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Assessing accessibility to the extracorporeal cardiopulmonary resuscitation pathway for out-of-hospital cardiac arrests in London

Abstract Aims Extracorporeal cardiopulmonary resuscitation (ECPR) may improve outcomes in selected patients with refractory out-of-hospital cardiac arrest (OHCA), but timely access is essential. In Greater London, a prehospital ECPR pathway..

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Pregnancy-associated extracorporeal life support: insights from a nationwide dual-cohort analysis

Abstract Background Extracorporeal life support (ECLS) is used as rescue therapy for refractory cardiopulmonary failure. Population-level evidence on prognosis and long-term sequelae in patients requiring ECLS during pregnancy or the..

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Not Just for the Dying: The Benefits of Routine Palliative Medicine Consultation in ECMO Care

Abstract Introduction Palliative medicine (PM) aims to enhance the quality of life of patients and families facing serious illness. Currently, there are no national guidelines for involving PM in the..

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Cerebral protection strategies in aortic arch surgery: a review of techniques and outcomes

Abstract Background: Cerebral protection is a key determinant of perioperative outcomes in aortic arch surgery. Despite significant advances, optimal strategies regarding temperature, perfusion modality, and cannulation site remain controversial, with..

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A regional partnership model for VA-ECMO initiation and transfer from remote centers using air medical transport

Abstract Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted treatment modality for refractory cardiogenic shock (CS). However, its use is limited to tertiary centers due to resource allocation, education,..

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2026 American Association for Thoracic Surgery (AATS) expert consensus statement: Antithrombotic management of neonates/infants undergoing cardiac interventions

Abstract Objectives The hemostatic system in neonates and infants with congenital heart disease is distinct as a result of developmental and disease-specific factors, necessitating population-specific periprocedural evaluation and antithrombotic management...

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Decreasing the post surgical ooze: Utilizing a perioperative guideline to decrease transfusion needs following congenital diaphragmatic hernia repair on ECMO

Abstract Purpose To evaluate changes in post-operative transfusion requirements of infants undergoing congenital diaphragmatic hernia (CDH) repair on ECMO following implementation of a perioperative guideline. Methods In 2021, a multidisciplinary..

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Impella Versus VA-ECMO in Cardiogenic Shock: An Updated Systematic Review and Meta-Analysis With Exploratory Matched-Cohort Analyses

Abstract Observational studies comparing Impella and venoarterial extracorporeal membrane oxygenation (VA-ECMO) in cardiogenic shock have reported inconsistent findings. We performed an updated systematic review and meta-analysis, with exploratory matched-cohort analyses..

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Intravenous iron to treat anaemia before cardiac surgery (ITACS): international, double blind, placebo controlled randomised trial

Abstract Objective To evaluate the effects of intravenous iron on red cell transfusion and recovery after cardiac surgery. Design International, multicentre, double blind, placebo controlled randomised trial (ITACS). Setting 33..

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Physiological anticoagulant deficiencies: pathogenesis, diagnosis, and clinical implications

Abstract Physiological anticoagulants are essential regulators of coagulation, and their deficiency shifts hemostasis toward a prothrombotic state, increasing the risk of venous thromboembolism. The main physiological anticoagulants, antithrombin (AT), protein..

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The Trial of Heart Transplant vs LVAD: Could it Be Done? Would the Answer Matter?

Abstract Introduction to the Problem Triage of patients referred with advanced heart failure (HF) continues to revive the classic question: can we conduct a randomized trial comparing heart transplantation with..

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Venoarterial ECMO management: Clinical considerations

Abstract Venoarterial extracorporeal membrane oxygenation (V-A ECMO) is a technique used to provide short-term circulatory and respiratory support in patients with refractory cardiogenic shock and cardiac arrest who do not..

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Elevated Cardiopulmonary Bypass Flow for Renal Protection in Cardiac Surgery: A Randomized Trial

Abstract BACKGROUND: Acute kidney injury (AKI) is a common and severe complication after cardiac surgery with cardiopulmonary bypass (CPB). Experimental data suggest that increasing CPB flow beyond standard targets may..

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Extracorporeal Carbon Dioxide Removal Combined With Inhaled Nitric Oxide for Hypercapnic Acute Respiratory Distress Syndrome With Active Airway Hemorrhage: A…

Abstract Low-flow extracorporeal carbon dioxide removal (ECCO2R) may be useful when severe hypercapnia limits ultra-protective ventilation but full venovenous extracorporeal membrane oxygenation (VV-ECMO) is not pursued. We describe a 68..

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Antimicrobial use in adult patients receiving extracorporeal membrane oxygenation in a center without routine prophylaxis

Abstract Antimicrobial use in patients receiving extracorporeal membrane oxygenation (ECMO) is poorly described. In this study, evaluating antimicrobial use at a single center without ECMO-specific antimicrobial prophylaxis protocols, antimicrobials were..

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Extracorporeal membrane oxygenation in congenital cardiac surgery: a 10-year single-centre experience

Abstract Introduction:Extracorporeal Membrane Oxygenation (ECMO) has evolved as an effective mechanical support for cardiorespiratory failure in patients undergoing congenital cardiac surgery, and the threshold of using it has substantially reduced...

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Hemostatic therapies and ambiguous abnormal bleeding in cardiac operating rooms: A real-world, case-based evaluation of clinical practices

Abstract Objective Hemostatic therapy is commonly used in cardiac surgery. Despite tools to reduce inappropriate use, variability remains, mainly due to a lack of standards, especially intraoperatively. This study examined..

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Challenging the Obesity Paradox: A Multicenter Study of Body Mass Index and Mortality in Venovenous Extracorporeal Membrane Oxygenation

Abstract Obesity is common among critically ill adults, but its association with outcomes during venovenous extracorporeal membrane oxygenation (VV ECMO) remains controversial. We evaluated associations of body mass index (BMI)..

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Development and validation of a novel nursing activities for extracorporeal membrane oxygenation scale in the Netherlands: A nationwide multicentre study

Abstract Objectives To develop and validate a scale to measure nursing activities in patients receiving extracorporeal membrane oxygenation (ECMO) and to examine its underlying factor structure. Methods A multicentre cross-sectional..

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Optimizing Heparin and Protamine Dosing During Cardiopulmonary Bypass Using Activated Clotting Time-Guided Protocols: A Single-Centre Prospective Randomized Controlled Trial

Abstract Objectives To evaluate whether an activated clotting time (ACT)-guided, formula-based anticoagulation strategy supported by viscoelastic coagulation monitoring (ROTEM) improves perioperative coagulation management and reduces bleeding compared with standard weight-based..

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Palliative Extracorporeal Membrane Oxygenation Decannulation: An Ethical, Evidence-Based Approach

Abstract Background Extracorporeal membrane oxygenation, although lifesaving, is invasive. Complications affecting all body systems mandate reevaluation of goals of care. When extracorporeal membrane oxygenation is nonbeneficial, planning for de-escalation/decannulation to..

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Patient-reported outcome and experience measures in post-ECMO follow-up: a scoping review

Abstract Objectives To map the use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in adult follow-up after extracorporeal membrane oxygenation (ECMO), and to identify measurement gaps relevant..

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Extracorporeal Membrane Oxygenation Cannulation and Early Management in the Emergency Resuscitation Room Versus Intensive Care Unit: Single-Center Experience

Abstract In this single-center retrospective cohort study, we compared extracorporeal membrane oxygenation (ECMO) cannulation and early management performed in the emergency resuscitation room (ERR) versus the intensive care unit (ICU)...

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Use of whole blood in pediatric congenital heart surgery

Abstract Objectives Cardiopulmonary bypass is necessary for surgical repair of complex congenital heart disease. We studied whether whole blood use in circuit prime and for initial intraoperative transfusion needs improved..

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Cerebro‑Cardiovascular Coupling During Extracorporeal Membrane Oxygenation Using Cerebral Oxygenation, Doppler Flow, and Echocardiography

Abstract Cerebral injury remains a major contributor to morbidity and mortality in VA‑ECMO patients. Disruption of cerebral autoregulation during extracorporeal support may predispose to neurological damage. This prospective study evaluated..

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Electrical Impedance Tomography Reveals Venoarterial Extracorporeal Membrane Oxygenation Flow-Induced Ventilation-Perfusion Mismatch

Abstract An obese female patient with ischemic cardiomyopathy was placed on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock after in-hospital cardiac arrest. Despite biventricular recovery by day 3, VA-ECMO..

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The Relationship Between the Preoperative Gut Microbiome and Systemic Inflammatory Response Syndrome After Cardiac Surgery: A Prospective Cohort Study

Abstract Objectives To determine whether preoperative intestinal microbiome characteristics are associated with the development of systemic inflammatory response syndrome (SIRS) after cardiac surgery. Design Single-center prospective observational cohort study. Setting..

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Interfacial Pathway in EAS-Modified PMP Membranes Synergistically Enhances CO2/O2 Selectivity for ECMO

Abstract Efficient and selective gas transport across soft and nonporous interfaces remains a pivotal challenge for biomimetic membrane design, particularly in extracorporeal membrane oxygenation (ECMO) systems. Here, we report a..

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Characterization of Ventilator-Associated Pneumonia in Patients Receiving Extracorporeal Membrane Oxygenation Support

Abstract In this retrospective cohort study at a quaternary referral hospital, 829 adult patients supported by extracorporeal membrane oxygenation (ECMO) between January 1, 2014, and October 31, 2024, were screened..

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Survival After Extracorporeal Membrane Oxygenation Decannulation Due to Poor Prognosis in Children—An Extracorporeal Life Support Organization Registry Study

Abstract Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for critically ill children. However, decisions regarding discontinuation due to poor prognosis remain ethically complex. While outcomes after successful weaning are..

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