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.
Journal of Clinical Medicine,
Journal Year:
2024,
Volume and Issue:
13(18), P. 5484 - 5484
Published: Sept. 15, 2024
Myocardial
infarction
(MI)
is
a
leading
cause
of
mortality
globally
and
predominantly
attributed
to
coronary
artery
disease
(CAD).
MI
categorized
as
ST-elevation
(STEMI)
or
non-ST-elevation
(NSTEMI),
each
with
distinct
etiologies
treatment
pathways.
The
goal
in
for
both
restoring
blood
flow
back
the
myocardium.
STEMI,
characterized
by
complete
occlusion
artery,
managed
urgently
reperfusion
therapy,
typically
percutaneous
intervention
(PCI).
In
contrast,
NSTEMI
involves
partial
treated
medical
management,
PCI,
bypass
grafting
(CABG)
depending
on
risk
scores
clinical
judgment.
Heart
Team
approach
can
assist
deciding
which
technique
would
provide
greatest
benefit
patient
especially
useful
complicated
cases.
Despite
advances
treatment,
complications
such
cardiogenic
shock
(CS)
ischemic
heart
failure
(HF)
remain
significant.
While
(PCI)
considered
primary
MI,
it
important
recognize
significance
cardiac
surgery
when
there
complex
MI-related
complications.
This
comprehensive
review
analyzes
role
recognizing
useful,
not.
Journal of Clinical Medicine,
Journal Year:
2024,
Volume and Issue:
13(19), P. 5863 - 5863
Published: Oct. 1, 2024
This
comprehensive
review
examines
the
role
of
Fenoldopam,
a
selective
dopamine-1
receptor
agonist,
in
preventing
and
treating
acute
kidney
injury
(AKI)
during
cardiac
surgery.
AKI
remains
significant
complication
surgery,
associated
with
increased
morbidity,
mortality,
healthcare
costs.
The
explores
Fenoldopam’s
pharmacological
properties,
mechanism
action,
clinical
applications,
synthesizing
evidence
from
randomized
controlled
trials,
meta-analyses,
observational
studies.
While
some
studies
have
shown
promising
results
improving
renal
function
reducing
incidence,
others
failed
to
demonstrate
benefits.
discusses
these
conflicting
findings,
potential
reasons
for
discrepancies,
identifies
areas
requiring
further
research.
It
also
compares
Fenoldopam
other
renoprotective
strategies,
including
dopamine,
diuretics,
N-acetylcysteine.
safety
profile
common
side
effects
contraindications,
is
addressed.
Current
guidelines
recommendations
use
surgery
are
presented,
along
cost-effectiveness
analysis.
concludes
by
outlining
future
research
directions
new
applications
By
providing
thorough
overview
current
state
knowledge,
this
aims
facilitate
informed
decision-making
clinicians
researchers
while
highlighting
investigation.
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.
