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[PMID]:28823328
[Au] Autor:Berdajs D
[Ad] Endereço:Division of Cardiac Surgery, University Hospital Basel, Basel, Switzerland. Electronic address: denis.berdajs@bluewin.ch.
[Ti] Título:Primmum Nil Nocere, Second Be Cautious, and Third Try to Use the Right Extracorporeal Membrane Oxygenator Modality.
[So] Source:Semin Thorac Cardiovasc Surg;29(2):196-197, 2017.
[Is] ISSN:1532-9488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea
Oxigenadores de Membrana
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170822
[St] Status:MEDLINE


  2 / 1624 MEDLINE  
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[PMID]:28397410
[Au] Autor:Glass K; Trivedi P; Wang S; Woitas K; Kunselman AR; Ündar A
[Ad] Endereço:Department of Pediatrics, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, PA, USA.
[Ti] Título:Building a Better Neonatal Extracorporeal Life Support Circuit: Comparison of Hemodynamic Performance and Gaseous Microemboli Handling in Different Pump and Oxygenator Technologies.
[So] Source:Artif Organs;41(4):392-400, 2017 Apr.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neurologic complications during neonatal extracorporeal life support (ECLS) are associated with significant morbidity and mortality. Gaseous microemboli (GME) in the ECLS circuit may be a possible cause. Advances in neonatal circuitry may improve hemodynamic performance and GME handling leading to reduction in patient complications. This study compared hemodynamic performance and GME handling using two centrifugal pumps (Maquet RotaFlow and Medos Deltastream DP3) and polymethylpentene oxygenators (Maquet Quadrox-iD and Medos Hilite 800LT) in a neonatal ECLS circuit model. The experimental circuit was primed with Lactated Ringer's solution and packed human red blood cells (hematocrit 40%) and arranged in parallel with the RotaFlow and DP3 pump, Quadrox-iD and Hilite oxygenator, and Better-Bladder. Hemodynamic trials evaluating pressure drops and total hemodynamic energy (THE) were conducted at 300 and 500 mL/min at 36°C. GME handling was measured after 0.5 mL of air was injected into the venous line using the Emboli Detection and Classification Quantifier System with unique pump, oxygenator, and Better-Bladder combinations. The RotaFlow pump and Quadrox oxygenator arrangement had lower pressure drops and THE loss at both flow rates compared to the DP3 pump and Hilite oxygenator (P < 0.01). Total GME volume and counts decreased with Better-Bladder at both flow rates with all combinations (P < 0.01). Hemodynamic performance and energy loss were similar in all of the circuit combinations. The Better-Bladder significantly decreased GME. All four combinations of pumps and oxygenators also performed similarly in terms of GME handling.
[Mh] Termos MeSH primário: Embolia Aérea/prevenção & controle
Desenho de Equipamento/métodos
Oxigenação por Membrana Extracorpórea/instrumentação
Coração Auxiliar
Hemodinâmica
Oxigenadores de Membrana
[Mh] Termos MeSH secundário: Oxigenação por Membrana Extracorpórea/efeitos adversos
Oxigenação por Membrana Extracorpórea/métodos
Seres Humanos
Recém-Nascido
Modelos Cardiovasculares
Doenças do Sistema Nervoso/prevenção & controle
Pressão
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12908


  3 / 1624 MEDLINE  
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[PMID]:28181301
[Au] Autor:Griep LM; van Barneveld LJ; Simons AP; Boer C; Weerwind PW
[Ad] Endereço:Department of Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam.
[Ti] Título:Impact of Distinct Oxygenators on Pulsatile Energy Indicators in an Adult Cardiopulmonary Bypass Model.
[So] Source:Artif Organs;41(2):E15-E25, 2017 Feb.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The quantification of pulse energy during cardiopulmonary bypass (CPB) post-oxygenator is required prior to the evaluation of the possible beneficial effects of pulsatile flow on patient outcome. We therefore, evaluated the impact of three distinctive oxygenators on the energy indicators energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) in an adult CPB model under both pulsatile and laminar flow conditions. The pre- and post-oxygenator pressure and flow were measured at room temperature using a 40% glycerin-water mixture at flow rates of 1, 2, 3, 4, 5, and 6 L/min. The pulse settings at frequencies of 40, 50, 60, 70, and 80 beats per minute were according to the internal algorithm of the Sorin CP5 centrifugal pump. The EEP is equal to the mean pressure, hence no SHE is present under laminar flow conditions. The Quadrox-i Adult oxygenator was associated with the highest preservation of pulsatile energy irrespective of flow rates. The low pressure drop-high compliant Quadrox-i Adult oxygenator shows the best SHE performance at flow rates of 5 and 6 L/min, while the intermediate pressure drop-low compliant Fusion oxygenator and the high pressure drop-low compliant Inspire 8F oxygenator behave optimally at flow rates of 5 L/min and up to 4 L/min, respectively. In conclusion, our findings contributed to studies focusing on SHE values post-oxygenator as well as post-cannula in clinical practice. In addition, our findings may give guidance to the clinical perfusionist for oxygenator selection prior to pulsatile CPB based on the calculated flow rate for the individual patient.
[Mh] Termos MeSH primário: Ponte Cardiopulmonar/instrumentação
Modelos Cardiovasculares
Oxigenadores de Membrana
Fluxo Pulsátil
[Mh] Termos MeSH secundário: Adulto
Desenho de Equipamento
Hemodinâmica
Seres Humanos
Pressão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170216
[Lr] Data última revisão:
170216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12889


  4 / 1624 MEDLINE  
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[PMID]:28093804
[Au] Autor:Mongé MC; Kulat BT; Eltayeb O; Zingle NR; Moss ST; Gossett JG; Pahl E; Costello JM; Backer CL
[Ad] Endereço:Divisions of Cardiovascular-Thoracic Surgery, Chicago, IL, USA.
[Ti] Título:Successful Bridge-to-Transplant of Functionally Univentricular Patients With a Modified Continuous-Flow Ventricular Assist Device.
[So] Source:Artif Organs;41(1):25-31, 2017 Jan.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A continuous flow extracorporeal ventricular assist device (VAD) was modified to support functionally univentricular infants and children awaiting heart transplantation. A centrifugal VAD, designed to flow from 1.5 to 8 L/min, was used as a bridge-to-transplant in four patients with functionally univentricular circulation. A variable restrictive recirculation shunt permitted lower flow ranges in small patients. In hypoxic patients, an oxygenator was incorporated into the circuit. From 2012 to 2015, the modified VAD was placed in four patients with Glenn physiology. Age ranged from 0.97 to 6.98 years (median = 2.2 yrs). Body surface area ranged from 0.41 to 0.84 m (median = 0.54 m ). One patient was on extracorporeal membrane oxygenation prior to VAD. A recirculation shunt was used in three patients. Three patients required temporary use of an oxygenator for 4, 10, and 27 days. Median time on the VAD was 32.3 days (range = 23-43 days). A decrease in the cavopulmonary pressure was noted in all patients, as was a fall in the B-type natriuretic peptide. Three patients survived transplant and were discharged at 28-82 days post-transplantation. One patient died after 35 days of support. Two patients experienced major bleeding events. Two patients experienced cerebrovascular accidents, one major and one minor. The centrifugal VAD successfully supported palliated functionally univentricular patients awaiting heart transplantation. The modified recirculation shunt facilitated the successful support of patients in whom optimal flows were substantially lower than that recommended by the manufacturer. The continuous-flow VAD effectively decompressed the cavopulmonary system. The design allowed placement of an in-line oxygenator in hypoxic patients. Further investigation is required to decrease the thromboembolic events, and associated morbidity, in patients supported with this device.
[Mh] Termos MeSH primário: Transplante de Coração
Coração Auxiliar
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Desenho de Equipamento
Oxigenação por Membrana Extracorpórea
Feminino
Técnica de Fontan/efeitos adversos
Técnica de Fontan/métodos
Coração Auxiliar/efeitos adversos
Seres Humanos
Lactente
Masculino
Peptídeo Natriurético Encefálico/análise
Oxigenadores de Membrana
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
114471-18-0 (Natriuretic Peptide, Brain)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170127
[Lr] Data última revisão:
170127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170118
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12881


  5 / 1624 MEDLINE  
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[PMID]:27925231
[Au] Autor:Kaesler A; Schlanstein PC; Hesselmann F; Büsen M; Klaas M; Roggenkamp D; Schmitz-Rode T; Steinseifer U; Arens J
[Ad] Endereço:Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
[Ti] Título:Experimental Approach to Visualize Flow in a Stacked Hollow Fiber Bundle of an Artificial Lung With Particle Image Velocimetry.
[So] Source:Artif Organs;41(6):529-538, 2017 Jun.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Flow distribution is key in artificial lungs, as it directly influences gas exchange performance as well as clot forming and blood damaging potential. The current state of computational fluid dynamics (CFD) in artificial lungs can only give insight on a macroscopic level due to model simplification applied to the fiber bundle. Based on our recent work on wound fiber bundles, we applied particle image velocimetry (PIV) to the model of an artificial lung prototype intended for neonatal use to visualize flow distribution in a stacked fiber bundle configuration to (i) evaluate the feasibility of PIV for artificial lungs, (ii) validate CFD in the fiber bundle of artificial lungs, and (iii) give a suggestion how to incorporate microscopic aspects into mainly macroscopic CFD studies. To this end, we built a fully transparent model of an artificial lung prototype. To increase spatial resolution, we scaled up the model by a factor of 5.8 compared with the original size. Similitude theory was applied to ensure comparability of the flow distribution between the device of original size and the scaled-up model. We focused our flow investigation on an area (20 × 70 × 43 mm) in a corner of the model with a Stereo-PIV setup. PIV data was compared to CFD data of the original sized artificial lung. From experimental PIV data, we were able to show local flow acceleration and declaration in the fiber bundle and meandering flow around individual fibers, which is not possible using state-of-the-art macroscopic CFD simulations. Our findings are applicable to clinically used artificial lungs with a similar stacked fiber arrangement (e.g., Novalung iLa and Maquet QUADROX-I). With respect to some limitations, we found PIV to be a feasible experimental flow visualization technique to investigate blood-sided flow in the stacked fiber arrangement of artificial lungs.
[Mh] Termos MeSH primário: Velocidade do Fluxo Sanguíneo
Hidrodinâmica
Pulmão/irrigação sanguínea
Oxigenadores de Membrana
Reologia/métodos
Ventiladores Mecânicos
[Mh] Termos MeSH secundário: Simulação por Computador
Desenho de Equipamento
Hemodinâmica
Seres Humanos
Modelos Cardiovasculares
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161208
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12812


  6 / 1624 MEDLINE  
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[PMID]:27881701
[Au] Autor:Evans CF; Li T; Mishra V; Pratt DL; Mohammed ISK; Kon ZN; Griffith BP
[Ad] Endereço:Department of Surgery, Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
[Ti] Título:Externally visible thrombus partially predicts internal thrombus deposition in extracorporeal membrane oxygenators.
[So] Source:Perfusion;32(4):301-305, 2017 May.
[Is] ISSN:1477-111X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: We sought to quantify the location and volume of thrombus in used hollow-fiber membrane oxygenators and correlate the volume of thrombus with patient demographics, flow characteristics and anticoagulation parameters. METHODS: Hollow-fiber membrane oxygenators (Quadrox D, Maquet, Rastatt, Germany) were collected after clinical use in ECMO circuits and divided into sections. Each section was digitally imaged and analyzed using ImageJ software. The location and total volume (cm ) of thrombus was calculated for different sections. In an effort to predict thrombus formation, we correlated thrombus volume with possible aggravating and mitigating variables. RESULTS: We collected 41 oxygenators from 27 patients. Twenty-seven (66%) were configured in the veno-venous mode and 14 (34%) in the veno-arterial mode. The median duration of use was 131 hours (interquartile range 61-214 hours). Eighteen (44%) were removed when the patient recovered, six (15%) were removed after withdrawal of care and seventeen (41%) were exchanged. The median volume of thrombus was 11.4 cm (interquartile range 2.2-44.5 cm ). CONCLUSIONS: A multivariable linear regression model suggested that the combination of median flow, configuration of ECMO and visible thrombus partially predicted internal thrombus volume (adjusted R =0.39).
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/instrumentação
Oxigenação por Membrana Extracorpórea/métodos
Oxigenadores de Membrana
Trombose/patologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Trombose/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161125
[St] Status:MEDLINE
[do] DOI:10.1177/0267659116678679


  7 / 1624 MEDLINE  
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[PMID]:27815558
[Au] Autor:Wagner D; Caraballo M; Waldvogel J; Peterson Y; Sun D
[Ad] Endereço:1 Pharmacy/Anesthesiology, University of Michigan Hospitals and Health Systems, Ann Arbor, MI, USA.
[Ti] Título:In vitro effects of an extracorporeal membrane oxygenation circuit on the sequestration of ϵ-aminocaproic acid.
[So] Source:Perfusion;32(3):226-229, 2017 Apr.
[Is] ISSN:1477-111X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the in vitro effects of drug sequestration in extracorporeal membrane oxygenation (ECMO) on ϵ-aminocaproic acid (EACA) concentrations. METHODS AND DESIGN: This in vitro study will determine changes in EACA concentration over time in ECMO circuits. A pediatric dose of 2,500 mg was administered to whole expired blood in the simulated pediatric ECMO circuit. Blood samples were collected at 0, 30, 60, 360 and 1440-minute intervals after initial administration equilibration from three different sites of the circuit: pre-oxygenator (PRE), post-oxygenator (POST) and PVC tubing (PVC) to determine the predominant site of drug loss. The circuit was maintained for two consecutive days with a re-dose at 24 hours to establish a comparison between unsaturated (New) and saturated (Old) oxygenator membranes. Comparisons between sample sites, sample times and New versus Old membranes were statistically analyzed by a linear mixed-effects model with significance defined as a p-value <0.05. RESULTS: There were no significant differences in EACA concentration with respect to sample site, with PRE and POST samples demonstrating respective mean differences of 0.30 mg/ml and 0.34 mg/ml as compared to PVC, resulting in non-significant p-values of 0.373 [95% CI (-0.37, 0.98)] and 0.324 [95% CI (-0.34, 1.01)], respectively. The comparison of New vs. Old ECMO circuits resulted in non-significant changes from baseline, with a mean difference of 0.50 mg/ml, 95% CI (-0.65, 1.65), p=0.315. CONCLUSION: The findings of this study did not show any significant changes in drug concentration that can be attributed to sequestration within the ECMO circuit. Mean concentrations between ECMO circuit sample sites did not differ significantly. Comparison between New and Old circuits also did not differ significantly in the change from baseline concentration over time. Sequestration within ECMO circuits appears not to be a considerable factor for EACA administration.
[Mh] Termos MeSH primário: Ácido Aminocaproico/análise
Antifibrinolíticos/análise
Oxigenação por Membrana Extracorpórea/instrumentação
[Mh] Termos MeSH secundário: Ácido Aminocaproico/metabolismo
Antifibrinolíticos/metabolismo
Seres Humanos
Oxigenadores de Membrana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); U6F3787206 (Aminocaproic Acid)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161106
[St] Status:MEDLINE
[do] DOI:10.1177/0267659116678476


  8 / 1624 MEDLINE  
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[PMID]:27806995
[Au] Autor:Bleilevens C; Grottke O; Groening S; Honickel M; Kopp R; Singh S; Arens J; Rossaint R
[Ad] Endereço:Department of Anesthesiology, University Hospital RWTH Aachen University, Aachen, Germany.
[Ti] Título:Septic porcine blood does not further activate coagulation during in vitro membrane oxygenation.
[So] Source:Eur J Cardiothorac Surg;51(3):449-456, 2017 03 01.
[Is] ISSN:1873-734X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Objectives: For patients with a severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) represents a life-saving measure. Frequently, patients with severe ARDS also show signs of severe sepsis. As blood contact with the membrane oxygenator surface leads to adverse effects due to insufficient biocompatibility partly caused by activation of platelets, coagulation factors and leucocytes, we hypothesized that these adverse effects would be amplified if septic blood in a preactivated state came into contact with the membrane oxygenator. Methods: In a previously established in vitro 12-h ECMO test system (mock loop), we used septic or healthy domestic pig blood to analyse coagulation and inflammatory parameters. Sepsis was induced by a caecal ligation and puncture model in pigs. Results: At the beginning of the mock loop experiments, the septic blood showed significantly increased thrombin-antithrombin complexes (76.9 vs 27.7 µg/l), D-dimers (1.2 vs 0.3 mg/l) and fibrinogen concentration (1.8 vs 1.5 g/l), as well as elevated extrinsic coagulation activity (shorter EXTEM-CT: 44.2 vs 57 s) and higher lactate (3.4 vs 1.5 mmol/l) and cytokine levels (interleukin-6: 827 vs 31 pg/ml) when compared with the blood from healthy animals. Despite the preactivated status of the septic blood, no further increase of coagulation activity, inflammatory response or increased oxygenator resistance was observed in comparison to the control experiments. Conclusion: Septic porcine blood was not further activated due to the contact with an oxygenator, and no increased clot formation or biocompatibility problems were observed.
[Mh] Termos MeSH primário: Coagulação Sanguínea/fisiologia
Oxigenação por Membrana Extracorpórea/métodos
Sepse/sangue
[Mh] Termos MeSH secundário: Animais
Materiais Biocompatíveis
Coleta de Amostras Sanguíneas/métodos
Citocinas/sangue
Modelos Animais de Doenças
Hemodinâmica/fisiologia
Mediadores da Inflamação/metabolismo
Oxigenadores de Membrana
Ativação Plaquetária
Sepse/diagnóstico
Sus scrofa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Cytokines); 0 (Inflammation Mediators)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161104
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw345


  9 / 1624 MEDLINE  
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[PMID]:27658844
[Au] Autor:Cheng R; Ramzy D; Azarbal B; Arabia FA; Esmailian F; Czer LS; Kobashigawa JA; Moriguchi JD
[Ad] Endereço:Division of Cardiology, Cedars-Sinai Heart Institute.
[Ti] Título:Device Strategies for Patients in INTERMACS Profiles 1 and 2 Cardiogenic Shock: Double Bridge With Extracorporeal Membrane Oxygenation and Initial Implant of More Durable Devices.
[So] Source:Artif Organs;41(3):224-232, 2017 Mar.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:For Interagency Registry for Mechanically Assisted Circulatory Support profiles 1 and 2 cardiogenic shock patients initially placed on extracorporeal membrane oxygenation (ECMO), whether crossover to more durable devices is associated with increased survival, and its optimal timing, are not established. Profiles 1 and 2 patients placed on mechanical support were prospectively registered. Survival and successful hospital discharge were compared between patients placed on ECMO only, ECMO with early crossover, and ECMO with delayed crossover. Survival of patients directly implanted with non-ECMO devices was also reported. One-hundred and sixty-two patients were included. Mean age was 52.2 ± 13.8 years. Seventy-three of 162 (45.1%) were initiated on ECMO. Of these, 43 were supported with ECMO only, 11 were crossed-over early <4 days, and 19 were crossed-over in a delayed fashion. Survival was different across groups (Log-rank P < 0.002). In multivariate analysis, early crossover was associated with decreased mortality as compared with no crossover (hazard ratio [HR] 0.201, 95% confidence interval [95%CI] 0.058-0.697, P = 0.011) or with delayed crossover (HR 0.255, 95%CI 0.073-0.894, P = 0.033). Mortality was not different between delayed crossover and no crossover (P = 0.473). In patients with early crossover there were no deaths at 30 days, and 60-day survival was 90.0 ± 9.5%. Survival to hospital discharge was 72.8%. For patients directly implanted with non-ECMO devices, 30-day and 60-day survival was 90.9 ± 3.1% and 87.3 ± 3.8%, respectively, and survival to hospital discharge was 78.7%. Both initial implant of durable devices and double bridge strategy was associated with improved outcomes. If the double bridge strategy is chosen, early crossover is associated with improved survival and successful hospital discharge.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/instrumentação
Coração Auxiliar
Oxigenadores de Membrana
Choque Cardiogênico/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Distribuição de Qui-Quadrado
Oxigenação por Membrana Extracorpórea/efeitos adversos
Oxigenação por Membrana Extracorpórea/mortalidade
Feminino
Mortalidade Hospitalar
Seres Humanos
Estimativa de Kaplan-Meier
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Alta do Paciente
Seleção de Pacientes
Modelos de Riscos Proporcionais
Desenho de Prótese
Sistema de Registros
Estudos Retrospectivos
Fatores de Risco
Choque Cardiogênico/diagnóstico
Choque Cardiogênico/mortalidade
Choque Cardiogênico/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Função Ventricular
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170321
[Lr] Data última revisão:
170321
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12758


  10 / 1624 MEDLINE  
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[PMID]:27654663
[Au] Autor:Fuchs G; Berg N; Eriksson A; Prahl Wittberg L
[Ad] Endereço:Umeå University Medical School, Umeå.
[Ti] Título:Detection of Thrombosis in the Extracorporeal Membrane Oxygenation Circuit by Infrasound: Proof of Concept.
[So] Source:Artif Organs;41(6):573-579, 2017 Jun.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:As of today, there exist no reliable, objective methods for early detection of thrombi in the extracorporeal membrane oxygenators (ECMO) system. Within the ECMO system, thrombi are not always fixed to a certain component or location in the circuit. Thus, clot fragments of different shapes and consistencies may circulate and give rise to vibrations and sound generation. By bedside sound measurements and additional laboratory experiments (although not detailed herein), we found that the presence of particles (clots or aggregates and fragments of clots) can be detected by analyzing the strength of infra-sound (< 20 Hz) modes of the spectrum near the inlet and outlet of the centrifugal pump in the ECMO circuit. For the few patients that were considered in this study, no clear false positive or negative examples were found when comparing the spectral approach with clinical observations. A laboratory setup provided insight to the flow in and out of the pump, confirming that in the presence of particles a low-amplitude low-frequency signal is strongly amplified, enabling the identification of a clot.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/efeitos adversos
Trombose/diagnóstico
Trombose/etiologia
[Mh] Termos MeSH secundário: Acústica
Centrifugação/efeitos adversos
Centrifugação/instrumentação
Desenho de Equipamento
Oxigenação por Membrana Extracorpórea/instrumentação
Feminino
Seres Humanos
Masculino
Oxigenadores de Membrana/efeitos adversos
Som
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160923
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12782



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