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Oxygenation During Venoarterial Extracorporeal Membrane Oxygenation: Physiology, Current Evidence, and a Pragmatic Approach to Oxygen Titration

Abstract OBJECTIVES:  This review aims to: 1) identify the key circuit and patient factors affecting systemic oxygenation, 2) summarize the literature reporting the association between hyperoxia and patient outcomes, and..

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Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin

Abstract Objectives We aimed to evaluate thrombotic and hemorrhagic complications with heparin versus bivalirudin use in veno-venous extracorporeal membrane oxygenation (V-V ECMO). Methods We performed a retrospective cohort study of..

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Left Ventricular Unloading With Impella Versus IABP in Patients With VA-ECMO: A Systematic Review and Meta-Analysis

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) use for circulatory support in cardiogenic shock results in increased left ventricular (LV) afterload. The use of concomitant Impella or intra-aortic balloon pump (IABP)..

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Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: 10-year experience in a metropolitan cardiac arrest centre in Milan, Italy

Abstract Introduction Growing evidence supports  cardiopulmonary resuscitation (ECPR) for refractory out-of-hospital cardiac arrest (OHCA) patients, especially in experienced centres. We present characteristics, , and outcomes of patients treated with ECPR in a..

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Pre-hospital ECPR in an Australian metropolitan setting: a single-arm feasibility assessment—The CPR, pre-hospital ECPR and early reperfusion (CHEER3) study

Abstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was..

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Predictors of thrombosis during VV ECMO: an analysis of 9809 patients from the ELSO registry

Abstract Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving therapy for critically ill patients, but it carries an increased risk of thrombosis due to blood interacting with non-physiological surfaces. While..

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Anti-Xa assay monitoring improves the precision of anticoagulation in venovenous extracorporeal membrane oxygenation

Abstract Unfractionated heparin (UFH) is the most used anticoagulant in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO). Its therapeutic levels are monitored using activated partial thromboplastin time ratio (aPTTr) or..

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Subclavian Artery Cannulation For Left Ventricular Unloading During Extracorporeal Membrane Oxygenation Support

Abstract Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective mechanical circulatory support for cardiac insufficiency following cardiac surgery especially cardiac surgery with extracorporeal circulation, which can quickly restore the perfusion..

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Contemporary Outcomes of Children With Acute Fulminant Myocarditis Supported With Peripheral Extracorporeal Membrane Oxygenation

Abstract Despite extracorporeal membrane oxygenation (ECMO) utilization in nearly 20% of cases, there are limited data in children with acute fulminant myocarditis (AFM) requiring ECMO. Herein we identify risk factors..

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Left Ventricle Unloading Through Pulmonary Artery in Patients With Venoarterial Extracorporeal Membrane Oxygenation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation for patients with cardiogenic shock or cardiac arrest is an attractive strategy since it provides a quick restoration of organ perfusion. One major..

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Percutaneous Left Ventricle Unloading During Venoarterial Extracorporeal Membrane Oxygenation

Abstract The issue of left ventricular (LV) distention during venoarterial extracorporeal membrane oxygenation (VA-ECMO) is crucial as it markedly impacts on patients’ weanability and, ultimately, outcome. Numerous techniques have been..

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Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Abstract Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary bypass for patients with acute respiratory or cardiac failure refractory to conventional therapy. Its usage has become increasingly widespread..

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Ambulatory extracorporeal membrane oxygenation simulator: The next frontier in clinical training

Abstract Background Current medical simulators for extracorporeal membrane oxygenation (ECMO) are expensive and rely on low-fidelity methodologies. This creates a challenge that demands a new approach to eliminate high costs..

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Standardized nomenclature for peripheral percutaneous cannulation of the pulmonary artery in extracorporeal membrane oxygenation: Current uptake and recommendations for improvement

Abstract The rising application of extracorporeal membrane oxygenation (ECMO) has emphasized the need for consistent and standardized terminology, especially concerning peripheral percutaneous cannulation of the pulmonary artery (PPC-PA). The Extracorporeal..

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ECMO simulation: How much, who to train, and a review of cost, fidelity and performance

Abstract Background Extracorporeal Membrane Oxygenation (ECMO) is a high-risk, low-volume procedure requiring repetition, skill and multiple disciplines with fidelity of communication. Yet many barriers exist to maintain proficiency and skills..

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Evaluation of Left Ventricular Overload and Use of Unloading Techniques in Venoarterial Extracorporeal Life Support: A Nationwide Survey

Abstract Cardiogenic shock (CS) and cardiac arrest (CA) are among the most lethal complications of acute cardiovascular disease, affected by high in-hospital mortality rates. Venoarterial extracorporeal life support (VA ECLS)..

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Perspectives and Considerations of IABP in the Era of ECMO for Cardiogenic Shock

Abstract The development of mechanical circulatory support (MCS) has been rapid, and its use worldwide in patients with cardiogenic shock is increasingly widespread. However, current statistical data and clinical research..

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Prone Positioning During Extracorporeal Membrane Oxygenation in Patients With Severe ARDS

Abstract Importance  Prone positioning may improve outcomes in patients with severe acute respiratory distress syndrome (ARDS), but it is unknown whether prone positioning improves clinical outcomes among patients with ARDS who..

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The Surface of a PMP Hollow Fiber Membrane Was Modified with a Diamond-like Carbon Film to Enhance the Blood Compatibility…

Abstract The contact between the blood and the surface of medical materials causes a series of rejection reactions. In this process, the plasma protein is adsorbed to the surface of..

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Circuit change in neonatal and pediatric extracorporeal membrane oxygenation is associated with adverse outcomes

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) circuits may be changed during the run for multiple reasons; however, these circuit changes may be associated with adverse events. Predictors for undergoing a..

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Central Extracorporeal Membrane Oxygenation Support Following Calcium Channel Blocker Overdose in Children

Abstract Refractory vasodilatory shock (RVS) following massive calcium channel blocker (CCB) overdose remains a challenging clinical entity. Peripheral venoarterial extracorporeal membrane oxygenation (ECMO) has proven useful in several cases of..

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Biofilm Assessment and Metagenomic Analysis of Venoarterial Extracorporeal Membrane Oxygenation Cannulas and Membrane Oxygenators

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) exposes the patient to infectious complications related to the cannulas or the site of insertion. The aim of the current study was to investigate..

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Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomised controlled trials and propensity score matched studies.

Abstract Background: Cardiogenic shock is associated with high mortality. In refractory shock, it is unclear if mechanical circulatory support (MCS) devices improve survival. We conducted a systematic review and network meta-analysis..

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Epidemiology of ischemic stroke and hemorrhagic stroke in venoarterial extracorporeal membrane oxygenation

Abstract Background While venoarterial extracorporeal membrane oxygenation (V‑A ECMO) provides lifesaving supportfor cardiopulmonary failure, complications may increase mortality, with few studies focusing on ischemic/hemor‑rhagic stroke. We aimed to determine the..

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ECMO as an Indirect Bridge to Durable Left Ventricular Assist Device Implantation

Abstract Introduction: The need for preoperative extracorporeal membrane oxygenation (ECMO) support prior to left ventricular assist device(LVAD) therapy has been associated with increased mortality. Our study investigated the impact of de-escalating..

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Extracorporeal Membrane Oxygenation Without Invasive Ventilation for Respiratory Failure in Adults: A Systematic Review

Abstract OBJECTIVES:  Extracorporeal membrane oxygenation (ECMO) is an advanced treatment for acute severe respiratory failure. Patients on ECMO are frequently maintained sedated and immobilized until weaning from ECMO, first, and..

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Outcomes of Recipients Aged 65 Years and Older Bridged to Lung Transplant With Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplant (BTT) has been used for critically ill candidates with excellent outcomes, but data on this strategy in older recipients..

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A Novel Approach to Measuring Physiologic Changes during Ambulation for a Patient with Post Infarct VSD Supported on Femoral IABP…

Abstract Post-infarct ventricular septal defect (PIVSD) is a rare, life-threatening complication following acute myocardial infarction (MI), associated with high overall mortality. Interventions include medical management, percutaneous closure, and/or surgical closure...

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Obesity is Associated with Increased Mortality in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation

Abstract Background: Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) is used to support patients with cardiac and respiratory failure. The relationship between obesity and VA-ECMO outcomes is unknown. Objectives: To determine the relationship between..

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Tranexamic Acid for Bleeding Management in Adult Patients on Extracorporeal Membrane Oxygenation

Abstract This study described the outcomes of patients receiving topical, nebulized, endobronchial, or systemic tranexamic acid (TXA) for bleeding events while on extracorporeal membrane oxygenation (ECMO). We performed a single-center..

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