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Mechanical circulatory support in the treatment of cardiogenic shock

Abstract Purpose of review  Cardiogenic shock is a condition that is characterized by end-organ hypoperfusion secondary to reduced cardiac output, and is associated with substantial mortality. The mainstay of therapy..

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Venoarterial extracorporeal membrane oxygenation flow or dobutamine to improve microcirculation during ECMO for refractory cardiogenic shock

Abstract Purpose Venoarterial  (VA ECMO) effectively supports refractory  (rCS), and sustains macro- and . We investigated the respective impact of increasing VA ECMO flow or  dose on microcirculation in stabilized VA ECMO–treated patients with..

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Intra-aortic balloon pump for left ventricular unloading in VA-ECMO: timing is everything

Abstract An editorial published in April 2022 discusses the benefits and pitfalls of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) combined with intra-aortic balloon pumps (IABP) to manage CS. The complete manuscript,..

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Predictors of Survival and Ventricular Recovery Following Acute Myocardial Infarction Requiring Extracorporeal Membrane Oxygenation Therapy

Abstract The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) following acute myocardial infarction with cardiogenic shock (AMI-CS) is increasing, but the ability to predict favorable outcomes with support remains limited...

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Extracorporeal membrane oxygenation and left ventricular unloading: What is the evidence?

Abstract Although mechanical circulatory support (MCS) has been used to support patients with cardiogenic shock (CS) for many years, recent advances in device technology, together with the lackluster performance of..

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Early Blood Pressure Variables Associated With Improved Outcomes in VA-ECLS: The ELSO Registry Analysis

Abstract Background As utilization of veno-arterial  (VA-ECLS) in treatment of  (CS) continues to expand, clinical variables that guide clinicians in early recognition of myocardial recovery and therefore, improved survival, after VA-ECLS are..

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Temporary Left Ventricular Support Device as a Bridge to Heart-Liver or Heart-Kidney Transplant: Pushing the Boundaries of Temporary Support

Abstract In patients with severe cardiogenic shock, temporary mechanical circulatory support has become a viable strategy to bridge patients to heart transplantation. However, end-stage heart failure is often associated with progressive organ..

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Veno-arterial extracorporeal membrane oxygenation for drug intoxications: A single center, 14-year experience

Abstract Background and Aim of the Study Acute cardiovascular failure remains a leading cause of death in severe poisonings. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used as a..

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Preoperative patient factors associated with blood product use in cardiac surgery, a retrospective cohort study

Abstract Background Cardiac surgery is associated with a high rate of blood use. The aim of this study is to identify preoperative patient factors associated with allogeneic Red Blood Cell..

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Bivalirudin Versus Unfractionated Heparin in Patients with Cardiogenic Shock Requiring Venoarterial Extracorporeal Membrane Oxygenation

Abstract This study evaluated differences in efficacy and safety outcomes with bivalirudin compared with unfractionated heparin (UFH) in patients with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA ECMO). We..

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Temporary mechanical circulatory support for COVID-19 patients: A systematic review of literature

Abstract Objective Myocardial damage occurs in up to 25% of coronavirus disease 2019 (COVID-19) cases. While veno-venous extracorporeal life support (V-V ECLS) is used as respiratory support, mechanical circulatory support..

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Impact of the inspiratory oxygen fraction on the cardiac output during jugulo-femoral venoarterial extracorporeal membrane oxygenation in the rat

Abstract Background Venoarterial extracorporeal membrane oxygenation (V-A ECMO) with femoral access has gained wide acceptance in the treatment of critically ill patients. Since the patient´s cardiac output (CO) can compete..

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Admission blood glucose level and outcome in patients requiring venoarterial extracorporeal membrane oxygenation

Abstract Background Patients with cardiogenic shock or cardiac arrest undergoing venoarterial extracorporeal membrane oxygenation (V-A ECMO) frequently present with blood glucose levels out of normal range. The clinical relevance of..

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Assessment of cardiac recovery in patients supported with venoarterial extracorporeal membrane oxygenation

Abstract Aims Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used to support patients in cardiogenic shock (CS). Early determination of disposition is paramount, as longer durations of support have..

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Initiation of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock during out of hours versus working hours is not associated…

Abstract Background: Initiation of veno-arterial (VA) Extracorporeal Membrane Oxygenator (ECMO) is associated with severe complications. It is unknown whether these adverse consequences occur more often after initiations during out of..

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Long-Term Follow-Up of Survivors of Extracorporeal Life Support Therapy for Cardiogenic Shock: Are They Really Survivors?

Abstract Background and Objectives:  Cardiogenic shock (CS) is a medical emergency associated with a high mortality rate. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted therapy for CS. Despite..

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Early experience with the Impella pump: Single-center registry

Abstract Background: With the rapid development of mechanical circulatory support technologies, patients presenting with cardiogenic shock have gained access to various treatment opportunities which were not until recently available. The Impella®..

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Effect of Moderate Hypothermia vs Normothermia on 30-Day Mortality in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation

Abstract Importance  The optimal approach to the use of venoarterial extracorporeal membrane oxygenation (ECMO) during cardiogenic shock is uncertain. Objective  To determine whether early use of moderate hypothermia (33-34 °C) compared with..

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VA-ECMO rescue therapy in propofol infusion syndrome after cardiac surgery

Abstract Introduction Propofol infusion syndrome (PRIS) is a rare entity that could lead to profound cardiogenic shock (CS). Mitochondrial toxicity and sympathetic blockade are the mechanisms leading to CS in..

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Weaning from Veno Arterial Extracorporeal Membrane Oxygenation

The ELSO Interim Guidelines for venoarterial extracorporeal membrane oxygenation (VA ECMO) is timely. I would like to raise a few points on weaning recommendations. First, the parameters detailed in Figure 11..

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Surgically Implanted Impella Device for Patients on Impella CP Support Experiencing Refractory Hemolysis

Abstract The Impella CP (Abiomed Inc., Danvers, MA) is widely used in cardiac catheterization laboratories for patients presenting with cardiogenic shock, but it is also known to cause significant hemolysis. The risk..

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Early Implantation of Extracorporeal Membrane Oxygenator After Open-Heart Surgery

Abstract Extracorporeal membrane oxygenator (ECMO) is effective for maintaining oxygenation and hemodynamic support in patients with post-cardiotomy cardiogenic shock (PCCS). Researchers, led by Ahmed Abdeljawad, sought to compare the effect..

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Perioperative incidence of ECMO and IABP on 5901 mitral valve surgery procedures

Abstract Background Report the incidence and results of peri-operative extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP) of patients undergoing mitral valve surgery (MVS) through right mini-thoracotomy (RT) and..

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Transapical Cannulation with a Dual Lumen Cannula for Mechanical Circulatory Support in Cardiogenic Shock

Abstract Temporary mechanical circulatory support can be delivered through a variety of techniques, including percutaneous left ventricular assist devices, surgically implanted rotary pumps, and veno-arterial extracorporeal membrane oxygenation. However, limitations..

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Buttock Ischemia in Venoarterial Extracorporeal Membrane Oxygenation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a bridging therapy for refractory cardiogenic shock, and limb ischemia is a concern with femoral cannulation. Because of the rich collateral pelvic circulatory..

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Extracorporeal Membrane Oxygenation as a Bridge to Surgical Repair of Postinfarct Ventricular Septal Defect

Abstract Postinfarct ventricular septal defect (PIVSD) is associated with high mortality and the management of these patients has been a challenge with little improvement in outcomes. We commenced a protocol..

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A Review of Pulmonary Arterial Hypertension Treatment in Extracorporeal Membrane Oxygenation: A Case Series of Adult Patients

Abstract Background: Little data is published describing the use of medications prescribed for pulmonary arterial hypertension (PAH) in patients receiving extracorporeal membrane oxygenation (ECMO). Even though many patients with PAH..

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A mock circulation loop to evaluate differential hypoxemia during peripheral venoarterial extracorporeal membrane oxygenation

Abstract Introduction Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) creates a retrograde flow along the aorta competing with the left ventricle (LV) in the so-called ‘mixing zone’ (MZ). Detecting it..

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Impella Management for the Cardiac Intensivist

Abstract The Impella mechanical circulatory support (MCS) system is a catheter-based continuous flow cardiac assist device that is widely used in the treatment of cardiogenic shock in medical and surgical cardiac intensive..

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Echocardiography in Weaning Right Ventricular Mechanical Circulatory Support: Are We Measuring the Right Stuff?

Abstract Although acute right ventricular (RV) failure is uncommon, it is associated with a poor prognosis and high mortality. A range of devices now exist to provide temporary mechanical circulatory..

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