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The Role of Imaging During Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

Abstract OBJECTIVE. Extracorporeal membrane oxygenation (ECMO) is increasingly widely used in pediatric respiratory failure. Despite playing a key part in patient management during ECMO, the role of radiology is not widely..

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Optimizing Contrast-Enhanced Thoracoabdominal CT in Patients During Extracorporeal Membrane Oxygenation

Abstract Rationale and Objectives To evaluate the quality and value of contrast-enhanced (CE) chest- and abdominal computed tomography (CT) and CT angiography in neonates, children, and adults undergoing extracorporeal membrane..

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Actual Cost of Extracorporeal Cardiopulmonary Resuscitation: A Time-Driven Activity-Based Costing Study

Abstract OBJECTIVES:  To determine the actual cost and drivers of the cost of an extracorporeal cardiopulmonary resuscitation (E-CPR) care cycle. PERSPECTIVE:  A time-driven activity-based costing study conducted from a healthcare..

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Immediate Clinical Complications Occurring During Membrane Change in Patients on Veno-Venous Extracorporeal Membrane Oxygenation

Abstract The clinical tolerance of extracorporeal membrane oxygenation (ECMO) membrane changes in acute respiratory distress syndrome (ARDS) patients under veno-venous ECMO (VV-ECMO) has not been reported. The aim of this..

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Blood Transfusion During Extracorporeal Membrane Oxygenation: An ELSO Position Statement

Abstract The threshold for packed red blood cell (pRBC) transfusion has been an important focus in the management of critically ill patients since the publication of randomized control trials (RCTs)..

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Pediatric Hematology and Oncology Patients on Extracorporeal Membrane Oxygenation: Outcomes in a Multicenter, Retrospective Cohort 2009–2021

Abstract Objective:  To describe characteristics associated with survival for pediatric patients with an oncologic diagnosis or hematopoietic cell transplant (HCT) supported with extracorporeal membrane oxygenation (ECMO). Design:  Multicenter, retrospective study...

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Dialoxygenation: A Preclinical Trial for Transforming the Artificial Kidney Into an Oxygenator

Abstract Critically ill patients sometimes require tandem application of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) which is easier and cheaper. We aimed to transform the kidney..

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Cerebral Autoregulation: A Target for Improving Neurological Outcomes in Extracorporeal Life Support

Abstract Despite improvements in survival after illnesses requiring extracorporeal life support, cerebral injury continues to hinder successful outcomes. Cerebral autoregulation (CA) is an innate protective mechanism that maintains constant cerebral..

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Characterization of Protein Binding on an Extracorporeal Membrane Oxygenation (ECMO) Circuit Following the Priming Procedure

Abstract Extracorporeal membrane oxygenation (ECMO) circuit priming procedures are crucial for removing air bubbles and the albumin in priming solution is thought to create a protective layer against blood exposure..

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Venoarterial extracorporeal membrane oxygenation in immunocompromised patients with cardiogenic shock: a cohort study and propensity-weighted analysis

Abstract Purpose: The outcomes of immunocompromised patients with cardiogenic shock treated with venoarterial extra‑corporeal membrane oxygenation (VA‑ECMO) are seldom documented, making ECMO candidacy decisions challeng‑ing. This study aims (1) to..

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Critical insights into venoarterial extracorporeal membrane oxygenation outcomes in immunocompromised patients: addressing uncertainties in cause of death and treatment strategies

Abstract In a recent issue of Intensive Care Medicine, we read with great interest the article by Moyon et al. [1] who retro-spectively studied the outcomes of immunocompromised patients with..

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Evaluation of the Nautilus Smart Extracorporeal Membrane Oxygenation in Patients With Hemostatic Alteration: A Case Series

Abstract The intricate management of hemostatic disorders in extracorporeal membrane oxygenation (ECMO) assisted patients poses challenges, particularly when procoagulant administration is necessary. We hereby report the performance of the Nautilus*..

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Venovenous extracorporeal membrane oxygenation drainage cannula performance: From generalized to patient-averaged vessel model

Abstract Venovenous extracorporeal membrane oxygenation is used for respiratory support in the most severe cases of acute respiratory distress syndrome. Blood is drained from the large veins, oxygenated in an..

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Routine Versus Selective Distal Perfusion Catheter Use in Venoarterial Extracorporeal Membrane Oxygenation

Abstract Although current studies support the use of prophylactic distal perfusion catheters (DPCs) to decrease limb ischemia in patients on venoarterial extracorporeal membrane oxygenation (VA ECMO), methods for monitoring limb..

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Red Cell Damage During Extracorporeal Life Support

Abstract Sublethal damage to red blood cells (RBCs) during extracorporeal life support (ECLS) may lead to RBC loss. Using flow cytometry, phosphatidylserine-positive (PhS+) RBCs and RBC extracellular vesicles were quantified..

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Anticoagulation Can Be Held in Traumatically Injured Patients on Veno-Venous Extracorporeal Membrane Oxygenation Support

Abstract Traumatic injury is associated with several pulmonary complications, including pulmonary contusion, transfusion-related acute lung injury (TRALI), and the development of acute respiratory distress syndrome (ARDS). There is a lack..

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The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative (PEACE) Consensus Conference

Abstract OBJECTIVES:  To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation..

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Flow capabilities of arterial and drainage cannulae during venoarterial extracorporeal membrane oxygenation: A simulation model

Abstract Background Large cannulae can increase cannula-related complications during venoarterial extracorporeal membrane oxygenation (VA ECMO). Conversely, the ability for small cannulae to provide adequate support is poorly understood. Therefore, we..

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The importance of the development of extracorporeal life support simulation centres for improving skills and knowledge during the COVID-19 pandemic

Abstract Introduction Extracorporeal techniques have been present in medicine for over 70 years. Many factors in history have influenced their development and popularisation, in particular the first discoveries of heparin..

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Developing a generalizable pediatric ECMO emergency checklist for clinical specialist: Progress and challenges

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) emergencies require skilled clinical specialist (CS) who manage ECMO circuits. While tools for assessing CS skills have been published, there is significant variation in..

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Carboxyhemoglobin predicts oxygenator performance and imminent oxygenator change in extracorporeal membrane oxygenation

Abstract Background The continuous exposure of blood to a non-biological surface during extracorporeal membrane oxygenation (ECMO) may lead to progressive thrombus formation in the oxygenator, hemolysis and consequently impaired gas..

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The effect of excessive gas to blood ratios in an ECMO oxygenator

Abstract Introduction Oxygenators for paediatric Extracorporeal Membrane Oxygenation (ECMO) are required to operate over a wide range of flow rates, in a patient group ranging from neonates through to fully..

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Psychological safety in an ECMO retrieval team: a qualitative study to inform improvement

Abstract Introduction In healthcare teams, psychological safety is associated with improved performance, communication, collaboration and patient safety. Extracorporeal membrane oxygenation (ECMO) retrieval teams are multidisciplinary teams that initiate ECMO therapy for..

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Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

Abstract According to the Extracorporeal Life Support Organization (ELSO) guidelines, pre-assembled and already primed extracorporeal membrane oxygenation (ECMO) systems can be safely stored for up to 30 days under specific..

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Right Ventricular Assist Device Placement During Left Ventricular Assist Device Implantation Is Associated With Improved Survival

Abstract Right ventricular failure (RVF) is a significant cause of mortality in patients undergoing left ventricular assist device (LVAD) implantation. Although right ventricular assist devices (RVADs) can treat RVF in..

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Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome

Abstract Background: Acute respiratory distress syndrome (ARDS) presents a significant challenge in critical care settings, characterized by compromised gas exchange, necessitating in the most severe cases interventions such as veno-venous extracorporeal..

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Carbon Dioxide Targets in Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome

Abstract Target values for arterial carbon dioxide tension (PaCO2) in extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) are unknown. We hypothesized that lower PaCO2 values on ECMO would..

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Validation of predictive models for 90-day survival in immunocompromised patients with cardiogenic shock on venoarterial extracorporeal membrane oxygenation

Abstract Predictive survival models have been proposed to esti-mate survival rates in patients with refractory cardio-genic shock considered for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) [1, 2]. Notably, the Survival after..

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Why left atrial venting fails to influence extracorporeal life support survival in cardiogenic shock: Unravelling the intricate reality of unloading

Abstract Over the past decade, extracorporeal life support (ECLS) has gained increasing utilization in the management of refractory cardiogenic shock (CS) with a class IIaC recommendation according to the latest..

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Prone Positioning and Right Ventricular Protection During Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome

Abstract In critically ill patients with moderate to severe acute respiratory distress syndrome (ARDS) receiving invasive mechanical ventilation, prone positioning for 16 hours/day has been shown to confer significant mortality..

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