Journal of Artificial Organs最新文献

Hemadsorption with CytoSorb®: focus on the latest experiences in cardiac surgery patients.

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-21 DOI: 10.1007/s10047-024-01485-5

Leonardo Spatola, Antonio Granata, Maria D'Amico, Gaspare Oddo, Alessia Gambaro

{"title":"Hemadsorption with CytoSorb®: focus on the latest experiences in cardiac surgery patients.","authors":"Leonardo Spatola, Antonio Granata, Maria D'Amico, Gaspare Oddo, Alessia Gambaro","doi":"10.1007/s10047-024-01485-5","DOIUrl":"https://doi.org/10.1007/s10047-024-01485-5","url":null,"abstract":"Cardiac surgery patients are potentially exposed to an acute inflammatory host response with a huge release of both pro- and anti-inflammatory cytokines both through intrinsic (e.g., tissue damage, endothelial injury) and extrinsic (e.g., anesthesia, extracorporeal circuits) mechanisms. Current standard of care therapy includes several invasive supportive treatments such as mechanical ventilation, continuous renal replacement therapy, ECMO, and/or cardiopulmonary bypass which may be responsible for an important inflammatory response. The inflammatory cytokine levels and hemodynamic status following these artificial treatments along with the current standard therapy are not always well controlled and may lead to worsened acute clinical conditions with prolonged in-hospital length of stay and increased mortality. In these settings, the administration of hemadsorption therapy with CytoSorb® has been supported by the successful results in several clinical studies as it has shown improvement of both the inflammatory profile and the hemodynamic vascular status of the patients. Therefore, in this narrative review, we summarized and discussed the current scientific literature on the role of CytoSorb® treatment in case of cardiac surgery. According to the current evidences, the raised inflammatory levels and both inotropic and vasopressor requests in cardiac surgery patients need more tailored therapies and, in this contest, the hemadsorption with CytoSorb® could play a pivotal role, especially on heart transplant patients. Furthermore, CytoSorb is currently the only hemadsorption sorbent authorized and efficiently applied for removing anticoagulant agents such as ticagrelor or rivaroxaban in patients undergoing cardiac surgery, to reduce perioperative bleeding complications and should be considered in high-risk patients.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872151","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}

引用次数: 0

Clinical outcomes of modified left ventricular assist device driveline management.

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-18 DOI: 10.1007/s10047-024-01482-8

Shusuke Imaoka, Noriyuki Kashiyama, Daisuke Yoshioka, Shunsuke Saito, Takuji Kawamura, Ai Kawamura, Ryohei Matsuura, Yusuke Misumi, Koichi Toda, Shigeru Miyagawa

{"title":"Clinical outcomes of modified left ventricular assist device driveline management.","authors":"Shusuke Imaoka, Noriyuki Kashiyama, Daisuke Yoshioka, Shunsuke Saito, Takuji Kawamura, Ai Kawamura, Ryohei Matsuura, Yusuke Misumi, Koichi Toda, Shigeru Miyagawa","doi":"10.1007/s10047-024-01482-8","DOIUrl":"https://doi.org/10.1007/s10047-024-01482-8","url":null,"abstract":"Left ventricular assist devices (LVADs) are implanted in patients with heart failure to support cardiac circulation. However, no standardized methods have been established for LVAD driveline exit site management for the prevention of infections. Therefore, this study evaluated the efficacy of modified driveline management compared with that of conventional driveline management. We retrospectively assessed the outcomes of 262 patients who underwent continuous-flow LVAD implantation between January 2005 and March 2023 at Osaka University in Japan. In conventional driveline management, an LVAD driveline penetrates the skin along the body surface and is fixed near the penetration site (n = 224). In contrast, in our modified fixation method, the LVAD driveline vertically penetrates the skin to prevent ischemia at the driveline exit site and is fixed at a distant abdominal site to prevent the movement of the driveline exit site due to body movement (n = 38). The rates of freedom from LVAD driveline infection in patients with conventional driveline management were 86, 75, and 63% at 1, 2, and 3 years after LVAD implantation, respectively. The rate of freedom from LVAD driveline infection in patients managed by the modified fixation method was 91% at 1, 2, as well as 3 years after LVAD implantation. The freedom rates from LVAD driveline infection in the patients with modified fixation method was lower than in the patients with the conventional method (p = 0.04). Our study revealed that the modified fixation method may offer the possibility for preventing LVAD driveline infection.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854033","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}

引用次数: 0

ECMO-weaning facilitated by neurally adjusted ventilatory assist (NAVA): a case for principal clarification.

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-13 DOI: 10.1007/s10047-024-01484-6

F Heinold, O Moerer, L O Harnisch

{"title":"ECMO-weaning facilitated by neurally adjusted ventilatory assist (NAVA): a case for principal clarification.","authors":"F Heinold, O Moerer, L O Harnisch","doi":"10.1007/s10047-024-01484-6","DOIUrl":"https://doi.org/10.1007/s10047-024-01484-6","url":null,"abstract":"The use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has become increasingly prevalent, particularly in respiratory disease pandemics such as H1N1-influenza and SARS-CoV-2. This surge has emphasized the importance of clear therapy recommendations, improved accessibility to ECMO technology, established ECMO teams, and structured networks to ensure access to specialized care throughout the course of the disease for patients with severe ARDS. Although the initiation criteria for VV-ECMO are well defined, treatment strategies while on ECMO regarding e.g., ventilator management or ECMO weaning strategies remain variable and with lack of consensus. NAVA (Neurally Adjusted Ventilatory Assist), as an assisted mechanical ventilation modality, offers real-time electromyographic feedback, which has been shown to enhance prolonged weaning processes from mechanical ventilation. We present a case of penetrating thoracic trauma complicated by ARDS, successfully managed with VV-ECMO. NAVA was employed to monitor and facilitate ECMO. This approach integrates ECMO weaning with ventilation settings, considering both gas exchange lung function, such as carbon dioxide removal, and respiratory mechanics in the form of neuromuscular coupling. This is a new approach to VV-ECMO weaning. More research is planned to validate the efficacy of this method in conjunction with additional parameters, such as diaphragm activity evaluated sonographically in a randomized design. This case underscores the potential of NAVA in VV-ECMO weaning, offering a promising avenue for optimizing patient care and outcomes.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818138","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}

引用次数: 0

Total reversal of the pulmonary circulation (RPC) induced by peripheral cannulation for veno-arterial ECMO in a patient with aortic and mitral valve insufficiency: a case report.

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-13 DOI: 10.1007/s10047-024-01483-7

Johannes Heymer, Daniel Bent, Daniel Raepple

引用次数: 0

Human induced pluripotent stem cell-derived cardiomyocyte patches ameliorate right ventricular function in a rat pressure-overloaded right ventricle model.

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-06 DOI: 10.1007/s10047-024-01479-3

Takuji Watanabe, Takuji Kawamura, Akima Harada, Masaki Taira, Daisuke Yoshioka, Kazuo Shimamura, Tadashi Watabe, Eku Shimosegawa, Takayoshi Ueno, Shigeru Miyagawa

{"title":"Human induced pluripotent stem cell-derived cardiomyocyte patches ameliorate right ventricular function in a rat pressure-overloaded right ventricle model.","authors":"Takuji Watanabe, Takuji Kawamura, Akima Harada, Masaki Taira, Daisuke Yoshioka, Kazuo Shimamura, Tadashi Watabe, Eku Shimosegawa, Takayoshi Ueno, Shigeru Miyagawa","doi":"10.1007/s10047-024-01479-3","DOIUrl":"https://doi.org/10.1007/s10047-024-01479-3","url":null,"abstract":"Right ventricular (RV) failure following surgical repair of congenital heart disease affects survival. Human induced pluripotent stem cell-derived cardiomyocyte (hiPS-CM) sheet transplantation ameliorated left ventricular dysfunction in preclinical studies, indicating its efficacy in RV failure in congenital heart disease. This study aimed to evaluate whether hiPS-CMs could improve RV function in rats with pressure-overloaded RV failure. F344/NJcl-rnu/rnu rats underwent pulmonary artery banding (PAB) via left thoracotomy. Four weeks after PAB, hiPS-CM patch transplantation to the RV was performed in the hiPS-CM group (n = 33), and a sham operation was performed in the sham group (n = 18). We evaluated cardiac catheterization, positron emission tomography data, and pathological results 8 weeks following PAB. RV end-diastolic pressure, the time constant of isovolumic relaxation, and end-diastolic pressure-volume relation were significantly ameliorated in the hiPS-CM group compared with in the sham group. Picrosirius red staining revealed that anti-fibrotic effects were significantly higher in the hiPS-CM group than in the sham group. Von Willebrand factor staining revealed significantly higher myocardial capillary vascular density in the hiPS-CM group than in the sham group. hiPS-CMs were detected in the epicardium 4 weeks after hiPS-CM sheet transplantation. The angiogenic gene expression in the myocardium was significantly higher in the hiPS-CM group than in the sham group. Overall, in rats with pressure-overloaded RV failure, hiPS-CM patch transplantation could improve diastolic function, suppress ventricular fibrosis, and increase capillary density, suggesting that it is a promising treatment for RV failure.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785791","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}

引用次数: 0

Left ventricular assist devices: yesterday, today, and tomorrow. 左心室辅助装置：昨天、今天和明天。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-01 Epub Date: 2024-03-07 DOI: 10.1007/s10047-024-01436-0

Athanasios Tsiouris, Mark S Slaughter, Ashok Kumar Coimbatore Jeyakumar, Adam N Protos

引用次数: 0

Utilizing a long sheath to minimize atheroma manipulation (minimal manipulation approach) during Zone 1 and 2 thoracic endovascular aortic repair with a shaggy aorta. 在 1 区和 2 区胸腔内血管主动脉修补术中，利用长鞘管尽量减少对粥样斑块的操作（最小操作法）。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-01 Epub Date: 2024-03-21 DOI: 10.1007/s10047-024-01440-4

Hidetake Kawajiri, Takuma Kobayashi, Kaichiro Manabe, Keiichi Kanda, Satoshi Numata

引用次数: 0

Successful management of HeartMate 3 in a patient with arrhythmogenic right ventricular cardiomyopathy. 成功治疗一名心律失常性右室心肌病患者的 HeartMate 3。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-01 Epub Date: 2024-02-24 DOI: 10.1007/s10047-024-01434-2

Makiko Nakamura, Teruhiko Imamura, Yuki Hida, Toshihide Izumida, Masaki Nakagaito, Saori Nagura, Toshio Doi, Kazuaki Fukahara, Koichiro Kinugawa

引用次数: 0

Characteristics of macrophage aggregates prepared by rotation culture and their response to polymeric materials. 旋转培养法制备的巨噬细胞聚集体的特征及其对聚合物材料的反应

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-01 Epub Date: 2024-01-09 DOI: 10.1007/s10047-023-01428-6

Shota Toda, Yoshihide Hashimoto, Naoko Nakamura, Masahiro Yamada, Ryusuke Nakaoka, Wataru Nomura, Masaya Yamamoto, Tsuyoshi Kimura, Akio Kishida

{"title":"Characteristics of macrophage aggregates prepared by rotation culture and their response to polymeric materials.","authors":"Shota Toda, Yoshihide Hashimoto, Naoko Nakamura, Masahiro Yamada, Ryusuke Nakaoka, Wataru Nomura, Masaya Yamamoto, Tsuyoshi Kimura, Akio Kishida","doi":"10.1007/s10047-023-01428-6","DOIUrl":"10.1007/s10047-023-01428-6","url":null,"abstract":"Understanding the interaction between macrophages and biomaterials is important for the creation of new biomaterials and the development of technologies to control macrophage function. Since macrophages are strongly adhesive, caution is required when performing in vitro evaluations. Similarly, when THP-1 cells, macrophage precursor cells, are differentiated into macrophages using phorbol-12-myristate-13-acetate (PMA), it becomes difficult to detach them from the adherent substrate, which has been a problem on investigation of immunological responses to biomaterials. In this study, the interaction of THP-1 cell-differentiated macrophages with biomaterials was analyzed based on a new method of seeding THP-1 cells. THP-1 cells were cultured in static and rotation culture without and with PMA. In undifferentiated THP-1 cells, there was no change in cellular function between static and rotation cultures. In rotation culture with PMA, THP-1 cells differentiated and formed macrophage aggregates. IL-1β and MRC1 expression in macrophage aggregates was examined after differentiation and M1/M2 polarization. Macrophage aggregates in rotation culture tended to be polarized toward M2 macrophages compared with those in static culture. In the evaluation of the responses of macrophage aggregates to several kinds of polymeric materials, macrophage aggregates showed different changes in MRC1 expression over time at 30, 50, and 70 rpm. Rotation speed of 30 rpm was considered most appropriate condition in that it gave stable results with the same trend as obtained with static culture. The use of macrophage aggregates obtained by rotational culture is expected to provide new insights into the evaluation of inflammatory properties of biomaterials.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"410-418"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The outcomes of a standardized protocol for extracorporeal mechanical circulatory support selection-left ventricular challenge protocol. 体外机械循环支持选择标准化方案-左心室挑战方案的成果。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-12-01 Epub Date: 2024-01-08 DOI: 10.1007/s10047-023-01427-7

Naoki Tadokoro, Tetsuya Koyamoto, Kohei Tonai, Yuki Yoshida, Koudai Hirahsima, Satoshi Kainuma, Naonori Kawamoto, Kimito Minami, Hiroshi Nishioka, Tsukamoto Yasumasa, Tomoyuki Fujita, Satsuki Fukushima

{"title":"The outcomes of a standardized protocol for extracorporeal mechanical circulatory support selection-left ventricular challenge protocol.","authors":"Naoki Tadokoro, Tetsuya Koyamoto, Kohei Tonai, Yuki Yoshida, Koudai Hirahsima, Satoshi Kainuma, Naonori Kawamoto, Kimito Minami, Hiroshi Nishioka, Tsukamoto Yasumasa, Tomoyuki Fujita, Satsuki Fukushima","doi":"10.1007/s10047-023-01427-7","DOIUrl":"10.1007/s10047-023-01427-7","url":null,"abstract":"There are no criteria for surgical mechanical circulatory system (MCS) selection for acute heart failure. Since 2021, we have utilized cardiopulmonary bypass system to assess patients' heart and lung condition to inform surgical MCS selection. we aimed to retrospectively analyze the outcomes of treatments administered using our protocol. We analyzed the data of 19 patients who underwent surgical MCS implantation. We compared patients' characteristics across the biventricular-assist device (BiVAD), central Y-Y extracorporeal membrane oxygenation (ECMO), central ECMO, and left VAD (LVAD) systems. Patients' diagnoses included fulminant myocarditis (47.4%), dilated cardiomyopathy (21.1%), acute myocardial infarction (15.8%), infarction from aortic dissection (5.3%), doxorubicin-related cardiomyopathy (5.3%), and tachycardia-induced myocarditis (5.3%). Eight patients (42.1%) underwent LVAD implantation, 1 (5.2%) underwent central ECMO, 4 (21.1%) underwent BiVAD implantation, and 6 (31.6%) underwent central Y-Y ECMO. 48 h after surgery, both the pulmonary arterial and right atrial pressures were effectively controlled, with median values being 19.0 mmHg and 9.0 mmHg, respectively. No patients transitioned from LVAD to BiVAD in the delayed period. Cerebrovascular events occurred in 21.1%. Successful weaning was achieved in 11 patients (57.9%), and 5 patients (26.3%) were converted to durable LVAD. Two-year cumulative survival was 84.2%. Our protocol showed good results for device selection in patients with heart failure, and device selection according to this protocol enabled good control of the pulmonary and systemic circulations.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"358-367"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377672","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}

引用次数: 0