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Rising Above the Limits of Critical Care ECMO: A Narrative Review

Abstract Extracorporeal membrane oxygenation (ECMO), an advanced life support method, was developed to treat severe cardiac and pulmonary failure in critically ill patients. ECMO was previously used to treat ARDS,..

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Antepartum Extracorporeal Life Support: A Viable Way to Improve Fetal Outcomes

Abstract Extracorporeal life support (ECLS) has become increasingly common in the United States to manage refractory cardiopulmonary failure and has been used in complex populations including pregnant women. Application of..

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Scrutinizing the Role of Venoarterial Extracorporeal Membrane Oxygenation: Has Clinical Practice Outpaced the Evidence?

Abstract The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for temporary mechanical circulatory support in various clinical scenarios has been increasing consistently, despite the lack of sufficient evidence regarding its..

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Early Intra-Aortic Balloon Support for Heart Failure-Related Cardiogenic Shock: A Randomized Clinical Trial

Abstract Background The impact of intra-aortic balloon pump (IABP) on survival and successful bridging to heart replacement therapies (HRT) in patients with heart failure–cardiogenic shock (HF-CS) remains unclear. Objectives The..

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Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation

Abstract Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used to treat cardiogenic shock. However, VA-ECMO might hamper myocardial recovery. The Impella unloads the left ventricle. This study aimed to..

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In Silico Analysis of Pulsatile Flow Veno-Arterial Extracorporeal Membrane Oxygenation on Human Aorta Model

Abstract Electrocardiogram (ECG)—synchronized pulsatile veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a recent development in extracorporeal therapy for patients with severe cardiogenic shock. Although preclinical studies have shown benefits of..

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Expert consensus on the use of human serum albumin in critically ill patients

Abstract Human serum albumin (HSA) is a non-glycosylated, negatively charged, single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD. It is synthesized by..

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Comparison of Extracorporeal Membrane Oxygenation Initiation in Cardiogenic Shock During Work-Hours Versus After-Hours

Abstract Background Extracorporeal membrane oxygenation (ECMO) as rescue therapy for cardiogenic shock (CS) is highly dependent on timeliness and medical resources. Objectives Aimed to assess ECMO management and outcomes in..

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Can utilization of the venous-to-arterial carbon dioxide difference improve patient outcomes in cardiogenic shock? A narrative review

Abstract Cardiogenic shock (CS) is a critical condition with high mortality, characterized by reduced cardiac output (CO) and tissue hypoperfusion, despite advancements in treatment. Traditional hemodynamic markers like CO measurements,..

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Obesity and Venoarterial Extracorporeal Membrane Oxygenation Outcomes: The Plot Thickens

Abstract We read with great interest a recent article on the association between body mass index (BMI) and outcomes in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). In a review..

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Parallel Venovenous Extracorporeal Membrane Oxygenation Circuits During Bridge-to-Lung Transplantation

Abstract Venovenous (VV) extracorporeal membrane oxygenation (ECMO) supports end-organ oxygen delivery in patients with refractory respiratory failure. Physical therapy (PT) while on ECMO provides conceptual benefits of strength and conditioning...

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Treatment time limit for successful weaning from veno‐arterial extracorporeal membrane oxygenation in cardiogenic shock

Abstract Aims Knowing the upper time limit for successful weaning from temporary mechanical circulatory support in cardiogenic shock will help with decision‐making regarding advanced heart failure (HF) therapy or considering..

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ECMO in the Cardiac Catheterization Lab—Patient Selection Is Key

Abstract The use of extracorporeal membrane oxygenation (ECMO) has emerged as a rescue intervention for hemodynamically unstable patients and prophylactic intraprocedural hemodynamic support in the cardiac catheterization laboratory. The prompt..

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Treatment of Cardiogenic Shock: Inotropes, Vasopressors and Machines

Abstract Cardiogenic shock (CS) is associated with significant mortality. Advances in pharmacological therapies and mechanical circulatory support (MCS) devices have markedly improved the therapeutic approach to CS, though treatment efficacy..

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A Novel Valveless Pulsatile Flow Pump for Extracorporeal Blood Circulation

Abstract Extracorporeal Membrane Oxygenation (ECMO) is a modality of extracorporeal life support which allows temporary support in cases of cardiopulmonary failure and cardiogenic shock. This study presents a valveless pump..

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The Potential Role of Albumin in Reducing Cardiac Surgery–Associated Acute Kidney Injury: A Randomized Controlled Trial

Abstract Objectives Cardiac surgery–associated acute kidney injury (CSA-AKI) is a common complication with high morbidity and mortality. This study was designed to determine whether adding human albumin to the cardiopulmonary..

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Mechanical circulatory support: when, how, and for whom

Abstract Cardiogenic shock represents a critical condition in which the heart is unable to maintain adequate circulation leading to insufficient tissue perfusion and end-organ failure. Temporary mechanical circulatory support offers..

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Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis

Abstract Background Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is associated with a high rate of morbidity and mortality. Beside other therapeutic measures (e.g. intraaortic balloon pump (IABP)), extracorporeal life..

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Changes in Neutrophil-to-Lymphocyte Ratio During Venoarterial Extracorporeal Membrane Oxygenation

Abstract Mortality remains elevated during venoarterial extracorporeal membrane oxygenation support (VA-ECMO) for cardiogenic shock and the role of inflammation is uncertain. By using the neutrophil-to-lymphocyte ratio (NLR), we investigated inflammatory..

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Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review

Abstract Background Acute lung injury and acute respiratory failure are frequent complications of cardiogenic shock and are associated with increased morbidity and mortality. Even with increased use of temporary mechanical..

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Global Trends in Ambulation Practices for Patients Supported by Temporary Mechanical Circulatory Support: A Survey-Based Analysis

Abstract In recent years, there has been an increased utilization of temporary mechanical circulatory support (tMCS) in patients with cardiogenic shock (CS), with many transitioning to recovery or advanced therapies..

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Pitfalls of computed tomography angiography examination in veno-arterial extracorporeal membrane oxygenation patients: a case report of a patient with cardiac…

Abstract Background Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is commonly used for patients with cardiac arrest, cardiogenic shock, or heart failure and is a life-saving technique. Computed tomography angiography (CTA)..

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Left atrial appendage cannulation for left ventricular unloading in a patient with ventricular thrombus on extracorporeal life support

Abstract Background Left ventricular unloading is needed in patients on extracorporeal life support (ECLS) with severely impaired left ventricular contractility to avoid stasis and pulmonary congestion, and to promote LV..

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Prophylactic use of inotropic agents for the prevention of low cardiac output syndrome and mortality in adults undergoing cardiac surgery

Abstract Background As the burden of cardiovascular disease grows, so does the number of cardiac surgeries. Surgery is increasingly performed on older people with comorbidities who are at higher risk..

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Establishing an Extracorporeal Cardiopulmonary Resuscitation Program

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective..

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Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach..

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Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is applied for the treatment of cardiogenic shock. Concomitant left ventricular unloading (LVU) with a microaxial flow pump (mAFP) enables myocardial and pulmonary recovery..

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Unfractionated heparin monitoring by anti-factor Xa versus activated partial thromboplastin time strategies during venoarterial extracorporeal life support

Abstract Introduction No clear guidelines exist for unfractionated heparin (UFH) monitoring in adult patients on veno-arterial extracorporeal life support (VA-ECLS) for refractory cardiogenic shock. In this study, we sought to..

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Pulse Pressure During VA-ECMO Support and Neurologic Outcomes: Worth Getting Pumped Up About?

Abstract Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for the management of refractory cardiogenic shock. Although VA-ECMO can stabilize hemodynamics and improve systemic flow, morbidity, and mortality on support..

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Mechanical circulatory support in cardiogenic shock

Abstract Cardiogenic shock is a complex and diverse pathological condition characterized by reduced myocardial contractility. The goal of treatment of cardiogenic shock is to improve abnormal hemodynamics and maintain adequate..

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