ASAIO Journal最新文献_第10页

The Role of Recirculation-Guided Blood Flow Adjustment in Venovenous Extracorporeal Membrane Oxygenation: A Pilot Study. 再循环引导血流调节在静脉-静脉体外膜氧合中的作用：一项初步研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-23 DOI: 10.1097/MAT.0000000000002796

Niklas Behnel, Wiebke Heilmann, Vladimir Skrypnikov, Björn Weiss, Laurenz Seesko, Philipp A Pickerodt, Martin Russ

{"title":"The Role of Recirculation-Guided Blood Flow Adjustment in Venovenous Extracorporeal Membrane Oxygenation: A Pilot Study.","authors":"Niklas Behnel, Wiebke Heilmann, Vladimir Skrypnikov, Björn Weiss, Laurenz Seesko, Philipp A Pickerodt, Martin Russ","doi":"10.1097/MAT.0000000000002796","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002796","url":null,"abstract":"Recirculation reduces the efficiency of venovenous extracorporeal membrane oxygenation (V-V ECMO), but patient-specific determinants of recirculation and the feasibility of recirculation-guided flow adjustment are not well defined. In this prospective, single-center pilot study, 21 patients with severe acute respiratory distress syndrome (ARDS) on high-flow V-V ECMO underwent recirculation assessment by ultrasound dilution measurements. Clinically relevant recirculation was defined as ≥10%. Right ventricular dysfunction (RVD) was adjudicated by echocardiography. In patients with relevant recirculation, ECMO blood flow was reduced stepwise by the estimated recirculating blood volume per unit of time. Recirculation was measurable in 19 patients (90%), with a median of 14% (interquartile range [IQR], 7-25). Twelve patients (57%) had a recirculation ≥10%. Patients with RVD showed a significantly higher recirculation than those without (25% [21-30] vs. 9% [7-15], p = 0.024). Flow reduction was attempted in 12 patients; nine (75%) completed the intervention, while in three (25%), the reduction had to be aborted. Systemic oxygenation was maintained despite flow reduction (arterial oxygen saturation [SaO2] decreased from 99% [97-99] to 98% [95-98], arterial oxygen tension [PaO2] from 104 mm Hg [83-130] to 83 mm Hg [71-91]; p < 0.05). Recirculation was frequent during high-flow V-V ECMO and was amplified in patients with RVD. Recirculation-guided flow reduction was feasible in most patients and maintained adequate oxygenation in this trial.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577051","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

Early Experience of a Fully Magnetically Levitated Temporary Ventricular Assist Device in China: A Multicenter Single-Arm Study. 全磁悬浮临时心室辅助装置在中国的早期应用：一项多中心单臂研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-22 DOI: 10.1097/MAT.0000000000002711

Ping Li, Tingting Wu, I-Wen Wang, Wei Su, Guohua Wang, Shu Chen, Yingbin Xiao, Xiaotong Hou, Ming Gong, Jinsong Huang, Min Wu, Jicheng Xi, Zhao Jian, Xin Chen, Zhibing Qiu, Zhibiao Zhang, Xinmin Zhou, Yuan Zhao, Nianguo Dong

{"title":"Early Experience of a Fully Magnetically Levitated Temporary Ventricular Assist Device in China: A Multicenter Single-Arm Study.","authors":"Ping Li, Tingting Wu, I-Wen Wang, Wei Su, Guohua Wang, Shu Chen, Yingbin Xiao, Xiaotong Hou, Ming Gong, Jinsong Huang, Min Wu, Jicheng Xi, Zhao Jian, Xin Chen, Zhibing Qiu, Zhibiao Zhang, Xinmin Zhou, Yuan Zhao, Nianguo Dong","doi":"10.1097/MAT.0000000000002711","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002711","url":null,"abstract":"Mechanical circulatory support (MCS) is an important option for patients unresponsive to medical therapy. This prospective, multicenter, single-arm study assessed the safety and efficacy of the newly developed MoyoAssist extracorporeal ventricular assist device (magAssist, Suzhou, China) in Chinese patients with cardiogenic shock (CS). Forty patients from seven national centers received temporary left, right, or biventricular support for acute heart failure and CS. Major indications were postcardiotomy cardiogenic shock (PCCS, 50%) and bridge-to-transplant (BTT, 32.5%). Cannulation was performed via sternotomy (22.5%), peripheral access (52.5%), or mini-thoracotomy (25%). MoyoAssist provided effective short-term circulatory support with no severe device-related adverse events or malfunctions. Complication profiles did not differ by cannulation approach. The mean support duration was 8.2 days, with an overall 30 day success rate of 62.5%. Hemodynamic improvements included increased mean arterial pressure, decreased central venous pressure, reduced lactate in the PCCS-success subgroup, and reduced aspartate aminotransferase in the BTT-success subgroup. Success rates exceeded the target in both PCCS (75%) and BTT (70%) groups. MoyoAssist demonstrated reliable short-term support and favorable outcomes in patients with CS, especially in PCCS and BTT populations, highlighting its clinical value as a temporary MCS option.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560740","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

Myocardial Stress During Donor Withdrawal Is Associated With Graft Dysfunction After Circulatory Death Heart Transplant. 供体停供期间心肌应激与循环死亡心脏移植后移植物功能障碍相关

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-17 DOI: 10.1097/MAT.0000000000002786

Awab Ahmad, Chen Chia Wang, Mark Petrovic, Aaron M Williams, John Trahanas, Swaroop Bommareddi, Kevin McGann, Hasan Siddiqi, Aniket S Rali, Sandip Zalawadiya, Matthew Bacchetta, JoAnn Lindenfeld, Kelly Schlendorf, Ashish S Shah, Brian Lima

{"title":"Myocardial Stress During Donor Withdrawal Is Associated With Graft Dysfunction After Circulatory Death Heart Transplant.","authors":"Awab Ahmad, Chen Chia Wang, Mark Petrovic, Aaron M Williams, John Trahanas, Swaroop Bommareddi, Kevin McGann, Hasan Siddiqi, Aniket S Rali, Sandip Zalawadiya, Matthew Bacchetta, JoAnn Lindenfeld, Kelly Schlendorf, Ashish S Shah, Brian Lima","doi":"10.1097/MAT.0000000000002786","DOIUrl":"10.1097/MAT.0000000000002786","url":null,"abstract":"We developed a physiologically grounded metric-the Delta Myocardial Stress Index (ΔMSI)-to estimate myocardial oxygen supply-demand imbalance during the donor agonal phase and evaluated its association with posttransplant graft dysfunction. We performed a retrospective single-center study of adult donation after circulatory death (DCD) heart transplants (February 2020-June 2025). High-resolution hemodynamic data from withdrawal to declaration of death (WTD) were analyzed. Delta Myocardial Stress Index, integrating myocardial oxygen supply-demand balance, was derived from available hemodynamic data. Associations between ΔMSI and severe primary graft dysfunction (PGD) were assessed. Among 191 cases (16 severe PGD events), ΔMSI trajectories were significantly elevated in donors who developed severe PGD ( p < 0.001). Two distinct ΔMSI trajectory phenotypes were identified; high ΔMSI was independently associated with severe PGD (odds ratio [OR]: 2.49, p = 0.02) and 90 day mortality (OR: 4.58, p = 0.03). The association between WTD and PGD operated primarily through cumulative ΔMSI burden ( p = 0.02), whereas WTD alone was not associated with PGD after accounting for ΔMSI ( p = 0.25). Delta Myocardial Stress Index provides a noninvasive quantification of myocardial stress during DCD withdrawal. Myocardial stress, rather than agonal duration alone, was associated with severe PGD. These findings support a shift from time-based thresholds toward physiologic assessment of donor myocardial resilience.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468647","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

Dialysis-Requiring Renal Failure at the Time of HeartMate 3 Left Ventricular Assist Device Implantation. 心脏伴侣3型左心室辅助装置植入时需要透析的肾功能衰竭。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-16 DOI: 10.1097/MAT.0000000000002793

Jonathan Eisenberger, Eyal Nachum, Shmuel Somer, Sarit Malayev, Alexander Kogan, Leonid Sternik, Jeffrey A Morgan

{"title":"Dialysis-Requiring Renal Failure at the Time of HeartMate 3 Left Ventricular Assist Device Implantation.","authors":"Jonathan Eisenberger, Eyal Nachum, Shmuel Somer, Sarit Malayev, Alexander Kogan, Leonid Sternik, Jeffrey A Morgan","doi":"10.1097/MAT.0000000000002793","DOIUrl":"10.1097/MAT.0000000000002793","url":null,"abstract":"Dialysis-requiring renal failure at left ventricular assist device (LVAD) implantation represents a critical clinical phenotype. We retrospectively analyzed 235 adults undergoing HeartMate 3 implantation at a single tertiary center (2016-2025), comparing 27 dialysis-dependent patients with 208 non-dialysis recipients. Dialysis patients exhibited markedly higher preoperative acuity, including more frequent pre-implant extracorporeal membrane oxygenation (ECMO) support (59.3% vs. 20.2%; p < 0.001) and lower Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) scores (median 1.0 vs. 3.0; p < 0.001). Postoperatively, dialysis patients had significantly higher tracheostomy rates (51.9% vs. 18.8%; p < 0.001), prolonged mechanical ventilation (386 vs. 21 hours; p < 0.001), and longer intensive care unit (ICU) stays (455 vs. 118 hours; p < 0.001). Hospital mortality was significantly higher in the dialysis group (33.3% vs. 12.5%; p = 0.009). One-year survival was 55.6% vs. 79.8% ( p = 0.013), and 2 year survival was 55.6% vs. 75.5% ( p = 0.037). On multivariable analysis, age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.02-1.09; p < 0.001) and INTERMACS score were independent mortality predictors, whereas dialysis status was not independently associated after adjustment. Pre-implant ECMO was the strongest tracheostomy predictor (OR: 3.65; 95% CI: 1.65-8.28; p = 0.001). Dialysis-requiring renal failure at HM3 implantation identifies a high-risk population with significantly worse outcomes, driven primarily by preoperative hemodynamic severity rather than renal failure itself.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468712","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

The Hemodynamic Performance of Two Mechanical Cardiopulmonary Resuscitation Devices. 两种机械心肺复苏装置的血流动力学性能。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-14 DOI: 10.1097/MAT.0000000000002770

Uzma Sajjad, Rupert Simpson, Guilherme Movio, Christopher Cook, Grigoris Karamasis, Paul Rees, Maria Maccaroni, Gerald Clesham, Nilesh Pareek, Rohan Jagathesan, John R Davies, Thomas R Keeble

{"title":"The Hemodynamic Performance of Two Mechanical Cardiopulmonary Resuscitation Devices.","authors":"Uzma Sajjad, Rupert Simpson, Guilherme Movio, Christopher Cook, Grigoris Karamasis, Paul Rees, Maria Maccaroni, Gerald Clesham, Nilesh Pareek, Rohan Jagathesan, John R Davies, Thomas R Keeble","doi":"10.1097/MAT.0000000000002770","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002770","url":null,"abstract":"Mechanical cardiopulmonary resuscitation (mCPR) devices are increasingly used during percutaneous coronary intervention (PCI) in intracardiac arrest patients. However, the optimal invasive hemodynamic parameter to guide mCPR remains unclear. This study compared the hemodynamic performance of two devices, LUCAS and Corpuls, using invasive blood pressure (IBP) measurements during early mCPR. This retrospective, single-center study included adult patients undergoing catheterization laboratory procedures (2021-2024). Invasive blood pressure readings were recorded every 10 seconds during initial manual CPR and the first 5 minutes of mCPR. Hemodynamic parameters and return of spontaneous circulation (ROSC) outcomes were analyzed. Twenty-five cases were analyzed (15 LUCAS, 10 Corpuls; mean age 79.1 ± 14 years; 56% male). Both devices generated higher IBP compared with manual CPR. Corpuls produced greater increases from the manual CPR baseline in ΔDBP (delta diastolic blood pressure) and ΔMAP (delta mean arterial blood pressure), whereas ΔSBP (delta systolic blood pressure) did not differ significantly. Variability metrics were comparable, and ROSC rates were similar. Both devices provided effective hemodynamic support during cardiac arrest in the catheterization laboratory. Although Corpuls produced greater increases in diastolic and MAP from baseline, no clear device superiority was demonstrated. Larger prospective studies are required to define optimal hemodynamic targets during mechanical CPR.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444216","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

Clinical Outcomes and Complications in Pediatric Ventricular Assist Devices Implanted as Bridge to Candidacy. 儿童心室辅助装置作为候选桥梁的临床结果和并发症。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-14 DOI: 10.1097/MAT.0000000000002787

Alireza Raissadati, Christopher Knoll, Donald Mattia, Bethany Wisotzkey, Lydia K Wright, Muhammad Shezad, Seth A Hollander

{"title":"Clinical Outcomes and Complications in Pediatric Ventricular Assist Devices Implanted as Bridge to Candidacy.","authors":"Alireza Raissadati, Christopher Knoll, Donald Mattia, Bethany Wisotzkey, Lydia K Wright, Muhammad Shezad, Seth A Hollander","doi":"10.1097/MAT.0000000000002787","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002787","url":null,"abstract":"Although the bridge-to-transplant (BTT) is the most common ventricular assist device (VAD) strategy, rapidly declining patients receive VADs as a \"bridge to candidacy\" (BTC) as their transplant candidacy is assessed. However, a lack of outcomes data for this group hinders informed decision-making and counseling. We compared outcomes between BTT and BTC cohorts in a retrospective analysis of the Advanced Cardiac Therapies Improving Outcomes Network registry of VADs implanted between January 2012 and August 2023. Of the patients studied, 383 (28.7%) underwent a BTC implant at a median age of 10.3 years and a median weight of 33.2 kg. The most common indications were dilated cardiomyopathy/myocarditis (51.6%) and congenital heart disease (38.0%). Nearly one-third (29.3%) were on ECMO at the time of implant. Major bleeding, renal dysfunction, and respiratory failure were significantly more common among BTC patients (p = 0.001-0.03). Bridge to candidacy candidates died more frequently on the device (21.9% vs. 9.7%, p < 0.001) and underwent successful transplantation less often (75% BTT vs. 50.4% BTC, p < 0.001). In conclusion, BTC VAD patients have higher rates of major adverse events and death. These data will assist in counseling and clinical decision-making for these patients.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444203","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

Incidence and Outcomes of Late Right Heart Failure Following Left Ventricular Assist Device Implantation. 左心室辅助装置植入后晚期右心衰的发生率和结局。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-09 DOI: 10.1097/MAT.0000000000002788

Yantong Wang, Tony Vu, James Farag, Michael Z L Zhu, Janelle McLean, Julia Rix, Andrew J Taylor, Silvana F Marasco

{"title":"Incidence and Outcomes of Late Right Heart Failure Following Left Ventricular Assist Device Implantation.","authors":"Yantong Wang, Tony Vu, James Farag, Michael Z L Zhu, Janelle McLean, Julia Rix, Andrew J Taylor, Silvana F Marasco","doi":"10.1097/MAT.0000000000002788","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002788","url":null,"abstract":"Late right heart failure (LRHF) following left ventricular assist device (LVAD) implantation remains an under-recognized complication with significant impact on patient outcomes. We conducted a retrospective cohort study of 183 consecutive LVAD patients at our institution between 2010 and 2024. LRHF was defined according to the 2020 Mechanical Circulatory Support Academic Research Consortium criteria. Clinical, echocardiographic, and perioperative parameters were analyzed with group comparisons and logistic regression, whereas outcomes were evaluated using Kaplan-Meier and competing-risk analyses. LRHF occurred in 17% of patients at a median of 8.8 months following LVAD implantation. Patients with LRHF had larger preoperative right ventricular (RV) basal diameters. Early right heart failure (ERHF) and RV basal diameter were independently associated with LRHF development. LRHF patients had significantly longer intensive care unit and hospital stays, higher rates of chest re-exploration, acute kidney injury, ventricular arrhythmias, and significantly more heart failure-related readmissions. Although overall survival was lower among LRHF patients, it did not reach statistical significance (p = 0.06). In conclusion, LRHF remains a frequent and morbid complication after LVAD implantation. Early recognition of RV dysfunction may help identify patients at risk of developing LRHF.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418354","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

Side Port Resistance Limits Distal Perfusion Flow. 侧端口阻力限制远端灌注流。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-08 DOI: 10.1097/MAT.0000000000002789

Takeshi Matsumoto, Shin Yajima, Daisuke Yoshioka, Takuji Kawamura, Yusuke Misumi, Shunsuke Saito, Shigeru Miyagawa

{"title":"Side Port Resistance Limits Distal Perfusion Flow.","authors":"Takeshi Matsumoto, Shin Yajima, Daisuke Yoshioka, Takuji Kawamura, Yusuke Misumi, Shunsuke Saito, Shigeru Miyagawa","doi":"10.1097/MAT.0000000000002789","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002789","url":null,"abstract":"Peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) and minimally invasive cardiac surgery often require femoral arterial cannulation, wherein lower limb ischemia remains a major complication. Although introducer sheaths with side ports are widely used to provide antegrade limb perfusion, their pressure-flow conducted using an extracorporeal membrane oxygenation circuit to compare the flow performance and pressure loss of two introducer sheaths with side ports and a catheter without a side port. Flow was measured at inlet pressures of 50-300 mm Hg, and pressure loss across the side port region was directly evaluated. In sheaths with side ports, increasing perfusion pressure produced progressively attenuated flow augmentation and an early plateau, whereas the catheter without a side port showed a linear pressure-flow relationship without saturation. In the 5Fr sheath, approximately 70% of the total pressure loss originated from the side port region, regardless of the perfusion pressure. The measured flow strongly correlated with flow meter values (r = 0.9997). These results indicate that the side port structure is the dominant resistance element and may explain why distal perfusion catheters fail to resolve limb ischemia. Catheters without side ports may help when conventional devices provide insufficient antegrade perfusion.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403428","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

The HELP Score in Non-Asphyxial Hypothermic Cardiac Arrest Treated With Extracorporeal Life Support: External Validation and Clinical Utility. 体外生命支持治疗非窒息性低温心脏骤停的HELP评分：外部验证和临床应用。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-07 DOI: 10.1097/MAT.0000000000002774

Konrad Mendrala, Tomasz Darocha, Shuhei Takauji, Tomáš Brožek, Megan Rischall, Tal Soumagnac, Paweł Podsiadło

{"title":"The HELP Score in Non-Asphyxial Hypothermic Cardiac Arrest Treated With Extracorporeal Life Support: External Validation and Clinical Utility.","authors":"Konrad Mendrala, Tomasz Darocha, Shuhei Takauji, Tomáš Brožek, Megan Rischall, Tal Soumagnac, Paweł Podsiadło","doi":"10.1097/MAT.0000000000002774","DOIUrl":"10.1097/MAT.0000000000002774","url":null,"abstract":"Hypothermic cardiac arrest can result in a good outcome when patients are rewarmed using extracorporeal life support (ECLS), but patient selection for this treatment is challenging. The HELP score (Hemoglobin, Exposure, Lactate, Potassium) is a novel prognostic tool for estimating the survival chances of patients with non-asphyxial hypothermic cardiac arrest rewarmed with ECLS. In this retrospective multicenter study, we performed external validation of the HELP score and evaluated its clinical utility. We calculated predicted survival based on the original HELP equation and assessed overall performance, discrimination, calibration, and decision curve analysis. The study population included 106 patients from eight countries. The survival rate to hospital discharge was 65% (69/106); a favorable neurological outcome was found in 88% of survivors. The HELP score showed excellent discrimination (area under the receiver operating characteristic curve 0.80) and good overall performance (Brier 0.17). Calibration analysis showed a mild underestimation of survival (slope 0.92; intercept 0.64). Decision curve analysis showed a positive net benefit compared with a \"treat all\" strategy across a wide range of thresholds. The HELP score revealed excellent discrimination, good overall performance, and clinically meaningful positive net benefit in the external validation cohort. This model can be a useful aid in decisions on ECLS application in adult patients with non-asphyxia-related hypothermic cardiac arrest, but it should not replace a team-based, multidisciplinary approach.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387251","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

Incidence and Mortality Outcomes of Extracorporeal Membrane Oxygenation in Infants With Congenital Lung Malformations: A Registry Study. 先天性肺畸形婴儿体外膜氧合的发病率和死亡率：一项登记研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-07-07 DOI: 10.1097/MAT.0000000000002790

Andreina Giron, Zhuo Chen, Peter T Yu, Yigit S Guner

{"title":"Incidence and Mortality Outcomes of Extracorporeal Membrane Oxygenation in Infants With Congenital Lung Malformations: A Registry Study.","authors":"Andreina Giron, Zhuo Chen, Peter T Yu, Yigit S Guner","doi":"10.1097/MAT.0000000000002790","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002790","url":null,"abstract":"Congenital lung malformations (CLMs) are rare developmental anomalies that can cause severe respiratory failure in early infancy, occasionally necessitating extracorporeal membrane oxygenation (ECMO). This study aimed to determine the incidence of ECMO use and identify predictors of survival among infants with isolated CLMs who required ECMO support. We conducted a retrospective cohort study using the Extracorporeal Life Support Organization (ELSO) registry from 2000 to 2024. The primary outcome was survival to hospital discharge. Bivariate and multivariable logistic regression analyses were performed. Among 451 infants, overall survival was 47%. The majority were neonates (< 28 days, 88%). Survival varied by CLM subtype: congenital pulmonary airway malformation (CPAM, 67%), followed by congenital lobar emphysema (CLE, 50%) and other CLMs (42%) (p < 0.001). Higher weight at ECMO initiation was associated with survival (odds ratio [OR]: 1.39, 95% CI: 1.10-1.78), and so was use of postnatal corticosteroids (OR: 1.99, 95% confidence interval [CI]: 1.15-3.49). Extracorporeal cardiopulmonary resuscitation (ECPR), hemorrhagic complications, and neurologic complications were independently associated with higher mortality. Survival among infants with CLMs requiring ECMO varies by diagnosis subtype, weight, and clinical complications. These findings offer important insights into risk stratification and may inform clinical decision-making.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387124","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