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Optimizing Regional Access to Extracorporeal Cardiopulmonary Resuscitation: A Geographic-Information-System-Based Comparison of Hospital- and Prehospital-Initiated Strategies in Nara Prefecture, Japan

Abstract Background: Extracorporeal cardiopulmonary resuscitation (ECPR) can improve outcomes following refractory out-of-hospital cardiac arrest (OHCA); however, access is constrained by geography and resources. This study compared two strategies against the..

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Safety of prolonged anticoagulation-free venovenous ECMO management beyond 72 hours in post-traumatic ARDS: A single-center retrospective cohort study

Abstract Introduction Standard anticoagulation protocols for patients with trauma-related acute respiratory distress syndrome (TR-ARDS) undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO) are often inapplicable due to high bleeding risks. This study..

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Safety of Invasive Procedures During Adult Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Background/Objectives: Adult patients supported with extracorporeal membrane oxygenation (ECMO) frequently require invasive diagnostic, therapeutic, surgical, or bedside procedures during ongoing extracorporeal support. These procedures are clinically challenging because ECMO-related anticoagulation,..

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Publication and Retraction Activity in the Field of Extracorporeal Membrane Oxygenation: Origins, Concerns, and Perspectives

Abstract Background Extracorporeal membrane oxygenation (ECMO) has become a vital life-support tool in critical care, particularly during the COVID-19 pandemic. The rapid growth of ECMO research necessitates bibliometric analysis to..

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Challenges of Intra-Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Cardiogenic Shock: Real-World Outcomes

Abstract Background: The aim of this study was to assess the long-term outcomes of patients treated with intra-aortic balloon pump (IABP) alone and in combination with extracorporeal membrane oxygenation (ECMO),..

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Standard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial

Abstract Background In patients receiving extracorporeal membrane oxygenation (ECMO), standard practice is full-dose intravenous unfractionated heparin (UFH) targeting an activated partial thromboplastin time of 2·0–2·5 times baseline to reduce thrombotic..

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ECMO for patients with obesity: evidence and practice

Abstract Purpose Obesity is increasingly encountered among patients requiring extracorporeal membrane oxygenation (ECMO) for severe respiratory or cardiac failure. It alters respiratory and cardiovascular physiology and drug pharmacokinetics and introduces..

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Hemodynamic-guided V-A ECMO management for cardiogenic shock: Insight from initial experience from TWEET study (to wean an ECMO trials)

Abstract Background Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used for refractory cardiogenic shock, yet optimal weaning strategies and the role of left ventricular (LV) venting remain unclear. The TWEET-1..

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Nutrition provision across acute hospitalization in adult patients receiving extracorporeal membrane oxygenation: A prospective multicenter observational, registry-embedded study

Abstract Background Patients receiving extracorporeal membrane oxygenation (ECMO) are considered nutritionally vulnerable, with previous studies focussed on Intensive Care Unit (ICU) admission alone. We aimed to address this gap by..

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Mechanical Ventilation and Extracorporeal Membrane Oxygenation in Acute Respiratory Insufficiency

Abstract Background: Invasive ventilation saves lives but carries major risks, including ventilation-associated lung damage and long-term functional impairment. Data from recent studies compel reassessment of the evidence for every step of..

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Nitric Oxide–Releasing Surfaces Reduce Thrombosis in Venovenous Extracorporeal Life Support: A 5 day Long Ovine Study

Abstract Extracorporeal life support (ECLS) components designed to reduce clot formation have been developed, but thrombosis remains a significant challenge, requiring systemic anticoagulation. To address this, we evaluated a nitric..

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A novel flow-controlled transaortic catheter venting (TACV) strategy for LV decompression in VA-ECMO: A case report

Abstract Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides crucial circulatory and respiratory support in refractory cardiogenic shock and cardiac arrest. However, peripheral VA-ECMO increases left ventricular (LV) afterload through retrograde..

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Feeding under support in critical care illness: metabolic and nutritional management during extracorporeal membrane oxygenation and continuous renal replacement therapy

Abstract Purpose of review The use of life-support therapies like extracorporeal membrane oxygenation (ECMO), mechanical circulatory systems (MCS), and continuous renal replacement therapy (CRRT) creates a complex and dynamic metabolic..

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60 years of ARDS and the evolution of extracorporeal lung support – from ECMO to ECCO2R

Abstract Extracorporeal life support (ECLS), including venovenous extracorporeal membrane oxygenation (VV-ECMO) and  extracorporeal carbon dioxide removal (ECCO₂R), is an established treatment for selected patients with acute respiratory distress syndrome (ARDS)...

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Prehabilitation clinic in cardiac surgery: multidisciplinary protocol for the improvement of postoperative outcomes

Abstract Background Prehabilitation in cardiac surgery is a multidisciplinary approach aimed at optimizing the clinical and functional status of patients awaiting elective procedures. Interventions addressing nutrition, physical activity, psychological support..

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Neurological complications in veno-arterial extracorporeal membrane oxygenation and the potential role of targeted temperature management– A narrative review

Abstract Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used to provide circulatory support in acute cardiac failure. However, it is frequently complicated by neurological injury, which substantially worsens morbidity..

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Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices

Abstract Acute brain injury (ABI) affects up to one-third of patients using mechanical circulatory support (MCS). In venoarterial extracorporeal membrane oxygenation (VA ECMO), ABI incidence (11%-40%) has not improved in..

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Determination of brain death in potential donors on ECMO support

Abstract Background A recent update of the German directive on determining brain death introduced changes regarding the diagnostics in potential donors on extracorporeal membrane oxygenation (ECMO). Physicians familiar with ECMO must..

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Reliable Flow, Cost-Effective, Comfortable: Tunneled Veno-Pulmonary Artery Extracorporeal Membrane Oxygenation Cannulation Technique

Abstract Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) has many limitations, including patient comfort and, oftentimes, mobility issues. Veno-pulmonary (VP) ECMO offers respiratory support without recirculation and right heart support. For..

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Venovenous Extracorporeal Membrane Support in the Setting of Type A Aortic Dissection Repair—Too Little Too Late?

Abstract Background Use of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) in the setting of type A aortic dissection (TAAD) has been described in the literature as salvage therapy, with morbid..

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The effects of mechanical ventilation during v-a ecmo support: a systematic review

Abstract Background Mechanical ventilation is routinely used during veno-arterial extracorporeal membrane oxygenation (V-A ECMO), but its role in influencing hemodynamics and supporting cardiac recovery remains poorly understood. This systematic review..

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Novel Extracorporeal Life Support System to Mitigate Ischemia-Reperfusion Injury During Prolonged Aortic and Inferior Vena Caval Occlusion

Abstract Extracorporeal membrane oxygenation (ECMO) and endovascular balloon occlusion of the aorta (REBOA) have been reported to manage hemodynamics and reduce blood loss and transfusion requirements during high-risk abdominal surgeries...

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Diagnostic Imaging Challenges During Extracorporeal Membrane Oxygenation

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a critical life support therapy for severe cardiac and respiratory failure, but it is associated with thromboembolic, hemorrhagic, and neurological complications. Diagnostic imaging..

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Anticoagulation Strategies in Adults Undergoing Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with severe cardiac or respiratory failure, but it is associated with a high risk of thrombotic and bleeding..

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Costs and complications of extracorporeal membrane oxygenation therapy in Australia and New Zealand

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving form of cardiopulmonary support for patients with severe refractory cardiopulmonary disease. It is a resource-intensive intervention requiring specialised equipment and personnel,..

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Comparison of Left Ventricular Pressure-Volume Loops With Veno-Arterial Extracorporeal Membrane Oxygenator Support: In Vitro Investigation

Abstract Background The hemodynamic consequence of increasing veno-arterial extracorporeal membrane oxygenator (V-A ECMO) flow on left ventricular (LV) loading is controversial, with in vivo studies reporting conflicting results on left ventricular..

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Clinical Outcomes of Different Heparin Anticoagulation Monitoring Targets in Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

Abstract Objectives This systematic review and meta-analysis aimed to evaluate clinical outcomes associated with different systemic heparin protocols (conservative v standard intensity) during extracorporeal membrane oxygenation (ECMO) support. Included studies comprised both..

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Safety and efficacy of OASSIST ECMO system: A first-in-human, multi-center, clinical trial

Abstract Background Extracorporeal Membrane Oxygenation (ECMO) provides respiratory and circulatory support in patients with severe cardiorespiratory failure. As ECMO technology advances, portability has become an important design consideration for transport..

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Hypothermia exacerbates kidney injury during extracorporeal cardiopulmonary resuscitation

Abstract Objective Kidney injury is one of the most common complications of extracorporeal cardiopulmonary resuscitation (ECPR), yet the renoprotective effects of temperature management during ECPR remain inconclusive. This study aimed..

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Rescue strategies combining ultra-protective ventilation and veno-venous ECMO in a patient with near-drowning-related severe ARDS: a case report and literature…

Abstract Background Drowning can lead to acute respiratory distress syndrome (ARDS), which is associated with high mortality and poses substantial clinical management challenges. Ultra-protective ventilation strategy combined with veno-venous extracorporeal..

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