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Impact of Venoarterial Extracorporeal Membrane Oxygenation Flow on Outcomes in Cardiogenic Shock

Abstract Venoarterial extracorporeal membrane oxygenation (VA ECMO) is used to provide cardiopulmonary support in cardiogenic shock; however, high extracorporeal flow may increase left ventricular (LV) afterload leading to LV distention..

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Red blood cell transfusion threshold and mortality in cardiac intensive care unit patients

Abstract Background The benefit of red blood cell (RBC) transfusion in anemic critically-ill patients with cardiovascular disease is uncertain, as is the optimal threshold at which RBC transfusion should be..

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The outcome of patients with peripartum cardiomyopathy and consecutive implantation of a left ventricular assist device

Abstract Objectives Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure occurring toward the end of pregnancy or in the period after delivery. Lack of myocardial recovery or therapy‐refractory..

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Development and Validation of a Risk Score for Respiratory Failure After Cardiac Surgery

Abstract Background Postoperative respiratory failure, defined as ventilator dependency for more than 48 hours or unplanned reintubation within 30 days, is a costly complication of cardiac surgery that increases mortality..

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Pump flow setting and assessment of unloading in clinical practice

Abstract The rationale for mechanical circulatory support (MCS) in cardiogenic shock is to restore cardiac output in selected patients when critically low or in case of refractory cardiac arrest. Furthermore,..

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Axial flow ventricular assist devices in cardiogenic shock complicating acute myocardial infarction

Abstract Cardiogenic shock (CS) remains the leading cause of death in patients hospitalised with acute myocardial infarction with mortality as high as 40%–50% prior to hospital discharge. The failure of..

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Long‐term renal function after venoarterial extracorporeal membrane oxygenation

Abstract Background The utilization of venoarterial extracorporeal membrane oxygenation (VA‐ECMO) as a life‐supporting therapy has increased exponentially over the last decade. As more patients receive and survive ECMO, there are..

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Concomitant Respiratory Failure Can Impair Myocardial Oxygenation in Patients with Acute Cardiogenic Shock Supported by VA-ECMO

Abstract Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment for acute cardiogenic shock in patients who also have acute lung injury predisposes development of a serious complication called “north-south syndrome” (NSS) which..

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Contraindicaciones y complicaciones de la asistencia circulatoria mecánica

Resumen La asistencia circulatoria mecánica se emplea cuando han fracasado todos los tratamientos posibles. Por ello, antes de su aplicación bastantes pacientes presentan ya contraindicaciones, absolutas o relativas, que hay..

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Venoarterial Extracorporeal Membrane Oxygenation for Postcardiotomy Shock—Analysis of the Extracorporeal Life Support Organization Registry

Abstract Objectives:  Refractory postcardiotomy cardiogenic shock complicating cardiac surgery yields nearly 100% mortality when untreated. Use of venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock has increased worldwide recently. The aim of the current..

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ECMO in cardiac arrest and cardiogenic shock

Abstract Cardiogenic shock is an acute emergency, which is classically managed by medical support with inotropes or vasopressors and frequently requires invasive ventilation. However, both catecholamines and ventilation are associated..

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Microvascular reactivity and clinical outcomes in cardiac surgery

Abstract Introduction Microvascular reactivity is decreased in patients with septic shock; this is associated with worse clinical outcomes. The objectives of the present study were to investigate microvascular reactivity in..

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Extracorporeal Membrane Oxygenation

Abstract Over the years, there have been many innovations that have come and gone. It is not often that a single idea dramatically changes how critical care is delivered. Since..

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Novel Rotational Speed Modulation System Used With Venoarterial Extracorporeal Membrane Oxygenation

Abstract Background Femoral venoarterial  (VA-ECMO) is widely used to maintain blood flow in patients with . However, retrograde blood flow increases left ventricular (LV) afterload during femoral VA-ECMO. Additional support by means..

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Modern hydroxyethyl starch and acute kidney injury after cardiac surgery: a prospective multicentre cohort.

Abstract Background Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also..

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Veno-venous ECMO as a safe bridge to recovery in a patient with severe peripartum cardiomyopathy – learning from errors

Abstract Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy..

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When all else fails: extracorporeal life support in therapy-refractory cardiogenic shock

Abstract OBJECTIVES No guidelines for mechanical circulatory support in patients with therapy-refractory cardiogenic shock and multiorgan failure including ongoing cardiopulmonary resuscitation (CPR) exist. To achieve immediate cardiopulmonary stabilization, we established..

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Percutaneous mechanical circulatory support: current concepts and future directions

Abstract Introduction Percutaneous mechanical circulatory support (MCS) strategies have been in the clinical arena for approximately half a century, with the main aim of providing adequate systemic tissue perfusion, while..

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ECPella: Concept, Physiology and Clinical Applications

Abstract Addition of Impella on top of venoarterial extracorporeal membrane oxygenation (VA-ECMO) has gained wide interest as it might portend improved outcomes in patients with cardiogenic shock. This has been..

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Prediction of the impact of venoarterial extracorporeal membrane oxygenation on hemodynamics

Abstract Although venoarterial extracorporeal membrane oxygenation (ECMO) was developed to rescue patients with cardiogenic shock, the impact of ECMO on hemodynamics is often unpredictable and can lead to hemodynamic collapse...

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Frequency and outcomes of severe hyperlactatemia after elective cardiac surgery

Abstract Background  is relatively common in the cardiac surgical patient and is usually considered a marker of illness severity. The frequency and impact of severe hyperlactatemia after elective cardiac surgery..

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Complete aortic thrombosis in SARS-CoV-2 infection

Abstract A 74-year-old man with a history of diabetes mellitus, coronary artery disease, and previous myocardial infarction presents to the emergency department with cardiogenic shock. Cardiopulmonary resuscitation and emergency care..

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Takotsubo Cardiomyopathy Following Cardiac Surgery

Abstract Background Takotsubo cardiomyopathy syndrome, commonly occurring in postmenopausal women, is characterized by transient apical systolic dysfunction in absence of coronary lesions. The cardiomyopathy is often observed after intense stressful..

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Feasibility of smaller arterial cannulas in venoarterial extracorporeal membrane oxygenation

Abstract To facilitate venoarterial extracorporeal membrane oxygenation (ECMO) insertion for cardiogenic shock, we recently adopted a strategy of using a 15F arterial cannula in all patients, rather than 1 designed..

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Intra‐aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock

Abstract Background Intra‐aortic balloon pump counterpulsation (IABP) is currently the most commonly used mechanical assist device for patients with cardiogenic shock due to acute myocardial infarction. Although there has been..

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Predictors for acute and chronic renal failure and survival in patients supported with veno-arterial extracorporeal membrane oxygenation

Abstract Background: Renal failure is a common occurrence in patients with refractory cardiogenic shock including those supported with veno-arterial extracorporeal membrane oxygenation. Prevalence and outcome of acute and chronic kidney..

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Outcomes after extracorporeal life support for postcardiotomy cardiogenic shock

Abstract Background and Aim of the Study Extracorporeal life support (ECLS) may be necessary in refractory postcardiotomy cardiogenic shock (PCS) unresponsive to optimal medical treatment. We sought to analyze the..

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Three consecutive cases of fatal intraoperative intracardiac thrombosis associated with the initiation of venoarterial extracorporeal membrane oxygenation in the presence…

Abstract Central venoarterial extracorporeal membrane oxygenation has been used since the 1970s to support patients with cardiogenic shock following cardiac surgery. Despite this, in-hospital mortality is still high, and although..

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Blood Lactate as a Reliable Marker for Mortality of Pediatric Refractory Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation

Abstract The objective of this study is to establish reliable markers for mortality in children with refractory cardiogenic shock who underwent extracorporeal membrane oxygenation. A retrospective observational cohort study was..

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Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Percutaneous Left Ventricular Decompression Therapy with Impella Is Associated with Improved Outcomes in Refractory…

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous..

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