Tag: ECMO

Upvote Story 5
Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score for in-hospital mortality for cardiogenic shock patients who received VA-ECMO after isolated CABG. The REMEMBER score might help clinicians at bedside to predict in-hospital mortality for patients receiving VA-ECMO after isolated CABG for refractory cardiogenic... Read More | Comment
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A crash course in Critical Care! Stabilize, treat, and save your sickest patients in the ed or the field – with ACEP’s ultimate resuscitation guide. packed with succinct evidence-based chapters written by the nation’s foremost authorities. With an in-depth and up-to-date description of the unique presentation, differential diagnosis, and management of specific critical illness, this second edition emphasizes on ECMO, sepsis, neuro, critical care, pulmonary... Read More | Comment
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Levosimendan has been demonstrated to have potential utility in a range of critical illness scenarios. It must be acknowledged, however, that in each sphere of application, the evidence is incomplete or indicative rather than conclusive, and further clinical evaluation will be needed to substantiate the case for levosimendan and to refine the patient categories and dosage schedules likely to be associated with the greatest clinical... Read More | Comment
Upvote Story 9
Thromboelastography (TEG) seems to be safely used to guide anticoagulation management during ECMO. Its use was associated with the administration of lower heparin doses compared to a standard of care aPTT-based protocol. Forty-two patients were enrolled: 21 were randomized to the TEG group and 21 to the aPTT group. Duration of ECMO was similar in the two groups (9 (7–16) days in the TEG group... Read More | Comment
Upvote Story 7
Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly flourished. This book presents a comprehensive overview of both pathophysiological and practical aspects of circulatory and respiratory extracorporeal support. The basics of ECMO, including its history, the “ECMO team”, cannulation,... Read More | Comment
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Quickly and accurately diagnose and treat the critically ill patient with guidance from the field’s definitive text. Considered the field’s definitive text, Principles of Critical Care offers unmatched coverage of the diagnosis and treatment of the most common problems encountered in the practice of critical care. Written by expert critical care physicians who are also experienced teachers, the book features an organization, thoroughness, and clarity... Read More | Comment
Upvote Story 9
Critical care transport of prone acute respiratory distress syndrome (ARDS) patients is a feasible and cost-effective intervention that will help prevent treatment delays and interruptions. A nonphysician critical care transport team (registered nurse and paramedic) can initiate prone positioning before transport. We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe... Read More | Comment
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Is emergency medicine on the verge of “the dawn of a new golden age of resuscitation?” That’s the bold prediction from CPR innovator Keith Lurie, MD, a professor of internal and emergency medicine at the University of Minnesota, a director of the CentraCare Heart and Vascular Center and the founder of Minnesota Resuscitation Solutions. Emergency physicians, EMS personnel, and other experts from around the world... Read More | Comment
Upvote Story 14
The Advanced Ventilator Book is a companion to the best-selling The Ventilator Book and is written for clinicians who already have a solid foundation in the basics of mechanical ventilation. It goes beyond the ventilator itself to discuss strategies for severe hypoxemia and rescue maneuvers for refractory respiratory failure. Subjects covered in The Advanced Ventilator Book include: Optimal PEEP, Treatment of severe bronchospasm, Prone positioning,... Read More | Comment
Upvote Story 8
This highly informative book provides essential insights for ICU nurses at ECMO centers around the world, who face the substantial challenges involved in the management of ECMO patients. Above all, it meets their training needs with regard to bedside monitoring for these patients, which has become a major issue. The editors and most of the contributors serve at La Pitié-Salpétrière ICU, France, which, in terms... Read More | Comment
Upvote Story 5
Multi-system organ failure is ubiquitous but treatable with adequate hemodynamic support. Neurologic recovery was prolonged requiring delayed prognostication. Immediate 24/7 availability of surgical and medical specialty expertise was required to achieve 48% functionally intact survival. Of 100 appropriately transported patients, 83 achieved CICU admission. 40/83 (48%) discharged functionally intact. Multi-system organ failure occurred in all patients. Cardiac, pulmonary, renal, and liver injury improved within 3-4... Read More | Comment
Upvote Story 7
Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based on our results, an early insertion of ECMO before lactate gets high was suggested. Serial changes on lactate levels and calculation of its clearance may be superior to single lactate... Read More | Comment
Upvote Story 10
The proportion of pediatric patients undergoing percutaneous extracorporeal membrane oxygenation cannulation is increasing. Mechanical and physiologic complications occur with both methods of cannulation, but percutaneous cannulation appears safe in this cohort. Further analysis is needed to evaluate long-term outcomes with this technique. Of 3,501 patients identified, 77.2% underwent open cannulation, with the frequency of open cannulation decreasing over the study period from approximately 80% to... Read More | Comment
Upvote Story 5
Mechanical ventilation and extracorporeal support are marginally integrated. The best environment for lung healing – complete lung collapse or protective ventilation strategy or fully open and immobile lung (all three conditions feasible with extracorporeal support) – remains to be defined. Recent studies provide a description on how mechanical ventilation is normally applied in combination with extracorporeal support in acute respiratory distress syndrome (ARDS). The data... Read More | Comment
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Prevalence of HIT among patients under VA‑ECMO is extremely low at 0.36% with an associated mortality rate of 33.3%, which appears to be in the same range as that observed in patients treated with VA‑ECMO without HIT. In addition, HIT was ultimately ruled out in one‑third of patients with clinical suspicion of HIT and positive anti‑PF4/heparin antibodies. A total of 5797 patients under VA‑ECMO were... Read More | Comment