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Clinical Outcomes and Cost Associated With an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump in Patients Presenting…

Abstract Importance  Intravascular microaxial left ventricular assist device (LVAD) compared with intra-aortic balloon pump (IABP) has been associated with increased risk of mortality and bleeding among patients with acute myocardial infarction..

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Two Birds, One Stone: Awake Extracorporeal Life Support

Case A 55 year old female, no previous medical history, underwent out-of-hospital cardiac arrest. Advanced cardiac life support (ACLS) was initiated, with return of spontaneous circulation after 30’ of conventional..

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How to perform focused transoesophageal echocardiography during extracorporeal cardiopulmonary resuscitation?

Abstract Focused cardiac ultrasound is an important aspect of the comprehensive management of patients with cardiac arrest, especially in patients selected for extracorporeal cardiopulmonary resuscitation (eCPR). It guides physician during..

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Effect of Lower vs Higher Oxygen Saturation Targets on Survival to Hospital Discharge Among Patients Resuscitated After Out-of-Hospital Cardiac Arrest

Abstract Importance  The administration of a high fraction of oxygen following return of spontaneous circulation in out-of-hospital cardiac arrest may increase reperfusion brain injury. Objective  To determine whether targeting a lower oxygen..

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Cost-effectiveness of extracorporeal cardiopulmonary resuscitation after in-hospital cardiac arrest: A Markov decision model

Abstract Background: This study aimed to estimate the cost-effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest treatment. Methods: A decision tree and Markov model were constructed based on current literature...

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Clinician Perspectives on Cannulation for Extracorporeal Cardiopulmonary Resuscitation: A Mixed Methods Analysis

Abstract Out-of-hospital cardiac arrest is a leading cause of mortality with survival rates of less than 10%. In selected patients, survival may be improved via timely application of extracorporeal cardiopulmonary resuscitation (ECPR)...

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Incidence of death or disability at 6 months after extracorporeal membrane oxygenation in Australia: a prospective, multicentre, registry-embedded cohort study

Abstract Background  (ECMO) is an invasive procedure used to support critically ill patients with the most severe forms of cardiac or respiratory failure in the short term, but long-term effects..

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Microplegia in paediatric hearts

Abstract Introduction A basic prerequisite for a good surgical outcome in heart surgery is optimal myocardial protection. However, cardioplegia strategies used in adult cardiac surgery are not directly transferable to..

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End-stage Renal Disease and Long-term Survival Among Survivors of Extracorporeal Membrane Oxygenation.

Abstract We aimed to investigate the prevalence and associated factors of newly diagnosed end-stage renal disease (ESRD) requiring renal-replacement therapy (RRT) among survivors of extracorporeal membrane oxygenation (ECMO) and determine..

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Inferior and Superior Vena Cava Saturation Monitoring After Neonatal Cardiac Surgery

Abstract OBJECTIVES:  Superior vena cava oxygen saturation (SVC O2) monitoring is well described for early detection of hemodynamic deterioration after neonatal cardiac surgery but inferior vena cava vein oxygen saturation (IVC O2) monitoring data..

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High-dose adenosine versus saline-induced cardioplegic arrest in coronary artery bypass grafting: A randomized double-blind clinical feasibility trial

Abstract Background and objective: In this clinical trial, we evaluated if a short-acting nucleoside, adenosine, as a high-dose bolus injection with blood cardioplegia induces faster arrest and provides better myocardial..

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Contemporary targeted temperature management: Clinical evidence and controversies

Abstract Advancements in cardiac arrest and post-cardiac arrest care have led to improved survival to hospital discharge. While survival to hospital discharge is an important clinical outcome, neurologic recovery is..

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Extracorporeal Membrane Oxygenation Outcomes in Children With Preexisting Neurologic Disorders or Neurofunctional Disability

Abstract OBJECTIVE:  Patient selection for pediatric extracorporeal membrane oxygenation (ECMO) support has broadened over the years to include children with pre-existing neurologic morbidities. We aimed to determine the prevalence and..

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Venoarterial Extracorporeal Membrane Oxygenation in Severe Drug Intoxication: A Retrospective Comparison of Survivors and Nonsurvivors

Abstract Selecting patients most likely to benefit from venoarterial extracorporeal membrane oxygenation (V-A ECMO) to treat refractory drug-induced cardiovascular shock remains a difficult challenge for physicians. This study reported short-term..

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Venting during venoarterial extracorporeal membrane oxygenation

Abstract Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering..

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Survival and Factors Associated with Survival with Extracorporeal Life Support During Cardiac Arrest: A Systematic Review and Meta-Analysis

Abstract The survival rate after cardiac arrest (CA) remains low. The utilization of extracorporeal life support is proposed to improve management. However, this resource-intensive tool is associated with complications and..

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Cardiac Arrest, E-CPR, & Post-Arrest Care with Dr. Jason Bartos

Abstract Approximately 350,000 adults per year in the US experienced out-of-hospital cardiac arrest (OHCA). Only about 10% of such patients survive their initial hospitalization. The key drivers of successful resuscitation..

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Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery

Abstract Objective Custodiol® and St. Thomas cardioplegia are widely employed in mini-thoracotomy mitral valve (MV) operations. One-dose of the former provides 3 h of myocardial protection. Conversely, St. Thomas solution is..

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Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine

Abstract Aim  Head and thorax elevation during cardio-pulmonary resuscitation improves cerebral hemodynamics and ultimate neurological outcome after cardiac arrest. Its effect during extracorporeal cardiopulmonary resuscitation (E-CPR) is unknown. We tested..

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Metabolomic profiling demonstrates evidence for kidney and urine metabolic dysregulation in a piglet model of cardiac surgery-induced acute kidney injury

Abstract Acute kidney injury (AKI) is a common cause of morbidity after congenital heart disease surgery. Progress on diagnosis and therapy remains limited, however, in part due to poor mechanistic..

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A qualitative analysis of physician decision making in the use of extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest

Abstract Aim of Study To prepare for the design of future  of  cardioupulmonary resuscitation (ECPR), we sought to understand physician beliefs regarding the use of ECPR and subsequent management, among physicians who..

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Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted Temperature Management Post Cardiac Arrest

Abstract Purpose: To evaluate unfractionated heparin (UFH) dosing guided by antifactor Xa levels during targeted temperature management (TTM) post-cardiac arrest. Methods: Single-center, retrospective, observational study between January 1, 2014 and..

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Stroke in pediatric ECMO patients: analysis of the National Inpatient Sample (NIS) database

Abstract Background The rates, outcomes, and long-term trends of stroke complicating the use of extracorporeal membrane oxygenation (ECMO) have been inconsistently reported. We compared the outcomes of pediatric ECMO patients..

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Proton magnetic resonance spectroscopy assessment of neonatal brain metabolism during cardiopulmonary bypass surgery

Abstract Here, we report on the development and performance of a robust 3-T single-voxel proton magnetic resonance spectroscopy (1H MRS) experimental protocol and data analysis pipeline for quantifying brain metabolism..

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Optimizing PO2 during peripheralveno-arterial ECMO: a narrative review

Abstract During refractory cardiogenic shock and cardiac arrest, veno‑arterial extracorporeal membrane oxygenation (VA‑ECMO) is used to restore a circulatory output. However, it also impacts significantly arterial oxygenation. Recentguidelines of the..

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Left ventricular venting during extracorporeal membrane oxygenation; the effects on cardiac performance in a porcine model of critical post-cardiotomy failure

Abstract Introduction Left ventricular distension is a major concern with postcardiotomy veno-arterial extracorporeal membrane oxygenation (VA-ECMO) supporting a critical heart failure after cardiac surgery. This porcine study evaluates the effects..

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Effect of 4% Albumin Solution vs Ringer Acetate on Major Adverse Events in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Abstract Importance  In cardiac surgery, albumin solution may maintain hemodynamics better than crystalloids and reduce the decrease in platelet count and excessive fluid balance, but randomized trials are needed to compare..

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Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: first results and outcomes of a newly established ECPR program in a large…

Abstract Objectives: Out-of-hospital cardiac arrest (OHCA) is associated with excessively high mortality rates. Recent studies suggest benefits from extracorporeal cardiopulmonary resuscitation (ECPR) performed in selected patients. We sought to present..

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ECPR2: Expert Consensus on Percutaneous Cannulation for Extracorporeal CardioPulmonary Resuscitation

Abstract Aim Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising resuscitation strategy for select patients suffering from refractory out-of-hospital cardiac arrest (OHCA), though limited data exist regarding the best..

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Hypothermic versus Normothermic Temperature Control after Cardiac Arrest

Abstract BACKGROUND The evidence for temperature control for comatose survivors of cardiac arrest is inconclusive. Controversy exists as to whether the effects of hypothermia differ per the circumstances of the..

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