International Journal of Artificial Organs最新文献

{"title":"Association between brain natriuretic peptide and invasive hemodynamics in left ventricular assist device HeartMate3-supported patients.","authors":"Elie Kozaily, Azalfa Lateef, Vishal N Rao, Gregory R Jackson, Anthony P Carnicelli, Chakradhari Inampudi, Lucas Witer, Mabelissa Geagea, Arman Kilic, Walker Blanding, Ryan J Tedford, Brian A Houston","doi":"10.1177/03913988261473044","DOIUrl":"10.1177/03913988261473044","url":null,"abstract":"<p><p>We report a serum BNP cut-off of 800 pg/mL above which all patients with LVAD HeartMate-3 had elevated biventricular filling pressures, suggesting it may be used to prompt invasive ramp study during routine post-LVAD clinic visit. We found stepwise increase in BNP levels across hemodynamic groups, with the lowest levels in patients with normal filling pressures, intermediate in those with elevated right or left-sided filling pressure and highest in those with elevated biventricular filling pressures. Furthermore, most patients with BNP above median value (335 pg/mL) required speed changes for either elevated right sided or left sided filling pressures. Conversely, patients with BNP below 335 pg/mL rarely required speed change. In conclusion, elevated serum BNP in patients with durable LVAD HeartMate-3 may have clinical value in prompting invasive hemodynamic assessment.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"834-836"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidance for clinical use of a haemoconcentration-based determination of recirculation in dialysis: Reproducibility, reliability, sensitivity of the measurements in clinical practice.","authors":"Alain Ficheux, Siavash Sohan Gir, Fernando Vetromile, Ilan Szwarc, Ruben Darmon, Raluca Leparau, Jonas Laget, Nathalie Gayrard, Àngel Argilés, Flore Duranton","doi":"10.1177/03913988261465312","DOIUrl":"10.1177/03913988261465312","url":null,"abstract":"<p><strong>Background: </strong>Blood access is of outmost importance for haemodialysis treated patients. Access blood flow is the first determining factor conditioning blood volume, clearance and dialysis delivery. Access blood flow reduction may result in increased recirculation of the extracorporeal circuit and dialysis deficiency, and be indicative of a pre-thrombosis state. Modern dialysis monitors are equipped with automatic systems to determine recirculation.</p><p><strong>Aim: </strong>We aimed at assessing the reproducibility, reliability and sensitivity of recirculation ratio measurements during its use in clinics.</p><p><strong>Methods: </strong>Forty-four unselected patients routinely treated with a monitor equipped with an ultrafiltration-based density modification to automatic assessment of recirculation were included in the study and two hundred and sixty-four dialysis procedures with over one thousand measurements of recirculation were analysed.</p><p><strong>Results: </strong>The median recirculation ratio observed was 3% and interquartile range of 6. Only 4% of the measurements were between 10% and 15% and 6% were greater than 15%. The observed recirculation ratio values were consistent throughout the dialysis sessions and reproducible as 90% of sessions had a difference in maximum values up to 10%.</p><p><strong>Conclusions: </strong>Recirculation monitoring remains an important parameter to prevent both blood access complications and dialysis insufficiency. Recirculation measurements showed to be uneventful and provided relevant clinical information.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"792-801"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma, self-efficacy, and patient activation in young and middle-aged patients undergoing maintenance hemodialysis.","authors":"Yuanying Wang, Ling Zhou, Jiping Jin, Danfeng Huang, Lin Huang","doi":"10.1177/03913988261465308","DOIUrl":"10.1177/03913988261465308","url":null,"abstract":"<p><strong>Background: </strong>The incidence of chronic kidney disease among young individuals in China is rising, with activation patterns differing from those of older adults. Evidence on activation in young and middle-aged patients receiving maintenance haemodialysis (MHD) is limited.</p><p><strong>Objectives: </strong>This study assessed activation levels and their relationship with disease stigma and self-efficacy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between January and May 2025 at five public nonprofit hospitals in Shanghai. Patient activation (PA), self-efficacy, and stigma were measured using the Patient Activation Measure Scale, Perceived Medical Condition Self-Management Scale, and Social Impact Scale. Data were analysed with descriptive statistics, <i>t</i>-tests, ANOVA, and multivariate regression.</p><p><strong>Results: </strong>A total of 393 patients were enrolled. Most (43.0%) were at activation level 4, while 11.5% were at level 1. Mean scores were 61.80 ± 17.10 (PA), 26.43 ± 4.26 (self-efficacy), and 64.70 ± 11.20 (stigma). Higher PA was positively associated with self-efficacy (β = 0.473, <i>p</i> < 0.001) and negatively with stigma (β = -0.402, <i>p</i> < 0.001). After adjusting for age, education, and haemodialysis knowledge, self-efficacy and stigma remained strong predictors, jointly explaining 53.2% of the variance in patient activation. Mediation analysis further revealed that self-efficacy partially mediated the relationship between stigma and PA, with the indirect effect accounting for 40.3% of the total effect (β = -0.211, 95% CI: -0.267 to -0.158).</p><p><strong>Conclusion: </strong>Self-efficacy and stigma are key predictors of activation in young and middle-aged patients with MHD, underscoring their importance for improving chronic disease care. Furthermore, self-efficacy mediates 40.3% of the total effect of stigma on patient activation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"774-782"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carboxyhemoglobin levels for the detection of hemolysis in patients supported by left ventricular assist devices: A case series.","authors":"Bernhard Baumeister, Susanne Bertermann, Johanna Protze, Nikolaos Evangelatos","doi":"10.1177/03913988261456927","DOIUrl":"10.1177/03913988261456927","url":null,"abstract":"<p><p>Hemolysis represents a severe, potentially life-threatening complication of extracorporeal circulation and percutaneous transvalvular microaxial flow pumps. Endogenous carbon monoxide (CO) production, measured via point-of-care (POC) CO-metry, has been investigated as a potential early marker of hemolysis in patients supported by extracorporeal membrane oxygenation (ECMO). We report two cases of hemolysis during percutaneous transvalvular microaxial flow pump therapy associated with significantly elevated carboxyhemoglobin (CO-Hb) levels. Consequently, we hypothesize that CO-Hb serves as a readily available bedside parameter for the early detection of hemolysis in this patient population.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"825-827"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of blood returning from the extracorporeal circuit after HD on cerebral and hepatic oxygenation.","authors":"Yusaku Watanabe, Kiyonori Ito, Kazuma Fukuda, Tomoko Iida, Kohei Takahashi, Masaya Kofuji, Moeka Suzuki, Junki Morino, Yuko Mutsuyoshi, Haruhisa Miyazawa, Jo Yoshizawa, Mamoru Yoshizawa, Susumu Ookawara","doi":"10.1177/03913988261465320","DOIUrl":"10.1177/03913988261465320","url":null,"abstract":"<p><strong>Introduction: </strong>Large extracorporeal blood volume causes intradialytic hemodynamic instability. However, the impact of blood returning from the extracorporeal circuit on systemic tissue oxygenation after hemodialysis (HD) remains inadequately studied.</p><p><strong>Methods: </strong>This single-center prospective observational study included 33 patients who underwent HD and clinical data from 81 HD sessions. Post-HD, blood is pumped at a rate of 120 mL/min for 3 min as the extracorporeal circuit is rinsed. Cerebral and hepatic regional oxygenation saturation (rSO₂) levels were monitored from the end of HD to 5 min post-HD.</p><p><strong>Results: </strong>There were significant increases in cerebral and hepatic rSO₂ levels at 5 min post-HD compared with those post-HD (cerebral rSO₂; 52.6 ± 7.3 vs 54.2 ± 7.1, hepatic rSO₂; 63.0% ± 10.9% vs 68.8% ± 10.3%, <i>p</i> < 0.001, respectively). %Changes in hepatic rSO₂ at 5 min post-HD were significantly greater than those in cerebral rSO₂ (3.4% ± 5.7% vs 9.9% ± 6.7%, <i>p</i> < 0.001) and were independently and significantly associated with ultrafiltration rate (standardized coefficient: 0.217), mean blood pressure post-HD (-0.374), and oxygen saturation post-HD (0.258).</p><p><strong>Conclusions: </strong>We demonstrated that the impact of blood returning post-HD on changes in tissue oxygenation may have been greater in the liver than in the brain.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"783-791"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for coronary artery calcification in patients on hemodialysis.","authors":"Fan Zhang, Guoli Li, Jie Yu, Shuangshuang Fu, Yiya Yang, Yumei Liang, Yinyin Chen, Xun Luo","doi":"10.1177/03913988261465532","DOIUrl":"10.1177/03913988261465532","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery calcification (CAC) is a predictor of poor survival and cardiovascular outcomes in patients with end-stage renal disease. This study assessed the risk factors for vascular calcification in patients on maintenance hemodialysis (HD).</p><p><strong>Methods: </strong>In total, 71 patients who underwent HD in our hospital from January 2022 to September 2022 were enrolled. The general clinical data and laboratory results of the patients were collected and the CAC score was calculated.</p><p><strong>Results: </strong>CAC occurred in 41/71 patients (57.75%) in the study. Baseline characteristics including primary disease, height, weight, blood pressure, dialysis duration, smoking history, and comorbid hypertension rates did not significantly differ between patients with and without CAC. Compared with the findings in the calcification group, the non-calcification group had significantly higher fibrinogen (4.2 (3.7-5.3) vs 3.6 (3.1-4.5); <i>p</i> = 0.01) and ferritin levels (194.0 (85.2-288.0) vs 44.9 (18.0-170.5); <i>p</i> < 0.01) and lower calcium levels (2.2 (2.0-2.3) vs 2.3 (2.2-2.4); <i>p</i> < 0.01) and red blood cell counts (3.0 ± 0.8 vs 3.4 ± 0.7; <i>p</i> < 0.01). In logistic regression analysis, the risk of CAC was predicted by diabetes (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.37-28.11; <i>p</i> = 0.02) and the red blood cell count (OR = 2.99, 95% CI = 1.05-5.02; <i>p</i> = 0.04). Based on receiver operating characteristic curve analysis, the area under the curve of the red blood cell count for predicting the risk of CAC was 0.66 (<i>p</i> = 0.02), using a clinical diagnostic cutoff of 2.99 (sensitivity, 75.6%; specificity, 56.7%).</p><p><strong>Conclusion: </strong>The incidence rate of CAC was high in patients on HD. Diabetes and elevated red blood cell count emerged as independent risk factors for predicting the risk of CAC in patients on HD.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"757-764"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulant choice or something more: What truly determines filter lifespan in real-world CRRT?","authors":"Lili Pan, Xingzhan Zhang, Jie Peng","doi":"10.1177/03913988261465317","DOIUrl":"10.1177/03913988261465317","url":null,"abstract":"","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"755-756"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerance-aware robust ranking of ventricular assist device rotor designs using strict feasibility and percentile-based criteria.","authors":"Mohamed Bounouib, Reda Lakraimi, Hamza Isksioui, Mourad Taha-Janan, Wajih Maazouzi","doi":"10.1177/03913988261479034","DOIUrl":"10.1177/03913988261479034","url":null,"abstract":"<p><p>Manufacturing variability can alter the hydraulic and hemocompatibility performance of a ventricular assist device (VAD) rotor even when the nominal design is computationally optimal. This study presents a surrogate-assisted robust-design workflow for a rotary VAD using a CFD-derived design-of-experiments database of 4809 rotor geometries defined by six input variables and seven performance outputs. Output-specific surrogate models were selected from linear regression, quadratic response-surface models, support-vector regression, random forests, gradient boosting, and multilayer perceptrons using five-fold cross-validated <i>R</i>², yielding values from 0.7367 to 0.9966. The 16 best nominal designs were then propagated through 2500 surrogate-evaluated Monte Carlo realizations under four manufacturing-tolerance scenarios ranging from mild to extreme. Nominal ranking was based on the geometric mean of normalized desirability functions, whereas robust ranking combined scaled nominal desirability, feasibility probability, percentile-based desirability, and a degradation penalty. D1297 was the nominal optimum (<i>D</i> = 0.8125), but D717 became the preferred robust design under mild and moderate tolerances, with robust scores of 0.9031 and 0.8741, respectively. Under severe and extreme perturbations, D174 emerged as the leading candidate because it retained the best conservative percentile behavior and the smallest degradation while preserving full feasibility. Local sensitivity analysis identified clearance gap and rotor length as the dominant robustness drivers. The results show that production-oriented VAD design selection can differ materially from nominal optimization and that tolerance-aware ranking provides a surrogate-assisted computational screening basis for prioritizing rotor candidates before direct CFD confirmation, prototype fabrication, dimensional metrology, and experimental hemocompatibility testing.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"802-814"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes in peritoneal dialysis-related peritonitis: Association with biochemical but not hematologic inflammatory indices.","authors":"Dilek Gibyeli Genek, Cihan Yeşil, Cemile Arslan Yeşil, Gülsüm Ceren Terzioğlu Yazıcı, Alper Alp, Bülent Huddam","doi":"10.1177/03913988261465304","DOIUrl":"10.1177/03913988261465304","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis-related peritonitis (PDRP) remains a significant cause of technical failure and mortality. Hematologic inflammatory indices (HIIs) have previously been associated with the incidence of peritonitis and long-term outcomes in peritoneal dialysis. Their prognostic usefulness in acute PDRP remains unclear. This study evaluated the relationship between HIIs and clinical outcomes in acute PDRP.</p><p><strong>Methods: </strong>This retrospective single-center study included 114 PDRP episodes recorded between 2012 and 2024. Baseline biochemical parameters and HIIs (NLR, PLR, MLR, NPAR, PIV) were collected at diagnosis. Clinical outcomes included treatment response, catheter removal, transition to hemodialysis, mortality and length of hospital stay. Correlation analyses, receiver operating characteristic (ROC) curves, and univariate and multivariable logistic regression analyses were performed.</p><p><strong>Results: </strong>Treatment response occurred in 71.9% of episodes and peritonitis-related mortality was 10.5%. HIIs showed weak correlations with dialysate leukocyte count at diagnosis (<i>r</i> = 0.210-0.369) and were not associated with treatment response or mortality (all <i>p</i> > 0.05). Lower serum creatinine and parathyroid hormone (PTH) levels were independently associated with poor treatment response (creatinine (OR 2.43, 95% CI 1.00-5.91); PTH (OR 2.99, 95% CI 1.24-7.24)). For mortality, lower phosphate, creatinine, urea and LDL-C levels were significant in univariate analysis. ROC analysis demonstrated moderate discrimination (AUC range: 0.698-0.729). In multivariable analysis, low urea (OR 5.91, 95% CI 1.34-26.08), low creatinine (OR 6.07, 95% CI 1.35-27.20), and low LDL-C (OR 4.82, 95% CI 1.15-20.24) remained independently associated with mortality.</p><p><strong>Conclusion: </strong>HIIs were not associated with clinical outcomes in PDRP. In contrast, lower creatinine and PTH levels were independently associated with treatment non-response, while lower urea, creatinine and LDL-C levels were independently associated with peritonitis-related mortality, suggesting that underlying nutritional and metabolic status may influence clinical outcomes.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"765-773"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-implant echocardiography plus EHR for post-LVAD risk stratification for survival: Single-center exploratory study.","authors":"Gabriel Farias Cacao, Dongping Du, Nandini Nair","doi":"10.1177/03913988261463234","DOIUrl":"10.1177/03913988261463234","url":null,"abstract":"<p><strong>Purpose: </strong>Durable LVAD therapy improves survival for advanced heart failure, yet adverse outcomes remain common. We evaluated whether combining pre-implant echocardiography with routinely available Electronic Health Record (EHR) data yields clinically useful post-LVAD risk predictions to improve patient selection and perioperative management.</p><p><strong>Methods: </strong>In this retrospective study (2015-2022), pre-implant apical four-chamber echocardiograms were processed via raw loops and U-Net segmentation. CNN embeddings were integrated with PCA-reduced EHR variables including demographics, laboratories, and hemodynamics. Survival models, including Cox proportional hazards and random survival forests, were trained on multimodal inputs. Performance was validated using stratified 5-fold cross-validation, targeting a primary endpoint of time to death or missed follow-up. Saliency mapping was utilized to ensure clinical interpretability of the model's features.</p><p><strong>Results: </strong>Multimodal models achieved higher discrimination than single-modality models, with segmented-echo inputs outperforming raw videos (mean C-index of 0.711). Saliency mapping identified clinically coherent predictors: right ventricular and septal geometry on imaging, alongside renal, hepatic, and nutritional status from the EHR.</p><p><strong>Conclusions: </strong>Integrating pre-implant echocardiography with EHR data enhances risk stratification survival for LVAD candidates. This multimodal approach identifies high-risk phenotypes, specifically right-heart and systemic frailty, providing a framework for personalized clinical decision support and future multicenter validation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"815-824"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}