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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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Step by step daily management of short-term mechanical circulatory support for cardiogenic shock in adults in the intensive cardiac care…

Abstract The use of mechanical circulatory support using percutaneous ventricular assist devices (pVAD) has increased rapidly during the last decade without substantial new evidence for their effect on outcome. In..

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The low hemoglobin levels were associated with mortality in post-cardiotomy patients undergoing venoarterial extracorporeal membrane oxygenation

Abstract Background Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used as a rescue strategy for patients with refractory post-cardiotomy cardiogenic shock (PCS). These patients often have varying degrees of reduced hemoglobin..

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Extracorporeal Life Support for Cardiogenic Shock in Adult Congenital Heart Disease—An ELSO Registry Analysis

Abstract There are minimal data on the use of venoarterial extracorporeal membrane life support (VA-ECLS) in adult congenital heart disease (ACHD) patients presenting with cardiogenic shock (CS). This study sought..

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Effective Treatment of Acute Tricyclic Antidepressant Poisoning with Cardiogenic Shock and Severe Rhabdomyolysis Using ECMO and CytoSorb® Adsorber

Abstract BACKGROUND Tricyclic antidepressant (TCA) drugs are a common cause of fatal poisoning because of their cardiotoxic and arrhythmogenic effects. Classic supportive management includes sodium bicarbonate, gastrointestinal chelating agents, and..

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The ProtekDuo in percutaneous peripheral venopulmonary-arterial ECMO and PROpella configuration for cardiogenic shock with biventricular failure

Abstract This article describes a case study where a patient with ProtekDuo + oxygenator and Impella CP (PROpella) in biventricular failure and cardiogenic shock was reconfigured to venopulmonary-arterial (VP-A) extracorporeal..

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Percutaneous decannulation of venoarterial extracorporeal membrane oxygenation using the Manta vascular closure device: A systematic review and meta-analysis

Abstract Objectives To perform a systematic review and meta-analysis of the techniques and outcomes associated with percutaneous decannulation of venoarterial extracorporeal membrane oxygenation (VA–ECMO) using the Manta vascular closure device...

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The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery

Abstract In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such..

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On-Support and Post-Weaning Mortality in Post-Cardiotomy Extracorporeal Membrane Oxygenation

Abstract BACKGROUND Post-cardiotomy veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is characterized by discrepancies between weaning and survival-to-discharge rates. This study analyzes the differences between post-cardiotomy V-A ECMO patients who survived,..

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Decannulation of Percutaneous Femoro-femoral VA-ECMO Using the Manta Vascular Closure Device

Abstract Percutaneous cannulation improved femoro-femoral veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) results, reducing infectious complications, but remains limited by vascular complications related to the arterial decannulation. Several techniques were described to perform a percutaneous decannulation..

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The ProtekDuo® Cannula for Acute Mechanical Circulatory Support

Abstract The ProtekDuo® is a dual lumen cannula that can be used in numerous configurations to treat cardiogenic shock and hypotension. Its default function is as a temporary percutaneous right..

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Evaluation of Vasoactive-Inotropic Score and Survival to Decannulation in Adult Patients on Venoarterial Extracorporeal Life Support: An Observational Cohort Study

Abstract Extracorporeal life support with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to assist circulation in patients with severe cardiogenic shock or cardiac arrest. The vasoactive-inotropic score (VIS) is a standardized calculation of vasoactive medication support which uses..

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Association of Arterial Blood pH at Cannulation With 1 Year Survival Among Veno-Arterial Extracorporeal Membrane Oxygenation Recipients: The Three Seven…

Abstract We aimed to describe the clinical outcomes of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy in our institution considering clinical context and pH at cannulation. All patients treated by VA-ECMO during the..

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Upper gastrointestinal bleeding in adults treated with veno-arterial extracorporeal membrane oxygenation: a cohort study

Abstract OBJECTIVES Upper gastrointestinal bleeding (UGIB) is a common complication in adults treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock or cardiac arrest. We aimed to determine..

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Outcomes of early versus delayed initiation of extracorporeal life support in cardiac surgery

Abstract Background Extracorporeal membrane oxygenation offers temporary hemodynamic support for patients with refractory cardiogenic shock after cardiovascular surgery. However, the initiation time for such patients is controversial. Changing the initiation..

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Can VA-ECMO Be Used as an Adequate Treatment in Massive Pulmonary Embolism?

Abstract Introduction: Massive acute pulmonary embolism (MAPE) with obstructive cardiogenic shock is associated with a mortality rate of more than 50%. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used..

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Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How?

Abstract Venoarterial extracorporeal membrane oxygenation provides cardiorespiratory support to patients in cardiogenic shock. This comes at the cost of increased left ventricle (LV) afterload that can be partly ascribed to retrograde..

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Prognosis of Venoarterial Extracorporeal Membrane Oxygenation in Mixed, Cardiogenic and Septic Shock

Abstract Mixed cardiogenic-septic shock (MS), defined as the combination of cardiogenic (CS) and septic (SS) shock, is often encountered in cardiac intensive care units. Herein, the authors compared the impact of..

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Preclinical Studies on Pulsatile Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Refractory cardiogenic shock is increasingly being treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO), without definitive proof of improved clinical outcomes. Recently, pulsatile V-A ECMO has been developed to address some of the..

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Timing of Active Left Ventricular Unloading in Patients on Venoarterial Extracorporeal Membrane Oxygenation Therapy

Abstract Background It is currently unclear if active left ventricular (LV) unloading should be used as a primary treatment strategy or as a bailout in patients with cardiogenic shock (CS)..

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Early hyperoxia and 28-day mortality in patients on venoarterial ECMO support for refractory cardiogenic shock: a bicenter retrospective propensity score-weighted…

Abstract Background The mortality rate for a patient with a refractory cardiogenic shock on venoarterial (VA) extracorporeal membrane oxygenation (ECMO) remains high, and hyperoxia might worsen this prognosis. The objective..

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Effect of flow change on brain injury during an experimental model of differential hypoxaemia in cardiogenic shock supported by extracorporeal…

Abstract Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is an increasingly used rescue therapy forpatients with refractory cardiogenic shock (CS) 1,2 . It provides mechanical circulatory support for both heartand lungs..

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Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Mortality in Patients with Cardiogenic Shock

Abstract Background: Exposure to hyperoxia, a high arterial partial pressure of oxygen (PaO2), may be associated with worse outcomes in patients receiving extracorporeal membrane oxygenator (ECMO) support. We examined hyperoxia in..

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Successful percutaneous coronary intervention with extracorporeal membrane oxygenation in a patient with acute inferior wall myocardial infarction complicated by electrical…

Abstract Background High-risk patients with coronary heart disease who develop acute myocardial infarction (AMI) have severe coronary lesions. If severe complications occur, such as malignant ventricular arrhythmia, cardiogenic shock, and..

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