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Neonatal ECMO survivors: The late emergence of hidden morbidities – An unmet need for long-term follow-up

Abstract Since the initiation of Extracorporeal Life Support Organization (ELSO) Registry in 1989, more than 47,000 neonates treated with extracorporeal membrane oxygenation (ECMO) have been registered worldwide with an overall..

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Certified Registered Nurse Anesthetists’ occupational exposure to inhalational anesthetic agents: a survey of anesthetic gas safety

Abstract Background Anesthetic gases have been known to cause damage when inhaled over long periods of time. Modern safety measures have been put in place to reduce the risk to..

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Early predictors of oxygenator exchange during veno-venous extracorporeal membrane oxygenation: A retrospective analysis

Abstract Introduction: Oxygenator exchange during extracorporeal membrane oxygenation (ECMO) is a life-threatening procedure. D-dimer has been used to predict oxygenator failure, but it is a parameter used a few days..

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Perioperative Management of the Patient at High-Risk for Cardiac Surgery-Associated Acute Kidney Injury

Abstract Acute kidney injury (AKI) is one of the most common major complications of cardiac surgery, and is associated with increased morbidity and mortality. Cardiac surgery-associated AKI has a complex,..

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Assessment of Rotational Thromboelastometry and Thrombin Generation Assay to Identify Risk of High Blood Loss and Re-Operation After Cardiac Surgery

Abstract Introduction: We aimed to investigate parameters for prediction of post-operative blood loss and re-operation in patients who underwent cardiopulmonary bypass.  Methods: Thrombin generation assay, activated partial thromboplastin time, activated clotting time..

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Oxygenator impact on meropenem/vaborbactam in extracorporeal membrane oxygenation circuits

Abstract Introduction: To determine the oxygenator impact on alterations of meropenem (MEM)/vaborbactam (VBR) in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extra corporeal membrane oxygenation (ECMO) circuit including the Quadrox-i® oxygenator...

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In-situ modified polyethersulfone oxygenation membrane with improved hemocompatibility and gas transfer efficiency

Abstract Extracorporeal membrane oxygenation (ECMO) is one of the most important supporting therapies for patients with severe cardiopulmonary failure, and the core component of ECMO is the membrane oxygenator. However,..

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Medical nutrition therapy in patients receiving ECMO: Evidence-based guidance for clinical practice

Abstract Patients receiving extracorporeal membrane oxygenation (ECMO) inherit substantial disease-associated metabolic, endocrinologic, and immunologic modifications. Along with the technical components of ECMO, the aforementioned alterations may affect patients' needs and..

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Normothermic Versus Hypothermic Norwood Procedure

Abstract Background Either deep hypothermia with circulatory arrest or hypothermic perfusion with antegrade selective cerebral perfusion is used during the Norwood procedure for hypoplastic left heart syndrome. Normothermic perfusion has..

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Role of nebulized heparin in mechanically ventilated critically ill patients

Abstract Background  Mechanical ventilation is a technique for supporting or substituting respiration. Fibrin deposition in the pulmonary microcirculation and alveolar sacs (hyaline membrane generation) is a major inflammatory route of..

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The multifactorial dynamic perfusion index: A predictive tool of cardiac surgery associated acute kidney injury

Abstract Introduction Cardiac surgery associated acute kidney injury (CSA-AKI) has a number of preoperative and intraoperative risk factors. Cardiopulmonary bypass (CPB) factors have not yet been elucidated in a single..

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Cardiopulmonary bypass parameters improve the prediction of 30-day mortality following cardiac surgery

Abstract Currently 30-day mortality is commonly used as a quality indicator for cardiac surgery; however, prediction models have not included the role of cardiopulmonary bypass (CPB). We hypothesized that reproducing..

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Factor XII Silencing Using siRNA Prevents Thrombus Formation in a Rat Model of Extracorporeal Life Support

Abstract Heparin anticoagulation increases the bleeding risk during extracorporeal life support (ECLS). This study determined whether factor XII (FXII) silencing using short interfering RNA (siRNA) can provide ECLS circuit anticoagulation without bleeding. Adult..

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Diagnostic and Therapeutic Implications of Ex Vivo Lung Perfusion in Lung Transplantation: Potential Benefits and Inherent Limitations

Abstract Ex vivo lung perfusion (EVLP), a technique in which isolated lungs are continually ventilated and perfused at normothermic temperature, is emerging as a promising platform to optimize donor lung..

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Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest

Abstract BACKGROUND Extracorporeal cardiopulmonary resuscitation (CPR) restores perfusion and oxygenation in a patient who does not have spontaneous circulation. The evidence with regard to the effect of extracorporeal CPR on..

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Risk Factors for Lower Extremity Vascular Complications in Adult Patients on Veno-Arterial Extracorporeal Membrane Oxygenation

Abstract Introduction Utilization of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has increased significantly over the last decade. Prior studies have reported worse mortality for patients with vascular complications on VA-ECMO; however,..

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Extracorporeal cardiopulmonary resuscitation: pre-hospital or in-hospital cannulation?

Abstract Extracorporeal cardiopulmonary resuscitation (E-CPR) is the establishment of veno-arterial extracorporeal membrane oxygenation (ECMO) during ongoing cardiopulmonary resuscitation (CPR). E-CPR is the last rescue therapy when, despite high-quality conventional CPR,..

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On the Rise, Candida auris Outwits Treatments and Travels Incognito in Health Care Settings

Abstract To quote medical mycologist Shawn Lockhart, PhD, Candida auris “is a very clever bug.” This hardy yeast species can remain viable for at least 2 weeks on plastic surfaces and for months..

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Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)

Abstract OBJECTIVES:  We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress..

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Extracorporeal Membrane Oxygenation in Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Abstract OBJECTIVES:  To systematically review and assimilate literature on children receiving extracorporeal membrane oxygenation (ECMO) support in pediatric acute respiratory distress syndrome (PARDS) with the goal of developing an update to the..

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Variation in electroencephalography and neuroimaging for children receiving extracorporeal membrane oxygenation

Abstract Background Seizures, strokes, and intracranial hemorrhage are common and feared complications in children receiving extracorporeal membrane oxygenation (ECMO) support. Researchers and clinicians have proposed and deployed methods for monitoring..

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High versus low blood pressure targets for cardiac surgery while on cardiopulmonary bypass

Abstract Background Cardiac surgery is performed worldwide. Most types of cardiac surgery are performed using cardiopulmonary bypass (CPB). Cardiac surgery performed with CPB is associated with morbidities. CPB needs an..

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Intraoperative cell salvaging: ex vivo evaluation of two swab-washing methods

Abstract OBJECTIVE To compare erythrocyte recovery by a cell salvage device between swab-washing by manual agitation or filtration. SAMPLE 12 recently expired units of canine packed RBCs. PROCEDURE The packed..

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Outcomes of Venovenous Extracorporeal Membrane Oxygenation in Viral Acute Respiratory Distress Syndrome

Abstract Our study assessed the relationship between the duration of venovenous extracorporeal membrane oxygenation (V-V ECMO) and patient outcomes. We studied patients undergoing V-V ECMO support for acute respiratory distress..

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Mitochondrial respiration during normothermic liver machine perfusion predicts clinical outcome

Abstract Background Reliable biomarkers for organ quality assessment during normothermic machine perfusion (NMP) are desired. ATP (adenosine triphosphate) production by oxidative phosphorylation plays a crucial role in the bioenergetic homeostasis..

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Complications Associated With Venovenous Extracorporeal Membrane Oxygenation—What Can Go Wrong?

Abstract OBJECTIVES:  Despite increasing use and promising outcomes, venovenous extracorporeal membrane oxygenation (V-V ECMO) introduces the risk of a number of complications across the spectrum of ECMO care. This narrative review describes..

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Cardiac surgery, ICU sedation, and delirium: is dexmedetomidine the silver bullet?

Abstract Purpose of review  Delirium is a marker of acute brain insufficiency and a harbinger of poor outcomes and increased healthcare costs. Despite success preventing delirium by nonpharmacologic measures, the..

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Pre-operative kidney biomarkers and risks for death, cardiovascular and chronic kidney disease events after cardiac surgery: the TRIBE-AKI study

Abstract Background Soluble tumor necrosis factor receptor (sTNFR)1, sTNFR2, and plasma kidney injury molecule-1 (KIM-1) are associated with kidney events in patients with and without diabetes. However, their associations with..

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Assessment of fluid balance after neonatal cardiac surgery: a description of intake/output vs. weight-based methods

Abstract Background Fluid overload associates with poor outcomes after neonatal cardiac surgery, but consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight..

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H1 and H2 antihistamines pretreatment for attenuation of protamine reactions after cardiopulmonary bypass: a randomized-controlled study

Abstract Background: Protamine administration post-cardiopulmonary bypass (CPB) can potentially cause hemodynamic instability. Histamine released from mast cells is believed to be responsible for hypotension after protamine administration. The aim of this..

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