Algorithm of High-Risk Massive Pulmonary Thromboembolism with Extracorporeal Membrane Oxygenation DOI Open Access
Çağdaş Baran, Ahmet Kayan,

Canan Soykan Baran

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(22), P. 6822 - 6822

Published: Nov. 13, 2024

Objective: Massive pulmonary embolism (PE) remains a life-threatening condition, often leading to acute respiratory and cardiac failure. This study evaluates the role of extracorporeal membrane oxygenation (ECMO) as supportive treatment for high-risk patients undergoing surgical embolectomy or catheter-based thrombectomy. Methods: Between January 2018 December 2023, 27 with massive PE were treated at our center. Surgical (n = 7) thrombectomy 5) performed, ECMO support (veno-arterial [VA] veno-arterial-venous [VAV]) initiated preoperatively, intraoperatively, postoperatively, based on hemodynamic instability. was used bridge recovery, outcomes assessed in terms mortality, stabilization, recovery. Results: Of patients, 20 supported ECMO, 7 requiring VA-ECMO intraoperatively due difficulties weaning from cardiopulmonary bypass (CPB). Nine later transitioned VAV-ECMO Harlequin syndrome persistent The in-hospital mortality rate 18.5% 5), survivors showing significant improvements biochemical parameters post-ECMO, including reduced lactate levels, improved right ventricular function, stabilization mean arterial pressure. follow-up time 10.2 ± 3.9 months, no late deaths complications observed. Conclusions: provides effective life who are It stabilizes hemodynamics, improves facilitates recovery critically ill patients. Further research is needed refine patient selection, optimize timing, assess long-term determine its definitive management PE.

Language: Английский

Plasma brain-related biomarkers and potential therapeutic targets in pediatric ECMO DOI Creative Commons
Sue J. Hong,

Bradley J. De Souza,

Kristen K. Penberthy

et al.

Neurotherapeutics, Journal Year: 2025, Volume and Issue: 22(1), P. e00521 - e00521

Published: Jan. 1, 2025

Language: Английский

Citations

1
Impact of hyperoxia on the gut during critical illnesses DOI Creative Commons

Ninan Dai,

Juan Gu,

Yanhong Luo

et al.

Critical Care, Journal Year: 2024, Volume and Issue: 28(1)

Published: March 1, 2024

Abstract Molecular oxygen is typically delivered to patients via inhalation or extracorporeal membrane oxygenation (ECMO), potentially resulting in systemic hyperoxia from liberal localized the lower body peripheral venoarterial (VA) ECMO. Consequently, this exposes gastrointestinal tract excessive levels. Hyperoxia can trigger organ damage due overproduction of reactive species and associated with increased mortality. The gut microbiome play pivotal roles critical illnesses even small variations levels have a dramatic influence on physiology ecology microbes. Here, we reviewed emerging preclinical evidence which highlights how inhaled provoke diffuse villous damage, barrier dysfunction gut, dysbiosis. hallmark dysbiosis includes expansion oxygen-tolerant pathogens (e.g., Enterobacteriaceae ) depletion beneficial oxygen-intolerant microbes Muribaculaceae ). Furthermore, discussed potential impact various underlying involving inspiratory VA-ECMO. Currently, available findings area are somewhat controversial, consensus has not yet be reached. It appears that targeting near-physiological may offer means avoid hyperoxia-induced injury hypoxia-induced mesenteric ischemia. However, optimal target vary depending special clinical conditions, including acute hypoxia adults neonates, as well particular undergoing surgery VA-ECMO support. Last, outlined current challenges need for future studies area. Insights into vital ongoing research assist clinicians optimizing critically ill patients.

Language: Английский

Citations

7
Conservative or liberal oxygen targets in patients on venoarterial extracorporeal membrane oxygenation DOI Creative Commons
Aidan Burrell, Michael Bailey, Rinaldo Bellomo

et al.

Intensive Care Medicine, Journal Year: 2024, Volume and Issue: 50(9), P. 1470 - 1483

Published: Aug. 20, 2024

Patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) frequently develop arterial hyperoxaemia, which may be harmful. However, lower oxygen saturation targets also lead to harmful episodes of hypoxaemia. In this registry-embedded, multicentre trial, we randomly assigned adult patients VA-ECMO in an intensive care unit (ICU) either a conservative (target SaO2 92–96%) or liberal strategy 97–100%) through controlled administration via the ventilator and ECMO gas blender. The primary outcome was number ICU-free days day 28. Secondary outcomes included 60, mortality, ventilation duration, ICU hospital lengths stay, functional at 6 months. From September 2019 June 2023, 934 who received were reported EXCEL registry, whom 300 (192 cardiogenic shock, 108 refractory cardiac arrest) recruited. We randomised 149 151 strategy. median 28 similar both groups (conservative: 0 [interquartile range (IQR) 0–13.7] versus liberal: [IQR 0–13.7], treatment effect: [95% confidence interval (CI) – 3.1 3.1]). Mortality (59/159 [39.6%] vs 59/151 [39.1%]) 60 (64/149 [43%] 62/151 [41.1%] groups, as all other secondary adverse events. group experienced 44 (29.5%) major protocol deviations compared 2 (1.3%) (P < 0.001). adults ICU, strategy, did not affect

Language: Английский

Citations

6
New Design of an Oxygenation Cannula with a Comprehensive Set of Blood Pump DOI

Hiromi Sato,

Kotaro Nakano,

Francis Chikweto

et al.

IFMBE proceedings, Journal Year: 2025, Volume and Issue: unknown, P. 95 - 101

Published: Jan. 1, 2025

Language: Английский

Citations

0
Opinion: exploring alternative pathways to neuroprotection—nicotine and carbon monoxide as antioxidative factors in neurodegeneration and delirium DOI Creative Commons
Marcos Delgado, Reto A. Schuepbach,

Jan Bartussek

et al.

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: April 9, 2025

Language: Английский

Citations

0
Continuous Renal Replacement Therapy and Extracorporeal Membrane Oxygenation in Patients with Cardiogenic Shock: Results from the Rescue Registry DOI Open Access
Chewan Lim, Young Hak Chung, Chul‐Min Ahn

et al.

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1498 - 1498

Published: Feb. 24, 2025

Background: Cardiogenic shock (CS) frequently leads to multiorgan failure, often necessitating continuous renal replacement therapy (CRRT) or extracorporeal membrane oxygenation (ECMO). We evaluated the association between CRRT, ECMO, and its prognostic implication in patients with CS. Methods: A total of 1247 CS were enrolled from RESCUE (Retrospective Prospective Observational Study Investigate Clinical Outcomes Efficacy Left Ventricular Assist Device for Korean Patients Shock) registry January 2014 December 2018. The primary outcomes, including 72 h 30-day all-cause mortality rates, analyzed relation use ECMO CRRT among patients. Results: Among 751 non-ECMO patients, 90 (12%) underwent while 496 195 (39.3%) CRRT. Overall, was associated higher mortality. However, linked lower (19.6% versus 12.3%; p = 0.045). Multivariate analysis showed that reduced (hazard ratio: 0.44; 95% confidence interval: 0.21–0.91; 0.027). Independent predictors included an estimated GFR < 44 mL/min/1.73 m2, mechanical ventilation, use, IABP increased lactate. Conclusions: receiving had Nonetheless, administration more common potentially improving early in-hospital clinical outcomes.

Language: Английский

Citations

0
Relationship between the Pre-ECMO and ECMO Time and Survival of Severe COVID-19 Patients: A Systematic Review and Meta-Analysis DOI Open Access

Ziqi Tan,

Longxiang Su, Xiangyu Chen

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(3), P. 868 - 868

Published: Feb. 1, 2024

Background: Coronavirus disease 2019 (COVID-19) is the etiology of acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) used to support gas exchange in patients who have failed conventional mechanical ventilation. However, there no clear consensus on timing ECMO use severe COVID-19 patients. Objective: The aim this study compare differences pre-ECMO time and duration between survivors non-survivors explore association them. Methods: PubMed, Cochrane Library, Embase, other sources were searched until 21 October 2022. Studies reporting relationship ECMO-related survival included. All available data pooled using random-effects methods. Linear regression analysis was determine correlation duration. meta-analysis registered with PROSPERO under registration number CRD42023403236. Results: Out initial 2473 citations, we analyzed 318 full-text articles, 54 studies included, involving 13,691 There significant from diagnosis (standardized mean difference (SMD) = −0.41, 95% confidence interval (CI): [−0.53, −0.29], p < 0.00001), hospital (SMD −0.53, CI: [−0.97, −0.09], 0.02) intensive care unit (ICU) admission −0.28, [−0.49, −0.08], 0.007), intubation or ventilation −0.21, [−0.32, 0.0003) −0.18, [−0.30, −0.06], 0.003). statistical a longer symptom onset (hazard ratio (HR) 1.05, [0.99, 1.12], 0.11) (MV) risk mortality (highest vs. lowest groups odds (OR) 1.18, [0.78, 1.78], 0.42; per one-day increase OR 1.14, [0.86, 1.52], 0.36; HR 0.99, [0.95, 1.02], 0.39). linear Conclusion: are non-survivors, insufficient evidence conclude that responsible for reduced differed does not an impact Further needed

Language: Английский

Citations

2
Effects of very early hyperoxemia on neurologic outcome after out-of-hospital cardiac arrest: A secondary analysis of the TTM-2 trial DOI
Filippo Sanfilippo, Agnieszka Uryga, Cristina Santonocito

et al.

Resuscitation, Journal Year: 2024, Volume and Issue: unknown, P. 110460 - 110460

Published: Dec. 1, 2024

Language: Английский

Citations

2
The correlation study between post-surgery oxygen partial pressure level and prognosis of patients with sepsis during hospitalization DOI Creative Commons
Anqi Wang,

Jieying Chen,

JL Gao

et al.

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: March 28, 2024

Abstract Background The high mortality and medical costs of sepsis have resulted in a significant consumption resources, improving the diagnosis treatment strategies for disease has always been hot area. Studies indicated that clinical outcomes patients with hyperoxaemia after surgery improved, but they are still limited to observational studies small samples. aim this study is examine suitable range oxygen partial pressure post-surgery its correlation prognosis. Methods We extracted data from adult who met diagnostic criteria Medical Information Mart Intensive Care (MIMIC)-IV database. By retrieving patient's surgical information time, we obtained on developed undergoing surgery.Firstly, categorized into control group (PaO2 ≤ 100mmHg) hyperoxemia > based their levels. preliminarily evaluated information, scores, laboratory parameters two groups patients. primary outcome set was 90-day rate ICU admission, secondary included 1-year rate, length stay, hospital incidence duration invasive ventilation. Subsequently, conducted restricted cubic spline analysis patients' re-categorized levels 48 hours into: normal 128.7mmHg), mild (128.7mmHg < PaO2 162.1mmHg), severe ≥ 162.1mmHg) results analysis. re-evaluated grouping, then Kaplan-Meier analysis, univariate multivariate regression rate. Finally, subgroup meaningful variables plotted forest plot. Results A total 1220 were study. Compared group, hyperxemia typically younger, had lower scores within 24 received more aggressive treatment. proportion high-flow therapy tracheostomy relatively low. Data, grouping by patients, showed similar results. Meanwhile, complications acute respiratory failure kidney injury lower. In final logistic model, grouped (OR:0.54, 95%CI 0.34–0.86, P = 0.010) than did not show statistical value (OR:0.60, 0.30–1.20, 0.147). After plotting survival curve 28-day, 90-day, 180-day, 365-day rates, it found long-term higher, which statistically significant. Conclusion occurrence post-surgical associated reduction mortality.

Language: Английский

Citations

0
Protocol for a systematic review and individual participant data meta-analysis of optimizing oxygen therapy in critically ill patients DOI Creative Commons
Xiaobo Yang,

Yaqi Ouyang,

Jiqian Xu

et al.

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: Aug. 23, 2024

Background Oxygen therapy is a cornerstone treatment of critically ill patients in the intensive care unit (ICU). Whether lower oxygenation brings superior survival outcomes to higher unknown. Methods We will search electronic databases: PubMed, Embase, Web Science, Cochrane Central Register Controlled Trials (CENTRAL), International Clinical Registry Platform (ICTRP), and ClinicalTrials.gov from inception 1 January 2024. Two authors independently screen for all eligible clinical studies. Emails be sent individual participant data. The statistical analyses conducted using STATA 15.0 software. Results evaluate efficacy compared with based on Conclusion This study offer evidence oxygen ICU patients.

Language: Английский

Citations

0