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The role of the perfusionist in the extracorporeal life support management: An international survey

Abstract Background Extracorporeal Life Support (ECLS) services are characterised by variability in resource availability, specific expertise, device management and team organisation, especially regarding the role of perfusionists. This international survey..

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Extracorporeal membrane oxygenation, acute kidney injury, fluid balance, and continuous renal replacement therapy: Acute Disease Quality Initiative (ADQI) and Extracorporeal…

Abstract Extracorporeal membrane oxygenation (ECMO) is increasingly being utilized for life-threatening cardiac and/or respiratory failure refractory to conventional treatment. Acute kidney injury (AKI) and fluid balance disorders commonly occur both..

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Prehospital initiation of extracorporeal life support for refractory out-of-hospital cardiac arrest–results of a prospective observational study

Abstract Background Despite advances in cardiopulmonary resuscitation (CPR), survival after out-of-hospital cardiac arrest (OHCA) remains low. Use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as extracorporeal CPR (ECPR) may improve..

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Intra-aortic balloon pump support in patients undergoing durable left ventricular assist device implantation: contemporary evidence and practical considerations

Abstract The role of intra-aortic balloon pump (IABP) use in optimizing patients for durable left ventricular assist device (LVAD) implantation is being reevaluated in the era of modern centrifugal, magnetically..

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Ethical Challenges of Extracorporeal Membrane Oxygenation: Enhanced Recovery After Surgery Cardiac Society Consensus on Key Issues and Practical Recommendations

Abstract Extracorporeal membrane oxygenation (ECMO) provides lifesaving support for patients with cardiopulmonary failure but poses complex ethical challenges that may generate moral distress for clinicians, patients, and families. We convened..

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Use of Artificial Intelligence to Predict Outcomes in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Extracorporeal membrane oxygenation (ECMO) is widely used in patients with severe cardiac or respiratory failure. ECMO is resource and cost intensive and carries the potential for significant complications; therefore,..

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The Facilitated hospital-based ECPR via Helicopter Transport (FLIGHT-to-ECPR) Study

Abstract Introduction Survival after out-of-hospital cardiac arrest (OHCA) remains poor, particularly for refractory ventricular fibrillation/ventricular tachycardia (VF/VT). Extracorporeal cardiopulmonary resuscitation (ECPR) improves outcomes when delivered within 60 minutes of low-flow..

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The six phases of prolonged veno-venous extracorporeal membrane oxygenator support: a conceptual framework

Abstract Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a complex and invasive intervention used increasingly in the management of severe respiratory failure. Once established, the management of prolonged V-V ECMO..

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Preoperative Use of Venoarterial Extracorporeal Membrane Oxygenation in Postinfarct Ventricular Septal Rupture: Insights From the Extracorporeal Life Support Organization Registry

Abstract Ventricular septal rupture (VSR) is a rare but often fatal complication of acute myocardial infarction (AMI), with a high mortality largely driven by resultant cardiogenic shock. Venoarterial extracorporeal membrane..

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The Use of Extracorporeal Membrane Oxygenation in Traumatic Brain Injury and Neurosurgical Patients: A Single-Center Analysis and Systematic Review

Abstract Background This study evaluates the outcomes and management considerations associated with using extracorporeal membrane oxygenation (ECMO) in patients with traumatic brain injury (TBI), including those requiring neurosurgical intervention. It..

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Temporary Mechanical Circulatory Support and Shock Teams in High-Risk Cardiac Surgery: The Strategic Evolution of Protected Cardiac Surgery

Abstract Background Protected cardiac surgery is a proactive strategy that applies temporary mechanical circulatory support to prevent perioperative low cardiac output syndrome in high-risk cardiac surgery. Rather than escalating vasoactive..

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Use of Extracorporeal Membrane Oxygenation for Management of Hemostasis After Complex Cardiac Surgery

Abstract Intractable bleeding during cardiac surgery is a rare but life-threatening complication. We describe a novel management approach in which the patient was supported with venoarterial extracorporeal membrane oxygenation until..

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Parallel Dual-Lumen Venovenous Extracorporeal Membrane Oxygenation Following Extracorporeal Cardiopulmonary Resuscitation

Abstract Differential oxygenation may complicate extracorporeal cardiopulmonary resuscitation (ECPR) either due to the initial pathology or subsequent lung injury. The dual circulation phenomenon inherent to peripheral venoarterial extracorporeal membrane oxygenation..

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Elective Use of Veno-Venous Extracorporeal Membrane Oxygenation to Support Complex Surgery Involving the Central Airways

Abstract Introduction Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports oxygenation and carbon dioxide (CO2) clearance in the short- or mid-term, and is traditionally utilized in severe, refractory respiratory failure. There is..

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Epidemiology of nosocomial infections in ECMO patients in Qatar: the CLEAN-Q seven-year retrospective cohort study

Abstract Background Extracorporeal Membrane Oxygenation (ECMO) is a critical rescue therapy complicated by high rates of nosocomial infections (NIs). While Western data abound, evidence from the Middle East remains limited...

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Early Postoperative Mitral Bioprosthetic Thrombosis During ECMO Support: Urgent Transcatheter Valve-in-Valve Implantation

Abstract Acute postoperative bioprosthetic valve thrombosis is a rare complication with challenging treatment. We present two consecutive cases of patients with myocardial infarction and papillary muscle rupture requiring urgent surgical..

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In-Hospital Mortality Prediction of Patients Requiring Extracorporeal Membrane Oxygenation Using Composite Lactate Metrics and Weight-of-Evidence Modeling

Abstract BACKGROUND:  Mortality prognostication in adult patients requiring extracorporeal membrane oxygenation (ECMO) is not accurate or established. We hypothesized that composite lactate-based metrics and machine-learning models would improve in-hospital mortality..

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Introducer–Cannula Diameter Mismatch and Difficult Veno-Venous Extracorporeal Membrane Oxygenation Cannulation: A Case Report

Abstract Obesity poses technical challenges during veno-venous extracorporeal membrane oxygenation (VV-ECMO) cannulation because of thick subcutaneous tissue and increased insertion resistance. While patient-related factors are well recognized, the impact of..

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Hospital Costs Associated With Mechanical Left Ventricular Unloading Devices During VA ECMO for Adult Cardiogenic Shock

Abstract Importance To date, no studies have described the financial burden and behaviors of left ventricular mechanical unloading (LVMU) for patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Given the..

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Differential hypercapnia: Recognition, management, and outcomes in an awake patient supported with peripheral veno-arterial extracorporeal membrane oxygenation

Abstract Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving intervention for individuals with refractory cardiopulmonary failure and is associated with several complications. Differential hypercapnia, also known as RIDDLER syndrome or..

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Markers of inflammation and immunological competence: Assessment in the early postoperative phase of cardiac surgery involving extracorporeal circulation

Abstract Background To gain insight into the role and relevance of inflammatory and immunological markers in the comprehensive assessment of a patient's immune response to surgical procedures. This study focused..

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Clinical correlates for major bleeding during veno-arterial extracorporeal membrane oxygenation support: a time-dependent perspective

Abstract Background Major bleeding is a common and serious complication of veno-arterial extracorporeal membrane oxygenation (VA ECMO). Current perspectives on bleeding risk fail to reflect dynamic changes over time in..

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Continuous vs pulsatile arterial cannula flow for venoarterial extracorporeal membrane oxygenation: A multiscale computational fluid dynamics analysis

Abstract Background and Objective Venoarterial extracorporeal membrane oxygenation (VA ECMO) circuits typically utilise a continuous flow (CF) of blood to support patients suffering from refractory cardiorespiratory dysfunction. Pulsatile flow (PF)..

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Semi-Empirical Model to Predict Blood Flow in an Extracorporeal Respiratory Support Circuit Driven by Ventricular Assist Devices

Abstract Despite increasing clinical interest in ambulatory extracorporeal membrane oxygenation (ECMO), its equipment is not optimally designed for portability. Blood pumps are too heavy for ambulation, as the lightest system..

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Acid–Base Status During Venoarterial Extracorporeal Membrane Oxygenator Support in Patients With Cardiogenic Shock

Abstract Background The prognostic significance of an adverse acid–base milieu despite venoarterial extracorporeal membrane oxygenation support in patients with cardiogenic shock remains poorly defined. We examined metabolic and respiratory disturbances..

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Standardization of In Vitro Evaluation of Extracorporeal Life Support (ECLS) Devices for Research and Development

Abstract Extracorporeal life support (ECLS) technology has witnessed remarkable advancements during the last decades. However, further research and development of devices are required to increase, for example, performance-efficiency, hemocompatibility, and..

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A Landmark Case in ECMO-Supported Bridge-to-Transplant Care

A Landmark Case in ECMO-Supported Bridge-to-Transplant Care  Extracorporeal membrane oxygenation (ECMO) has always been a therapy defined by its ability to buy time; time for a heart to recover, for lungs..

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Effect of ECMO Flow Variations on Pulmonary Capillary Wedge Pressure in Patients With Cardiogenic Shock

Abstract Background The hemodynamic effects of femoro-femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) on pulmonary capillary wedge pressure (PCWP) remain poorly defined. High ECMO flow is believed to increase PCWP..

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Evaluation of bivalirudin-based anticoagulation for extracorporeal membrane oxygenation, including patients with COVID-19

Abstract Background: Although unfractionated heparin (UFH) has traditionally been used for anticoagulation during extracorporeal membrane oxygenation (ECMO), bivalirudin may be preferred due to fewer complications. A prior medication use evaluation..

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Clinician Perspectives on the Extracorporeal Membrane Oxygenation Decision-Making Process

Abstract Importance  Venovenous extracorporeal membrane oxygenation (VV ECMO) is a resource-intensive, life-sustaining technology to support patients with severe refractory respiratory failure. Its precise indications and contraindications are not standardized, and expert..

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