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Open-access Cost-effectiveness of the timing of respiratory extracorporeal membrane oxygenation initiation in pediatric patients

Abstract Objective:  The aim of this study was to assess the cost-effectiveness of early versus late initiation of extracorporeal membrane oxygenation (ECMO) in pediatric patients with acute respiratory distress syndrome..

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Perioperative Antithrombin Activity and Postoperative Outcomes in Adult Cardiac Surgery: A Prospective Cohort in Contemporary Plasma-Sparing Practice

Abstract Objectives To determine whether low pre- or post-bypass antithrombin (AT) activity identifies adult cardiac surgery patients at increased risk of adverse outcomes in settings where plasma transfusion is rare...

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Progress Toward a Portable Artificial Lung: A Systematic Review

Abstract Background Chronic respiratory diseases are the third leading global cause of death. As lung transplantation is a definitive treatment for highly selected candidates, extracorporeal membrane oxygenation (ECMO) can be..

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Road Map of Extracorporeal Membrane Oxygenation in the Early Post–Lung Transplant Period

Abstract Extracorporeal membrane oxygenation is increasingly used in the early postoperative period after lung transplantation, mainly to support patients with primary graft dysfunction and severe right ventricular failure. Recipients with..

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Thermal heterogeneity after deep hypothermic circulatory arrest: a new framework for understanding rewarming and physiological recovery

Abstract Deep hypothermic circulatory arrest (DHCA) is widely used during complex aortic arch surgery to reduce metabolic demand and protect vital organs. Conventional temperature management assumes that restoration of core..

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Acute Severe Asthma in the Intensive Care Unit: From Bronchodilators to Extracorporeal Membrane Oxygenation

Abstract Acute severe asthma exacerbations are life-threatening critical care emergencies characterized by profound airflow obstruction, respiratory acidosis, and risk for cardiopulmonary arrest. For the purposes of this review, the term..

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Nurse-led acute care post-operative interventions in adult cardiac surgery: a systematic review

Abstract Aims The primary aim of this systematic review was to identify nurse-led clinical interventions evaluated in randomized controlled trials (RCTs) for adults who had undergone cardiac surgery. The secondary..

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The Perioperative Management of Cold-Induced Urticaria in Cardiac Surgery With Hypothermia on Cardiopulmonary Bypass

Abstract Cold-induced urticaria is a chronic urticaria subtype which can result in a severe, life-threating, anaphylaxis type reaction to cold stimuli. While a rare condition, it has potentially significant implications..

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Neuroprognostication After Extracorporeal Cardiopulmonary Resuscitation: ECMO-Specific Challenges and a Multimodal Time-Sensitive Framework

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising strategy for selected patients with refractory cardiac arrest, improving survival and the likelihood of favorable neurological outcomes. However, neurological prognostication..

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East-West Syndrome in Extracorporeal Membrane Oxygenation: Implications for Clinical Nursing Practice

Abstract As extracorporeal membrane oxygenation technology has evolved, interest in awake peripheral venoarterial extracorporeal membrane oxygenation has grown. This approach poses new challenges in patient monitoring. East-west syndrome is a..

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Severity and timing of elevated lactate correlates with mortality after cardiac surgery

Abstract Objective Extreme serum hyperlactatemia is common after cardiac surgery but can portend organ ischemia and mortality. Thus, we sought to determine which lactate thresholds warrant concern at various time..

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Experimental Extracorporeal Circulation System: A Pilot Study in Rats

Abstract Background Extracorporeal circulation (ECC) has become an important component in cardiac surgery, for cardiopulmonary support, and as a bridge to transplantation. Optimization of systems, components, and management requires further..

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Assessment of Microcirculation and Microcirculatory Function During Cardiopulmonary Bypass Using Hyperspectral Imaging and a Vascular Occlusion Test: An Observational Pilot…

Abstract Objectives To evaluate perioperative changes in cutaneous microcirculation and microvascular reactivity using hyperspectral imaging (HSI) with a standardized vascular occlusion test (VOT) in cardiac surgery with cardiopulmonary bypass (CPB),..

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In Situ Venous Cannula Puncture: A Simplified Technique for Extracorporeal Membrane Oxygenation Blood Salvage

Abstract Salvaging residual circuit blood upon extracorporeal membrane oxygenation (ECMO) discontinuation is a clinically valuable blood conservation strategy, mirroring standard cardiopulmonary bypass protocols. We describe a simplified technique using an..

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Randomized Clinical Trial Comparing Effects of Pulsatile vs Nonpulsatile Cardiopulmonary Bypass on Neurologic Outcomes

Abstract Background The objective of this secondary analysis was to examine the impact of 2 perfusion modalities on S100 calcium-binding protein B (S100B) levels and neural injury outcomes in patients..

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Upper-Body Versus Femoral Return in Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

Abstract Upper-body peripheral arterial return is used during veno-arterial extracorporeal membrane oxygenation (VA-ECMO), but its clinical tradeoffs versus femoral return are uncertain. We reviewed observational studies comparing upper-body to femoral..

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Neuropsychological and structural brain abnormalities in adults with d-transposition of the great arteries: The Boston Circulatory Arrest Study

Abstract Introduction Neurocognitive impairments are frequent in congenital heart disease. The Boston Circulatory Arrest Study (BCAS) is a randomized trial comparing the developmental and neurological outcomes of newborns born with..

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Living-donor lung transplantation for patients on extracorporeal membrane oxygenation support: A case series

Abstract In Japan, the average waiting time for deceased-donor lung transplantation exceeds 900 days, and living-donor lung transplantation (LDLT) has been performed in a certain number of patients who are..

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Prolonged hypoxemia before tetralogy of Fallot surgery: Harmful or harmless?

Abstract Introduction Tetralogy of Fallot (TOF) is the most common cyanotic heart disease (CHD). The associated cardiac abnormalities disrupt oxygenation and depending on disease severity, infants with TOF syndrome are..

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Association between rewarming rate during cardiopulmonary bypass and postoperative delirium in patients receiving olanzapine after cardiac surgery: A retrospective cohort…

Abstract Background The relationship between rewarming rate during cardiopulmonary bypass (CPB) and postoperative delirium (POD) in cardiac surgery remains unclear. This retrospective study aimed to evaluate whether rapid rewarming is..

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Challenges in monitoring and titration of argatroban versus unfractionated heparin in extracorporeal membrane oxygenation

Abstract Objectives Anticoagulation during extracorporeal membrane oxygenation (ECMO) remains challenging. Direct thrombin inhibitors such as argatroban are increasingly proposed as alternatives to unfractionated heparin (UFH). We sought to characterize the..

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Acute rheumatic fever and rheumatic heart disease in Latin America: a contemporary review of epidemiology

Abstract Rheumatic heart disease (RHD) remains a significant public health challenge in Latin America, disproportionately affecting vulnerable populations despite global declines in disease prevalence and mortality. It is known that..

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Hemocompatible polymer coating for extracorporeal circulation circuit affects lactate levels during cardiopulmonary bypass surgery

Abstract Introduction Blood lactate level (LL) is a useful predictor of physiological issues during extracorporeal circulation (ECC) treatment. To determine variations in LL depending on the hemocompatible coatings used for..

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Vaso-active inotropic scores: Clinical value, pros and cons

Abstract OBJECTIVE Vasoactive-inotropic scores (VIS) are used as predictors of outcome in pediatric and adult patients with cardiogenic shock undergoing cardiac surgery. VIS is calculated by combining the doses of..

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Extracorporeal Carbon Dioxide Removal as a Multimodal Strategy for Severe Acute Respiratory Distress Syndrome: A Case Series

Abstract Severe acute respiratory distress syndrome (ARDS) is associated with substantial morbidity and mortality ranging from 37 to 44%. Although extracorporeal membrane oxygenation (ECMO) is often indicated in ARDS, it..

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International Variation in Cardiopulmonary Bypass-Associated Coagulation Management: A Cross-Sectional Survey

Abstract Background Considerable variability persists in coagulation management during cardiopulmonary bypass (CPB) supported cardiac surgery. This survey aimed to describe contemporary reported practices across international settings. Methods A cross-sectional, web-based..

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Universal modular strategy for constructing anticoagulant coatings on surfaces of medical devices

Abstract Thrombus on implants is dangerous, necessitating anticoagulant coatings for most of blood-contacting devices with various substances. So far, there is no universal strategy of the pertinent surface modification for..

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Extracorporeal membrane oxygenation liberation before heart transplantation in the modern allocation era: Predictors and one-year outcomes from the National OPTN/UNOS…

Abstract Background The clinical significance of ECMO liberation before heart transplantation remains poorly defined. Objectives To identify predictors of pre-transplant ECMO liberation and evaluate its association with 1-year post-transplant survival...

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Cardiovascular Involvement of Multisystem Inflammatory Syndrome in Children: A Multicentric Observational Study on Mid- and Long-term Follow-up with Cardiovascular Imaging

Abstract Background: Multisystem inflammatory syndrome in children (MIS-C) is a relatively rare complication of COVID-19, with frequent cardiovascular involvement, in terms of pericarditis, valvulitis, coronary aneurysms, and myocardial dysfunction/cardiogenic shock...

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Mechanical circulatory support strategy in post–myocardial infarction ventricular septal defect repair

Abstract Post–myocardial infarction (PMI) ventricular septal defect (VSD) repair is associated with high mortality., The pathophysiology varies based on the size of the infarction and the VSD, which results in..

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