Perfusion-Uk最新文献

{"title":"Corrigendum to: \"Standardization of <i>in-vitro</i> evaluation of extracorporeal life support (ECLS) devices for research and development\".","authors":"","doi":"10.1177/02676591261443100","DOIUrl":"https://doi.org/10.1177/02676591261443100","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261443100"},"PeriodicalIF":1.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857579","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":"Post-cardiotomy ECMO configurations after mitral valve replacement: a case series and strategy development.","authors":"Matteo Giunta, Antonio Loforte, Alberto Orsello, Andrea Costamagna, Erika Simonato, Erik Cura Stura, Maria Luisa Contristano, Anna Chiara Trompeo, Luca Brazzi, Mauro Rinaldi","doi":"10.1177/02676591261425075","DOIUrl":"https://doi.org/10.1177/02676591261425075","url":null,"abstract":"<p><p>Post-Cardiotomy Cardiogenic Shock (PC-CS) after Mitral Valve Replacement (MVR) is a rare but severe complication, which may require ECMO for the acute phase of the illness. These PC-ECMO (Post-Cardiotomy ECMO) are particularly complex cases, as the low flow through the newly replaced valve may cause a very rapid formation of thrombus, blocking the leaflets, that worsens the blood stasis inside the left atrium, extending the thrombosis. To maintain the trans-mitral flow during PC-ECMO, three milestone should be present: the transpulmonary flow should be maintained, the blood reaching the left atrium should be free to cross the mitral prosthesis and the left ventricle should be fully unloaded. The selection of the appropriate PC-ECMO configuration should be guided by the specific functional status of the right ventricle (RV) and left ventricle (LV). When only one ventricle is failing, monoventricular support is preferable. However, when PC-CS involves both ventricles, ex-BiVAD might be a valuable option, but it requires invasiveness on the LV and may be challenging to manage, especially in the early phase of the illness. Conversely, when minimal residual LV function is preserved, the blood flow drained by the venous cannula (V) can be divided into two components, supporting respectively the RV and the systemic circulation. This newly proposed configuration may be referred to as V-PaA ECMO. In this case series, we analyse the physiological implication and the management consideration of three different ECMO configurations: Vpv-A ECMO, V-PaLVxA ECMO (ex-BiVAD) and our newly proposed configuration for biventricular support, V-PaA ECMO. This case series underscores how tailoring PC-ECMO configuration to ventricular physiology can critically influence clinical outcomes, highlighting the need for individualized support strategies after MVR.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"150S-156S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845226","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":"Improving outcomes of patients with venovenous extracorporeal membrane oxygenation.","authors":"Alexander Supady","doi":"10.1177/02676591261424665","DOIUrl":"https://doi.org/10.1177/02676591261424665","url":null,"abstract":"<p><p>Venovenous extracorporeal membrane oxygenation (VV ECMO) is a potentially lifesaving yet resource-intensive organ support option for patients with very severe respiratory failure refractory to optimized conventional management. Mortality remains high, and ECMO is associated with significant complications, including bleeding, thrombosis, and vascular injury. Indication and timing of ECMO initiation are critical, as premature and also delayed use can affect outcomes. Current evidence, including findings from the CESAR and EOLIA trials and subsequent meta-analyses, supports the consideration of ECMO in very severe acute respiratory distress syndrome (ARDS) when lung-protective ventilation, prone positioning, and adjunctive therapies fail to ensure adequate gas exchange. Patient selection should rely on individualized risk-benefit assessment considering age, comorbidities, organ dysfunction, reversibility of lung injury, and patient-centered goals, rather than any single exclusion criterion. Management during ECMO focuses on ultra-protective ventilation to minimize ventilator-induced lung injury, early detection of complications, and tailored anticoagulation strategies, although optimal anticoagulation protocols remain undefined. When performed in experienced centres, prone positioning during ECMO is feasible and safe, but evidence for a survival benefit is inconclusive. Extracorporeal carbon dioxide removal (ECCO₂R) may facilitate ultra-protective ventilation but lacks a proven mortality benefit. Therefore, its use is currently not recommended outside the setting of well-designed clinical trials. Weaning from ECMO should be structured and guided by physiological readiness while maintaining lung-protective ventilation. Optimal outcomes are achieved in high-expertise, multidisciplinary centres, with ongoing research needed to refine patient selection, ventilation strategies, and complication management. Overall, VV ECMO remains an essential tool in the management of severe respiratory failure, requiring careful balancing of risks, resources, and individualized clinical decision-making.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"83S-94S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845248","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":"From ECPR for refractory cardiac arrest to heart transplant and neurologically intact survival.","authors":"A Hutin, D Vimpere, J H Raphalen, C Dagron, W Sutter, M Para, K An, L Lamhaut","doi":"10.1177/02676591261427651","DOIUrl":"https://doi.org/10.1177/02676591261427651","url":null,"abstract":"<p><p>A 58-year-old male wearing a wearable cardioverter defibrillator due to severe dilated cardiomyopathy with multi-vessel coronary disease presented a cardiac arrest (CA) with ventricular fibrillation refractory to conventional cardiopulmonary resuscitation (CPR). The decision was made to expand CPR to extracorporeal cardiopulmonary resuscitation (ECPR) using extracorporeal life support in the prehospital setting. ROSC was obtained after pump activation, and the patient was admitted to the intensive care unit, sedated and mechanically ventilated while under ECPR support. Despite an initial hemorrhagic shock due to mispositioning of the initial arterial canula requiring surgical repair, neurological evaluation was favorable and allowed for emergency heart transplantation candidacy. The patient was transplanted on day 7 after CA and discharged neurologically intact for rehabilitation on day 60. This case report shows how ECPR can be a bridge to definitive treatment if adequately integrated into an optimized out-of-hospital cardiac arrest chain of survival.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"166S-168S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845261","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":"ECMO transports perspectives on organization and patient management: A narrative review.","authors":"Lars Mikael Broman, Jérôme Rambaud, Andrea Moscatelli, Matteo Di Nardo","doi":"10.1177/02676591261424682","DOIUrl":"https://doi.org/10.1177/02676591261424682","url":null,"abstract":"<p><p>BackgroundExtracorporeal membrane oxygenation (ECMO) is an established life support technique for refractory acute cardiorespiratory failure in children and adult patients. However, ECMO support is provided only by specialized centers; therefore, demand for ECMO transport retrieval services is increasing. Mobile teams assess, accept, implant ECMO, and then transport for continued support at an ECMO center.AimTo provide an updated practical review to support ECMO teams for safe and effective transports.Material and methodsWe retrospectively reviewed literature limited to ECMO transport published between January 2014 to October 2025.ResultsForty-five manuscripts were included in this narrative review. Patient selection focused on reversible, refractory respiratory or cardiac failure not responding to maximal conventional therapy. Time to reach the referring hospital is the most frequent factor limiting the feasibility of transport; both ground ambulances and aircraft were the most common means used, depending on distance. Weather and road conditions may influence transport safety. Familiar equipment was generally used during transport, but with adaptation and certification for transport. Team experience and training were important factors for safe transport since complications frequently occurred, requiring fast decision and action. Foreign country missions required involvement of insurance, legal, and administrative support.ConclusionsRegional, national, and international inter-hospital ECMO transports can be conducted safely. Preparation of ECMO transport services regarding adapted equipment, checklists, and comprehensive training for ECMO team members is essential to ensure secure transport, enabling early identification and appropriate management of adverse events. International transports operate within different regulatory frameworks and therefore require special considerations.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"117S-125S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845268","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":"Spoilt for choice? Temporary mechanical circulatory support in cardiogenic shock: The importance of the patient.","authors":"Dirk W Donker, Libera Fresiello","doi":"10.1177/02676591261424661","DOIUrl":"https://doi.org/10.1177/02676591261424661","url":null,"abstract":"<p><p>Despite major advances in temporary mechanical circulatory support (tMCS), cardiogenic shock remains associated with high mortality. Early management strategies were dominated by the intra-aortic balloon pump (IABP), widely adopted on physiological grounds despite limited randomized evidence and later declining use due to downgraded guideline recommendations. Subsequent shifts toward more potent tMCS devices, including transaortic micro-axial flow pumps and venoarterial extracorporeal membrane oxygenation (VA ECMO), were driven by the pursuit of improving systemic perfusion and ventricular unloading. However, enhanced hemodynamic support has not consistently translated into superior clinical outcomes and is frequently accompanied by substantial device-related complications. Increasing recognition of the complex and patient-specific physiology of cardiogenic shock has fueled a transition from device-centred to patient-centred strategies, emphasizing tailored support configurations, multimodal monitoring, and physiology-driven decision-making. Adjunct left ventricular unloading during VA ECMO has emerged as a promising yet controversial approach, with ongoing trials expected to clarify its clinical role. Recent evidence, including the DanGer Shock trial, suggests that timely initiation of appropriately selected tMCS may improve longer-term outcomes in selected populations. Parallel advances in biomedical engineering have enabled physiology-based cardiovascular simulators that allow systematic comparison of tMCS strategies, pharmacological support, and device hemocompatibility under controlled conditions. When extended to virtual populations, these in silico approaches can complement clinical evidence through virtual clinical trials, potentially reducing the size and cost of traditional studies. Together, these developments highlight a new era of patient-centred critical care and biomedical innovation in cardiogenic shock.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"60S-65S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845170","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":"The utilization of large bore mechanical thrombectomy and extracorporeal pulmonary resuscitation in catastrophic pulmonary embolism: A case series.","authors":"Shan P Modi, Cali Clark, Karthikeyan Ranganathan, Adnan Khalif","doi":"10.1177/02676591251415339","DOIUrl":"https://doi.org/10.1177/02676591251415339","url":null,"abstract":"<p><p>BackgroundThe combined use of extracorporeal cardio-pulmonary resuscitation (ECPR) and large bore mechanical thrombectomy represents an emerging strategy for patients experiencing cardiac arrest secondary to catastrophic pulmonary embolism.MethodsThis retrospective, single-center study included patients treated between January 2023 and June 2025 who experienced cardiac arrest due to catastrophic pulmonary embolism and underwent ECPR followed by large bore mechanical thrombectomy. Primary outcomes were 90-days post-discharge survival and cerebral performance category (CPC) at discharge. Secondary outcomes included support duration, complications during support, and ICU and hospital length of stay.ResultsFifteen patients were included. Four (27%) sustained out-of-hospital cardiac arrest, and twelve (80%) presented with pulseless electrical activity. All patients underwent large bore mechanical thrombectomy using the Inari FlowTriever System (Inari Medical, Irvine, CA) within 6 hours of arrest in the cardiac catheterization laboratory. Eight patients (53%) survived to discharge with favorable neurological outcomes (CPC 1-2). Seven patients died following withdrawal of care due to cerebrovascular accident or anoxic brain injury (<i>n</i> = 4), intracranial hemorrhage (<i>n</i> = 2), or mesenteric ischemia (<i>n</i> = 1). Cerebrovascular or anoxic brain injury occurred more frequently among non-survivors (<i>p</i> = 0.02). No significant differences were observed in baseline characteristics, ECMO or ventilator duration, or length of stay between survivors and non-survivors.ConclusionECPR followed by large bore mechanical thrombectomy is a feasible resuscitative strategy for patients presenting with catastrophic pulmonary embolism. Larger, multicenter studies are warranted to better define outcomes and the overall impact of this combined approach.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"179S-184S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845244","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":"High-fidelity extracorporeal membrane oxygenation simulation in medical training: A review and opportunities for the future.","authors":"Nicole M Thomasian, Wenting Ma, Sagar R Navare, Natalia I Girardi, Berhane M Worku, Ankur Srivastava, Liang Shen","doi":"10.1177/02676591251363773","DOIUrl":"10.1177/02676591251363773","url":null,"abstract":"<p><p><b>Background:</b> The growing popularity of extracorporeal membrane oxygenation (ECMO) necessitates adequate education and training of the multidisciplinary teams caring for these medically complex patients. Simulation-based education (SBE) has been used in medical education for decades and has demonstrated effectiveness for teaching both procedural competency and teamwork-related skills. The continued wider adoption of SBE within medical training and the development of newer digital technologies have also seen SBE being increasingly adapted for ECMO education. <b>Purpose:</b> To qualitatively review the state of published knowledge on simulation-based ECMO education and training. <b>Research Design:</b> A literature search of electronic databases was conducted using Medical Subject Headings (MeSH) terms \"Extracorporeal Membrane Oxygenation\", \"Simulation Training\", \"High-Fidelity Simulation Training\", and \"Patient Simulation\", as well as relevant synonyms and keywords. Studies meeting inclusion criteria were analyzed, with information extracted regarding study characteristics and key findings. Major themes were identified and compiled into a narrative review. <b>Results:</b> A total of 38 articles published from 2006 to 2023 met criteria for inclusion for review. The literature reveals significant heterogeneity in the use of simulation-based ECMO curricula across medical specialties and institutions. A wide array of ECMO simulators and equipment are commercially available or have been described, with numerous small studies describing individual ECMO simulation training programs with substantial differences in practices. More recently, ECMO procedural skills training has utilized augmented reality, which may be a promising modality for future training. <b>Conclusions:</b> The literature regarding simulation-based ECMO education is heterogenous, but available studies suggest this modality of education can improve procedural skills, increase efficiency and familiarity with equipment, reduce procedural errors, practice team-based communication skills, and increased learner confidence. As the use of ECMO simulation expands, efforts should focus on the identification of high-fidelity simulators for specific purposes, developing standardized training regimens, and emphasizing team-based dynamics.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"370-381"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790556","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":"An initiative to reduce blood stream infections (BSI) in patients on ECMO.","authors":"Adeeb Khan, Mohammed Abraar Quraishi, Anthony Hume, Kurt Osterby, Paula Fanning, Paul Campbell","doi":"10.1177/02676591251360914","DOIUrl":"10.1177/02676591251360914","url":null,"abstract":"<p><p>IntroductionBlood Stream Infections (BSI) occur in 3-35% of patients on ECMO (Extracorporeal membrane Oxygenation). With the increased use of ECMO since the COVID-19 pandemic, the magnitude of this problem has increased. There are no clear established practice guidelines for BSI prevention on ECMO.MethodsSingle center retrospective study. Data collected for adult and pediatric ECMO patients between the ages of 0-82 years between January 2017 - December 2023. Outcomes from patients before and after we implemented our ECMO-specific BSI prevention bundle in February 2021. This bundle includes two person ECMO cannula and central line dressing changes, daily chlorhexidine (CHG) bathing of the entire tubing of the ECMO circuit, including the hubs and connectors and avoiding prophylactic antibiotic use.Results142 admissions for ECMO and ECPR during the study period were evaluated. 110 admissions were finally included for data analysis after 32 met exclusion criteria. 47 patients included from the preintervention and 63 in the post-intervention periods. The difference in BSI per admission between the preintervention and postintervention groups was statistically significant (<i>p</i> = .0003). The mean BSI rate was 0.468 in the preintervention group and 0.0159 in the post intervention group. Mortality showed a trend towards statistical significance (p = .082). There were no statistical differences in age, sex of the patient, body mass index (BMI), CRRT/AKI use/incidence, type of ECMO (VV or VA), presence of COVID-19 infection, and duration of ECMO.ConclusionsThe introduction of an ECMO-specific BSI reduction bundle resulted in a greater than 10-fold reduction in BSI. There was a trend towards statistically significant improvement in mortality between the two groups. We believe that this intervention is implementable at other hospitals.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"382-391"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755005","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":"\"Bridging Europe\" advancing Education: The 12^th Educational Corner at EuroELSO 2024 conference in Krakow, Poland.","authors":"Mirjana Cvetkovic, Marta Velia Antonini, Alex Rosenberg, Marek Dąbrowski, Mateusz Puslecki, Maura O'Callaghan, Lien Vanrijkel, Luigi Camporota, Alexander Supady, Ibrahim Fawzy Hassan, Jo-Anne Fowles, Sebastian Stefaniak, Jordi Riera, Jan Bělohlávek, Matteo Di Nardo, Aparna Hoskote, Justyna Swol","doi":"10.1177/02676591251363101","DOIUrl":"10.1177/02676591251363101","url":null,"abstract":"<p><p>IntroductionThe increasing need for high-quality training in Extracorporeal Life Support (ECLS) has highlighted the importance of simulation-based educational programs. The EduCorner, a key component of the EuroELSO conference since 2012, provides a platform for hands-on ECLS simulation, focusing on both technical and team-communication competencies.AimThis study evaluates the effectiveness of the EduCorner sessions conducted during the 12^th EuroELSO Conference in Krakow, Poland, assessing their impact on the participants' ECLS knowledge and skills.MethodsA total of 45 adult and pediatric ECLS simulation sessions were conducted, covering various topics such as ECLS troubleshooting, sepsis management, and ultrasound-guided cannulation. Pre- and post-session assessments were collected from participants to measure changes in their confidence, familiarity with ECLS procedures, and ability to work within a team. The data were analyzed using paired t-tests, descriptive statistics, and linear mixed-effects models.ResultsThe results revealed significant improvements in participants' knowledge and competencies across various ECLS-related topics. Key areas of improvement included ECLS troubleshooting (<i>p</i> = .001), sepsis management (<i>p</i> = .022), and teamwork dynamics (<i>p</i> < .001). However, there was no significant change in familiarity with the ECLS circuit. Participants, especially those with prior exposure to the EduCorner, demonstrated notable increases in confidence and proficiency.ConclusionThe EduCorner proved to be an effective educational platform for enhancing ECLS training, significantly improving both technical and non-technical skills. This study highlights the value of international simulation-based training in improving ECLS practice across multidisciplinary teams. Future initiatives should continue to foster collaboration between industry partners and congress organizers to maintain the quality and sustainability of such educational programs.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"414-431"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785803","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}