Perfusion-Uk最新文献

{"title":"Unexpected survivors in extracorporeal membrane oxygenation - When the margins of life expand.","authors":"Justyna Swol","doi":"10.1177/02676591261428039","DOIUrl":"https://doi.org/10.1177/02676591261428039","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"5S-7S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845186","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":"Successful ECPR and early surgical repair in STEMI complicated by left ventricular free-wall rupture.","authors":"Esther Tautz, Katharina Müller-Peltzer, Fatos Ballazhi, Justyna Swol, Dawid L Staudacher, Tobias Wengenmayer, Alexander Supady","doi":"10.1177/02676591261424370","DOIUrl":"https://doi.org/10.1177/02676591261424370","url":null,"abstract":"<p><p>IntroductionThe mortality of patients with mechanical complications following myocardial infarction is high. Surgical repair is challenging due to the fragility of ischemic myocardial tissue. The course is frequently complicated by cardiogenic shock, acute kidney injury and respiratory failure.Case reportWe present a patient with out-of-hospital cardiac arrest due to myocardial infarction and left ventricular free-wall rupture, who received extracorporeal cardiopulmonary resuscitation (ECPR), early surgical repair and prolonged veno-arterial extracorporeal membrane oxygenation (VA ECMO) support. The physical outcome of the patient was good with satisfactory exercise tolerance (NYHA II) and there were no neurological deficits following ECPR.DiscussionIn select cases, VA ECMO can be an option to stabilize patients before and after surgical repair to allow for myocardial scarring and hemodynamic recovery. Advanced hemodynamic monitoring should be considered during the run and weaning from ECMO.ConclusionCases of free-wall rupture and cardiogenic shock are challenging and multidisciplinary teamwork of cardiac surgeons, cardiologists, intensivists and nurses is indispensable.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"157S-160S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845219","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":"Calm before the storm - austere environments - challenging indications (trauma).","authors":"Taylor Miller, Andrew Alberter, Jennifer Munley, Patrick Walker, Elizabeth K Powell","doi":"10.1177/02676591261423411","DOIUrl":"https://doi.org/10.1177/02676591261423411","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) is increasingly used as an adjunct in the management of critically injured trauma patients requiring operative intervention. Although trauma represents a small proportion of overall ECMO use, its application has expanded due to advances in circuit technology, cannulation strategies, and anticoagulation practices. This review examines the role of ECMO in stabilizing operative trauma patients across preoperative, intraoperative, and postoperative phases. Preoperatively, ECMO is most commonly indicated for refractory hypoxemia or severe acidosis resulting from thoracic or airway injury, aspiration, transfusion-related acute lung injury, or acute respiratory distress syndrome. Early cannulation can restore gas exchange, improve hemodynamic stability, reduce ventilator-induced lung injury, and facilitate safe transport to the operating room during damage control resuscitation. Emerging evidence also supports selective use of ECMO in patients with traumatic brain injury requiring urgent neurosurgical intervention. Intraoperatively, ECMO has been used during high-risk damage control procedures, including trauma pneumonectomy, retrohepatic inferior vena cava injury, and operations complicated by hemorrhage, hypothermia, and acidosis. Veno-venous ECMO may improve oxygenation and reduce right ventricular strain, while veno-arterial ECMO may be appropriate in select cases of traumatic cardiogenic shock. Postoperatively, ECMO is most often employed for delayed respiratory failure due to acute respiratory distress syndrome, transfusion-related lung injury, or bronchopleural fistula, allowing lung-protective ventilation and recovery. Although evidence supporting ECMO for traumatic respiratory failure continues to grow, data for other perioperative indications remain limited. Prospective multicenter studies are needed to refine patient selection, timing, and outcomes in operative trauma populations.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"110S-116S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845272","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":"Extracorporeal life support in lung transplantation with dual-lumen cannulas: A systematic review.","authors":"Massimo Capoccia, J Michael Brewer, Mindaugas Rackauskas, Torben K Becker, Dirk M Maybauer, Yuriy Stukov, Mohammad Aladaileh, Roberto Lorusso, Marc O Maybauer","doi":"10.1177/02676591261430619","DOIUrl":"https://doi.org/10.1177/02676591261430619","url":null,"abstract":"<p><p>BackgroundRefractory end-stage lung failure may benefit from extracorporeal life support (ECLS) as a bridge to lung transplantation. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is indicated in patients who have failed conventional medical treatment and mechanical ventilation. The Avalon Elite Bi-Caval Dual-Lumen Catheter (Getinge) and the Crescent Jugular Dual-Lumen Catheter (MC3, Inc., Medtronic) have been used for this configuration. Venoarterial (VA) ECMO may be used in patients with acute right ventricular (RV) failure, haemodynamic instability or refractory respiratory failure. Peripheral percutaneous approaches such as dual-site single-lumen cannulation for venopulmonary (VP) ECMO or single-site dual-lumen (dl)VP ECMO using the ProtekDuo right ventricular assist device (RVAD) cannula have been considered more recently as a bridge to transplant. These configurations support the right ventricle, prevent recirculation by placing the tricuspid and pulmonary valve between drainage and return cannulas, provide direct introduction of oxygenated blood into the pulmonary artery, and decrease the incidence of acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) in certain disease states. This promotes haemodynamic stability and allows sedation-weaning trials, extubation, mobilisation, and pre-transplant rehabilitation. The aim of this review is the evaluation of the feasibility, outcomes and reported complications associated with dual-lumen cannulas - specifically the Avalon Elite, Crescent and ProtekDuo - used for VV and VP ECMO in adult patients requiring bridge to lung transplantation.MethodsA web-based literature search in PubMed and EMBASE was undertaken following a combination of key words. The PICOS and PRISMA approach was used.ResultsNine studies were identified out of 489 articles with a total of 251 patients placed on VV or VP ECMO as a bridge to lung transplantation. The age range was 23-68 years. The duration of ECMO support ranged from 42 h to 200 days. About 60% of patients were awake and underwent mobilisation. Survival to lung transplantation ranged from 25% to 100%. All relevant data were reviewed and integrated in the discussion.ConclusionsSingle-site dual-lumen cannulation has an established role in VV ECMO bridging strategies and an emerging role in VP ECMO for patients with RV injury. Broader adoption of VP ECMO as a bridging strategy will require rigorous reporting and inclusion into multicentre registries to generate high-level evidence.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"137S-149S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845297","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":"Left subclavian canulation in a newborn with right sided congenital diaphragmatic hernia: A case report.","authors":"Julie Starck, Pauline Clermidi, Khaldoun Farhat, Pauline Leroux, Cyril Guillier, Yohan Soreze, Pierre Louis Léger, Jerome Rambaud","doi":"10.1177/02676591261420651","DOIUrl":"https://doi.org/10.1177/02676591261420651","url":null,"abstract":"<p><p>Venous cannulation can be challenging in newborns, especially those under 3 kg or presenting with vascular malformations. Left subclavian vein cannulation is an alternative site described in adults and infants. We report the first neonatal case of left subclavian cannulation as a last-resort venous access in a newborn presenting with a right-sided congenital diaphragmatic hernia associated with right internal jugular vein malformation. The patient required extracorporeal membrane oxygenation (ECMO) support in the context of refractory septic shock at day 6 of life. ECMO was weaned after 16 days, and cannula was removed without bleeding complications. This alternative venous access may be a viable option for venous cannulation in cases where the right jugular vein is unavailable.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"173S-175S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844639","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":"Good outcome despite non-occlusive mesenterial ischemia after extracorporeal cardiopulmonary resuscitation, a case report.","authors":"Felix A Rottmann, Dominik Bettinger, Gabriel Seifert, Martin Alexander Schick, Katharina Mueller-Peltzer, Viviane Zotzmann, Philipp Diehl, Alexander Supady, Tobias Wengenmayer, Dawid L Staudacher","doi":"10.1177/02676591251413740","DOIUrl":"https://doi.org/10.1177/02676591251413740","url":null,"abstract":"<p><p>IntroductionRefractory cardiac arrest carries a poor prognosis. Extracorporeal cardiopulmonary resuscitation (ECPR) can be lifesaving but is associated with high morbidity and mortality. We report a likely underdiagnosed complication - non-occlusive mesenteric ischemia (NOMI) - following ECPR, emphasizing the diagnostic challenges and the role of early endoscopic evaluation and an interdisciplinary assessment of these patients.Case PresentationA 48-year-old man presented with ST-elevation myocardial infarction and developed refractory cardiac arrest due to ventricular fibrillation. ECPR was initiated, and extracorporeal membrane oxygenation (ECMO) flow was achieved after 77 min of cardiopulmonary resuscitation. Early after arrest, the patient passed bloody stool, raising suspicion of mesenteric ischemia. Computed tomography was inconclusive, but colonoscopy revealed ischemic bowel injury. Given the fatal potential of untreated NOMI, prompt colectomy was performed. The patient stabilized postoperatively, recovered progressively, and was discharged from the intensive care unit in good condition after 14 days.ConclusionNOMI should be considered in ECPR patients presenting with gastrointestinal bleeding, even when cross-sectional imaging findings are inconclusive. Early colonoscopy enables timely diagnosis and surgical intervention, potentially improving survival in this high-risk setting.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"198S-202S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845328","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":"Delirium after coronary artery bypass grafting with cardiopulmonary bypass surgery: The value of cerebral autoregulation.","authors":"Greta Kasputytė, Birutė Kumpaitienė, Milda Švagždienė, Judita Andrejaitiene, Edmundas Širvinskas, Yasin Hamarat, Edvinas Chaleckas, Vilma Putnynaitė, Laimonas Bartusis, Rolandas Žakelis, Vytautas Petkus, Arminas Ragauskas, Tadas Lenkutis, Rimantas Benetis","doi":"10.1177/02676591251370076","DOIUrl":"10.1177/02676591251370076","url":null,"abstract":"<p><p>IntroductionPostoperative delirium affects up to 60% of cardiac surgical patients. No reliable gold standard method exists for preventing delirium after cardiac surgery. An example of patient-personal monitoring is cerebral autoregulation (CA). This study aims to highlight the personal monitoring of patients' cerebral autoregulation and to determine its relationship with postoperative delirium. Additionally, it seeks to test the hypothesis that the duration of CA impairment influences the onset of postoperative delirium.MethodsA prospective study was conducted in 2021-2023. After approval of the Ethics Committee and with the patient's written consent, 104 adult patients undergoing elective coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB) surgery were enrolled. To diagnose possible delirium, all patients underwent a Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) test. CA monitoring using transcranial Doppler was performed. CA status index - Mx was recorded.ResultsOur study found that 12.5% of patients were diagnosed with delirium after on-pump CABG surgery. The total duration of cerebral autoregulation impairment (TCAI) was longer in the delirium group, 4783.0 seconds versus 4204.5 seconds (<i>p</i> = .047), with a cut-off at 4380 s. Longer cardiopulmonary bypass (CPB) leads to prolonged CA impairment (<i>p</i> < .001). The mean arterial pressure (MAP) during CPB was 69.67 mmHg in the non-delirium group and 74.91 mmHg in the delirium group (<i>p</i> = .001), with a cutoff at 73.669 mmHg.ConclusionsCA impairment is crucial for delirium development after cardiac surgery. The duration of the TCAI event increases the risk of delirium.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"462-469"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876493","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":"Successful rescue for anaphylactic shock due to sugammadex using extracorporeal cardiopulmonary resuscitation.","authors":"Soojin Lee, Ho Seong Cho, Seunghwan Song","doi":"10.1177/02676591261424676","DOIUrl":"https://doi.org/10.1177/02676591261424676","url":null,"abstract":"<p><p>IntroductionSugammadex (Bridion®, MSD, Seoul, Republic of Korea) is widely used for neuromuscular blockade reversal at the end of general anesthesia. We report a rare case of refractory cardiac arrest secondary to sugammadex-induced anaphylaxis, successfully managed with extracorporeal cardiopulmonary resuscitation.Case presentationA 44-year-old man with no history of cardiovascular disease underwent robotic-assisted partial nephrectomy for a renal mass; 3 min after sugammadex intravenous administration, the patient developed ventricular fibrillation. Advanced cardiac life support was initiated, and the extracorporeal membrane oxygenation (ECMO) team was activated. Venoarterial ECMO was initiated 37 min after cardiac arrest onset. The patient was successfully weaned off the ECMO the following day. During admission, intradermal and ergonovine provocation tests confirmed a hypersensitivity reaction to sugammadex and coronary artery spasm, respectively. The patient was discharged on postoperative day 71, without any neurological sequelae.ConclusionThis successful extracorporeal cardiopulmonary resuscitation (ECPR) in refractory perioperative cardiac arrest due to sugammadex-induced anaphylaxis, highlights that early ECMO team activation and rapid ECPR implementation may lead to favorable neurological recovery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"188S-190S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845204","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":"Prophylactic temporary mechanical circulatory support: The new paradigm in cardiac surgery.","authors":"Silvia Mariani, Gabor Bari, Paolo Meani, Alvaro Perazzo, Mariusz Kowalewski, Daniele Ronco, Matteo Matteucci, Giulio Massimi, Leonardo Salazar, Roberto Lorusso","doi":"10.1177/02676591261427298","DOIUrl":"https://doi.org/10.1177/02676591261427298","url":null,"abstract":"<p><p>BackgroundPost-cardiotomy cardiogenic shock (PCCS) remains one of the most lethal complications of cardiac surgery, with high in-hospital mortality despite major improvements in operative techniques, and intensive care management. Temporary mechanical circulatory support (tMCS) is widely applied as a rescue therapy for refractory PCCS. However, outcomes remain suboptimal, also due to delayed initiation after the onset of severe hemodynamic collapse and irreversible compromised end-organ states. This review summarizes current concepts of PCCS management and evaluates the emerging role of prophylactic tMCS within the framework of \"protected cardiac surgery\".MethodsA narrative review of the current international guidelines, expert consensus statements, and major observational studies addressing post-cardiotomy tMCS and prophylactic support strategies was carried out. Emphasis was placed on pathophysiology, indications, timing of support, and device selection.ResultsProphylactic tMCS has been applied in selected high-risk scenarios including acute coronary syndromes, acute valvular dysfunction, ventricular septal rupture, papillary muscle rupture, advanced heart failure requiring bridge-to-decision or to-transplant, or difficult and complex weaning from cardiopulmonary bypass. The concepts of preoperative (Type 1), planned intraoperative (Type 2), and unplanned early intraoperative (Type 3) protected cardiac surgery provide a practical framework for a timely evaluation and related action aiming at metabolic stabilization to reduce or prevent postoperative low cardiac output syndrome. Successful implementation depends on multidisciplinary Heart Team decision-making, advanced hemodynamic assessment, and tailored perfusion strategies as well as device selection also based on local resources and expertise.ConclusionsProphylactic tMCS represents a paradigm shift from reactive rescue therapy toward proactive cardio-circulatory protection in selected high-risk patients undergoing cardiac surgery procedures. While early observational data are encouraging, prospective trials, standardized risk stratification tools, and cost-effectiveness analyses are required to define its role in modern cardiac surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"66S-82S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845221","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":"Investigating the epigenetic basis for aortic aneurysm risk in patients with bicuspid aortic valve disease.","authors":"Abdul Badran, Christopher J Goulden, Amer Harky, Narain Moorjani, Sunil Ohri","doi":"10.1177/02676591251364499","DOIUrl":"10.1177/02676591251364499","url":null,"abstract":"<p><p>BackgroundBicuspid aortic valve (BAV) is a common congenital cardiac malformation associated with significant morbidity, including aortic dissection and thoracic aortic aneurysms. The mechanisms underlying BAV-associated aortopathy are unknown. We aimed to identify methylation profiles in BAV patients with aortopathy and investigate associated genetic pathways.MethodsTissue samples from the ascending aorta were obtained from BAV patients undergoing thoracic aortic surgery. DNA methylation profiles were measured using Illumina human 850K array. Probe methylation associations were reviewed, and a regression model assessed associations with aortic dimension.ResultsEight patients were recruited from University Hospital Southampton. Analysis revealed HEATR5A, PHLDB2, ADAMTS17, BID, and TLK1 as significantly associated genes. These genes were implicated in aortic wall remodelling through novel mechanisms identified by an unbiased, integrated epigenomic approach.ConclusionsThis study provides novel insights into epigenetic regulation in BAV-associated aortopathy. Identified genes, including HEATR5A, PHLDB2, ADAMTS17, BID, and TLK1, may contribute to aortic disease in BAV patients. Further research is needed to elucidate their mechanisms and therapeutic potential. Our findings improve understanding of the molecular basis of BAV-associated aortopathy and may inform future diagnostic and therapeutic strategies.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"432-443"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795985","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}