The journal of extra-corporeal technology最新文献

{"title":"Thanksgiving reflections.","authors":"Raymond K Wong","doi":"10.1051/ject/2025068","DOIUrl":"10.1051/ject/2025068","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"185"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770404","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":"Continuous furosemide does not prevent cardiopulmonary bypass-related acute kidney injury in minimally invasive cardiac surgery: the randomized furosemide trial.","authors":"Tomohisa Takeichi, Yoshihisa Morimoto, Akitoshi Yamada, Takanori Tanaka, Kunihiro Fujiwara, Masanobu Sato, Ryo Toma, Kiyoto Mitsui, Takumi Sugita, Hiroki Yamada, Kunio Gan","doi":"10.1051/ject/2025042","DOIUrl":"10.1051/ject/2025042","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess whether continuous furosemide administration during cardiopulmonary bypass (CPB) in minimally invasive cardiac surgery (MICS) reduces the incidence of cardiac surgery-associated acute kidney injury (AKI).</p><p><strong>Methods: </strong>A total of 100 patients undergoing MICS with CPB were randomly assigned to receive either continuous furosemide infusion or no continuous furosemide during CPB. The primary endpoint was the incidence of AKI. Secondary endpoints included the cardiac surgery-associated neutrophil gelatinase-associated lipocalin (CSA-NGAL) score, urine output within 12 h postoperatively, postoperative furosemide dose requirements, red blood cell transfusion volume, PaO₂/FiO₂ ratio, duration of mechanical ventilation, length of stay in the intensive care unit (ICU) and hospital, and in-hospital mortality.</p><p><strong>Results: </strong>AKI occurred in 8 patients (16%) in the continuous furosemide group and in 6 patients (12%) in the non-continuous group (relative risk, 0.72; 95% CI, 0.23-2.23). Among the secondary endpoints, urine output within the first 3 h postoperatively and the PaO₂/FiO₂ ratio were significantly higher in the continuous furosemide group. However, subgroup analyses revealed no significant differences between the two groups.</p><p><strong>Conclusions: </strong>Continuous furosemide administration during CPB did not effectively reduce the incidence of AKI. However, it was associated with a significant increase in postoperative urine output and an improvement in the PaO₂/FiO₂ ratio.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"209-217"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770335","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":"Effects of hyperoxia in pediatric perfusion patients: a scoping review.","authors":"Mariah DeRenzo, Vanessa Velazquez-Milton, Stepney Johnson","doi":"10.1051/ject/2025048","DOIUrl":"10.1051/ject/2025048","url":null,"abstract":"<p><p>Hyperoxia in pediatric cardiopulmonary bypass patients is associated with adverse effects, including reoxygenation injury, increased mortality, heightened inflammatory response, and cerebral injury. Although prior research has demonstrated a correlation between these adverse effects and hyperoxia during cardiac surgery, definitions of \"hyperoxia' vary across the literature. This scoping review synthesizes findings from PubMed, CINAHL, Embase, and Web of Science to categorize the adverse effects of hyperoxia based on age range, presence of cyanosis, and PaO₂ levels. The results highlight the need for standardized oxygenation management protocols in pediatric bypass procedures and a consistent definition of \"hyperoxia\" for cyanotic and acyanotic patients.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"263-269"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770375","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":"Normothermic regional perfusion and ex vivo perfusion position - endorsed.","authors":"William D Riley, Emily Saulitis Collins, Kirsten R Kallies, Emily L Thunstrom-Kahring, David Boyne, Jwana Ibsies, Scott M Noesges, Caleb Varner, Phillip Bailey","doi":"10.1051/ject/2025044","DOIUrl":"10.1051/ject/2025044","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"186-187"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770368","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":"List of JECT reviewers 2025.","authors":"","doi":"10.1051/ject/2025069","DOIUrl":"https://doi.org/10.1051/ject/2025069","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 4","pages":"294"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is hyperoxia during veno-arterial extracorporeal life support due to cardiopulmonary failure associated with mortality in pediatric patients?","authors":"Asaad G Beshish, Rebecca Shamah, Joshua Qian, Kasey Keane-Lerner, Paola Rodriguez Morales, Tawanda Zinyandu, Joel Davis, Joshua M Rosenblum, Heather K Viamonte","doi":"10.1051/ject/2025006","DOIUrl":"10.1051/ject/2025006","url":null,"abstract":"<p><strong>Background: </strong>Data is limited regarding the effects of supraphysiologic blood oxygen tension in patients requiring extracorporeal life support (ECLS). We sought to evaluate the association between hyperoxia and outcomes in pediatric patients requiring veno-arterial (VA) ECLS.</p><p><strong>Methods: </strong>Retrospective single-center study at an academic children's hospital that included all patients 0-18 years who required VA-ECLS between 01/2014 and 12/2019.</p><p><strong>Results: </strong>During the study period, 229 VA-ECLS runs occurred in 229 patients. The majority of patients were neonates (73.4%), with cardiac being the most common indication (48.9%). The median time from admission to cannulation was 78.5 h (IQR 14, 356) with a median ECLS duration of 111.5 h (IQR 65.5, 184.5). The overall mortality rate was 44.5%. Using a receiver operating curve, a mean PaO₂ of 233 mmHg in the first 48 h of ECLS was determined to have the optimal discriminatory ability for mortality (sensitivity 36% and specificity 76%). Of the VA-ECLS cohort, 68 (29.7%) had a mean PaO₂ > 233 mmHg (hyperoxia group). The hyperoxia group tended to be older (median age 4.6 vs 1.5 months, p = 0.019), had a primary cardiac indication for VA-ECLS (60% vs 44%, p = 0.0004), and had a higher mortality rate (54% vs 40%, p = 0.050). In the multivariable analysis, after adjusting for covariables, the data demonstrated increased odds of mortality (aOR 2.02, 95% CI [1.03, 3.97], p = 0.03). The odds of development of stage II or III acute kidney injury (AKI) (aOR 2.04, 95% CI [0.82, 5.50]), but that did not reach statistical significance (p = 0.120).</p><p><strong>Conclusion: </strong>There is evidence that hyperoxia during the first 48 h of VA-ECLS may be associated with mortality and development of acute kidney injury, although this did not reach statistical significance. Multicenter and prospective evaluation of this modifiable risk factor is imperative to improve the care of this high-risk cohort.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 3","pages":"129-136"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071542","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":"Automated temperature management during cardiopulmonary bypass: a step toward safety and precision perfusion.","authors":"Youssef El Dsouki, Ignazio Condello","doi":"10.1051/ject/2025021","DOIUrl":"10.1051/ject/2025021","url":null,"abstract":"<p><p>Precise temperature management during cardiopulmonary bypass (CPB) is crucial for optimizing patient outcomes, and influencing metabolic rate, organ protection, and neurological integrity. Traditionally, temperature control during CPB has relied on manual adjustments by perfusionists, a practice fraught with potential for human error and variability in outcomes. Such variability can lead to severe complications, including cerebral hyperthermia and inflammatory responses, which significantly impact patient recovery and morbidity. This paper introduces a novel, fully automated temperature management system, which integrates with existing heater-cooler units (HCUs) and advanced perfusion systems to enhance precision and reliability. By utilizing real-time physiological monitoring and intelligent automation, the system dynamically adjusts temperature phases based on continuous patient feedback. Preliminary simulation data are presented to validate the system's feasibility and responsiveness. Ethical considerations regarding automated decision-making in surgery are also briefly discussed.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 3","pages":"137-146"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071507","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":"Using an intermittent flow (\"clamp and flash\") method to assess the readiness to wean from VA ECMO in adult and pediatric patients.","authors":"James R Neal, Pavel V Mishin, Caitlin L Blau, Devon O Aganga, Troy G Seelhammer","doi":"10.1051/ject/2025018","DOIUrl":"10.1051/ject/2025018","url":null,"abstract":"<p><strong>Background: </strong>The use of VA extracorporeal membrane oxygenation (ECMO) for cardiac recovery is widely adopted, with extensive publications on assessing readiness to wean from VA ECMO. Techniques to reduce ECMO support vary, including reducing flows to a low continuous cardiac index, adding bridges, temporary flow cessation, or decreasing ECMO RPMs.</p><p><strong>Method: </strong>We propose an alternative method involving repeated cycles of 3-4 min of ECMO flow cessation (\"clamp\") followed by a 30-second return (\"flash\") of flow. This method requires additional anticoagulation to achieve an elevated ACT, targeting 220 s for adults and 210 s for pediatrics with heparin drip and bolus, or 240 s for adults and 225 s for pediatrics with bivalirudin drip and heparin bolus. During the clamp period, flow is stopped in adult ECMO circuits with a single venous line clamp, while in pediatric circuits, flow continues via the manifold shunt but is stopped in the arterial and venous lines with a single venous line clamp. Flashing the circuit resumes patient flow for 30 s to circulate stagnant blood.</p><p><strong>Results: </strong>This method significantly reduces support during the trial, which lasts one hour for adults and up to two hours for pediatric patients. The heart is unsupported 85-90% of the time, with an 85% decrease in cardiac support compared to low-flow trials.</p><p><strong>Conclusion: </strong>Since 2011, our center has used this technique without thrombotic complications when the protocol is followed. Most patients removed from ECMO did not require reinstitution, with rare cases needing VV support or VA support due to sepsis onset.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 3","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071497","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":"Pulmonary thrombectomy and extracorporeal membrane oxygenation: a case study.","authors":"Mariah DeRenzo","doi":"10.1051/ject/2025024","DOIUrl":"10.1051/ject/2025024","url":null,"abstract":"<p><p>A 71-year-old male with a history of chronic thromboembolic pulmonary hypertension scheduled for an elective pulmonary thrombectomy was removed from the surgical list in 2019 for unknown reasons. Four years later, a different surgeon elected to perform the surgery with cardiopulmonary bypass support. Following surgery, the patient was placed on extracorporeal membrane oxygenation and ultimately died. This case report highlights the surgical and perfusion techniques, as well as the rare events that occurred during his care.</p>","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 3","pages":"171-173"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071494","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":"Building better ECMO rooms: a roadmap to standardization and innovation.","authors":"Nada A Aljassim, Salman Abdulaziz, John F Fraser","doi":"10.1051/ject/2025032","DOIUrl":"10.1051/ject/2025032","url":null,"abstract":"","PeriodicalId":519952,"journal":{"name":"The journal of extra-corporeal technology","volume":"57 3","pages":"181-183"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071571","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}