Artificial organs最新文献

{"title":"Incidence and Predictors of Acute Kidney Injury and Continuous Renal Replacement Therapy in Critically Ill Trauma Patients: A 10-Year Retrospective Analysis.","authors":"Ayal Z Pierce, Kimberly Boswell, Emily C Esposito, Erin Niles, Matthew D Tadlock, Brinda S Mysore, Richard Betzold, Samuel M Galvagno, Elizabeth K Powell","doi":"10.1111/aor.15005","DOIUrl":"https://doi.org/10.1111/aor.15005","url":null,"abstract":"<p><strong>Background: </strong>Acute Kidney Injury (AKI) is common in critically ill trauma patients and is associated with increased morbidity and mortality. A subset of these patients requires Continuous Renal Replacement Therapy (CRRT) for severe AKI. This study investigates the incidence of AKI and CRRT and identifies predictors for AKI progression in trauma patients.</p><p><strong>Methods: </strong>We conducted a 10-year retrospective review of trauma ICU patients at a Level I trauma center from 2014 to 2023. Patients were classified into three groups: no AKI, AKI without CRRT, and AKI requiring CRRT. Statistical analyses, including logistic regression and Kaplan-Meier survival estimates, were used to assess risk factors and survival. Variables analyzed included age, injury severity score (ISS), admission hemodynamics, and procedural interventions.</p><p><strong>Results: </strong>Of 8427 patients, 5.5% developed AKI, and 1% required CRRT. AKI patients showed decreased survival (83% vs. 88%, p = 0.003). Survival was lower in CRRT compared to AKI only (73% v 83%, p < 0.001). Older age (OR 1.01, 95% CI 1.003, 1.012, p < 0.001), ISS (OR 1.02, 95% CI 1.01, 1.02, p < 0.001), and lower systolic blood pressure on admission (OR 0.98, 95% CI 0.98, 0.99, p < 0.001) were predictive of AKI. In AKI, tachycardia on admission was predictive of CRRT need (OR 1.01, 95% CI 1.01, 1.03, p = 0.04). The most common procedure with AKI was laparotomy (n = 42) with 40% requiring CRRT.</p><p><strong>Conclusions: </strong>AKI and CRRT are associated with mortality in trauma. Identifying predictors like age, injury severity, and hemodynamic changes can aid in early intervention. Further research should explore the timing and impact of CRRT in trauma-specific settings.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Stem Cell Entrapment in AN69 Membranes During Continuous Renal Replacement Therapy","authors":"Izzet Turkalp Akbasli,&nbsp;Ozlem Saritas Nakib,&nbsp;Selman Kesici,&nbsp;Fatma Visal Okur,&nbsp;Kadri Safak Gucer,&nbsp;Benan Bayrakci","doi":"10.1111/aor.15004","DOIUrl":"10.1111/aor.15004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Continuous renal replacement therapy (CRRT) is increasingly employed in pediatric intensive care units (PICUs) for managing both renal and non-renal conditions, including sepsis through cytokine removal. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical treatment for inherited bone marrow syndromes but poses challenges when performed alongside extracorporeal therapies like CRRT. This case explores the interaction between hematopoietic stem cells and AN69 membranes during CRRT in a pediatric patient undergoing allo-HSCT amid septic shock.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 10-year-old boy with bone marrow failure of unknown etiology and chronic kidney disease underwent allo-HSCT from a fully matched sibling donor. The patient developed septic shock following a reduced-intensity conditioning regimen and was managed with continuous venovenous hemodiafiltration using an AN69 membrane. During the allo-HSCT infusion, the CRRT membrane became clogged, prompting immunohistochemical analysis of the AN69 membrane to investigate potential HSC entrapment. CD34-positive cells and fibronectin expression on the membrane were assessed using staining protocols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite severe septic shock and potential HSC entrapment in the AN69 membrane, the patient achieved full donor chimerism with 97% hematopoietic engraftment by day nineteen post-HSCT. Immunohistochemical analysis revealed the presence of CD34-positive HSCs and strong fibronectin staining on the clogged AN69 membrane, indicating significant interaction and entrapment of stem cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Allo-HSCT can be performed successfully in pediatric patients with severe septic shock requiring CRRT, offering a potentially life-saving option in urgent transplant situations. This case highlights that although HSPCs can be entrapped on AN69 membranes, engraftment was not compromised. Our findings provide novel insights into HSPC interactions with AN69 membranes during CRRT, and further studies are needed to quantify stem cell loss and explore its clinical implications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1327-1331"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurologic Outcome After Venoarterial Extracorporeal Membrane Oxygenation in Rats: A Description of a Long-Term Survival Model","authors":"Mingyue Liu,&nbsp;Ziyi Wu,&nbsp;Chenyu Jiang,&nbsp;Yifan Zhu,&nbsp;Xin Li","doi":"10.1111/aor.15003","DOIUrl":"10.1111/aor.15003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neurological impairments seriously affect the quality of life in patients with venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the underlying mechanisms have been restricted to a satisfactory animal model with determined support and recovery time. This study aimed to establish a rodent VA-ECMO model with different durations, assessing the feasibility of a long-term surviving model with determined recovery time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-six Sprague–Dawley rats were divided into five groups: sham group (<i>n</i> = 10), ECMO-2 h group (<i>n</i> = 5), ECMO-3 h group (<i>n</i> = 5), ECMO-4 h group (<i>n</i> = 11) and ECMO-6 h group (<i>n</i> = 5). The ECMO-4 h group was further assigned to the surviving time of postoperative day 7 (<i>n</i> = 6) to perform the Morris water maze. VA-ECMO was established through the right external jugular vein–right atrium for venous drainage and tail artery for arterial infusion. The branch of the left femoral artery was cannulated for arterial blood pressure monitoring and blood gas analyses. Thereafter, the brains were fixed for histopathological assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All VA-ECMO processes were successfully achieved, and one rat in the ECMO-4 h group died 2 h after ECMO. The physiologic variables of all rats were stable. Histologic deficits (pathological score, surviving neurons, and loss of dendritic spines) were detectable after more than 3 h of support, and functional deficits were observed after 4 h of exposure, which persisted for 3 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We established a reproducible and long-term recovery model of VA-ECMO in rats with cerebral histologic deficits depending on support duration. The neurocognitive performance was impaired after 4-h VA-ECMO exposure with the 3-day recovery time frame.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1277-1287"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vericiguat Experience in Durable Left Ventricular Assist Device Patients","authors":"Boaz Elad,&nbsp;Changhee Lee,&nbsp;Julia Baranowska,&nbsp;Dor Lotan,&nbsp;Justin Fried,&nbsp;Kevin Clerkin,&nbsp;Jayant Raikhelkar,&nbsp;Andrea Fernandez Valledor,&nbsp;Cathrine M. Moeller,&nbsp;Gabriel Sayer,&nbsp;Nir Uriel","doi":"10.1111/aor.14971","DOIUrl":"10.1111/aor.14971","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Durable left ventricular assist devices (LVADs) improve outcomes for advanced heart failure (HF) patients. Vericiguat, which enhances HF outcomes by affecting systemic and pulmonary vasculature, may benefit LVAD patients as well.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study aimed to investigate the safety and efficacy of Vericiguat in patient on LVAD support. This retrospective analysis included patients supported with LVAD who were treated with Vericiguat. Safety outcomes comprised LVAD-related hemocompatibility-related adverse events (HRAE) and Vericiguat adverse events. Efficacy outcomes included changes in NYHA functional class and NT-proBNP levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified eight HeartMate3 patients treated with Vericiguat. Median age was 65 years-old, 87.5% were men, and median duration on Vericiguat therapy was 254 days (161–272). None of the patients had experienced HRAE, adverse events related to Vericiguat or died. A reduction in pulmonary capillary wedge pressure was observed (17 [16–23.5] vs. 9 [6.5–11] mmHg, <i>p</i> = 0.06), along with an increase in cardiac index (from 1.9 [1.5–2.6] to 2.1 [1.8–3.2] L/min/m², <i>p</i> = 0.12) and right ventricle stroke work index (5.4 [4.1, 7.0] vs. 7.5 [6.9, 9.2] g/m/beat/m², <i>p</i> = 0.043). NT-proBNP levels (2171 [779–3366] vs. 1677 [406–2490] pg/mL, <i>p</i> = 0.438) decreased but did not reach statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preliminary results suggests that Vericiguat therapy in LVADs is safe and indicates a trend toward improved efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 5","pages":"907-910"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Role for Using Bioimpedance to Reduce the Risk of Intra-Dialytic Hypotension","authors":"Sabrina Haroon,&nbsp;Andrew Davenport","doi":"10.1111/aor.14999","DOIUrl":"10.1111/aor.14999","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intra-dialytic hypotension is the most common complication of hemodialysis treatments. Traditionally, clinical judgment determines the post-dialysis target weight and ultrafiltration volumes. We examined the role of pre-dialysis bioimpedance measurements and subsequent intradialytic hypotension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Segmental bioimpedance measurements were taken pre-dialysis from hemodialysis outpatients who had been acutely admitted to the hospital, with dialysis prescriptions and ultrafiltration targets determined by the clinical team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We studied 42 patients with a mean age of 66.9 ± 12.5 years. Among 28 patients (66.7%) that developed intradialytic hypotension, the group had shorter stature (163.9 ± 8.8 vs. 170.1 ± 7.8 cm, <i>p</i> &lt; 0.05), and lower N-terminal brain natriuretic peptide levels (11 269 (3523–33 843) vs. 28 454 (4957–59 867) pg/mL, <i>p</i> &lt; 0.05). The extracellular water to intracellular water ratio for the whole body was lower in the intradialytic hypotension group (68.0 ± 3.9 vs. 70.5 ± 3.4, <i>p</i> &lt; 0.05), and the relative extracellular to intracellular ratios were lower when the trunk, right leg, and left leg were compared to the left arm (<i>p</i> &lt; 0.01). Multivariable analysis showed that intradialytic hypotension was associated with the extracellular to intracellular ratio of the trunk compared to the ratio in the left arm (odds ratio 0.80, <i>p</i> = 0.01) and height (odds ratio 0.88 <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found that hemodialysis patients acutely admitted to hospital with a relatively lower extracellular to intracellular ratio of trunk compared to a similar ratio in the left arm had a greater incidence of intradialytic hypotension. As such, reviewing segmental bioimpedance may aid clinical assessments of patients in setting ultrafiltration volumes and post-dialysis target weights and prevent intradialytic hypotension.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1314-1320"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality With Impella Is Lowest in Overweight and Obese but Is Highest in Morbid Obesity","authors":"Mohammad Reza Movahed,&nbsp;Spencer Bradshaw,&nbsp;Mehrtash Hashemzadeh","doi":"10.1111/aor.15000","DOIUrl":"10.1111/aor.15000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mortality of cardiogenic shock remains high, prompting increased use of mechanical circulatory support devices such as Impella. This study sought to characterize whether weight categories predict mortality in patients who received Impella devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the National Inpatient Sample (NIS) database from the years 2016 to 2020 and ICD-10-CM/PCS codes to evaluate the effect of weight categories on mortality in patients undergoing Impella implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 86 810 patients underwent Impella device implantation, with an overall mortality of 29.85%. Mortality for normal weight was 30.4%, similar to cachexia (30.3%) and morbidly obese patients (31.1%). However, the overweight and obese categories had the lowest mortality (13.4% and 24.9%, <i>p</i> &lt; 0.0001). Using multivariate analysis adjusting for comorbid conditions, overweight and obesity remained significantly associated with the lowest mortality (overweight: OR: 0.3, CI: 0.16–0.68, <i>p</i> = 0.003, Obese: OR: 0.8, CI: 0.71–0.91, <i>p</i> &lt; 001) whereas morbid obesity was associated with the highest mortality (OR: 1.17, CI: 1.02–1.34, <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using a large database, we found that overweight and obesity have a protective effect on mortality in patients undergoing Impella insertion. However, morbid obesity appears to have detrimental effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1321-1326"},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Assessment of Venous and Pulmonary Congestion in Left Ventricular Assist Devices Patients","authors":"Attilio Iacovoni,&nbsp;Cinzia Giaccherini,&nbsp;Sara Paris,&nbsp;Raffaele Abete,&nbsp;Claudia Vittori,&nbsp;Riccardo Maria Inciardi,&nbsp;Ottavio Zucchetti,&nbsp;Amedeo Terzi,&nbsp;Michele Senni","doi":"10.1111/aor.14985","DOIUrl":"10.1111/aor.14985","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A significant number of (left ventricular assist device) LVAD patients (pts) have hemodynamic-related adverse events requiring right heart catheterization (RHC). Venous and lung ultrasound is an established method for evaluating congestion in heart failure pts. This study aimed to investigate the role of these ultrasound parameters in the hemodynamic assessment of LVAD pts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RHC and complete echocardiography were performed on 50 consecutive LVAD pts, 12 of whom were the validation cohort. Pts were stratified based on right atrial pressure (RAP) ≥ 7 mmHg and pulmonary capillary wedge pressure (PCWP) &gt; 15 mmHg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median LVAD follow-up time was 400 (209–900) days. Baseline characteristics were similar between high vs. normal RAP groups, except for NYHA class and renal function in the former group. High vs. normal PCWP showed a greater NYHA class and a furosemide dose. All hemodynamic parameters were significantly different in the high RAP group except for cardiac output (CO) and cardiac index (CI). In contrast, in the high PCWP group, no differences in CO, CI, and pulmonary vascular resistances were apparent. The most accurate non-invasive variable for detecting high RAP was renal venous stasis index (RVSI), receiver-operating characteristic curves for areas under the curve (AUC), 0.78 (95% CI, 0.62–0.93). Estimated left atrial pressure (LAP-eRAP) was the most accurate non-invasive value to discriminate high PCWP (AUC 0.85 95% CI 0.73–0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found a good correlation between RAP, PWCP, and non-invasive parameters, such as RVSI and LAP-eRAP, suggesting the importance of peripheral venous ultrasound in LVAD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 7","pages":"1171-1184"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.14985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Vitamin E-Coated Membrane Hemodiafilter on Serum Albumin Redox State in the Acute Kidney Injury Pig Hemodialysis Model","authors":"Shouichi Fujimoto,&nbsp;Masahide Koremoto,&nbsp;Shushi Yamamoto,&nbsp;Hiroshi Umeno,&nbsp;Yusuke Sano,&nbsp;Toshihiro Tsuruda","doi":"10.1111/aor.14982","DOIUrl":"10.1111/aor.14982","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several studies have evaluated the biocompatibility of dialysis membranes. The use of vitamin E-coated membranes has been reported multilaterally in in vitro and clinical studies. Nevertheless, the effect of vitamin E-coated membranes on the redox state of serum albumin, which forms the largest fraction of reactive sulfhydryl groups, has not been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hemodiafiltration (HDF) with and without a vitamin E-coated hemodiafilter (V-RA^TM group and ABH^TM groups, respectively) was performed in an acute kidney injury pig model to determine whether changes in the serum albumin, the oxidized albumin (OxiALB), and the reduced albumin (RedALB) levels differ between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analyses were conducted 22–24 times in the V-RA^TM group and 16–18 times in the ABH^TM group, excluding missing data. The serum albumin levels decreased in both groups after nephrectomy; however, the decrease observed in the V-RA^TM group was significantly lesser than that in the ABH^TM group. RedALB levels were significantly higher in the V-RA^TM group; in contrast, OxiALB levels did not differ between the two groups. A significant positive correlation was observed between the serum albumin and RedALB levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study demonstrated that HDF performed using a vitamin E-coated hemodiafilter effectively minimized the reduction in serum albumin and RedALB levels compared to the vitamin E-non-coated hemodiafilter in an acute kidney injury pig model.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 6","pages":"1076-1081"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.14982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmission and Temporal Trends of Post-LVAD Placement Complications in Patients With End-Stage Heart Failure","authors":"Sherif Eltawansy,&nbsp;Faizan Ahmed,&nbsp;Grishma Sharma,&nbsp;Areehah Zafar Masood,&nbsp;Naazmin Chandrani,&nbsp;Mohammad Hossein,&nbsp;Swapnil Patel,&nbsp;Ravitej Khunkhun,&nbsp;Hritvik Jain,&nbsp;Mushood Ahmed,&nbsp;Raheel Ahmed,&nbsp;Adnan Bhat,&nbsp;Nisar Asmi,&nbsp;Kainat Aman,&nbsp;Joseph Heaton,&nbsp;Jesus Almendral","doi":"10.1111/aor.14989","DOIUrl":"10.1111/aor.14989","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Approximately 5%–10% of heart failure (HF) patients progress to advanced stages. Left ventricular assist devices (LVADs) have emerged as a favored therapy for end-stage HF as destination therapy or as a bridge to heart transplantation. However, complications and provider expertise hinder their widespread use. To address this, the third-generation LVAD was introduced in late 2018 to enhance usability and reduce complications. We aimed to investigate the temporal trends in post-LVAD complications with the newest generation LVAD versus the previous version.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized the 2016–2020 Nationwide Readmission Database to identify patients ≥ 18 years of age with advanced HF implanted with an LVAD. Variables were determined using the International Classification of Diseases, Tenth revision codes. We compared patients through all years individually. In addition, we created two groups based on the implant year (2016–2018 and 2019–2020). The primary outcome was 30-day readmission, while secondary outcomes were complications and mortality rates. Multivariate analyses and descriptive bivariate analyses were performed. A value of <i>p</i> &lt; 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 7975 patients (21.3% females), of which 17.1% (<i>n</i> = 1214) were readmitted within 30 days. Readmission rates were 18% (<i>n</i> = 778) for 2016–2018 and 16% (<i>n</i> = 435) for 2019–2020 (adjusted Wald test, <i>p</i> = 0.26). The 2019–2020 group exhibited a reduction in cardiac device complications (<i>p</i> = 0.024), cardiac tamponade (<i>p</i> = 0.009), and periprocedural circulatory complications (<i>p</i> = 0.014) in subgroup comparison (2016–2018 vs. 2019–2020). Despite these improvements, the mortality rate and hospital stay did not differ significantly between the two periods. No significant differences in mortality or LOS were observed between the two groups (adjusted Wald test, <i>p</i> &gt; 0.05 in both).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Complications following LVAD placement continue to impede its broader adoption for advanced HF. Advancements in newer LVAD technology and improved provider expertise hold promise for increased utilization. Our study indicated a decline in some complications, including cardiac tamponade and cardiac device complications, including periprocedural circulatory ones, which may be attributed to newer device innovations. Further research is necessary to explore this correlation in greater depth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 7","pages":"1197-1206"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Suitability for Axillary Intra-Aortic Balloon Pump Circulatory Support","authors":"Carlos Alberto Valdes,&nbsp;Kristin Drew,&nbsp;Omar M. Sharaf,&nbsp;Mustafa M. Ahmed,&nbsp;Alex M. Parker,&nbsp;Juan R. Vilaro,&nbsp;Juan M. Aranda Jr,&nbsp;Michael R. Massoomi,&nbsp;R. David Anderson,&nbsp;Yomary Jimenez,&nbsp;Mohammad A. Z. Al-Ani","doi":"10.1111/aor.14994","DOIUrl":"10.1111/aor.14994","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intra-aortic balloon pumps (IABP) are commonly used as a bridge to heart transplant (Htx). Although IABPs were designed for transfemoral arterial placement, axillary IABPs (axIABP) allow for continued ambulation and rehabilitation. However, increased rates of device complications with axillary compared to femoral insertion suggest anatomic variations that predispose patients to device failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective study of patients who received axIABP as a bridge to HTx between February 2018 and July 2022. Pre-axIABP computed tomography (CT) images were reviewed for all patients, and anatomic features of the axillary and central arteries were measured and correlated with mechanical axIABP complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 48 patients underwent successful axIABP placement with available pre-insertion CT images, of whom 35 (72.9%) were male. Out of 48 patients, 26 (54.2%) experienced 34 complications, including axIABP rupture (<i>n</i> = 10, 29%), infection (<i>n</i> = 8, 23%), and thrombosis (<i>n</i> = 6, 18%). CTs showed an average axillary artery diameter and depth of 6.79 and 55.6 mm, respectively. The average subclavian artery takeoff angle from the aortic arch was 95.4°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Of the 10 vascular anatomic features measured, there was no association between any single measurement and axIABP complications. However, there may be other structural features not measured by routine CT, technical issues with insertion, and device factors not accounted for in this study that drive axIABP complications. Nonetheless, our findings suggest that normal variations in the measured vascular anatomy should not preclude axIABP use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 7","pages":"1207-1214"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}