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Outcomes in Obese Adult Venoarterial Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Historically, extracorporeal membrane oxygenation (ECMO) in critical illness and respiratory failure has been used cautiously in patients with morbid obesity. However, recent data show favorable mortality outcomes for higher..

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Increasing utilization of extracorporeal membrane oxygenation and its association with venous thromboembolism following lung transplant

Abstract Background Venous thromboembolism (VTE) is a common complication following lung transplantation, and perioperative extracorporeal membrane oxygenation (ECMO) use has increased substantially over time. The relationship between ECMO exposure and..

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Extracorporeal membrane oxygenation may prevent preterm cerebral atrophy in survivors of acute respiratory distress syndrome: a pilot trial

Abstract BACKGROUND: Individuals who survive acute respiratory distress syndrome (ARDS) often face prolonged cognitive impairments. Comparable consequences have been observed in chronic hypoxic conditions, like COPD and obstructive sleep apnea..

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Association between preoperative hydration and cardiac surgery-associated acute kidney injury: a prospective observational study

Abstract Background Cardiac surgery associated acute kidney injury (CSA-AKI) is a common and serious complication following cardiac surgery with cardiopulmonary bypass (CPB), associated with prolonged hospitalization, increased costs, and higher..

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A Structured Checklist for Bedside Rounds on Extracorporeal Membrane Oxygenation Patients

Abstract Patients supported with extracorporeal membrane oxygenation (ECMO) represent a uniquely challenging population. These patients require specific interventions, such as repeated circuit and lower extremity perfusion assessments, anticoagulation management, frequent..

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Revolutionizing Accelerated Percutaneous Initiation and Deployment of ECPR (RAPID ECPR): Single-Center Process and Outcomes

Abstract Objectives Recent randomized controlled trials comparing extracorporeal cardiopulmonary resuscitation (ECPR) with conventional cardiopulmonary resuscitation (CCPR) reveal mixed outcomes; however, current data support an association between ECPR and neurologically intact..

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Postoperative Hematocrit and Lactate Trajectory After Neonatal Cardiopulmonary Bypass: A Retrospective Cohort Study

Abstract Lactate clearance is a key marker of oxygen delivery after neonatal cardiac surgery. While higher hematocrit (HCT) is often targeted to optimize oxygen delivery, its relationship with postoperative lactate..

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Awake paediatric venovenous extracorporeal membrane oxygenation case report: Feasibility of PICUStars Liberation Bundles to achieve early mobilisation

Abstract Awake extracorporeal membrane oxygenation (aECMO) has emerged as a strategy to minimise physical and neurocognitive complications of a prolonged intensive care admission. However, the safety and implementation in critically..

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How to monitor and manage unfractionated heparin in practice (Part 1)? Guidance from the SSC of the ISTH

Abstract The International Society on Thrombosis and Haemostasis (ISTH) recently published a survey on the management of unfractionated heparin (UFH), which revealed substantial heterogeneity in practice and highlighted the need..

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Is Preoperative Serum Bicarbonate an Undervalued Risk Factor in Cardiac Surgery?

Abstract Existing risk stratification methods in cardiothoracic surgery do not use pre-operative bicarbonate levels. We investigate if these levels carry predictive value when compared with demographic, hematologic, and other renal..

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Meropenem Exposure During Extracorporeal Membrane Oxygenation: What Should Intensivists Know? A Scoping Review

Abstract Background Extracorporeal membrane oxygenation (ECMO) is increasingly used in adults with severe respiratory and/or cardiac failure. Because ECMO may alter drug pharmacokinetics (PK), optimizing antimicrobial dosing in this population..

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Efficacy of intraoperative hemoadsorption in patients undergoing cardiac surgery, a meta-analysis

Abstract Objectives Comparing clinical outcomes after cardiopulmonary bypass with hemodsorption (HA) versus cardiopulmonary bypass without HA in patients undergoing cardiac surgery in terms of mortality and major complications. Methods PubMed,..

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Superiority of Fibrinogen Concentrate Versus Cryoprecipitate for Treatment of Bleeding in Cardiac Surgery Patients: A Secondary Analysis of the FIBRES…

Abstract Objectives To explore the superiority of fibrinogen concentrate (FC) versus cryoprecipitate for bleeding after cardiac surgery. Design Secondary analysis of the FIBRES randomized trial. Setting Eleven Canadian hospitals, February..

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Mortality risk model for acute myocardial infarction complicated by cardiogenic shock: development, external validation, and exploratory application in a VA-ECMO…

Abstract Background Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) carries a high risk of in-hospital death. Randomized evidence does not support routine VA-ECMO use in unselected AMI-CS populations. Objective..

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From Pump to Neck: A Focused Review of Mechanical Complications in Extracorporeal Membrane Oxygenation (ECMO) Circuits

Abstract Extracorporeal membrane oxygenation (ECMO) is a life-saving modality, yet it carries inherent risks of device-related adverse events. This manuscript is a focused review of ECMO circuit mechanics, monitoring, and..

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Combining biomarkers with clinical risk factors to predict acute kidney injury after cardiopulmonary bypass surgery: An observational cohort study

Abstract Cardiac surgery-associated acute kidney injury (CSA-AKI) is a prevalent complication subsequent to cardiopulmonary bypass (CPB) surgery. Timely diagnosis is essential for enhancing patient outcomes. Traditional diagnostic approaches that depend..

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Initial cardioplegia dose indexed to left ventricular mass in mitral valve surgery

Abstract Background In mitral valve surgery, cardioplegia is commonly dosed by body weight or body surface area (BSA), which may not reflect true cardiac mass. We evaluated whether indexing the..

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Severe hyperoxia during VA-ECMO promotes oxidative stress and multi-organ injury in an experimental rat model of septic cardiomyopathy

Abstract Background Severe hyperoxia during venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been associated with adverse clinical outcomes in observational studies. However, causal evidence and optimal oxygen targets remain uncertain. Hyperoxia..

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Relationship Between Entropy-Guided Sevoflurane Administration and End Oxygenator Sevoflurane Concentration in Adult Patients Undergoing Cardiopulmonary Bypass Surgery

Abstract Background: Cardiopulmonary bypass (CPB) during cardiac surgery poses physiological challenges such as altered drug pharmacokinetics. Sevoflurane, a commonly used volatile agent, provides favorable myocardial protection; however, precise dosing during..

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Management of Harlequin syndrome in veno-arterial extracorporeal membrane oxygenation

Abstract Background Veno-arterial extracorporeal membrane oxygenation (VA ECMO) provides temporary mechanical circulatory support, primarily for patients with compromised cardiac function. In individuals supported on femoral VA ECMO with concurrent pulmonary..

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Impact of cannula configuration on efficiency and mechanical ventilation intensity during venovenous ECMO

Abstract Background The efficiency of venovenous extracorporeal membrane oxygenation (VV ECMO) may be influenced by cannula configuration, potentially affecting oxygenation and the ability to apply ultra-protective ventilation in severe ARDS...

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Harbinger of Difficult Weaning from Cardiopulmonary Bypass in Aortic Valve Replacement Surgery: A Case Report

Abstract Failure to wean from cardiopulmonary bypass (CPB) is a rare but critical intraoperative challenge. Common causes include residual structural defects (causing intracardiac shunting, prosthetic valve leaks), left ventricle outflow..

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Safety of Delayed Venoarterial Extracorporeal Membrane Oxygenation Decannulation in Pediatric Patients

Abstract Background Optimal timing of venoarterial extracorporeal membrane oxygenation (VA-ECMO) decannulation in pediatric patients with congenital or acquired heart disease remains challenging, particularly when myocardial recovery is uncertain. Some centers..

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The extracorporeal cardiopulmonary resuscitation outcomes database

Abstract Background Cardiac arrest impacts more than 500,000 people in the United States annually. Overall, cardiac arrest, particularly when it occurs outside of a hospital, is associated with low rates..

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Coronary artery bypass grafting in a patient with factor XIII deficiency: case report and review of perioperative management

Abstract Factor XIII (FXIII) is the final enzyme in the coagulation cascade that cross-links the fibrin monomers, thereby enhancing the clot strength. Congenital FXIII deficiency is rare and is inherited..

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Retrograde Lower Body Perfusion Is Associated with Reduced Acute Kidney Injury in Stage II Palliation for Hypoplastic Left Heart Syndrome

Abstract Objective Acute kidney injury (AKI) complicates pediatric cardiac surgery, particularly in single-ventricle palliation. While retrograde lower body perfusion (LBP) has been associated with a renal-protective signal during aortic arch..

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Enhanced antithrombogenic performance of microfluidic oxygenators through dual bioactive surface modification for an artificial placenta system

Abstract In recent years, artificial placenta systems have been developed for the clinical treatment of infant respiratory distress syndrome (RDS). Their use requires systemic anticoagulation to prevent clotting during treatment...

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Design and in vitro evaluation of a parallel gas-exchange chambers oxygenator with reduced hemolysis and pressure drop

Abstract Background: Hemolytic complications remain a major limitation of membrane oxygenators in clinical support. Compared with human lungs, most commercial oxygenators generate substantial pressure drops and high shear stress, increasing..

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Randomized pilot trial of intraoperative hemoadsorption in clopidogrel treated patients undergoing urgent coronary artery bypass grafting

Abstract Background Patients receiving clopidogrel who undergo urgent CABG before the recommended 5-day washout period are at increased risk of perioperative bleeding. This study evaluated whether intraoperative hemoadsorption can reduce..

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Artificial Intelligence for Predicting Perioperative Outcomes in Cardiac Surgery: A Systematic Review

Abstract Objective: Cardiac surgery carries a significant risk of complications and mortality. Artificial intelligence (AI), particularly machine learning (ML), is increasingly being explored to enhance perioperative risk prediction and support..

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