The journal of extra-corporeal technology最新文献

{"title":"Endo-aortic balloon occlusion for reoperative minimally invasive mitral valve replacement on intra-aortic balloon pump: a case report.","authors":"Jenna L Cornibe, Vivek Patel, Austin Erney","doi":"10.1051/ject/2025023","DOIUrl":"10.1051/ject/2025023","url":null,"abstract":"<p><p>Minimally invasive approaches are the future of cardiac surgery. Coupled with that are devices such as endo-aortic balloon occlusion (EABO) which allow the success of such procedures. EABO has also proven invaluable in high-risk or reoperative cases. We report a severely high-risk patient who presented for reoperative minimally invasive mitral valve replacement with an intra-aortic balloon pump (IABP) and multiple high-dose vasopressors. The EABO was utilized over a transthoracic cross clamp (TCC). With careful maneuvering upon ascent into the aorta, the deflated endoballoon easily passed beyond the deflated IABP balloon under transesophageal echocardiogram (TEE) guidance. After completion of arrest, surgical placement of the bioprosthetic valve, and spontaneous return of cardiac rhythm once EABO was completed, the deflated endoballoon was carefully retracted back down through the aorta past the deflated IABP balloon. The integrity of the IABP balloon remained intact and was able to resume function once cardiopulmonary bypass (CPB) was terminated. We found that EABO was a safe and effective alternative technique for aortic occlusion in our patient supported on IABP with previous sternotomy.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"284-286"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of extracorporeal membrane oxygenation: historical milestones and advanced developments.","authors":"Lajos Szentgyorgyi, Salman Pervaiz Butt, Bhuvaneswari Krishnamoorthy","doi":"10.1051/ject/2025033","DOIUrl":"10.1051/ject/2025033","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) has a history that is a testament to the pioneering spirit of medical innovators. It is intricately linked with the development of cardiopulmonary bypass (CPB) technology. The journey of ECMO can be traced back to the mid-20th century when experiments with CPB began to support patients undergoing cardiac surgery. However, it was not until the 1970s that ECMO emerged as a standalone therapy. Throughout the following decades, ECMO technology advanced rapidly, with improvements in circuit design, oxygenators, and pump technology enhancing its safety and efficacy. ECMO's versatility soon became apparent as it was employed in various clinical scenarios, including acute respiratory distress syndrome (ARDS), cardiac failure, and even as a bridge to lung or heart transplantation. In recent years, efforts have focused on miniaturisation, cost reduction, and the development of portable systems, enabling their use outside traditional intensive care settings. Today, ECMO remains not just a tool but a lifeline in the management of life-threatening cardiorespiratory failure. It offers hope and a second chance to patients when conventional therapies fall short, underscoring its critical importance in critical care medicine, cardiology, transplant and cardiothoracic surgery. This article provides a concise yet comprehensive overview of the history and recent advancements in ECMO.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"243-262"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of insensible water loss and sodium accumulation behavior from the Medtronic Nautilus Extracorporeal Membrane Oxygenation (ECMO) oxygenator: An in vitro study.","authors":"Carrie Whittaker Striker, Gabriel Kong","doi":"10.1051/ject/2025026","DOIUrl":"10.1051/ject/2025026","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid and electrolyte balance is closely managed in extracorporeal membrane oxygenation (ECMO) patients. Neglecting oxygenator-related insensible fluid losses can distort fluid balance and electrolyte levels. While ECMO oxygenator insensible losses are reported, they remain undefined for the Medtronic Nautilus oxygenator. Through in vitro analysis of the Nautilus, we quantified insensible water losses while concurrently observing sodium behavior.</p><p><strong>Methods: </strong>Insensible water losses were determined using a closed circuit. A 12-hour pilot run was conducted to saturate the oxygenator and determine probable water loss rates and sodium accumulation behaviors. Fluid loss and sodium measurements were made at 0, 6, and 12 h. Immediately following the pilot run, three randomly assigned sweep gas rates, 0.5, 1.0, and 1.5 L/min, were evaluated over a 24 h period and replicated in triplicate. The circuit parameters were consistent and controlled for each trial. Data were collected at 0, 12, and 24 h for visualized water loss in the reservoir. After each trial, sterile water was introduced into the circuit via syringe and recorded as replacement volume. Sodium measurements were made for three trials (0.5, 1.0, and 1.5) and collected at 0 and 24 h.</p><p><strong>Results: </strong>Using linear regression analysis, the following insensible water loss equations were produced. Visualized volume: 2.74 mL/h per 1 L/min sweep gas rate or 65.66 mL/day per 1 L/min of sweep gas rate (p < 0.001). Replacement volume: 3.02 mL/h per 1 L/min of sweep gas rate or 72.5 mL/day per 1 L/min of sweep rate (p < 0.001). Sodium accumulation was observed, but not statistically significant due to the small sample size.</p><p><strong>Conclusion: </strong>Insensible water loss in the Nautilus ECMO oxygenator increases linearly with sweep gas rate (p < 0.001), leading to sodium accumulation through evaporation. These losses and the associated risk for hypernatremia should be considered when managing a patient's fluid and electrolyte balance on ECMO.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"201-208"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An in-vitro study of the timing between protamine sulfate administration and cardiotomy suction termination.","authors":"Jennifer Gavin-Veyna, Carolyn Taylor Troester, Reid Homann, Samantha Varela, Amber Lickert, Scott C Sanderson","doi":"10.1051/ject/2025028","DOIUrl":"10.1051/ject/2025028","url":null,"abstract":"<p><strong>Background: </strong>During cardiopulmonary bypass (CPB), anticoagulation of the blood is the paramount responsibility of a perfusionist. The perfusionist should ensure the termination of cardiotomy suction at the onset of protamine sulfate (protamine) administration to prevent compromising the integrity of the extracorporeal circuit (AmSect. Standards and Guidelines for Perfusion Practice. 2023. https://www.amsect.org/Policy-Practice/AmSECTs-Standards-and-Guidelines). Although coagulopathy causes the largest mortality risk in adult CPB cases, standardization is not seen universally, and practice often varies between institutions (Stammers et al. Perfusion. 2001;16(3):189-198. https://doi.org/10.1177/026765910101600304; Jansa et al. Ann Thorac Surg. 2022;113(2):506-510. https://doi.org/10.1016/j.athoracsur.2021.04.059).</p><p><strong>Methods: </strong>Activated clotting times (ACTs) were measured in five swine subjects that were heparinized and placed on CPB for a total of approximately 6 h each. Samples of blood were drawn from the CPB circuit; ACTs were measured before the administration of protamine, after a protamine test dose (PTD), and after 1/3 of the full protamine dose had been introduced to each sample. Protamine dosing was determined by a 1:100 ratio of protamine to heparin.</p><p><strong>Results: </strong>60 blood samples were included in the final analysis. The mean ACT after the PTD was 290.4 s (seconds), and 147.5 s after 1/3 of the full protamine dose. ACTs after the PTD decreased significantly by an average of 38.2% (p < 0.0001), and by 50.8% (p < 0.0001) after 1/3 of the full protamine dose was given.</p><p><strong>Conclusion: </strong>This investigation demonstrated an analysis of heparin reversal via protamine administration. The findings revealed that in the majority of samples, the PTD was sufficient to decrease the ACT below 480 s, the determined benchmark upon which CPB can be safely conducted. After 1/3 of the full protamine dose was given, nearly every sample's ACT reached a value considered unsafe for bypass. The interpretation of the data suggests that there are significant grounds for advocating for a more disciplined approach to cardiotomy suction termination to preserve the integrity of the CPB circuit and to safely conduct CPB.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"188-193"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining flow measurement in centrifugal pump: the case for RPM and power consumption-based estimation.","authors":"Ignazio Condello","doi":"10.1051/ject/2025038","DOIUrl":"10.1051/ject/2025038","url":null,"abstract":"<p><p>Mechanical circulatory support (MCS) devices, particularly those utilizing centrifugal pumps (CP), are crucial in sustaining patients with severe cardiac conditions. Traditional flowmeters, integral to these systems, present considerable challenges, including substantial physical bulk, complex wiring, and a dependency on robust backup systems. These challenges become acute in portable applications, where compact, reliable, and discrete solutions are essential for enhancing patient mobility and quality of life. This paper proposes a strategic shift towards integrating RPM (Revolutions Per Minute) and power consumption-based flow estimation as a standard in MCS device design. This approach reduces device complexity, enhances reliability, and diminishes the need for invasive hardware, aligning with broader goals of patient safety and device efficiency. By adopting RPM and power consumption-based estimation, MCS devices can achieve improved ergonomics, fail-safe operational integrity, and enhanced energy efficiency, which are crucial for achieving patient-centric outcomes. This advancement signals a move towards more intelligent, adaptive medical devices that could redefine standards in mechanical circulatory support.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"290-291"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta-P as an early indicator of oxygenator failure: the case for standardized manufacturer reference values.","authors":"Salman Pervaiz Butt, Salman Abdulaziz, Ashwaq Mahdaly, Nabeel Razzaq, Drisya Paul, Umer Darr, Gopal Bhatnagar","doi":"10.1051/ject/2025039","DOIUrl":"10.1051/ject/2025039","url":null,"abstract":"<p><p>The evolution of extracorporeal membrane oxygenation (ECMO) has led to an increasing reliance on objective parameters to detect complications early and enhance patient safety. One such parameter is the transmembrane pressure gradient, more commonly referred to as delta P (ΔP), the difference between the inlet and outlet pressures of the oxygenator. This measure has increasingly been recognized as a critical early indicator of thrombus formation within the oxygenator during ECMO support. However, its interpretation remains complex and context-dependent, particularly because delta P values are significantly influenced by the design features of different ECMO circuits, including pump head geometry and oxygenator configuration.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"292-293"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECMO to CPB: A single circuit approach.","authors":"Jeffrey Zalfa, Daniel Duncan, Paul Kerins","doi":"10.1051/ject/2025035","DOIUrl":"10.1051/ject/2025035","url":null,"abstract":"<p><strong>Background: </strong>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and cardiopulmonary bypass (CPB) are used during pediatric heart surgery to provide cardiopulmonary support to patients as they undergo and recover from surgical procedures. On occasion, CPB and extracorporeal membrane oxygenation (ECMO) circuits are used within the same surgical period. In this technique article, we report on our experience using an ECMO circuit with the addition of a cardiotomy reservoir to convert to CPB.</p><p><strong>Methods: </strong>Patients on VA-ECMO were converted to CPB by the splicing of a cardiotomy reservoir and ECMO circuit.</p><p><strong>Results: </strong>Seven patients underwent conversion from VA-ECMO to CPB with a total of eight procedures. Mean nadir hematocrit on CPB was 31.1% ± 6.06. Mean blood product usage on CPB was 238 ± 155 mL. All the patients were decannulated from CPB or ECMO.</p><p><strong>Conclusion: </strong>Conversion from VA-ECMO to CPB with the use of the same circuit is an effective technique for congenital heart patients on VA-ECMO who require surgical intervention with CPB.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"270-273"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic acid does not have a dose-dependent effect on postoperative delirium after cardiac surgery - a retrospective cohort study.","authors":"Rachel Wong, Scott Minns, Florian Falter","doi":"10.1051/ject/2025025","DOIUrl":"10.1051/ject/2025025","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium, regularly seen after cardiac surgery, is challenging. It has significant implications for healthcare resources and significant implications for individual patients and their families. Although the exact mechanisms are not understood, there is emerging evidence that blood-brain-barrier disruption and neuroinflammation may play a role in developing postoperative delirium. Tranexamic acid, frequently used in cardiac surgery for its transfusion-sparing effect, has recently been shown to ameliorate neuroinflammation and stabilise the blood-brain barrier. This study investigates if there is a dose-dependent effect of tranexamic acid on developing postoperative delirium after cardiac surgery on cardiopulmonary bypass.</p><p><strong>Methods: </strong>5525 patients were included in this retrospective, observational database study. Patients were divided into three groups, depending on the dose of tranexamic acid they had received before heparinisation (Group A (n = 1780) up to 22 mg/kg, Group B (n = 2130) 22.01 - 27 mg/kg, and Group C (n = 1615) 27.01 mg/kg or more). All three doses are clinically relevant and seen regularly. The presence of postoperative delirium was defined by at least one \"CAM-ICU positive\" entry in the patient's medical record.</p><p><strong>Results: </strong>There was no statistically significant difference between the three groups in the incidence of postoperative delirium. The percentage of CAM-ICU-positive patients in each group was in keeping with the overall cohort (Overall = 18%, Group A = 18%, Group B = 17%, Group C = 20%, p = 0.25).</p><p><strong>Conclusion: </strong>The results do not support the theory that tranexamic acid given in the higher clinically acceptable dose range decreases the incidence of postoperative delirium after cardiac surgery.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"194-200"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe cholestasis in neonatal extracorporeal membrane oxygenation.","authors":"Michelle Jancaric, Benjamin Langworthy, Sixto Guiang, Bradley Segura, Rachel Wallace, Catherine Larson-Nath, Katherine M Satrom","doi":"10.1051/ject/2025031","DOIUrl":"10.1051/ject/2025031","url":null,"abstract":"<p><strong>Introduction: </strong>Cholestasis is a common complication of Extracorporeal Membrane Oxygenation (ECMO) secondary to patient physiology and circuit-induced factors. In our institution's Neonatal Intensive Care Unit (NICU), we noted cases of severe cholestasis, with peak conjugated bilirubin levels much higher than previously reported in the literature. The objective of our study was to identify the contributing factors to the development of severe cholestasis in neonatal ECMO cases.</p><p><strong>Methods: </strong>Using our institutional ECMO database, all neonates who received ECMO at our institution were identified. A retrospective chart review was completed for a sample of 30 neonates. Univariate, multivariate, and logistic regression models were utilized.</p><p><strong>Results: </strong>Twenty percent of the patients in our study developed severe cholestasis (peak conjugated bilirubin > 10.0 mg/dL). Comparing the group of neonates that developed severe cholestasis to those who did not, we found that severe cholestasis was associated with the use of the Getinge Pediatric Quadrox-iD oxygenator. Mean plasma free hemoglobin levels were significantly higher in cases using pediatric oxygenators vs. adult (204.6 mg/dL vs. 110.4 mg/dL, p = 0.01). Longer ECMO courses and percent time within the ACT goal were also associated with severe cholestasis.</p><p><strong>Conclusion: </strong>Our study describes a cohort of neonatal ECMO cases complicated by severe cholestasis that was mediated by hemolysis due to circuit factors. In particular, circuit factors (the use of a pediatric oxygenator), longer duration of ECMO, and anticoagulation management were all significant factors. Future studies are needed to further elucidate the impact of these circuit factors and how they interplay with neonatal physiology.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"235-242"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Membrane Oxygenation (ECMO) and hospital economics.","authors":"Anna Ratiu, Julie A Linick, Angelica Oyugi, Jennifer Williams, Kael Wherry, Eric Klavetter","doi":"10.1051/ject/2025043","DOIUrl":"10.1051/ject/2025043","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) is a powerful, life-prolonging technology, but is resource-intensive.</p><p><strong>Methods: </strong>This retrospective analysis utilized Medicare Fee-for-Service (FFS) inpatient data (October 2019-December 2022) to identify ECMO hospitalizations with continuous FFS coverage. We assessed total payment, costs, length of stay (LOS), and predominant medical severity diagnosis-related group (MS-DRG) and International Classification of Diseases (ICD-10) codes. Outcomes were stratified by DRG code, ICD-10 procedure codes, and ECMO type. Hospital costs were estimated using cost-to-charge ratios from the Centers for Medicare and Medicaid Services with a 3-year lag.</p><p><strong>Results: </strong>Continuous ECMO within MS-DRG 003 discharged between January 1, 2020, and December 31, 2022, were a subset of hospitalizations analyzed. For continuous central (CC) ECMO, mean costs were $287,334, median costs were $223,766, and the standard deviation (SD) was $224,261. Mean payment was $264,021, median was $218,642, and SD was $157,882. For continuous venoarterial (VA) ECMO, mean costs were $245,448, median was $191,363, and SD was $212,822. Mean payment was $241,617, median was $202,199, and SD was $145,456. For continuous venovenous (VV) ECMO, mean costs were $329,111, median was $256,706, and SD was $285,745. Mean payment was $298,141, median was $237,679, and SD was $198,160. The majority of patients (64%) received VA, which was the only ECMO type with a median payment that surpassed median costs. Rural facilities and teaching hospitals had consistently higher mean frequencies among all ECMO claims (CC, VA, VV) from October 2019 to December 2022 compared to their counterparts (Rural: CC = 2.4, VA = 9.3, VV = 4.9; Urban: CC = 1.4, VA = 6.1, VV = 2.2; Teaching: CC = 2.1, VA = 8.6, VV = 3.4; Non-teaching: CC = 0.5, VA = 1.9, VV = 0.7).</p><p><strong>Conclusion: </strong>VV ECMO had the highest median costs and payment among the ECMO types. Median payment was less than median hospitalization costs for all types of ECMO, apart from continuous VA ECMO.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"218-224"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}