Journal of Artificial Organs最新文献_第6页

Critical hematological parameters in bleeding during extracorporeal membrane oxygenation support. 体外膜氧合支持期间出血的关键血液学参数。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-08-12 DOI: 10.1007/s10047-024-01466-8

Ngan Hoang Kim Trieu, Tuan Anh Mai, Huy Minh Pham

引用次数: 0

The foremost and greatest barrier to end-stage heart failure treatment: the impact of caregiver shortage. 终末期心力衰竭治疗的首要和最大障碍：护理人员短缺的影响。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-08-07 DOI: 10.1007/s10047-024-01463-x

Shunsuke Saito, Daisuke Yoshioka, Takuji Kawamura, Ai Kawamura, Yusuke Misumi, Yasuhiro Akazawa, Fusako Sera, Kaori Kubota, Takashi Yamauchi, Yasushi Sakata, Shigeru Miyagawa

{"title":"The foremost and greatest barrier to end-stage heart failure treatment: the impact of caregiver shortage.","authors":"Shunsuke Saito, Daisuke Yoshioka, Takuji Kawamura, Ai Kawamura, Yusuke Misumi, Yasuhiro Akazawa, Fusako Sera, Kaori Kubota, Takashi Yamauchi, Yasushi Sakata, Shigeru Miyagawa","doi":"10.1007/s10047-024-01463-x","DOIUrl":"https://doi.org/10.1007/s10047-024-01463-x","url":null,"abstract":"We examined the number of patients abandoning cardiac replacement therapy due to the inability to secure a designated caregiver. At Osaka University Hospital Heart Center, when we receive a consultation for a patient with severe heart failure from another hospital, a heart failure team makes a visit to the referring hospital as soon as possible. We retrospectively analyzed this hospital-visit database. We received 199 severe heart failure consultations from 2016-2023. Issues identified during hospital visits included age ≥ 65 years (8%), inability to confirm the patient's intention (8.5%), and explicit refusal of therapy (2.5%). Medical problems included multiple organ failure (18.1%), obesity (13.1%), diabetes (9.5%), malignancy (5.5%), chronic dialysis (1.0%), and other systemic diseases (12.6%). Adherence problems included poor medication compliance (3.5%), history of heavy drinking (2.5%), and smoking (2.0%). Social problems included inadequate family support in 16.1% of patients. Of the 199 patients, 95 (48.0%) proceeded to a heart transplant and LVAD indication review meeting at Osaka University Hospital. The remaining 104 patients (52.0%) did not proceed to the meeting. Reasons included improvement of heart failure with conservative treatment in 37 cases (35.6%), death before discussion in 21 cases (20.2%), medical contraindications in 18 cases (18.3%), lack of caregivers in 18 cases (18.3%; 9.5% of 199 cases), and patient refusal in 5 cases (4.8%). Approximately 10% of patients consulted at Osaka University Hospital Heart Center for severe heart failure abandoned cardiac replacement therapy due to the lack of caregivers.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897528","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

Relation between antithrombin-III activity and activated clotting time for cardiopulmonary bypass. 心肺旁路术中抗凝血酶-III 活性与活化凝血时间之间的关系。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-08-02 DOI: 10.1007/s10047-024-01462-y

Tomoaki Yamashiro, Yoshiyuki Takami, Yasushi Takagi

{"title":"Relation between antithrombin-III activity and activated clotting time for cardiopulmonary bypass.","authors":"Tomoaki Yamashiro, Yoshiyuki Takami, Yasushi Takagi","doi":"10.1007/s10047-024-01462-y","DOIUrl":"https://doi.org/10.1007/s10047-024-01462-y","url":null,"abstract":"Heparin resistance (HR) is observed before cardiopulmonary bypass (CPB), despite with normal antithrombin III (AT-III) levels. The relationships between preoperative AT-III activity and activated clotting time (ACT) after the first heparin dose should be clarified. We retrospectively analyzed the data of 818 patients who underwent CPB surgery, with the initial heparin of 300, 400, and 500 IU/kg, between 2017 and 2021. We defined HR as the failure to achieve ACT after the initial heparin dose (Post ACT) of > 480 s.There were no significant correlations between the AT-III activity and Post ACT in all patients, including 143 patients with AT-III activity < 80% and 675 patients with AT-III activity of ≥ 80%. Also, there were no significant correlations between the AT-III activity and Post ACT in 74 patients who received heparin of 300 IU/kg, in 186 patients with 400 IU/kg, and in 339 patients with 500 IU/kg. After identifying smoking, HR, activated partial thromboplastin time, fibrinogen degradation products (FDP), and ACT as influencing factors, multiple comparisons using the Steel-Dwass test showed significant difference in FDP and HR among the patients who received heparin of 300 IU/kg, 400 IU/kg, and 500 IU/kg. There is no association between preoperative AT-III activity and ACT after the first heparin administration for CPB, even in different dose of heparin. Rather, the higher the initial UFH dose is, the higher ACT may be, regardless of the AT-III activity.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878750","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

Effect of online hemodiafiltration on quality of life, fatigue and recovery time: a systematic review and meta-analysis 在线血液透析对生活质量、疲劳和恢复时间的影响：系统回顾和荟萃分析

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-07-27 DOI: 10.1007/s10047-024-01459-7

Maurizio Bossola, Ilaria Mariani, Manuela Antocicco, Gilda Pepe, Enrico Di Stasio

{"title":"Effect of online hemodiafiltration on quality of life, fatigue and recovery time: a systematic review and meta-analysis","authors":"Maurizio Bossola, Ilaria Mariani, Manuela Antocicco, Gilda Pepe, Enrico Di Stasio","doi":"10.1007/s10047-024-01459-7","DOIUrl":"https://doi.org/10.1007/s10047-024-01459-7","url":null,"abstract":"The present systematic review and meta-analysis aims to compare the effect of bicarbonate hemodialysis and HDF on quality of life (QoL), fatigue, and time to recovery in end-stage renal disease (ESRD) patients. Searches were run on January 2024 and updated on 3 March 2024 in the following databases: Ovid MEDLINE (1985 to present); Ovid EMBASE (1985 to present); Cochrane Library (Wiley); PubMed (1985 to present). Ten articles were fully assessed for eligibility and included in the investigation. Compared to HD, online HDF had a pooled MD of the mental component score (MCS) of the SF-36 of 0.98 (95% CI − 0.92, 2.87; P = 0.31). and of the physical component score (PCS) of 0.08 (95% CI − 1.32, 1.48; P = 0.91). No significant heterogeneity was observed (Chi2 = 4.85; I2 = 38%; P = 0.18 and Chi2 = 3.85; I2 = 22%; P = 0.28, respectively). Studies that compared the QoL assessed through the Kidney Disease Questionnaire or KDQOL-SF and show that HDF does not improve QoL when compared with HD, in most studies. In five out of seven studies, HDF was not significantly more effective than HD in improving fatigue. The length of the recovery time resulted in similar in patients receiving HDF and HD in all studies included in the present review. HDF is not more effective than HD in improving QoL and fatigue and in reducing the length of time of recovery after dialysis.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"27 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141786150","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

A case of truncus arteriosus with severe heart failure and pulmonary stenosis: bridge to transplant candidacy with surgical correction and a ventricular-assist device. 一例动脉导管未闭并伴有严重心衰和肺动脉狭窄的病例：通过手术矫正和心室辅助装置为移植候选者搭建桥梁。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-07-15 DOI: 10.1007/s10047-024-01456-w

Kazuki Tanimoto, Takashi Kido, Masaki Taira, Takuji Watanabe, Jun Narita, Hidekazu Ishida, Ryo Ishii, Takayoshi Ueno, Shigeru Miyagawa

{"title":"A case of truncus arteriosus with severe heart failure and pulmonary stenosis: bridge to transplant candidacy with surgical correction and a ventricular-assist device.","authors":"Kazuki Tanimoto, Takashi Kido, Masaki Taira, Takuji Watanabe, Jun Narita, Hidekazu Ishida, Ryo Ishii, Takayoshi Ueno, Shigeru Miyagawa","doi":"10.1007/s10047-024-01456-w","DOIUrl":"https://doi.org/10.1007/s10047-024-01456-w","url":null,"abstract":"Ventricular-assist device therapy for small patients with congenital heart disease is challenging due to its complex anatomy and hemodynamics. We describe a 3-year-old patient with heart failure with truncus arteriosus in the palliative stage. The patient underwent palliative right ventricular outflow tract reconstruction following bilateral pulmonary artery banding. At 6 months of age, the patient developed severe truncal valve regurgitation and left ventricular dysfunction. Emergent truncal valve replacement with a mechanical valve was performed, but left ventricular dysfunction persisted. At 3 years of age, the patient developed acute progression of heart failure triggered by influenza infection. The patient was intubated and transferred to our center to determine the indication for heart transplantation. On the second day after admission, signs of multiorgan failure appeared. Emergent ventricular-assist device implantation for both ventricles was performed with truncal valve closure, ventricular septal defect closure, atrial septal defect closure, and re-right ventricular outflow tract reconstruction. The right ventricular-assist device was successfully removed on the seventh postoperative day. Due to the small pulmonary arteries, severe pulmonary stenosis persisted after ventricular-assist device implantation, but it gradually improved with multiple pulmonary angioplasties. The patient was registered in the Japanese organ transplant network and is awaiting a donor organ in a stable condition.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616449","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

Relationships among hemolysis indicators and neuron-specific-enolase in patients undergoing veno-arterial extracorporeal membrane oxygenation. 静脉-动脉体外膜氧合患者溶血指标与神经元特异性烯醇化酶之间的关系。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-07-10 DOI: 10.1007/s10047-024-01454-y

Ryo Okubo, Tomonori Shirasaka, Ryohei Ushioda, Masahiko Narita, Shingo Kunioka, Yuta Kikuchi, Masahiro Tsutsui, Nobuya Motoyoshi, Hiroyuki Kamiya

{"title":"Relationships among hemolysis indicators and neuron-specific-enolase in patients undergoing veno-arterial extracorporeal membrane oxygenation.","authors":"Ryo Okubo, Tomonori Shirasaka, Ryohei Ushioda, Masahiko Narita, Shingo Kunioka, Yuta Kikuchi, Masahiro Tsutsui, Nobuya Motoyoshi, Hiroyuki Kamiya","doi":"10.1007/s10047-024-01454-y","DOIUrl":"https://doi.org/10.1007/s10047-024-01454-y","url":null,"abstract":"Neuron-specific-enolase is used as a marker of neurological prognosis after cardiopulmonary resuscitation. It is also present in red blood cells and platelets. It is not known whether hemolysis increases the values of neuron-specific-enolase enough to clinically affect its interpretation in critically ill patients who are to be introduced to veno-arterial extracorporeal oxygenation. In this study, we examined the relationships among neuron-specific-enolase and hemolysis indicators such as free hemoglobin and lactate dehydrogenase after the introduction of veno-arterial extracorporeal oxygenation. Of the 91 patients who underwent veno-arterial extracorporeal membrane oxygenation in our hospital from January 1, 2018, to February 24, 2021, 68 patients survived for more than 24 h. Of these, 14 patients who were categorized into the better cerebral performance categories (1-3) and 19 patients who were categorized into the poor neurological prognosis category (4) were included. After the introduction of veno-arterial extracorporeal membrane oxygenation, neuron-specific-enolase was markedly higher in the poor neurological prognosis group than in the good neurological prognosis group (41.6 vs. 92.0, p = 0.04). A significant positive correlation was revealed between neuron-specific-enolase and free hemoglobin in the good neurological prognosis group (rs = 0.643, p = 0.0131). A similar relationship was observed for lactate dehydrogenase and neuron-specific-enolase in both the conscious (rs = 0.737, p = 0.00263) and non-conscious groups (rs = 0.544, p = 0.0176). When neuron-specific-enolase is used as a marker for neuroprognostic evaluation, an abnormally high value is likely to indicate the lack of consciousness, whereas a lower elevation should be interpreted with caution, taking into account the effects of hemolysis.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579772","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

Veno-venous extracorporeal membrane oxygenation in managing acute respiratory distress syndrome associated with hemolytic uremic syndrome and septic shock: a case report. 静脉体外膜氧合治疗急性呼吸窘迫综合征伴溶血性尿毒症和脓毒性休克：病例报告。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-06-25 DOI: 10.1007/s10047-024-01457-9

Genta Kinoshita, Asami Ito-Masui, Takafumi Kato, Fumito Okuno, Kaoru Ikejiri, Ken Ishikura, Kei Suzuki

{"title":"Veno-venous extracorporeal membrane oxygenation in managing acute respiratory distress syndrome associated with hemolytic uremic syndrome and septic shock: a case report.","authors":"Genta Kinoshita, Asami Ito-Masui, Takafumi Kato, Fumito Okuno, Kaoru Ikejiri, Ken Ishikura, Kei Suzuki","doi":"10.1007/s10047-024-01457-9","DOIUrl":"https://doi.org/10.1007/s10047-024-01457-9","url":null,"abstract":"Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a rescue therapy for severe respiratory failure in which conventional mechanical ventilation therapy is unsuccessful. Hemolysis during VV-ECMO support arises from multiple factors associated with organ damage and poor outcomes. Therefore, close and prompt monitoring is needed. Hemolytic uremic syndrome (HUS) is characterized by hemolysis, acute renal failure, and thrombocytopenia. Hemolytic features of the disease may complicate VV-ECMO management. A 26-year-old man with a history of cerebral palsy underwent VV-ECMO for acute respiratory distress syndrome (ARDS) due to septic shock caused by bacterial translocation during treatment for HUS. He showed features of hemolysis, with elevated lactate dehydrogenase (LDH), fragmented red blood cells, and low haptoglobin levels. Plasma free hemoglobin was measured daily throughout the whole course of ECMO with levels higher than 10 mg/dL but not exceeding 50 mg/dL. The extracorporeal membrane oxygenation (ECMO) circuit pressures were carefully monitored to ensure the pump generated no excessive negative pressure. The patient was weaned off ECMO on the eleventh day. There have been several cases of VA-ECMO in patients with HUS; however, there is limited literature on VV-ECMO. As the days on VV-ECMO tend to be longer than those on VA-ECMO, features of hemolysis may complicate management. Although HUS did not directly influence the clinical course in the present case, features of hemolysis were continuously observed. This case highlighted the importance of standard ECMO monitoring, especially daily measurement of plasma free hemoglobin.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446231","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

Aortic valve area index values of Trifecta implants correlate with energy loss and increased valve stress. Trifecta 植入物的主动脉瓣面积指数值与能量损失和瓣膜应力增加相关。

IF 1.1 4区医学

Journal of Artificial Organs Pub Date : 2024-06-25 DOI: 10.1007/s10047-024-01453-z

Toru Tsukada, Yasuyuki Suzuki, Bryan J Mathis, Kimi Sato, Takeshi Kawamata, Akito Imai, Tomomi Nakajima, Yuichiro Kaminishi, Hideyuki Kato, Hiroaki Sakamoto, Yuji Hiramatsu

{"title":"Aortic valve area index values of Trifecta implants correlate with energy loss and increased valve stress.","authors":"Toru Tsukada, Yasuyuki Suzuki, Bryan J Mathis, Kimi Sato, Takeshi Kawamata, Akito Imai, Tomomi Nakajima, Yuichiro Kaminishi, Hideyuki Kato, Hiroaki Sakamoto, Yuji Hiramatsu","doi":"10.1007/s10047-024-01453-z","DOIUrl":"https://doi.org/10.1007/s10047-024-01453-z","url":null,"abstract":"Biological valves are becoming more frequently used in aortic valve replacement. While several reports have evaluated the performance of biological valves, echocardiography studies during exercise stress remain scarce. Furthermore, no current reports compare rate changes in the aortic valve area of biological valves under increased exercise load. Here, we performed exercise stress echocardiography in patients after AVR with Trifecta or Inspiris valves and compared the rates of change in aortic valve areas (AVA). In addition, hydrodynamic analysis at rest was conducted with four-dimensional flow magnetic resonance imaging (4D-flow MRI). Exercise stress echocardiography was performed in seven Trifecta and seven Inspiris patients who underwent AVR at our hospital while 4D flow MRI was performed in all but two Trifecta cases. Comparing the percentage change in AVA when loaded to 25 W versus at rest, Trifecta was greater than Inspiris (28.7 ± 36.0 vs - 0.8 ± 12.4%). The smaller AVA at rest was considered causative for this. Meanwhile, Trifecta systolic energy loss in the prosthetic valve segment on 4D-flow MRI (97.5 ± 35.9 vs 52.7 ± 25.3 mW) was higher than Inspiris. The opening of the Trifecta valve was considered to be restricted at rest and this may reflect the current reports of early valve degradation requiring reoperation. Taken together, we observed that the Trifecta design may promote faster wear due to higher valve stress.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446230","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

A case of destination therapy for post-fulminant myocarditis with myelodysplastic syndrome. 骨髓增生异常综合征后急性心肌炎的终点治疗病例。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-06-11 DOI: 10.1007/s10047-024-01455-x

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

{"title":"A case of destination therapy for post-fulminant myocarditis with myelodysplastic syndrome.","authors":"Makiko Nakamura, Teruhiko Imamura, Yuki Hida, Toshihide Izumida, Masaki Nakagaito, Saori Nagura, Toshio Doi, Kazuaki Fukahara, Koichiro Kinugawa","doi":"10.1007/s10047-024-01455-x","DOIUrl":"https://doi.org/10.1007/s10047-024-01455-x","url":null,"abstract":"We encountered a 64-year-old woman who experienced fulminant myocarditis and underwent treatment with veno-arterial extracorporeal membrane oxygenation and Impella CP support. Subsequently, she underwent a device upgrade to Impella 5.5 and received continuous hemodiafiltration for 3 months. During mechanical circulatory support, she developed refractory anemia and thrombocytopenia, leading to a diagnosis of myelodysplastic syndrome. Following the removal of the devices, she no longer required blood transfusions. She received HeartMate 3 left ventricular assist device implantation as a destination therapy indication despite the presence of myelodysplastic syndrome. She was successfully managed by aspirin-free antithrombotic therapy without any hemocompatibility-related adverse events for 4 months after index discharge on foot. We present a patient with a unique and rare presentation, wherein HeartMate 3 was implanted and successfully managed without aspirin to prevent bleeding complications associated with myelodysplastic syndrome.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305974","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

Usefulness of bicarbonate-based Impella purge solution in a patient with heparin-induced thrombocytopenia: the first case report of long-term management in Japan. 以碳酸氢盐为基础的 Impella 冲洗液在肝素诱发血小板减少症患者中的应用：日本首例长期管理病例报告。

IF 1.3 4区医学

Journal of Artificial Organs Pub Date : 2024-06-06 DOI: 10.1007/s10047-024-01452-0

Shin Nagai, Hiroaki Hiraiwa, Ryota Ito, Yuichiro Koyama, Kiyota Kondo, Shingo Kazama, Toru Kondo, Ryota Morimoto, Takahiro Okumura, Hideki Ito, Tomo Yoshizumi, Masato Mutsuga, Toyoaki Murohara

{"title":"Usefulness of bicarbonate-based Impella purge solution in a patient with heparin-induced thrombocytopenia: the first case report of long-term management in Japan.","authors":"Shin Nagai, Hiroaki Hiraiwa, Ryota Ito, Yuichiro Koyama, Kiyota Kondo, Shingo Kazama, Toru Kondo, Ryota Morimoto, Takahiro Okumura, Hideki Ito, Tomo Yoshizumi, Masato Mutsuga, Toyoaki Murohara","doi":"10.1007/s10047-024-01452-0","DOIUrl":"https://doi.org/10.1007/s10047-024-01452-0","url":null,"abstract":"Percutaneous mechanical circulatory support utilizing micro-axial flow pumps, such as the Impella group of devices, has become a life-saving technique in the treatment of refractory cardiogenic shock, with ever-increasing success rates. A 30-year-old man presented with acute decompensated heart failure and a severely reduced left ventricular ejection fraction (17%). Despite initial treatment with inotropic drugs and intra-aortic balloon pump support, his hemodynamic status remained unstable. Transition to Impella CP mechanical circulatory support was made on day 6 owing to persistently low systolic blood pressure. A significant decline in platelet count prompted suspicion of heparin-induced thrombocytopenia (HIT), later confirmed by positive platelet-activated anti-platelet factor 4/heparin antibody and a 4Ts score of 6 points. Argatroban was initially used as the purge solution, but owing to complications, a switch to Impella 5.0 and a bicarbonate-based purge solution (BBPS) was performed. Despite additional veno-arterial extracorporeal membrane oxygenation support on day 24, the patient, aiming for ventricular assist device treatment and heart transplantation, died from infection and multiple organ failure. Remarkably, the Impella CP continued functioning normally until the patient's demise, indicating stable Impella pump performance using BBPS. This case highlights the usefulness of BBPS as an alternative to conventional Impella heparin purge solution when HIT occurs.","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261966","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