;66(7):734-738

Anaesthesiology and Intensive Care Unit, Cardio-Thorac-Vascular Department, S. Orsola Hospital, ALMA Mater Studiorum University of Bologna, Bologna, Italy.

SARS-CoV-2 may cause severe respiratory failure due to massive alveolar damage. Currently, no adequate curative therapy for Coronavirus Disease 2019 (COVID-19) disease exists. By considering overall impact of COVID-19 pandemic outbreak, an increased need of extracorporeal membrane oxygenation (ECMO) support becomes evident. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MAT.0000000000001198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268877PMC

Preemptive veno-venous ECMO support in a patient with anticipated difficult airway: A case report.

Respir Med Case Rep 2020 11;30:101130. Epub 2020 Jun 11.

Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany Robert-Koch-Str. 40, D-37099, Göttingen, Germany.

This report presents a case of endotracheal metastasis in which elective veno-venous extracorporeal membrane oxygenation (VV ECMO) was used to undergo tracheal laser-surgery prior to establishment of a definitive airway. Specifically, we describe the respiratory and airway management in an adult patient from the preclinical phase throughout elective preoperative ECMO implantation to postoperative ECMO weaning and decannulation in the Intensive Care Unit. This case report lends further supports to the idea that the extracorporeal membrane oxygenation could be electively used to provide safe environment for surgery in situations where the standard maneuvers of sustaining adequate gas exchange are anticipated to fail. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rmcr.2020.101130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306610PMC

Transposition of the great vessels and intact ventricular septum: is there an age limit for the arterial switch? Personal experience and review of the literature.

Cardiol Young 2020 Jun 29:1-6. Epub 2020 Jun 29.

Istituto Giannina Gaslini Istituto Pediatrico di Ricovero e Cura a Carattere Scientifico, Cardiovascular Surgery, Genova, Liguria, Italy.

Objective: Prognosis of the transposition of the great arteries has completely changed since the introduction of the arterial switch. Time limit to perform this intervention is still controversial. The aim of this study is to demonstrate the early and late outcome of primary arterial switch operation beyond the age of months. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1047951120001456DOI Listing

Extracorporeal membrane oxygenation in patients with SARS-CoV-2.

Heart Lung 2020 May 31. Epub 2020 May 31.

Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil; Universidade de São Paulo, São Paulo, SP, Brazil.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.hrtlng.2020.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261427PMC

COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.

Lancet Child Adolesc Health 2020 Jun 25. Epub 2020 Jun 25.

Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address:

Background: To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.

Methods: This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2352-4642(20)30177-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316447PMC

A COVID-19 pandemic guideline in evidence-based medicine.

Authors:
Erfan Shamsoddin

Evid Based Dent 2020 06;21(2):71-73

National Institute for Medical Research Development (NIMAD), Tehran, Iran.

Data sources This review article scrutinised 16 clinical studies (clinical trials and observational studies) concerning coronavirus disease of 2019 (COVID-19). Additionally, 18 guidelines about the COVID-19 were reviewed and the key points were represented in this study.Study selection The review included human trials, in-vitro studies, review articles, and credible news reports about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 complications, treatment guidelines, management strategies, and epidemiological features. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41432-020-0105-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317259PMC

Description of Bivalirudin Use for Anticoagulation in Pediatric Patients on Mechanical Circulatory Support.

Ann Pharmacother 2020 Jun 26:1060028020937819. Epub 2020 Jun 26.

University of Florida Health Shands Children's Hospital, Gainesville, FL, USA.

Although heparin has previously been the anticoagulant of choice during mechanical circulatory support (MCS), there is a lack of consistency in dose-response in pediatric patients. Bivalirudin offers more consistent dose-response in adults; however, there are limited data for pediatrics use. The purpose was to characterize the usage, dosage, and safety profile of bivalirudin when used for pediatric MCS in a tertiary care pediatric hospital. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/1060028020937819DOI Listing

Pediatric Cardiopulmonary Resuscitation Tasks and Hands-Off Time: A Descriptive Analysis Using Video Review.

Pediatr Crit Care Med 2020 Jun 25. Epub 2020 Jun 25.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD.

Objectives: To characterize tasks performed during cardiopulmonary resuscitation in association with hands-off time, using video recordings of resuscitation events.

Design: Single-center, prospective, observational trial.

Setting: Twenty-six bed cardiac ICU in a quaternary care free standing pediatric academic hospital. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/PCC.0000000000002486DOI Listing

Prevalence of Seizures and Risk Factors for Mortality in a Continuous Cohort of Pediatric Extracorporeal Membrane Oxygenation Patients.

Pediatr Crit Care Med 2020 Jun 25. Epub 2020 Jun 25.

Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Objectives: To evaluate the risk factors for mortality in pediatric extracorporeal membrane oxygenation patients.

Design: Retrospective, single-center study.

Setting: PICU and Pediatric cardiothoracic ICU in an urban, quaternary care center. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/PCC.0000000000002468DOI Listing

Hospital-Acquired Infection in Pediatric Subjects With Congenital Heart Disease Postcardiotomy Supported on Extracorporeal Membrane Oxygenation.

Pediatr Crit Care Med 2020 Jun 25. Epub 2020 Jun 25.

Division of Cardiac Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objective: To determine prevalence of and risk factors for infection in pediatric subjects with congenital heart disease status postcardiotomy supported on extracorporeal membrane oxygenation, as well as outcomes of these subjects.

Design: Retrospective cohort from the Extracorporeal Life Support Organization.

Setting: U. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/PCC.0000000000002409DOI Listing

Mobile Extracorporeal Membrane Oxygenation: 5-Year Experience of a French Pediatric and Neonatal Center.

Pediatr Crit Care Med 2020 Jun 25. Epub 2020 Jun 25.

Pediatric and Neonatal Intensive Care Unit, Armand Trousseau Hospital, APHP Sorbonne University, Paris, France.

Objectives: Extracorporeal membrane oxygenation is an established therapy for refractory cardiac and/or pulmonary failure that is not available in all centers. When infants and children require extracorporeal membrane oxygenation, they are sometimes placed on extracorporeal membrane oxygenation support in peripheral centers where extracorporeal membrane oxygenation is not available and then transferred on extracorporeal membrane oxygenation to specialized centers. The objective of this study is to first describe one of the largest cohorts of infants and children transported by a mobile unit while on extracorporeal membrane oxygenation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/PCC.0000000000002421DOI Listing

Critically ill patients with COVID-19 with ECMO and artificial liver plasma exchange: A retrospective study.

Medicine (Baltimore) 2020 Jun;99(26):e21012

Department of Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.

COVID-19 is an emerging infectious disease capable of causing severe pneumonia. We aimed to characterize a group of critically ill patients in a single-center study.This was a retrospective case series of 23 patients with confirmed COVID-19-related critical illness in the intensive care unit (ICU) of a hospital in Hangzhou Zhejiang Province between January 22 and March 20, 2020. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000021012DOI Listing

Extracorporeal membrane oxygenation with continuous renal replacement therapy to treat metformin-associated lactic acidosis: A case report.

Medicine (Baltimore) 2020 Jun;99(26):e20990

Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China.

Rationale: Metformin-associated lactic acidosis (MALA) is rarely encountered, but has a high mortality rate, Conventional treatments include hemodialysis or continuous renal replacement therapy (CRRT); however, when the disease progresses to end-stage, cardiac function is significantly inhibited, circulation cannot be maintained, CRRT cannot be tolerated, V-A extracorporeal membrane oxygenation (ECMO) may be the last treatment.

Patient Concerns: The study report a rare case of MALA in an elderly female patient at the age of 72 who was admitted to hospital because of nausea for 2 days, complicated with systemic fatigue.

Diagnosis: MALA was cofirmed because of patient have increased lactic acid levels, blood pH <7. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000020990DOI Listing

Mechanical Ventilation Strategy Guided by Transpulmonary Pressure in Severe Acute Respiratory Distress Syndrome Treated With Venovenous Extracorporeal Membrane Oxygenation.

Crit Care Med 2020 Jun 25. Epub 2020 Jun 25.

All authors: Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, China.

Objectives: Previous studies have suggested that adjusting ventilator settings based on transpulmonary pressure measurements may minimize ventilator-induced lung injury, but this has never been investigated in patients with severe acute respiratory distress syndrome supported with venovenous extracorporeal membrane oxygenation. We aimed to evaluate whether a transpulmonary pressure-guided ventilation strategy would increase the proportion of patients successfully weaned from venovenous extracorporeal membrane oxygenation support in patients with severe acute respiratory distress syndrome.

Design: Single-center, prospective, randomized controlled trial. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCM.0000000000004445DOI Listing

Analysis of clinical features and early warning signs in patients with severe COVID-19: A retrospective cohort study.

PLoS One 2020 26;15(6):e0235459. Epub 2020 Jun 26.

Medical Records Management Department, The First Affiliated Hospital of Zhenghzou University, Zhengzhou, Henan, China.

Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, in December 2019. Although previous studies have described the clinical aspects of COVID-19, few studies have focused on the early detection of severe COVID-19. Therefore, this study aimed to identify the predictors of severe COVID-19 and to compare clinical features between patients with severe COVID-19 and those with less severe COVID-19. Read More

View Article

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235459PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319317PMC

Pulmonary embolism in acute medicine: a case-based review incorporating latest guidelines in the COVID-19 era.

Br J Hosp Med (Lond) 2020 Jun 18;81(6):1-12. Epub 2020 Jun 18.

Acute Medicine Department, Royal Free Hospital, London, UK.

Pulmonary embolism remains an important cause of morbidity and mortality in the UK, particularly following the outbreak of the novel coronavirus 2019 (COVID-19), where those infected have an increased prevalence of venous thromboembolic events. The pathophysiology in COVID-19 patients is thought to relate to a thromboinflammatory state within the pulmonary vasculature, triggered by the infection, but other risk factors such as reduced mobility, prolonged immobilisation and dehydration are likely to contribute. Several societies have released comprehensive guidelines emphasising the importance of risk stratification in patients with acute pulmonary embolism. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.12968/hmed.2020.0300DOI Listing

Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database.

Gen Thorac Cardiovasc Surg 2020 Jun 25. Epub 2020 Jun 25.

Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.

Background: Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry.

Methods: We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11748-020-01418-yDOI Listing

Early lactate changes improve the outcome prediction for extracorporeal membrane oxygenation.

Eur J Cardiothorac Surg 2020 Jun 25. Epub 2020 Jun 25.

Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

Objectives: Serial lactate (clearance) data are commonly used for risk stratification in patients receiving veno-arterial extracorporeal life support (ECLS).

Methods: We retrospectively analysed 855 patients who had undergone ECLS due to cardiac (n = 578) and non-cardiac (n = 277) aetiologies between 2002 and 2013 at National Taiwan University Hospital. Serial lactate (clearance) data were collected before ECLS and at 8, 16, 24, 48 and 72 h after ECLS. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/ejcts/ezaa171DOI Listing

Increasing Veno-Arterial Extracorporeal Membrane Oxygenation Flow Reduces Electrical Impedance of the Lung Regions in Porcine Acute Heart Failure.

Physiol Res 2020 Jun 25. Epub 2020 Jun 25.

Department of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a technique used in patients with severe heart failure. The aim of this study was to evaluate its effects on left ventricular afterload and fluid accumulation in lungs with electrical impedance tomography (EIT). In eight swine, incremental increases of extracorporeal blood flow (EBF) were applied before and after the induction of ischemic heart failure. Read More

View Article

Download full-text PDF

Source

Single stick access using a VA-ECMO arterial return cannula for coronary intervention in cardiogenic shock.

Catheter Cardiovasc Interv 2020 Jun 25. Epub 2020 Jun 25.

The CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA.

Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is growing exponentially for cardiogenic shock and cardiac arrest, and many of these patients require percutaneous coronary intervention (PCI). In some cases, radial arterial access may not feasible among patients with peripheral vascular disease or if larger diameter guide catheters are required. Further, VA-ECMO is commonly used in combination with an intra-aortic balloon pump or Impella, thereby limiting vascular access options and increasing the risk of vascular complications including bleeding and limb ischemia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccd.29073DOI Listing

Massive Pulmonary Embolism in a Recent Intracranial Hemorrhage: A Case Report of Inhaled Nitric Oxide to Improve Outcomes.

Cureus 2020 May 21;12(5):e8218. Epub 2020 May 21.

Pulmonary, Critical Care & Sleep Medicine, West Virginia University, Morgantown, USA.

Acute massive pulmonary embolism (PE) has a high mortality if left untreated. The mainstay of treatment is systemic thrombolysis which has some absolute contraindications like intracranial hemorrhage (ICH). Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that decreases pulmonary artery pressure (PAP) and allows the right ventricle of the heart to pump against less resistance. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.8218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306673PMC

Thyrotoxicosis-Induced Cardiogenic Shock with Encephalopathy and Acute Respiratory Distress: A Case Report and Literature Review.

Cureus 2020 May 20;12(5):e8213. Epub 2020 May 20.

Neurology, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA.

Thyrotoxicosis-induced cardiomyopathy and cardiogenic shock (CS) can lead to sudden mortality in adults. Hemodynamic instability and collapse occur due to functional alterations in both peripheral circulation and myocardium. Thyroid storm (TS) increases preload and decreases afterload along with an increase in cardiac contractility and heart rate leading to high output acute failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.8213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306666PMC

Influenza-associated Fulminant Myocarditis Complicated by Guillain-Barré Syndrome.

Intern Med 2020 Jun 23. Epub 2020 Jun 23.

Division of Cardiology, Shimane University Faculty of Medicine, Japan.

We herein report the case of a 47-year-old woman who was admitted with weakness and numbness of the limbs and dyspnea after being infected with influenza virus A. She had a history of Guillain-Barré syndrome (GBS) 7 years prior to this presentation. On admission, she was in shock, and transthoracic echocardiography showed severely reduced left-ventricular function. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2169/internalmedicine.4950-20DOI Listing