ASAIO Journal最新文献

Sepsis-Extracorporeal Membrane Oxygenation Score in Patients Receiving Extracorporeal Membrane Oxygenation Support for Sepsis.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-07 DOI: 10.1097/MAT.0000000000002409

Hongfu Fu, Liangshan Wang, Yan Wang, Yaxin Xie, Haixiu Xie, Xiaotong Hou, Hong Wang

{"title":"Sepsis-Extracorporeal Membrane Oxygenation Score in Patients Receiving Extracorporeal Membrane Oxygenation Support for Sepsis.","authors":"Hongfu Fu, Liangshan Wang, Yan Wang, Yaxin Xie, Haixiu Xie, Xiaotong Hou, Hong Wang","doi":"10.1097/MAT.0000000000002409","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002409","url":null,"abstract":"Predictive scoring systems for adult patients receiving extracorporeal membrane oxygenation (ECMO) support for sepsis have not been yet reported. Based on the Chinese Society of ExtraCorporeal Life Support (CSECLS) Registry database, we conducted a retrospective observational study on adult patients supported with ECMO for sepsis (n = 465). On the basis of multivariable logistic regression analyses, four parameters at 24 h post-ECMO initiation (T24) were identified as prognostic factors associated with in-hospital mortality: age, vasoactive inotropic score (VIS), partial pressure of oxygen in arterial blood (PaO2), and lactate clearance. The sepsis-ECMO score was calculated based on these prognostic factors, which were converted into categorical variables. The area under the receiver operating characteristic curve for the sepsis-ECMO score was 0.704 (95% confidence interval [CI]: 0.658-0.751). Four risk classes, namely class Ⅰ (score 0), class Ⅱ (score 5), class Ⅲ (score 6-10), and class Ⅳ (score ≥ 11), were identified according to sepsis-ECMO score quartiles. Patients in the lower sepsis-ECMO score classes had significantly better survival than those in the higher classes (log-rank test, p < 0.001). The sepsis-ECMO score may help in the risk stratification of patients, facilitate the communication of objective prognostic information, and provide a clearer direction for shared decision-making.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571953","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}

引用次数: 0

Surgical Intervention for Outflow Graft Obstruction in Patients With Magnetically Levitated Centrifugal-Flow Left Ventricular Assist Devices.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-06 DOI: 10.1097/MAT.0000000000002412

Krish C Dewan, Alejandro Alvarez Lobo, Jacob N Schroder, Jeffrey E Keenan, Adam D DeVore, Stuart D Russell, Carmelo A Milano

{"title":"Surgical Intervention for Outflow Graft Obstruction in Patients With Magnetically Levitated Centrifugal-Flow Left Ventricular Assist Devices.","authors":"Krish C Dewan, Alejandro Alvarez Lobo, Jacob N Schroder, Jeffrey E Keenan, Adam D DeVore, Stuart D Russell, Carmelo A Milano","doi":"10.1097/MAT.0000000000002412","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002412","url":null,"abstract":"Outflow graft obstruction (OGO) is an under-reported but severe complication after insertion of magnetically levitated centrifugal-flow left ventricular assist devices (LVADs). The optimal treatment and long-term outcomes have not been well-described. We report a retrospective single high-volume center's experience with surgical exploration for OGO from June 2019 to October 2023. Outflow graft obstruction was identified in 19 LVAD recipients from a total experience of 550 LVAD implants (3.3%). Median time of LVAD support to development of OGO was 32.5 months (interquartile range [IQR], 28-47.5). Low-flow alarms were the most common presentation, followed by dyspnea on exertion, and syncope. Computed tomography angiography (CTA) and echocardiography were the most common diagnostic modalities. Aortic valve opening with every beat and worsened mitral insufficiency were both more common at presentation compared to prior echocardiographic studies. Surgical excision of the bend relief (BR) and evacuation of proteinaceous material between the BR and the outflow graft immediately improved hemodynamics and LVAD function. There were no in-hospital mortalities, and all patients were discharged home after a median length of stay of 9 days (IQR, 10-21). All but four patients were alive at median follow-up 21 months. Thirteen of the 19 patients were readmitted a total of 50 times, none for recurrent OGO.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566008","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}

引用次数: 0

A Predictive Marker for Right Heart Failure After Left Ventricular Assist Device Implantation: The Direct Bilirubin to Total Bilirubin Ratio.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-06 DOI: 10.1097/MAT.0000000000002398

Ping Qing, Sheng Zhao, Xingtong Zhou, Juan Du, Liang Zou, Fujian Duan, Haibo Chen, Xianqiang Wang, Shengshou Hu

{"title":"A Predictive Marker for Right Heart Failure After Left Ventricular Assist Device Implantation: The Direct Bilirubin to Total Bilirubin Ratio.","authors":"Ping Qing, Sheng Zhao, Xingtong Zhou, Juan Du, Liang Zou, Fujian Duan, Haibo Chen, Xianqiang Wang, Shengshou Hu","doi":"10.1097/MAT.0000000000002398","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002398","url":null,"abstract":"Early right heart failure (RHF) after left ventricular assist device (LVAD) implantation poses significant morbidity and mortality risks. Existing RHF prediction scores are complex, typically requiring multiple indicators and evaluation steps. This research aimed to explore a more feasible predictor for initial screening of early RHF. This multicenter, retrospective analysis included 83 consecutively enrolled patients undergoing continuous-flow LVAD implantation. Multivariable logistic regression identified independent predictors of early RHF, whereas receiver operating characteristic (ROC) curve analysis assessed predictive value. Among the 83 patients, 21 (25.3%) experienced early RHF. Logistic regression analyses revealed that the direct bilirubin to total bilirubin (DBIL/TBIL) ratio on admission was significantly correlated with early RHF (adjusted odds ratio [OR]: 2.41, 95% confidence interval [CI]: 1.35-4.31, p = 0.003). The DBIL/TBIL ratio on admission exhibited the highest area under the receiver operating characteristic curve (AUC) (0.767, 95% CI: 0.661-0.852). Internal validation using bootstrap techniques resulted in a mean AUC of 0.767 (95% CI: 0.640-0.879), whereas external validation in a cohort of 31 patients demonstrated an AUC of 0.682 (95% CI: 0.491-0.837). An optimal DBIL/TBIL ratio threshold of 0.52 yielded 76.19% sensitivity and 79.03% specificity for early RHF prediction. In subgroups with different TBIL levels, sensitivity and specificity were 70.0% and 86.67% for TBIL greater than or equal to 2 mg/dl, and 81.82% and 76.60% for TBIL less than 2 mg/dl, respectively. The DBIL/TBIL ratio upon admission is a viable predictor of early RHF following LVAD implantation, demonstrating acceptable predictive efficacy.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566003","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}

引用次数: 0

Antepartum Extracorporeal Life Support: A Viable Way to Improve Fetal Outcomes.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-06 DOI: 10.1097/MAT.0000000000002413

Maya Guglin, Dmitry Abramov

引用次数: 0

Incidence and Risk Factors of Cannula-Associated Deep Vein Thrombosis After Extracorporeal Life Support in Adult Critically Ill Patients.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-06 DOI: 10.1097/MAT.0000000000002405

Sayed Abdulmotaleb Almoosawy, Joud Albalool, Ahmad Alenezi, Anwar Murad, Sarah Buabbas, Abdulaziz Almutawa, Kefaya Abdulmalek, Abdulrahman Al-Fares

{"title":"Incidence and Risk Factors of Cannula-Associated Deep Vein Thrombosis After Extracorporeal Life Support in Adult Critically Ill Patients.","authors":"Sayed Abdulmotaleb Almoosawy, Joud Albalool, Ahmad Alenezi, Anwar Murad, Sarah Buabbas, Abdulaziz Almutawa, Kefaya Abdulmalek, Abdulrahman Al-Fares","doi":"10.1097/MAT.0000000000002405","DOIUrl":"10.1097/MAT.0000000000002405","url":null,"abstract":"Cannula-associated deep vein thrombosis (CaDVT) following decannulation from extracorporeal life support (ECLS) is a commonly reported complication with several associated risk factors. This study investigated the incidence and risk factors of CaDVT after ECLS decannulation from a nationwide registry. We analyzed consecutive patients who were successfully decannulated from ECLS and screened for CaDVT from two medical-surgical intensive care units (ICU) in Kuwait between 2016 and 2023. The incidence of CaDVT was assessed and correlated with risk factors such as baseline characteristics, ECLS mode and duration, and cannula sizes. Length of stay (LOS) in the ICU, along with ICU and in-hospital mortality were reported. Of 403 patients supported with ECLS, 144 underwent postdecannulation ultrasound. Cannula-associated deep vein thrombosis occurred in 94 (65%) patients. Venovenous ECLS (V-V ECLS) was the only independent risk factor associated with post-ECLS CaDVT (odds ratio [OR]: 4.78; 95% confidence interval [CI]: 1.18-19.4). Length of stay in the ICU and mortality were similar between patients with and without CaDVT. Cannula-associated deep vein thrombosis is a frequent complication of ECLS, occurring in more than half of patients. The use of V-V ECLS appears to be an independent risk factor for the development of post-ECLS CaDVT. Further efforts are needed to develop formal recommendations for screening and managing CaDVT post-ECLS.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566006","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}

引用次数: 0

Survival and Readmission Burden in Advanced Heart Failure Patients Managed With Ventricular Assist Device Versus Continued Medical Therapy.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-03 DOI: 10.1097/MAT.0000000000002382

Jeffrey D Alexis, Katherine Wood, Igor Gosev, Anas Jawaid, Leway Chen, Anuradha Godishala, Mark Tallman, Sabu Thomas, John Martens, Bronislava Polonsky, Anita Y Chen, Scott McNitt, Saadia Sherazi, Ilan Goldenberg

{"title":"Survival and Readmission Burden in Advanced Heart Failure Patients Managed With Ventricular Assist Device Versus Continued Medical Therapy.","authors":"Jeffrey D Alexis, Katherine Wood, Igor Gosev, Anas Jawaid, Leway Chen, Anuradha Godishala, Mark Tallman, Sabu Thomas, John Martens, Bronislava Polonsky, Anita Y Chen, Scott McNitt, Saadia Sherazi, Ilan Goldenberg","doi":"10.1097/MAT.0000000000002382","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002382","url":null,"abstract":"As questions remain about the risk-benefit of left ventricular assist device (LVAD) therapy, we evaluated the association between LVAD versus medical therapy for the competing risk of all-cause mortality and all-cause readmission. Among consecutive patients evaluated for advanced heart failure (HF) therapy, 260 were referred for LVAD implantation and 292 continued medical therapy in this retrospective, observational database study. At 2 years, all-cause mortality was significantly higher among medically managed patients versus LVAD recipients (37% vs. 25%, p = 0.014). Separation in event rates appeared within 3 months and was sustained throughout follow-up. The cumulative incidence rate of all-cause readmissions at 2 years was higher among LVAD recipients (78% vs. 40%, p < 0.001). In multivariate analysis, compared with medical therapy, LVAD therapy was associated with a significant 35% lower risk of death (p = 0.005), driven by a 57% reduction in the risk of death within the first 3 months (p < 0.001), and a 2.8-fold increased risk of readmission. Among medically managed patients, lower baseline hemoglobin and blood pressure, older age, and increased creatinine were predictors of death. In conclusion, among patients with advanced HF, LVAD therapy was associated with pronounced survival benefit, but a higher 2-year readmission rate compared with medical management.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540017","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}

引用次数: 0

Extracorporeal Life Support Organization 2024 Guideline for Early Rehabilitation or Mobilization of Adult Patients on Extracorporeal Membrane Oxygenation.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/MAT.0000000000002375

Stephen Ramsey, Ahmed Labib Shehatta, Kollengode Ramanathan, Kiran Shekar, Daniel Brodie, Rodrigo Diaz, Abigail Roberts, Sherene Cruz, Carol Hodgson, Bishoy Zakhary

引用次数: 0

The Use of Impella 5.5 Reduces Pulmonary Vascular Resistance as Bridge to Heart Transplant in a Pediatric Patient. 使用 Impella 5.5 降低肺血管阻力，为儿科患者的心脏移植架起桥梁。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-01 Epub Date: 2024-06-19 DOI: 10.1097/MAT.0000000000002256

Bradley Oelkers, Erin Schumer, Andrea N Lambert, Bahaaldin Alsoufi, Deborah Kozik, Sarah J Wilkens

引用次数: 0

Predictors of Mortality in Adults With Calcium Channel Blocker Toxicity Receiving Extracorporeal Membrane Oxygenation Support: An Extracorporeal Life Support Organization Registry Analysis. 接受体外膜氧合支持的钙通道阻滞剂毒性成人的死亡率预测因素：体外生命支持组织登记分析》。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-01 Epub Date: 2024-09-16 DOI: 10.1097/MAT.0000000000002307

Rakeshkumar Subramanian, Amelia Roebuck, Hariom Joshi, Michelle Drouin

{"title":"Predictors of Mortality in Adults With Calcium Channel Blocker Toxicity Receiving Extracorporeal Membrane Oxygenation Support: An Extracorporeal Life Support Organization Registry Analysis.","authors":"Rakeshkumar Subramanian, Amelia Roebuck, Hariom Joshi, Michelle Drouin","doi":"10.1097/MAT.0000000000002307","DOIUrl":"10.1097/MAT.0000000000002307","url":null,"abstract":"Calcium channel blocker (CCB) toxicity presents a significant mortality risk, highlighting the need for effective treatment strategies such as extracorporeal membrane oxygenation (ECMO). This study analyzes Extracorporeal Life Support Organization (ELSO) registry data to determine the mortality rate in adults treated with ECMO for CCB toxicity and identifies clinical predictors of mortality. A retrospective analysis of the ELSO registry from January 2016 to April 2023 was conducted, focusing on adults diagnosed with CCB toxicity (ICD-10 T46.1) who received ECMO. Data collected included patient demographics, ECMO details (mode, duration, type), pre-ECMO clinical indicators (pH, lactate levels, cardiac arrest incidence), and in-hospital mortality. The analysis employed descriptive statistics to profile the patient population, with independent t-tests and chi-square tests comparing survivors to nonsurvivors. Logistic regression identified mortality predictors, integrating multiple imputations to remedy missing data, thus ensuring the analysis's integrity. The mortality rate for ECMO-treated CCB toxicity was 40.6%. Severe acidosis and the need for pre-ECMO renal replacement therapy were identified as key predictors of mortality. Further research is needed to determine if early ECMO initiation before a significant pH drop improves outcomes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"200-203"},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280005","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}

引用次数: 0

Development and Evaluation of a Novel Drainage Cannula for Venoarterial Extracorporeal Membrane Oxygenation. 一种新型静脉外膜氧合引流套管的研制与评价。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-03-01 Epub Date: 2024-12-19 DOI: 10.1097/MAT.0000000000002360

Avishka Wickramarachchi, Saeedreza Zeibi Shirejini, Ashkan Vatani, Akshita Rana, Mehrdad Khamooshi, Michael Šeman, Sam Liao, Edwina Jap, Tuan H Nguyen, Karen Alt, Aidan Burrell, Vincent A Pellegrino, David M Kaye, Christoph E Hagemeyer, Shaun D Gregory

{"title":"Development and Evaluation of a Novel Drainage Cannula for Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Avishka Wickramarachchi, Saeedreza Zeibi Shirejini, Ashkan Vatani, Akshita Rana, Mehrdad Khamooshi, Michael Šeman, Sam Liao, Edwina Jap, Tuan H Nguyen, Karen Alt, Aidan Burrell, Vincent A Pellegrino, David M Kaye, Christoph E Hagemeyer, Shaun D Gregory","doi":"10.1097/MAT.0000000000002360","DOIUrl":"10.1097/MAT.0000000000002360","url":null,"abstract":"A critical factor in thrombus formation during venoarterial extracorporeal membrane oxygenation (VA ECMO) is prothrombotic flow dynamics generated by the drainage cannula's design. This study aimed to create and evaluate a novel drainage cannula design which optimized blood flow dynamics to reduce thrombus formation. Computational fluid dynamics (CFD) was used to iteratively vary drainage cannula design parameters such as inner wall shape and side hole shape. The final novel design was then placed in an ex vivo blood circulation loop, and compared against a Bio-Medicus cannula (n = 6, each). Clot volume, hemolysis, and other parameters were measured to assess thrombus formation markers. The novel design consisted of a parabolic inner wall profile with closely spaced side holes angled at 30º to align with flow. When tested in the ex vivo loop, the novel design resulted in lower instances (two vs . four) and volumes of clot in the cannula (360.5 ± 254.8 vs . 1258.0 ± 651.7 µl) when compared to the Bio-Medicus cannula. Results from tests assessing hemolysis, platelet activation, and other thrombotic markers revealed a noninferior relationship between the novel and Bio-Medicus designs. Future work will explore the clinical applicability of these findings.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"235-244"},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852338","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}

引用次数: 0