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Evaluation of Left Ventricular Overload and Use of Unloading Techniques in Venoarterial Extracorporeal Life Support: A Nationwide Survey

Abstract Cardiogenic shock (CS) and cardiac arrest (CA) are among the most lethal complications of acute cardiovascular disease, affected by high in-hospital mortality rates. Venoarterial extracorporeal life support (VA ECLS)..

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Perspectives and Considerations of IABP in the Era of ECMO for Cardiogenic Shock

Abstract The development of mechanical circulatory support (MCS) has been rapid, and its use worldwide in patients with cardiogenic shock is increasingly widespread. However, current statistical data and clinical research..

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Pulmonary Vasodilator and Inodilator Drugs in Cardiac Surgery: A Systematic Review With Bayesian Network Meta-Analysis

Abstract Objective The authors performed a systematic review to evaluate the effect of pharmacologic therapy on pulmonary hypertension in the perioperative setting of elective cardiac surgery (PROSPERO CRD42023321041). Design Systematic..

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Biofilm Assessment and Metagenomic Analysis of Venoarterial Extracorporeal Membrane Oxygenation Cannulas and Membrane Oxygenators

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) exposes the patient to infectious complications related to the cannulas or the site of insertion. The aim of the current study was to investigate..

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Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomised controlled trials and propensity score matched studies.

Abstract Background: Cardiogenic shock is associated with high mortality. In refractory shock, it is unclear if mechanical circulatory support (MCS) devices improve survival. We conducted a systematic review and network meta-analysis..

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Impella – Current issues and future expectations for the percutaneous, microaxial flow left ventricular assist device

Abstract Summary The importance of temporary mechanical circulatory support for treating acute heart failure with cardiogenic shock is increasingly recognized, and Impella (Abiomed, Danvers, MA, USA) has received particular attention..

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Left Atrial-Veno Arterial Extracorporeal Membrane Oxygenation as a Bridge to Surgery for Endocarditis–Related Acute Severe Aortic Regurgitation

Abstract Mechanical circulatory support for cardiogenic shock complicated by acute severe aortic regurgitation poses a unique challenge for traditional veno arterial extracorporeal membrane oxygenation (ECMO) because of rapidly rising left..

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Utilization of Impella as a Weaning Platform from ECMO is Associated with Increased Survival in Cardiogenic Shock Patients

Abstract Background: Although extracorporeal membrane oxygenation (ECMO) is an integral part of a robust cardiogenic shock program, it is associated with high mortality. The optimal strategy for weaning from ECMO is..

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Takotsubo Syndrome and Severe Cardiogenic Shock secondary to Plastic Surgery treated with VA-ECMO. Case Series

Abstract Beside the tremendous developments in cardiac surgical procedures, the use of cardiopulmonary bypass (CPB) remains the gold standard to perform cardiac surgery but is associated with detrimental effects (e.g...

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Venting the Left Ventricle from the Atrium: A Case Series of transeptal LA Vent VA-ECMO

Abstract Introduction: In cardiogenic shock, peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide hemodynamic support, however this results in adverse left ventricular afterload. Left ventricle (LV) venting (unloading) has favorable effects..

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De senectute and the art of medicine: how old is too old for ECMO in cardiogenic shock?

Abstract Complexity and a certain level of uncertainty are inherent to the clinical scenarios faced by the treating teams, often inundated with exhaustive details. Disease arises from a multitude of..

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Age and associated outcomes among patients receiving venoarterial extracorporeal membrane oxygenation–analysis of the Extracorporeal Life Support Organization registry

Abstract Purpose Venoarterial extracorporeal membrane oxygenation (V-A ECMO) can be used to support severely ill patients with cardiogenic shock. While age is commonly used in patient selection, little is known..

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Understanding lactate and its clearance during extracorporeal membrane oxygenation for supporting refractory cardiogenic shock patients

Abstract The recent study by Scolari et al. [] entitled ‘Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort..

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Concomitant Use of VA-ECMO and Impella Support for Cardiogenic Shock

Abstract Background: VA-ECMO with concomitant Impella support (ECpella) is an emerging treatment modality for cardiogenic shock (CS). Survival outcomes by CS etiology with ECpella support have not been well-described. Methods: This study..

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An emerging complementary strategy to treat acute heart failure (AHF) and cardiogenic shock (CS): the first clinical trial in China…

Abstract Mechanical circulatory support (MCS) is an emerging therapy for acute heart failure (AHF) or cardiogenic shock (CS) patients unresponsive to medicinal treatment. In China, common treatments using short-term MCS..

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Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial

Abstract BACKGROUND: Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) is beneficial for the treatment of profound cardiogenic shock, peripheral VA-ECMO cannulation can increase left ventricular afterload, thus compromising myocardial recovery. We..

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Extracorporeal Life Support in Infarct-Related Cardiogenic Shock

Abstract BACKGROUND Extracorporeal life support (ECLS) is increasingly used in the treatment of infarct-related cardiogenic shock despite a lack of evidence regarding its effect on mortality. METHODS In this multicenter..

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Predicting Hemodynamic Changes During Intra-Aortic Balloon Pump Support With a Longitudinal Evaluation

Abstract The use of intra-aortic balloon pump (IABP) has decreased in recent years due to negative outcome studies in cardiogenic shock complicating acute myocardial infarction, despite its favorable adverse-event profile...

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Acute stroke in patients undergoing coronary artery bypass grafting surgery in acute coronary syndrome: Predictors and outcomes

Abstract Objectives Coronary artery bypass grafting (CABG) surgery in patients with acute coronary syndrome (ACS) remains a high-risk procedure and is associated with adverse outcomes. The risk factors of acute..

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Risk factors for postoperative myocardial injury-related cardiogenic shock in patients undergoing cardiac surgery

Abstract Background Myocardial injury-related cardiogenic shock (MICS) is significantly associated with poor outcomes in patients after cardiac surgery. Herein, we aimed to investigate the risk factor for postoperative MICS. Methods..

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The association between intraoperative cardiopulmonary bypass power and complications after cardiac surgery

Abstract Background Low cardiac power (product of flow and pressure) has been shown to be associated with mortality in patients with cardiogenic shock after acute myocardial infarction, but has not..

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Extracorporeal Blood Purification with CytoSorb in 359 Critically Ill Patients

Abstract Introduction: Critically ill patients with inflammatory dysregulation and organ disfunction may benefit from blood purification, although the use of this technique has not been described in large case series. We..

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Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials

Abstract Background Venoarterial  (VA-ECMO) is increasingly used  with  despite the lack of evidence from adequately powered . Three trials reported so far were underpowered to detect a survival benefit; we therefore conducted an individual..

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Intraaortic Balloon Pump Counterpulsation, Part I: History, Technical Aspects, Physiologic Effects, Contraindications, Medical Applications/Outcomes

Abstract Intraaortic balloon pump counterpulsation is the most common form of mechanical circulatory support used in patients with myocardial ischemia and cardiogenic shock. The physiologic principles of counterpulsation include diastolic..

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Routine ECMO in AMICS Patients Not Protective: ECLS-SHOCK

Abstract In patients with acute MI complicated by cardiogenic shock (AMICS) who are slated to undergo early revascularization, routine use of extracorporeal membrane oxygenation (ECMO) doesn’t reduce 30-day mortality. The..

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Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials

Abstract Background Venoarterial  (VA-ECMO) is increasingly used  with  despite the lack of evidence from adequately powered . Three trials reported so far were underpowered to detect a survival benefit; we therefore conducted an individual..

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Interest Grows in LAVA-ECMO

Abstract LAVA-ECMO has recently gained attention in the medical community, specifically, as support for cardiogenic-shock patients. In particular, interest has picked up since it was highlighted at the 2023 Houston..

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Which Vasopressors and Inotropes to Use in the Intensive Care Unit

Abstract Introduction Cardiac output (CO) is a key determinant of oxygen delivery. Low cardiac output syndrome (LCOS) causes organ dysfunction, prolonged hospital stay, and reduces survival in perioperative settings and..

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The Burden of Survivorship After Venoarterial Extracorporeal Membrane Oxygenation: A Black Box

Abstract Due to advances in critical care medicine over the past several decades, the number of survivors of critical illness continues to grow despite increased severity of illness (). There..

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Extracorporeal membrane oxygenation as a bridge to advanced heart failure therapies

Abstract Background Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a key support modality for cardiogenic shock. The 2018 United Network for Organ Sharing (UNOS) heart transplant allocation algorithm prioritizes VA-ECMO patients...

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