ASAIO Journal最新文献

Anticoagulate the Circuit, Not the Patient: Nitric Oxide Reduces Thrombus Formation During Extracorporeal Carbon Dioxide Removal. 抗凝电路，而不是病人：一氧化氮减少体外二氧化碳去除过程中的血栓形成。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-19 DOI: 10.1097/MAT.0000000000002490

Teryn R Roberts, Yanyi Zang, George T Harea, Daniel S Wendorff, Brendan M Beely, Leopoldo C Cancio, Andrea Selkow Wallish, Tracey V Wick, Melissa M Reynolds, Andriy I Batchinsky

{"title":"Anticoagulate the Circuit, Not the Patient: Nitric Oxide Reduces Thrombus Formation During Extracorporeal Carbon Dioxide Removal.","authors":"Teryn R Roberts, Yanyi Zang, George T Harea, Daniel S Wendorff, Brendan M Beely, Leopoldo C Cancio, Andrea Selkow Wallish, Tracey V Wick, Melissa M Reynolds, Andriy I Batchinsky","doi":"10.1097/MAT.0000000000002490","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002490","url":null,"abstract":"Solutions to reduce the need for systemic anticoagulation during extracorporeal life support would improve safety and utility. The study objective was to evaluate the safety and efficacy of a nitric oxide-generating extracorporeal carbon dioxide removal (ECCO2R) system without systemic anticoagulation in a translational swine model. We hypothesized that nitric oxide reduces circuit thrombosis, without untoward systemic effects. Anesthetized, mechanically ventilated swine (50-60 kg) received bicaval jugular cannulation for 72 hour venovenous ECCO2R. Control (n = 6) received a standard ECCO2R device with systemic heparinization. Treatment (n = 6) received the same device, but with nitric oxide-generating circuitry and 80 ppm nitric oxide added to sweep gas, without systemic heparinization. No between-group differences in vitals, ventilator settings, blood gases, extracorporeal gas exchange, or fluid balance occurred. In both groups, ECCO2R enabled reduction in tidal volume. Oxygenator thrombus area, quantified following dissection and imaging, was reduced in treatment (10.2 ± 1.2%) versus control (15.2 ± 1.6%) (p = 0.03). One control oxygenator occluded. No nitric oxide-related adverse effects were observed, including methemoglobinemia. Nitric oxide-enhanced ECCO2R enabled 72 hours of support without systemic anticoagulation, and without altering oxygenator performance or causing untoward systemic effects. Future studies are needed to investigate efficacy in subjects with underlying coagulopathy and/or contraindications for systemic anticoagulation.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324398","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

Impact of Neonatal Ventilation Mode on Outcomes in Patients With Congenital Diaphragmatic Hernia Treated With Extracorporeal Life Support: A Propensity Score Analysis. 新生儿通气模式对体外生命支持治疗先天性膈疝患者预后的影响：倾向评分分析。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-18 DOI: 10.1097/MAT.0000000000002476

Sharada H Gowda, Joseph Hagan, Ahmed Almaazmi, Emily Niemyjski, Matteo Di Nardo, Tim Jancelewicz, Matthew T Harting, Caraciolo J Fernandes, Danh V Nguyen, Yigit S Guner

{"title":"Impact of Neonatal Ventilation Mode on Outcomes in Patients With Congenital Diaphragmatic Hernia Treated With Extracorporeal Life Support: A Propensity Score Analysis.","authors":"Sharada H Gowda, Joseph Hagan, Ahmed Almaazmi, Emily Niemyjski, Matteo Di Nardo, Tim Jancelewicz, Matthew T Harting, Caraciolo J Fernandes, Danh V Nguyen, Yigit S Guner","doi":"10.1097/MAT.0000000000002476","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002476","url":null,"abstract":"High-frequency oscillatory ventilation (HFOV) is used in neonates with hypoxic respiratory failure both as a primary mode and as a rescue mode of ventilation. It is unknown to what degree the use of HFOV provides a measurable benefit to infants with congenital diaphragmatic hernia (CDH) receiving extracorporeal life support (ECLS). We sought to determine whether pre-ECLS use of HFOV compared to conventional mechanical ventilation (CMV) was associated with differences in mortality. Neonates who underwent ECLS for CDH were identified within the Extracorporeal Life Support Organization (ELSO) Registry. Patients were categorized as those on HFOV versus on CMV immediately before initiating ECLS. Patients were matched 1:1 for severity based on pre-ECLS covariates using the propensity score (PS) for ventilator choice. There were 2,892 infants with an overall mortality of 47.3%. Conventional ventilation was used before ECLS in 677 (23.4%) and HFOV in 2,215 (76.6%). Of these, 1,354 infants were matched (1:1) based on ventilator choice (677 CMV and 677 HFOV). High-frequency oscillatory ventilation was associated with 49% higher odds of mortality based on 677 PS matched pairs (odds ratio [OR] = 1.492, 95% confidence interval [CI]: 1.200-1.856, p < 0.001). Patients who received pre-ECLS mechanical ventilation with HFOV were noted to have higher mortality in neonates with CDH compared to CMV.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324399","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

Time for an Update? Fungal Infection Trends and Practices With Mechanical Circulatory Support. 是时候更新了？机械循环支持下真菌感染的趋势和实践。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-18 DOI: 10.1097/MAT.0000000000002482

Mark Liotta, Virginia Gonzalez, Claire Zurlo, Yevgeniy Brailovsky, Salpy Pamboukian, Preethi Pirlamarla, Anju Bhardwaj, Maria Gamero Huaman, Indranee Rajapreyar

引用次数: 0

Reply Letter to "Reassessing the Chill: A Critical Perspective on SherpaPak Versus Ice Storage in Heart Transplantation". 对“重新评估寒冷：SherpaPak与冰储存在心脏移植中的关键观点”的回复。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-18 DOI: 10.1097/MAT.0000000000002488

Tarun Dalia, Hassan Farhoud, Andrija Vidic

引用次数: 0

Characterizing Microbiome Changes in Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report of Multidrug-Resistant Bacteremia. 静脉-静脉体外膜氧合中微生物组变化的表征：多药耐药菌血症一例报告。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-17 DOI: 10.1097/MAT.0000000000002479

Zachary S Jarrett, Hui Xia, Erika R O'Neil, Terence P Lonergan, Michael Gonzales, Michal Sobieszczyk, Thomas F Gibbons, Joseph E Marcus

{"title":"Characterizing Microbiome Changes in Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report of Multidrug-Resistant Bacteremia.","authors":"Zachary S Jarrett, Hui Xia, Erika R O'Neil, Terence P Lonergan, Michael Gonzales, Michal Sobieszczyk, Thomas F Gibbons, Joseph E Marcus","doi":"10.1097/MAT.0000000000002479","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002479","url":null,"abstract":"Microbiome analysis using metagenomics next-generation sequencing (mNGS) is rarely performed in patients receiving extracorporeal membrane oxygenation (ECMO). Patient body sites were swabbed within 72 hours of ECMO cannulation and weekly during ECMO course. Specimens underwent 16S sequencing to identify the microbiome along with mNGS to determine antimicrobial resistance genes. Fifty-two year old male who suffered polytraumatic injuries and developed acute respiratory syndrome was placed on veno-venous (VV) ECMO to treat severe respiratory failure. On ECMO day 1, the patient was undergoing treatment for urinary tract infection due to susceptible Pseudomonas aeruginosa (PsA). On ECMO day 22, the patient developed fulminant septic shock and tracheal aspirate and blood cultures both grew MDR PsA and Enterobacter cloacae complex (ECC) and ultimately died on day 23. There were significant microbiome and antimicrobial resistance changes that preceded sepsis on day 22, as evidenced by the increase in oral PsA colonization and expansion of resistance genes, such as KPC and OXA-50, which suggest several possible reservoirs for infection outside of the circuit. Further application of these methods is needed to understand microbiome changes in ECMO and ultimately guide infection prevention efforts.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315851","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

Post-Transplant Stroke in Patients Bridged to Transplantation With Impella 5.5 in the Era of Prolonged Duration of Support. 在延长支持时间的时代，用Impella 5.5桥接移植患者的移植后卒中。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-16 DOI: 10.1097/MAT.0000000000002484

Peter Marogil, Yu Xia, Joshua Hermsen, Maryl Johnson, Veli K Topkara

引用次数: 0

Fluorescent Imaging-Guided Ligation of Lymphatic Leaks Following Decannulation From Extracorporeal Membrane Oxygenation. 体外膜氧合脱管后淋巴渗漏的荧光成像引导结扎。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-12 DOI: 10.1097/MAT.0000000000002478

Hamzah Almadani, Youssef Aref, Zachary Brennan, Andrew Cantor, Tyler Gunn, Philip S Brazio

{"title":"Fluorescent Imaging-Guided Ligation of Lymphatic Leaks Following Decannulation From Extracorporeal Membrane Oxygenation.","authors":"Hamzah Almadani, Youssef Aref, Zachary Brennan, Andrew Cantor, Tyler Gunn, Philip S Brazio","doi":"10.1097/MAT.0000000000002478","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002478","url":null,"abstract":"Lymphocele is a known complication of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We present a novel application of fluorescent lymphatic imaging for the highly selective treatment of lymphatic leaks after VA-ECMO and describe patient outcomes at our institution. A retrospective review of patients who underwent lymphatic ligation following VA-ECMO from 2022 to 2024 was performed. Fluorescent imaging and intradermal indocyanine green injection were used to identify and ligate lymphatic leaks within the debrided wound bed. Ten patients with a mean age of 48.3 years were included. The mean number of lymphatics ligated was 5. Mean days from decannulation to ligation and from ligation to drain removal were 18.4 and 22.2, respectively. There was a significant decrease in drain output immediately following ligation (197.4 ml/day vs. 64.2 ml/day; p = 0.016). A shorter time from decannulation to ligation was significantly correlated with a decrease in drain output. A higher drain fluid lymphocyte percentage was significantly correlated with a shorter time to drain removal. Fluorescent imaging-guided lymphatic ligation is an effective method for treating lymphatic leak after decannulation from VA-ECMO. Drain fluid analysis and early consultation with plastic surgery should be encouraged in the event of high-output lymphocele.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274076","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

Use of Therapeutic Drug Monitoring to Personalize Antifungals for Blastomycosis in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Case Series. 应用治疗性药物监测个体化治疗体外膜氧合治疗的儿童芽孢菌病：一个病例系列。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-12 DOI: 10.1097/MAT.0000000000002480

Rana Khafagy, Erin Chung, Anne-Marie Guerguerian, Cory Anderson, Elaine Gilfoyle, Mark Todd, Sandra Pong, Mariella Vargas-Gutierrez, Gail Annich

{"title":"Use of Therapeutic Drug Monitoring to Personalize Antifungals for Blastomycosis in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Case Series.","authors":"Rana Khafagy, Erin Chung, Anne-Marie Guerguerian, Cory Anderson, Elaine Gilfoyle, Mark Todd, Sandra Pong, Mariella Vargas-Gutierrez, Gail Annich","doi":"10.1097/MAT.0000000000002480","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002480","url":null,"abstract":"Amphotericin B and posaconazole are used in the treatment of pulmonary blastomycosis. Previous reports found inadequate treatment to both antifungals due to potential sequestration in extracorporeal membrane oxygenation (ECMO). There is a lack of evidence supporting routine use of therapeutic drug monitoring (TDM) with these agents. We report amphotericin B and posaconazole TDM in two separate cases of patients with pulmonary blastomycosis and on ECMO. Plasma concentrations were collected pre- and post-ECMO membranes and used to calculate pharmacokinetic and pharmacodynamic parameters. Drug sequestration within ECMO was not evident in our cases. As such, we speculate the drugs may have saturated the circuits over time. TDM of amphotericin B and posaconazole may be beneficial in pediatric patients on ECMO, especially near initiation of therapy or after a circuit change. Further studies are warranted to evaluate the relationship between plasma concentrations of these antifungals and efficacy and safety outcomes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274078","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

Reassessing the Chill: A Critical Perspective on SherpaPak Versus Ice Storage in Heart Transplantation. 重新评估寒冷：心脏移植中SherpaPak与冰储存的关键观点。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-12 DOI: 10.1097/MAT.0000000000002481

Ibrahim Nagmeldin Hassan

引用次数: 0

Enhancing Survival Prediction After Venoarterial Extracorporeal Membrane Oxygenation Using Machine Learning. 利用机器学习增强静脉体外膜氧合后的生存预测。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-02 DOI: 10.1097/MAT.0000000000002475

Albert Leng, Preetham Bachina, Olivia Liu, Benjamin Shou, Charles Racz, David A Giliver, Ilya Shpitser, Glenn J R Whitman, Sung-Min Cho

{"title":"Enhancing Survival Prediction After Venoarterial Extracorporeal Membrane Oxygenation Using Machine Learning.","authors":"Albert Leng, Preetham Bachina, Olivia Liu, Benjamin Shou, Charles Racz, David A Giliver, Ilya Shpitser, Glenn J R Whitman, Sung-Min Cho","doi":"10.1097/MAT.0000000000002475","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002475","url":null,"abstract":"In-hospital mortality after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remains high. This study compared the performance of the Survival after Venoarterial ECMO (SAVE) score with machine learning (ML) models incorporating rich electronic medical record data to evaluate survival for patients on VA-ECMO support. We retrospectively reviewed adults undergoing VA-ECMO (2016-2022) at a single tertiary care center. The CatBoost algorithm was trained using leave-one-out cross-validation (LOOCV) on 74 extracted vital signs, laboratory values, and ventilator settings. Shapley Additive Explanations (SHAP) was used to identify key predictive features for logistic regression. Overall, 194 VA-ECMO patients (median age = 58 years, 36.6% female) were included, with 133 (69%) experiencing mortality. The SAVE score was compared to two predictive models: a pre-ECMO model (≤ 24 hours before cannulation) and an on-ECMO model (including up to the first 48 hours of ECMO). The LOOCV area under the receiver-operator characteristics curves (AUC) for the SAVE score, pre-ECMO, and on-ECMO models was 0.73, 0.77, and 0.83, respectively. Logistic regressions using ML-identified variables showed stepwise AUC improvements: 0.82 (pre-ECMO), 0.86 (on-ECMO), and 0.89 (combined). A novel, interpretable ML model predicted survival for VA-ECMO patients with accuracy comparable to the SAVE score. Incorporating on-ECMO variables significantly increased predictive performance and revealed novel variables associated with survival.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198221","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