ASAIO Journal最新文献

Computers in Cardiac Surgery. 心脏外科中的计算机。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-07-21 DOI: 10.1097/MAT.0000000000002441

William L Holman, James E Davies

引用次数: 0

Authors' Reply to "Improving the Safety of Circuit Changes During Venovenous Extracorporeal Membrane Oxygenation". 作者对“提高静脉-静脉体外膜氧合过程中回路改变的安全性”的答复。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-06-27 DOI: 10.1097/MAT.0000000000002497

Loic Gouriet, Nicolas de Prost, Paul Masi

引用次数: 0

Racial and Sex Disparities in Incidence, Risk Factors, and Outcomes of Neonatal Extracorporeal Life Support in the United States. 美国新生儿体外生命支持的发生率、危险因素和结果的种族和性别差异。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-04-02 DOI: 10.1097/MAT.0000000000002423

Lauren R Walker, Laura E Hollinger, Lizmarie Maldonado, Mulugeta Gebregziabher, Brian K Stansfield, Natalie Rintoul, Connor Kreese, Heidi J Steflik

{"title":"Racial and Sex Disparities in Incidence, Risk Factors, and Outcomes of Neonatal Extracorporeal Life Support in the United States.","authors":"Lauren R Walker, Laura E Hollinger, Lizmarie Maldonado, Mulugeta Gebregziabher, Brian K Stansfield, Natalie Rintoul, Connor Kreese, Heidi J Steflik","doi":"10.1097/MAT.0000000000002423","DOIUrl":"10.1097/MAT.0000000000002423","url":null,"abstract":"The impact of race on extracorporeal life support (ECLS) availability, morbidity, and mortality remains poorly defined. We sought to define the impact of race/ethnicity, sex, and location on ECLS outcomes, and identify potential disparities that remain intact using a modern, inclusive cohort of neonates receiving ECLS in the United States. Data were extracted from the Children's Hospital Association Pediatric Health Information System (PHIS) database on neonates who received ECLS from January 1, 2010-December 31, 2020. Both adjusted and unadjusted regression models were fitted to study the association between neonatal ECLS outcomes and covariates. During the study period, 6,695 neonates from 47 hospitals met the inclusion criteria. Non-Hispanic White neonates (45%), males (57%), and hospitals in the Southern region (32%) compromised the largest proportions of ECLS cases and cardiac disease (44%) was the most common indication for ECLS. Hospital region was associated with ECLS duration with hospitals in the Midwest (median 6 days) and West (6 days) having significantly shorter courses than those in the Northeast (7 days) and South (7 days) ( p < 0.01). Associations between race/ethnicity, sex, hospital region, and mortality were detected. Non-Hispanic Black neonates (35% mortality), males (37%), and neonates in the Midwest region (34%) experienced lower ECLS mortality rates (all p < 0.05).","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"841-848"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762623","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

Improving the Safety of Circuit Changes During Venovenous Extracorporeal Membrane Oxygenation. 提高静脉-静脉体外膜氧合过程中回路改变的安全性。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-06-26 DOI: 10.1097/MAT.0000000000002496

Steven A Conrad, Najam A Siddiqui, Anibal A Dominguez, Arunima Sharma

引用次数: 0

In Silico Analysis of Pulsatile Flow Veno-Arterial Extracorporeal Membrane Oxygenation on Human Aorta Model. 人体主动脉模型静脉-动脉体外膜氧合脉搏流的计算机分析。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-09-29 DOI: 10.1097/MAT.0000000000002418

Dhayananth Kanagarajan, Silver Heinsar, Van Thanh Dau, Jo P Pauls, Geoffrey D Tansley, John F Fraser

{"title":"In Silico Analysis of Pulsatile Flow Veno-Arterial Extracorporeal Membrane Oxygenation on Human Aorta Model.","authors":"Dhayananth Kanagarajan, Silver Heinsar, Van Thanh Dau, Jo P Pauls, Geoffrey D Tansley, John F Fraser","doi":"10.1097/MAT.0000000000002418","DOIUrl":"10.1097/MAT.0000000000002418","url":null,"abstract":"Electrocardiogram (ECG)-synchronized pulsatile veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a recent development in extracorporeal therapy for patients with severe cardiogenic shock. Although preclinical studies have shown benefits of pulsatile flow relative to continuous ECMO flow, none have explored the effects of the timing of ECMO pulses with respect to the cardiac cycle and its possible implications on ECMO complications. This study aimed to develop a computational fluid dynamics (CFD) model of V-A ECMO in a patient-specific human aorta and evaluate the effect of ECMO timing on cardiac unloading, surplus hemodynamic energy delivery, and mixing zone position. Using direct flow measurements from cardiogenic shock patients and an ECMO device, the model revealed that maximal left ventricular (LV) unloading occurred when the ECMO pulse was in early diastole (35-40% from LV peak systolic flow). Maximum surplus hemodynamic energy transmission to aortic branches occurred at 20% from LV peak systolic flow. This indicates a trade-off between heart afterload and hemodynamic energy delivery in selecting ECMO pulse timing. The mixing zone was primarily located in the aortic arch across timing configurations. Therefore, selecting ECMO pulse timing is crucial to maximizing the benefits of pulsatile flow in V-A ECMO treatment.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"814-822"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655575","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

Prolonged Use of Extracorporeal Membrane Oxygenators for COVID-19-Associated Acute Respiratory Distress Syndrome: A Retrospective Analysis. 长期使用体外膜氧合器治疗covid -19相关急性呼吸窘迫综合征：回顾性分析

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-03-25 DOI: 10.1097/MAT.0000000000002411

Halide Oğuş, Adile Ece Altinay, Şirin Menekşe, Mustafa Mert Özgür, Ali Karagöz, İsmail Yerli, Hülya Yük, Mehmet Kaan Kirali̇

{"title":"Prolonged Use of Extracorporeal Membrane Oxygenators for COVID-19-Associated Acute Respiratory Distress Syndrome: A Retrospective Analysis.","authors":"Halide Oğuş, Adile Ece Altinay, Şirin Menekşe, Mustafa Mert Özgür, Ali Karagöz, İsmail Yerli, Hülya Yük, Mehmet Kaan Kirali̇","doi":"10.1097/MAT.0000000000002411","DOIUrl":"10.1097/MAT.0000000000002411","url":null,"abstract":"Whether an anticoagulation strategy combining bivalirudin and aspirin during extracorporeal membrane oxygenation (ECMO) would prolong oxygenator use is unknown. No clear data exist on oxygenator life span during prolonged ECMO use. We evaluated 70 adult patients who received ECMO due to coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome for at least 7 days and who required no or at least one ECMO oxygenator replacement due to ECMO-circuit thrombosis. Anticoagulation parameters mainly included activated partial thromboplastin time (aPTT), with monitoring of international normalized ratio and platelet count. The main target aPTT was 45-60 seconds. The indication for oxygenator replacement was ECMO-circuit thrombosis. The mean ECMO duration was 41.8 ± 25.3 days. No oxygenator replacement was required in 48 patients (68.6%) during a mean of 34.9 ± 23.5 ECMO days (range 7-104). Twenty-two patients (31.4%) required 35 oxygenator replacements throughout a mean ECMO duration of 56.9 ± 22.8 days (range 19-102). The mean aPTT was similar throughout ECMO in the two groups. A higher percentage of out-of-target aPTT was associated with a shorter duration of oxygenator use. Bivalirudin plus aspirin may prove to be a more appropriate anticoagulation strategy during ECMO, resulting in more effective utilization of ECMO oxygenators.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"795-799"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699663","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

Acute Hemodynamic and Echocardiographic Consequences of Impella 5.5 Placement in Patients With Advanced Cardiogenic Shock. 晚期心源性休克患者植入Impella 5.5的急性血流动力学和超声心动图结果。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-04-18 DOI: 10.1097/MAT.0000000000002436

Michaela Asher, Amit Iyengar, David Rekhtman, Mark Helmers, Noah Weingarten, Cindy Song, John DePaolo, Max Shin, Alyson Brown, Joyce Wald, Aditya Parikh, Marisa Cevasco

{"title":"Acute Hemodynamic and Echocardiographic Consequences of Impella 5.5 Placement in Patients With Advanced Cardiogenic Shock.","authors":"Michaela Asher, Amit Iyengar, David Rekhtman, Mark Helmers, Noah Weingarten, Cindy Song, John DePaolo, Max Shin, Alyson Brown, Joyce Wald, Aditya Parikh, Marisa Cevasco","doi":"10.1097/MAT.0000000000002436","DOIUrl":"10.1097/MAT.0000000000002436","url":null,"abstract":"We sought to investigate the hemodynamic and echocardiographic consequences of the Impella 5.5 during the acute perioperative period. A retrospective analysis of patients who underwent device implantation at our institution between January 2021 and June 2023 was performed. Hemodynamic and echocardiographic changes were modeled as linear mixed models with random intercepts for patient and fixed as well as random effects of time. Of 87 patients identified, most were male (72, 83%) with nonischemic cardiomyopathy (44, 51%). In the first two postoperative days, the median cardiac output increased by 1.2 L/min ( p < 0.05), although the median Impella flow remained at 4.1 L/min. Mean pulmonary artery pressures (32 vs. 27 mm Hg, p < 0.05) and vasoactive inotrope scores (5.6 vs. 3.7, p < 0.01) were modestly reduced. Significant echocardiographic improvement was noted in 61% and 71% of patients with significant preoperative mitral or tricuspid regurgitation, respectively. However, no changes in ejection fraction, left ventricle (LV) diameter, or right ventricular function were noted (all p > 0.05). At 30 days, 27 (31%) patients were transplanted and 13 (15%) were bridged to a durable left ventricular assist device (LVAD). We conclude that in the acute phase following Impella implantation, LV offloading, reductions in pulmonary artery pressures, and improvement in valvular regurgitation are seen without changes to ventricular geometry.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"807-813"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967152","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

Intraoperative Epoprostenol in Type II Heparin-Induced Thrombocytopenia During Left-Ventricular Assist Device Implantation: A Case Series and Review of Literature. 左心室辅助装置植入期间II型肝素诱导的血小板减少术中使用环氧前列醇：一个病例系列和文献综述。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2024-12-02 DOI: 10.1097/MAT.0000000000002356

Akhil Avunoori Chandra, Vidish Pandya, Luis Pina Martina, Michael Freilich, Daniel B Sims, Sasa Vukelic, Jonathan D Leff, Daniel J Goldstein, Sandhya Murthy, Ulrich P Jorde, Omar Saeed

{"title":"Intraoperative Epoprostenol in Type II Heparin-Induced Thrombocytopenia During Left-Ventricular Assist Device Implantation: A Case Series and Review of Literature.","authors":"Akhil Avunoori Chandra, Vidish Pandya, Luis Pina Martina, Michael Freilich, Daniel B Sims, Sasa Vukelic, Jonathan D Leff, Daniel J Goldstein, Sandhya Murthy, Ulrich P Jorde, Omar Saeed","doi":"10.1097/MAT.0000000000002356","DOIUrl":"10.1097/MAT.0000000000002356","url":null,"abstract":"Type II heparin-induced thrombocytopenia and thrombosis (type II HITT) is a rare but serious complication in patients receiving heparin for anticoagulation. In type II HITT, an immune-mediated reaction against platelet factor four-heparin complexes results in thrombocytopenia and an elevated risk of thrombosis. This poses significant challenges for patients with advanced heart failure requiring urgent left-ventricular assist device (LVAD) implantation. The use of direct thrombin inhibitors, the typical alternative to heparin, is associated with increased bleeding risk and lacks a reversal agent, limiting their use in cardiac surgery. We present two cases of intraoperative epoprostenol to facilitate implantation of a durable LVAD in type II HITT, of which one case underwent preoperative plasmapheresis and intravenous immunoglobulin (IVIG) therapy. Epoprostenol, a prostacyclin analog, was used intraoperatively during LVAD implantation to inhibit platelet activation and allowed for the safe administration of heparin during cardiopulmonary bypass. Both patients underwent successful LVAD implantation without thrombotic or major bleeding complications. These cases highlight the potential of using intraoperative epoprostenol in conjunction with preoperative plasma exchange (PLEX) and IVIG to mitigate the risks associated with heparin use in patients with type II HITT, offering an alternative approach for this high-risk group requiring urgent cardiac surgery.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e147-e152"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765768","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

Association Between Red Blood Cells Transfusion and 1 Year Mortality in Patients on Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock. 心源性休克经静脉体外膜氧合治疗患者输血与1年死亡率的关系。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-04-02 DOI: 10.1097/MAT.0000000000002424

Mathilde Brouland, Antoine Kimmoun, Clément Delmas, Kevin Duarte, Nicolas Girerd, Fanny Vardon-Bounes, Thomas Klein

{"title":"Association Between Red Blood Cells Transfusion and 1 Year Mortality in Patients on Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock.","authors":"Mathilde Brouland, Antoine Kimmoun, Clément Delmas, Kevin Duarte, Nicolas Girerd, Fanny Vardon-Bounes, Thomas Klein","doi":"10.1097/MAT.0000000000002424","DOIUrl":"10.1097/MAT.0000000000002424","url":null,"abstract":"In patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock, red blood cell (RBC) transfusion is often necessary, but its impact on long-term mortality remains unclear. This multicenter retrospective cohort study aimed to assess the association between RBC transfusion and 1 year mortality in patients on VA-ECMO. Data were collected from two French intensive care units (ICUs) between January 1 st , 2016, and December 31 st , 2021. Adults with cardiogenic shock supported by VA-ECMO were included, while those under 18, with ECMO duration <24 hours, or cardiac arrest before or during implantation were excluded. Among 190 patients (71% male, median age 60 years), the median VA-ECMO duration was 8 days. One year mortality was 54%. Red blood cell transfusions were administered to 83% of patients, with a median of six packs. Multivariable analysis showed no significant association between RBC transfusion and 1 year mortality across various transfusion metrics, including transfusion status, total units, and daily packs (all p > 0.05). Subgroup analyses confirmed this consistent pattern. Although RBC transfusion is frequent in VA-ECMO-supported patients, this study found no significant association with 1 year survival. Given the risks of transfusion, a cautious approach is recommended. Further studies are needed to refine transfusion strategies for this high-risk population.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"833-840"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762452","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

Endostatin and Cystatin C as Predictors of 1 Month Renal Function Change in Patients With Left Ventricular Assist Device Support. 内皮抑素和胱抑素C作为左心室辅助装置支持患者1个月肾功能变化的预测因子。

IF 2.3 3区医学

ASAIO Journal Pub Date : 2025-10-01 Epub Date: 2025-03-10 DOI: 10.1097/MAT.0000000000002414

Shiyi Li, Katherine V Nordick, Iván Murrieta-Álvarez, Ismael Garcia, Randall P Kirby, Rishav Bhattacharya, Alexis E Shafii, Samiran Ghosh, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Carl P Walther, Nandan K Mondal

{"title":"Endostatin and Cystatin C as Predictors of 1 Month Renal Function Change in Patients With Left Ventricular Assist Device Support.","authors":"Shiyi Li, Katherine V Nordick, Iván Murrieta-Álvarez, Ismael Garcia, Randall P Kirby, Rishav Bhattacharya, Alexis E Shafii, Samiran Ghosh, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Carl P Walther, Nandan K Mondal","doi":"10.1097/MAT.0000000000002414","DOIUrl":"10.1097/MAT.0000000000002414","url":null,"abstract":"First-month renal function trajectories after left ventricular assist device (LVAD) implantation vary widely. Lack of renal function improvement (RFI) and postoperative acute kidney injury (AKI) are associated with increased mortality. This study evaluates plasma levels of endostatin and cystatin C as predictors of RFI and AKI 1 month post-LVAD implantation. We prospectively enrolled 52 advanced heart failure patients undergoing LVAD implantation. Blood samples were collected pre-implant and at 1, 2, 3, and 4 weeks post-implant. Plasma levels of endostatin and cystatin C were measured. Among 52 patients, 24 (46.2%) achieved RFI, whereas 28 (53.8%) did not. Of the non-RFI group, 15 (53.6%) developed AKI within the first month. Baseline endostatin was highly significant in predicting RFI ( p = 0.012), followed by cystatin C ( p = 0.045). The patients without RFI were considered high-risk patients for postoperative AKI. We noticed distinct trajectories for postoperative 1 week cystatin C value, not endostatin, between AKI and no-AKI patients. Postoperative 1 week level of cystatin C is identified as a good biomarker for postoperative AKI prediction in these high-risk group patients. Baseline endostatin levels can help identify patients with reduced renal adaptive capacity. For patients with high pre-implant plasma endostatin values, monitoring circulating postoperative 1 week cystatin C allows physicians to detect AKI early.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"785-794"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596029","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