Journal of Artificial Organs最新文献

{"title":"Central vein stenosis- prevalence, clinical characteristics, outcome and its impact on dialysis access.","authors":"K Sai Sindhu Singh, Yerramachu Dharanidhar Reddy, Manoj Kumar, Lakshmi Aishwarya Pavuluri, Elayaperumal Indhumathi","doi":"10.1007/s10047-025-01495-x","DOIUrl":"10.1007/s10047-025-01495-x","url":null,"abstract":"<p><p>Central vein stenosis (CVS) is a complication primarily affecting chronic hemodialysis patients, frequently resulting in vascular access dysfunction and decreased dialysis efficacy. While CVS has a variable mortality rate, its impact on dialysis access is profound, including arm edema, facial swelling, and venous hypertension. We describe the prevalence, clinical presentation, and treatment outcomes of CVS for vascular access in hemodialysis patients. We conducted a prospective observational study from July 2023 to June 2024, on patients undergoing maintenance hemodialysis (MHD) at a tertiary care center in South India who had CVS detected by CT Venography. Demographic information, comorbidity, access type, stenosis location, clinical presentation, treatment, and outcome data were collected and analyzed. Of the 152 patients on MHD, 20 (13.1%) had CVS. Of them, 7 patients were on tunneled catheter and 13 were on AVF. Arm edema (47%) was the most common symptom, followed by face swelling (29%) and prolonged bleeding (11%) from arteriovenous fistula post dialysis. The brachiocephalic vein (BCV) was the most common site of stenosis in 65% of patients. Angioplasty was performed in (N = 9) nine patients with a primary success rate of 66% and a six-month patency of 44.4%. In the remaining eleven (N = 11) four patients (20%) transitioned to CAPD, three (15%) had new access of which two had femoral catheter inserted and other one had new AVF creation done and two (10%) continued dialysis via same access. Mortality occurred in two patients (10%) due to pulmonary edema. The Prevalence of CVS in our study population was 13.1%. Six-month primary patency rate among those who underwent intervention was 44.4%. Vascular access had to be terminated in 55%.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"402-407"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472468","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":"Disseminated intravascular coagulation is associated with a poor outcome in patients with out-of-hospital cardiac arrest receiving VA-ECMO.","authors":"Satoshi Gando, Takumi Tsuchida, Takeshi Wada","doi":"10.1007/s10047-024-01487-3","DOIUrl":"10.1007/s10047-024-01487-3","url":null,"abstract":"<p><p>We tested the hypothesis that disseminated intravascular coagulation (DIC) predicts a poor prognosis in patients with out-of-hospital cardiac arrest (OHCA) treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Fifty-seven patients with cardiogenic OHCA who immediately underwent VA-ECMO upon admission to the emergency department were divided into 27 non-DIC and 30 DIC patients. DIC scores were calculated on admission and 24 h later (day 1). The primary outcome measure was the all-cause in-hospital mortality. The basic characteristics did not differ between the two groups; however, patients with DIC showed higher in-hospital mortality rates. Receiver operating characteristic curve analysis showed a moderate predictive ability of DIC scores on day 1 for in-hospital mortality. A lower probability of survival was observed in patients with DIC. The adjusted odds ratio for DIC on day 1 of in-hospital death was 5.67, confirmed by the adjusted hazard ratio of 3.472. The results indicate an association between DIC diagnosis 24 h following VA-ECMO induction for OHCA and poor outcome in these patients.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"473-476"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931923","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":"Admission hematocrit and fluctuating blood urea nitrogen levels predict the efficacy of blood purification treatment in severe acute pancreatitis patients.","authors":"Bibi Chen, Junhuang Chen, Handong Huang, Liqun Yan, Ling Lin, Hongwei Huang","doi":"10.1007/s10047-025-01501-2","DOIUrl":"10.1007/s10047-025-01501-2","url":null,"abstract":"<p><p>This study aimed to evaluate the prognostic significance of the levels of admission hematocrit (HCT) and the changes in the initial blood urea nitrogen (BUN) levels in predicting the efficacy of blood purification (BP) therapy in ameliorating severe acute pancreatitis (SAP) patients at admission. A retrospective study was conducted on 139 SAP patients from the People's Hospital of Guangxi Zhuang Autonomous Region from 2013 to 2022 and the data retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database for 346 SAP patients. The patients were stratified based on their HCT0 levels at admission; HCT < 44% (n = 93) and HCT ≥ 44% (n = 46) and ΔBUN levels within the first 24 h post-admission; ΔBUN ≤ 0 (n = 78) and ΔBUN > 0 (n = 61). Propensity score matching (PSM) was performed on factors such as age and gender to control for differences among the strata. The clinical outcomes of the patients receiving or not receiving BP therapy were compared based on the mentioned criteria. Patients with HCT0 ≥ 44%, who were treated with BP showed no significant difference in the 28-day mortality. However, a significant increase in hospital expenses and prolonged ICU stays was observed (P < 0.05). Conversely, patients with ΔBUN ≤ 0 who received BP therapy demonstrated relatively high 28-day mortality rates, prolonged ICU stays, increased hospital expenses, and low SOFA scores (P < 0.05). The analyses of MIMIC-IV database data corroborated these findings. The predictive efficacy of BP therapy in SAP patients was significantly influenced by the changes in BUN levels at 24 h post-admission compared to the initial levels of HCT on admission. Selecting SAP patients suitable for BP treatment should be based on the changes in BUN levels to enhance effective therapeutic outcomes.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"431-438"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010936","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":"Adaptation of the hemodialysis self-management scale into Turkish culture: a psychometric study.","authors":"Özge Coşkun, Hatice Karabuğa Yakar","doi":"10.1007/s10047-025-01498-8","DOIUrl":"10.1007/s10047-025-01498-8","url":null,"abstract":"<p><p>This study was conducted methodologically to determine the reliability and the validity of the Turkish version of the hemodialysis self-management scale in hemodialysis patients in Turkey. The study was conducted with 200 patients who received hemodialysis treatment between October 2022 and April 2023. Data were collected using a Patient Information Form and the Hemodialysis Self-Management Instrument. To test the reliability of the scale, the internal consistency coefficient Cronbach's Alpha, McDonald Omega, and test-retest reliability coefficients were calculated. Confirmatory factor analysis was performed to evaluate the validity. Unlike the original version, the scale consisted of 11 items and 4 subscales and showed an acceptable fit. The Cronbach alpha coefficient was 0.89; the McDonald Omega coefficient was 0.90. The hemodialysis self-management instrument is a reliable and valid scale in Turkey.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"415-422"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531492","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":"Barriers and solutions for introducing donation after circulatory death (DCD) in Japan.","authors":"Yasuhiro Kotani","doi":"10.1007/s10047-024-01491-7","DOIUrl":"10.1007/s10047-024-01491-7","url":null,"abstract":"","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"343-347"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983550","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}

{"title":"The role of ferroptosis in liver injury after cold ischemia-reperfusion in rats with autologous orthotopic liver transplantation.","authors":"Wei Wu, Bei Xu, Haibin Huang, Ying Mao, Yuan Gao, Wenhao Bu","doi":"10.1007/s10047-024-01488-2","DOIUrl":"10.1007/s10047-024-01488-2","url":null,"abstract":"<p><p>Using autologous orthotopic liver transplantation (AOLT) model in rats, the effect of lipid reactive oxygen species (L-ROS) inhibitor Ferrostain-1 on ferroptosis signal pathway was observed to determine whether ferroptosis occurred in rat liver injury after cold ischemia-reperfusion (I/R). Thirty-two healthy adult SPF male SD rats, 8 ~ 10 weeks old, weight 240 ~ 260 g, were divided into four groups by the method of random number table (n = 8): sham group, I/R group, I/R + Fer-1 group, I/R + DFO group. In the I/R + Fer-1 group, ferristatin-1(5 mg /kg) was intraperitoneally injected 30 min before surgery; in the I/R + DFO group, DFO 100 mg/kg was injected intraperitoneally 1 h before operation and 12 h after operation. Blood samples were taken from the inferior hepatic vena cava 24 h after reperfusion. After anesthesia, the rats were killed and part of their liver tissue was removed. The pathological changes of liver tissue sections were observed under a high-power microscope, and the liver injury was evaluated. Serum malondialdehyde (MDA) and serum levels of ALT, AST and IL-6 were determined by the ELISA method, Reduced glutathione (GSH), glutathione peroxidase 4 (GPX4), MDA, Fe2 + and superoxide dismutase (SOD) were determined in the liver tissue. Compared with the sham group, the serum levels of the IL-6,MDA, AST and ALT in I/R group were obviously higher (P < 0.05); The levels of MDA and Fe²⁺ in liver tissue were significantly increased (P < 0.05).The levels of SOD, GSH and GPX4 in liver tissue were decreased. The levels of serum MDA, IL-6, AST, and ALT in the I/R + Fer-1 and I/R + DFO groups were significantly lower than those in the I/R group at 24 h after reperfusion. In the I/R + Fer-1 group, the level of MDA in liver tissue decreased significantly, while the level of SOD, GSH and GPX4 in intestinal tissue increased (P < 0.05). In The I/R + DFO group, the levels of MDA and Fe²⁺ in liver tissue decreased significantly, while the level of SOD in intestinal tissue increased (P < 0.05). Ferroptosis is involved in pathophysiological process of liver injury after cold ischemia-reperfusion in AOLT rats.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"449-456"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931929","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}

{"title":"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.","authors":"Johannes Heymer, Daniel Bent, Daniel Raepple","doi":"10.1007/s10047-024-01483-7","DOIUrl":"10.1007/s10047-024-01483-7","url":null,"abstract":"<p><p>This case report details a rare instance of total reversal of the pulmonary circulation (RPC) in a 56-year-old male patient on veno-arterial extracorporeal membrane oxygenation (V-A ECMO) during emergency cardiopulmonary resuscitation (eCPR) following a myocardial infarction and cardiac arrest. Previously unrecognized aortic and mitral valve regurgitations, along with V-A ECMO flow, resulted in severe pulmonary edema. We describe how pulmonary artery cannulation and modifying the ECMO circuit to veno-pulmonary arterial-arterial (VPa-A) ECMO successfully alleviated the severe pulmonary edema but may have caused reversal of the pulmonary circulation (RPC). To our knowledge, this is the first reported case of this phenomenon in a human.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"457-461"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818141","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":"Prediction of acute lung injury/acute respiratory distress syndrome after cardiopulmonary bypass in infants by monitoring femoral oxygen saturation.","authors":"Kenta Matsui, Norihiko Oka, Fumiaki Shikata, Satoshi Kohira, Tadashi Kitamura, Toshiaki Mishima, Masaomi Fukuzumi, Ryoichi Kondo, Yusuke Motoji, Yoshimi Tamura, Saya Ishikawa, Kiyotaka Fujii, Masami Fujii, Kagami Miyaji","doi":"10.1007/s10047-025-01524-9","DOIUrl":"https://doi.org/10.1007/s10047-025-01524-9","url":null,"abstract":"<p><p>To investigate the feasibility of regional oxygen saturation (rSO₂) monitoring for preventing acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) caused by cardiopulmonary bypass (CPB) in infants undergoing ventricular septal defect (VSD) closure. This study included 49 infants who underwent VSD closure between January 2012 and December 2023. Patients with preoperative pulmonary hypertension were excluded. rSO₂ of the head, abdomen, and thigh was monitored perioperatively. ALI/ARDS was defined as a PaO₂/FiO₂ ratio (P/F ratio) ≤ 300 upon pediatric intensive care unit (PICU) admission. The median age at surgery was 4 (interquartile range: 3-5) months, and the median weight was 6.03 (interquartile range: 5.30-6.78) kg. Five (10%) patients developed postoperative ALI/ARDS and had a longer PICU stay (8 vs 5 days, P < 0.001) and hospital stay (10 vs 5 days, P = 0.005). According to multiple regression analysis, thigh rSO₂ during CPB was a significant predictor of postoperative P/F ratio (β: 4.88, standard error: 1.99, P = 0.02). Receiver operating characteristic curve analysis showed that thigh rSO₂ during CPB (area under the curve: 0.87, P = 0.01) significantly predicted postoperative ALI/ARDS. The optimal cutoff value for thigh rSO₂ was 71%, with a sensitivity of 80% and specificity of 93%. Thigh rSO₂ monitoring during CPB may be effective for detecting ALI/ARDS in infants who underwent VSD closure. Maintaining rSO₂ levels above 71% might help prevent the onset of ALI/ARDS.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955504","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":"Nomograms to predict outcome for patients undergoing venoarterial extracorporeal membrane oxygenation treatment for septic shock.","authors":"Kunlin Hu, Jing Wei, Xinyu Chi, Jiwang Zhang, Xuanliang Zhao, Liqiu Lu, Yufeng Liao, Shulin Xiang, Bin Xiong","doi":"10.1007/s10047-025-01523-w","DOIUrl":"https://doi.org/10.1007/s10047-025-01523-w","url":null,"abstract":"<p><p>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being employed to treat patients with refractory septic shock. Despite its growing use, there is a notable absence of prognostic assessment tools specifically designed for septic shock patients who have received VA-ECMO therapy. The aim of this study is to develop and validate a prognostic model for patients with refractory septic shock undergoing VA-ECMO, and to identify those who may derive the greatest benefit from this treatment. This single-center, retrospective cohort study was conducted at a comprehensive intensive care unit in China. Adult patients with refractory septic shock who received VA-ECMO treatment were included. Two hundred consecutive patients were randomly divided into training and validation cohorts in a 7:3 ratio. Least absolute shrinkage and selection operator regression analysis was employed to select relevant variables for the logistic regression model, and its performance was tested in both training and validation cohorts based on discrimination, calibration, and net benefit. Between January 2019 and September 2024, 293 patients were screened, 200 of whom were eligible and were divided into development (n = 140) and validation (n = 60) cohorts. The 28-day survival rate was 23.0%, and median duration of ECMO run was 6.0 days (IQR 2.0-8.0). Age, APACHE II score at ICU admission, immunosuppression status, hypertension, IL-6, and APTT measured within 6 h before ECMO initiation were the six predictors included in the nomograms. The nomogram demonstrated strong discriminative power in the training cohort (area under the curve [AUC]: 0.873, 95% CI 0.812-0.929), as well as in the validation cohort (area under the curve [AUC]: 0.818 (95% CI 0.687-0.920). The model's reliability in predicting outcomes was evident from the high consistency between predicted probabilities and observed proportions during calibration. Decision curve analysis indicated that the model's clinical benefit was advantageous. The novel validated nomogram is designed to predict outcomes after VA-ECMO treatment in individuals with refractory septic shock. It can support physicians in performing precise mortality risk evaluations and making more informed decisions regarding the application of VA-ECMO treatment.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955568","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":"Return to work following total hip arthroplasty: a Japanese retrospective cohort study highlighting the impact on satisfaction and life purpose.","authors":"Yuki Nakao, Satoshi Hamai, Satoshi Yamate, Toshiki Konishi, Shinya Kawahara, Goro Motomura, Takeshi Utsunomiya, Hayato Inoue, Yasuharu Nakashima","doi":"10.1007/s10047-025-01522-x","DOIUrl":"https://doi.org/10.1007/s10047-025-01522-x","url":null,"abstract":"<p><p>This study investigated return to work (RTW) patterns following total hip arthroplasty (THA), focusing on factors influencing RTW, RTW timing, and the relationship between postoperative employment and patient-reported outcome measures (PROMs). This retrospective cohort study included 310 patients who underwent THA between 2012 and 2016 in Japan. Mailed surveys assessed employment status, occupation type, RTW timing, and PROMs, including the Oxford Hip Score, Forgotten Joint Score-12, visual analog scale (VAS) for satisfaction, and Ikigai-9 for life purpose. Regression analyses were performed to identify predictive factors. Employment rates were 55% preoperatively and 45% postoperatively, with an overall RTW rate of 81%. Younger age (≤ 62 years) significantly predicted RTW (odds ratio, 0.94; p < 0.01). Among those returning to work, 66% did so within 3 months. Sedentary workers had a significantly higher RTW rate within 1 month (40.8%, p = 0.022), however, overall RTW rates did not differ significantly across occupational categories (p = 0.590). Anxiety about dislocation was the most common reason for delayed RTW. Postoperative employment significantly correlated with higher VAS satisfaction (β = 2.31, p = 0.01) and Ikigai-9 scores (β = 1.28, p < 0.01). The RTW rate was 81%, with higher rates in younger age. Sedentary work was associated with earlier RTW. Addressing anxiety about dislocation through appropriate education and rehabilitation may facilitate RTW after THA. Postoperative employment was linked to higher satisfaction and Ikigai for life purpose. Communicating these findings may improve patient RTW rates, satisfaction, and overall well-being.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955507","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}