ASAIO Journal最新文献_第10页

Meet the Authors. 见见作者。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-12-24 DOI: 10.1097/01.mat.0001096940.82911.0b

引用次数: 0

Signs of Hemolysis Predict Mortality and Ventilator Associated Pneumonia in Severe Acute Respiratory Distress Syndrome Patients Undergoing Veno-Venous Extracorporeal Membrane Oxygenation. 溶血征兆可预测接受静脉体外膜氧合治疗的严重急性呼吸窘迫综合征患者的死亡率和呼吸机相关性肺炎

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-07-30 DOI: 10.1097/MAT.0000000000002278

Emanuele Rezoagli, Michela Bombino, Lorraine B Ware, Eleonora Carlesso, Roberto Rona, Giacomo Grasselli, Antonio Pesenti, Giacomo Bellani, Giuseppe Foti

{"title":"Signs of Hemolysis Predict Mortality and Ventilator Associated Pneumonia in Severe Acute Respiratory Distress Syndrome Patients Undergoing Veno-Venous Extracorporeal Membrane Oxygenation.","authors":"Emanuele Rezoagli, Michela Bombino, Lorraine B Ware, Eleonora Carlesso, Roberto Rona, Giacomo Grasselli, Antonio Pesenti, Giacomo Bellani, Giuseppe Foti","doi":"10.1097/MAT.0000000000002278","DOIUrl":"10.1097/MAT.0000000000002278","url":null,"abstract":"Cell-free hemoglobin (CFH) is used to detect hemolysis and was recently suggested to trigger acute lung injury. However, its role has not been elucidated in severe acute respiratory distress syndrome (ARDS) patients undergoing extracorporeal membrane oxygenation (ECMO). We investigated the association of carboxyhemoglobin (COHb) and haptoglobin-two indirect markers of hemolysis-with mortality in critically ill patients undergoing veno-venous ECMO (VV-ECMO) with adjusted and longitudinal models (primary aim). Secondary aims included assessment of association between COHb and haptoglobin with the development of ventilator-associated pneumonia (VAP) and with hemodynamics. We retrospectively collected physiological, laboratory biomarkers, and outcome data in 147 patients undergoing VV-ECMO for severe ARDS. Forty-seven patients (32%) died in the intensive care unit (ICU). Average levels of COHb and haptoglobin were higher and lower, respectively, in patients who died. Higher haptoglobin was associated with lower pulmonary (PVR) and systemic vascular resistance, whereas higher COHb was associated with higher PVR. Carboxyhemoglobin was an independent predictor of VAP. Both haptoglobin and COHb independently predicted ICU mortality. In summary, indirect signs of hemolysis including COHb and haptoglobin are associated with modulation of vascular tone, VAP, and ICU mortality in respiratory ECMO. These findings suggest that CFH may be a mechanism of injury in this patient population.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"82-91"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791798","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

Anticoagulation in Extracorporeal Membrane Oxygenation for Trauma: Striking a Balance. 创伤体外膜氧合抗凝：寻求平衡。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-12-06 DOI: 10.1097/MAT.0000000000002362

Richard Greendyk, Phillip E Mason, Cara Agerstrand

引用次数: 0

Impact of Left Ventricular Size on Outcomes Following HeartMate 3 Left Ventricular Assist Device Implantation: Analysis of the European Registry for Patients With Mechanical Circulatory Support (EUROMACS). 心脏伴侣3型左心室辅助装置植入后左心室大小对结果的影响：欧洲机械循环支持（EUROMACS）患者登记的分析

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-31 DOI: 10.1097/MAT.0000000000002370

Gaik Nersesian, Abhishek Jaiswal, Julia Stein, Ashwin Pillai, Theo M M H de By, Evgenij Potapov, David A Baran

{"title":"Impact of Left Ventricular Size on Outcomes Following HeartMate 3 Left Ventricular Assist Device Implantation: Analysis of the European Registry for Patients With Mechanical Circulatory Support (EUROMACS).","authors":"Gaik Nersesian, Abhishek Jaiswal, Julia Stein, Ashwin Pillai, Theo M M H de By, Evgenij Potapov, David A Baran","doi":"10.1097/MAT.0000000000002370","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002370","url":null,"abstract":"We investigated the association of preimplant left ventricular end-diastolic diameter (LVEDD) with outcomes after HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation. Patients from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry who underwent HM3 implantation from August 2014 to February 2023 (n = 834) were analyzed according to preoperative LVEDD: less than or equal to 65 (n = 251), 65-80 (n = 441), and greater than or equal to 80 mm (n = 142). The mean age was 54.4 ± 12.4 years, body surface area (BSA) 2.0 ± 0.23 m2, body mass index (BMI) 27.3 ± 5.0 kg/m2; 87.9% were male and 40% had ischemic cardiomyopathy. Patients with LVEDD less than or equal to 65 mm were older (56.1 ± 11.0 vs. 53.8 ± 13.0 vs. 53.0 ± 12.3 years; p = 0.015), more female (17.9% vs. 11.6% vs. 4.9%; p < 0.001), smaller BSA (1.95 ± 2.03 vs. 2.01 ± 0.22 vs. 2.08 ± 0.22 m2; p < 0.01) and lower BMI (26.6 ± 4.8 vs. 27.4 ± 5.1 vs. 28.2 ± 5.0; p = 0.01) compared to LVEDD 65-80 and greater than or equal to 80 mm, respectively. One year survival was associated with increasing LVEDD (75.7% vs. 84.6% vs. 89.5%; p = 0.003). Patients with LVEDD less than or equal to 65 mm had a higher risk of postoperative right heart failure (14.7% vs.10.4% vs. 6.8%; p = 0.03), the risk for postoperative stroke was similar (10% vs. 12.8% vs. 9.5%; p = 0.4). A small left ventricular (LV) size (LVEDD ≤ 65 mm) was associated with an increase in postoperative right heart failure and unadjusted 1 year mortality in adults who underwent HM3 LVAD implantation.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943694","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

Over 100 Fontan Patients on Systemic Ventricular Assist Device Support: An ACTION Update. 超过100名Fontan患者接受系统心室辅助装置支持：ACTION更新。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-27 DOI: 10.1097/MAT.0000000000002367

Sharon Chen, Kathleen E Simpson

{"title":"Over 100 Fontan Patients on Systemic Ventricular Assist Device Support: An ACTION Update.","authors":"Sharon Chen, Kathleen E Simpson","doi":"10.1097/MAT.0000000000002367","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002367","url":null,"abstract":"As the Fontan population grows, understanding successful strategies for ventricular assist device (VAD) support of the failing Fontan circulation is needed. We performed a retrospective analysis of patients with Fontan circulation and systemic VAD support in the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry. Competing outcomes and Kaplan-Meier estimated survival methods were used. Between January 2012 and December 2022, 106 Fontan patients underwent VAD implant (median age 10 years, 20% age ≥18 years). At time of implant, 58% were on greater than or equal to 2 inotropes, 26% on extracorporeal membrane oxygenation (ECMO), and 41% intubated. Since 2018, there have been more patients implanted at INTERMACS profile 1 or 2 (88% vs. 71%, p = 0.02) and on inotropic support (95% vs. 76%, p = 0.01). Median duration of VAD support was 113 (interquartile range (IQR): 43-266) days. At 12 months post-VAD implant, 53% were transplanted, 27% were alive on device, 2% had successful recovery, and 18% had died. Overall, 75% experienced greater than or equal to 1 adverse event, with bleeding, infection, and neurologic dysfunction most common. Despite high acuity at the time of VAD implant and high rate of adverse events, the majority of Fontan patients were transplanted or still alive on device at 12 months post-VAD implant.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891790","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

Subnormothermic Machine Perfusion of Neonatal and Small-Sized Pediatric Donor Hearts. 新生儿和小型儿童供心的低温机器灌注。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-19 DOI: 10.1097/MAT.0000000000002366

Mitchell J Wagner, Guilherme Mainardi Aguiar da Silva, Sanaz Hatami, Mubashir Khan, Lily Lin, Xiuhua Wang, Tara Pidborochynski, Benjamin Adam, Jayan Nagendran, Jennifer Conway, Darren H Freed

{"title":"Subnormothermic Machine Perfusion of Neonatal and Small-Sized Pediatric Donor Hearts.","authors":"Mitchell J Wagner, Guilherme Mainardi Aguiar da Silva, Sanaz Hatami, Mubashir Khan, Lily Lin, Xiuhua Wang, Tara Pidborochynski, Benjamin Adam, Jayan Nagendran, Jennifer Conway, Darren H Freed","doi":"10.1097/MAT.0000000000002366","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002366","url":null,"abstract":"Donor heart machine perfusion enables avoidance of prolonged cold ischemia, however the optimal temperature is yet to be elucidated. Given that maintenance of temperature beyond ambient levels demands significant energy, we sought to determine the suitability of room-temperature perfusion preservation of neonatal/pediatric-sized (5-20 kg) piglet donor hearts. A custom device was fabricated suitable for this purpose, with continuous readout of perfusion pressure, flow rate, temperature, and oxygen saturation. Oxygen delivery was automated to keep saturation above 90%. The perfusate consisted of a 1:1 mix of donor whole blood and modified Krebs-Henseleit solution with albumin. Donor hearts were procured from 5 kg (n = 5), 10 kg (n = 3), and 20 kg (n = 5) piglets, and perfused for 10 hours. Subsequently, 20 kg piglet hearts were transplanted. Hemodynamic stability and echocardiographic measurement of donor heart function were evaluated posttransplant. Perfusate parameters were stable through the perfusion interval. Temperature was consistently 23.8 ± 1.6°C. pH (7.35 ± 0.09) and pO2 (102 ± 29 mm Hg) were steady throughout. Glucose (5.9 ± 1.8 mmol/L) and lactate (2.4 ± 1.5 mmol/L) were metabolized by the heart over the course of perfusion. Transplanted hearts displayed durable hemodynamics and good biventricular function. We conclude that neonatal and pediatric hearts can be safely perfused for extended periods at subnormothermic conditions using blood-based perfusate.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862943","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

Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation. 手术植入微轴流泵对静脉动脉膜氧合患者左心室负荷的影响。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-18 DOI: 10.1097/MAT.0000000000002364

Pia Lanmüller, Nils Hinrichs, Gaik Nersesian, Daniel Lewin, Ben O'Brien, Volkmar Falk, Evgenij Potapov, Christoph Starck, Sascha Ott

{"title":"Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation.","authors":"Pia Lanmüller, Nils Hinrichs, Gaik Nersesian, Daniel Lewin, Ben O'Brien, Volkmar Falk, Evgenij Potapov, Christoph Starck, Sascha Ott","doi":"10.1097/MAT.0000000000002364","DOIUrl":"10.1097/MAT.0000000000002364","url":null,"abstract":"Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is applied for the treatment of cardiogenic shock. Concomitant left ventricular unloading (LVU) with a microaxial flow pump (mAFP) enables myocardial and pulmonary recovery and may overcome some of the limitations of VA-ECMO. The study included 145 cardiogenic shock patients, 89 (61.4%) of whom were treated with VA-ECMO alone (ECMO group), whereas 56 (38.6%) received LVU with a surgically implanted mAFP on top of VA-ECMO (ECMELLA group). After 2:1 propensity score matching, 30 day and 1 year survival was similar between the groups ( p = 0.62 and 0.68, respectively). In the subgroup analysis, patients who received mAFP in the first 2 hours after VA-ECMO implantation had an improved 30 day (hazard ratio [HR]: 0.45 [95% confidence interval {CI}: 0.23-0.88], p = 0.02) and 1 year survival (HR: 0.52 [95% CI: 0.28-0.97], p = 0.04). The rate of limb ischemia, hemorrhage, and renal replacement therapy were comparable between the propensity score-matched cohorts. Early LVU with a surgically implanted mAFP in patients on VA-ECMO improved short-and long-term survival.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845744","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

Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model. 新型动态器官储存系统增强猪循环死亡模型捐献肝移植功能。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-18 DOI: 10.1097/MAT.0000000000002365

Yutaka Shishido, Kaitlyn M Tracy, Mark Petrovic, TiOluwanimi Adesanya, Avery K Fortier, Kimya Raietparvar, Gabriella A Glomp, Elizabeth Simonds, Timothy R Harris, Victoria Simon, William D Tucker, Brandon Petree, Michael Cortelli, Nancy L Cardwell, Christian Crannell, Jiancong Liang, Alexandria C Murphy, Blanche L Fields, Melanie McReynolds, Caitlin T Demarest, Rei Ukita, Michael Rizzari, Martin Montenovo, Joseph F Magliocca, Seth J Karp, M Ameen Rauf, Ashish S Shah, Matthew Bacchetta

{"title":"Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model.","authors":"Yutaka Shishido, Kaitlyn M Tracy, Mark Petrovic, TiOluwanimi Adesanya, Avery K Fortier, Kimya Raietparvar, Gabriella A Glomp, Elizabeth Simonds, Timothy R Harris, Victoria Simon, William D Tucker, Brandon Petree, Michael Cortelli, Nancy L Cardwell, Christian Crannell, Jiancong Liang, Alexandria C Murphy, Blanche L Fields, Melanie McReynolds, Caitlin T Demarest, Rei Ukita, Michael Rizzari, Martin Montenovo, Joseph F Magliocca, Seth J Karp, M Ameen Rauf, Ashish S Shah, Matthew Bacchetta","doi":"10.1097/MAT.0000000000002365","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002365","url":null,"abstract":"Donation after circulatory death (DCD) livers face increased risks of critical complications when preserved with static cold storage (SCS). Although machine perfusion (MP) may mitigate these risks, its cost and logistical complexity limit widespread application. We developed the Dynamic Organ Storage System (DOSS), which delivers oxygenated perfusate at 10°C with minimal electrical power requirement and allows real-time effluent sampling in a portable cooler. In a porcine DCD model, livers were preserved using DOSS or SCS for 10 hours and evaluated with 4 hours of normothermic MP, with n = 5 per group. After 4 hours of normothermic MP, the DOSS group demonstrated significantly lower perfusate lactate (p = 0.023), increased perfusate fibrinogen (p = 0.005), higher oxygen consumption (p = 0.018), greater bile production (p = 0.013), higher bile bicarbonate levels (p = 0.035) and bile/perfusate sodium ratio (p = 0.002), and lower hepatic arterial resistance after phenylephrine administration (p = 0.018). Histological analysis showed lower apoptotic markers in DOSS-preserved livers, with fewer cleaved caspase-3 (p = 0.039) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL; p = 0.009) positive cells. These findings suggest that DOSS can enhance DCD allograft function during transport, offering potential clinical benefits and contributing to the expansion of the donor pool.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852350","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 Practice With Preprimed Extracorporeal Membrane Oxygenation: Safety, Sterility, and Functionality. 体外膜充氧的临床实践：安全性、无菌性和功能性。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-17 DOI: 10.1097/MAT.0000000000002361

Mauro Renghini, Debora Maddinelli, Anna Papeo, Carmine Puglia, Andrea Montisci, Sergio Cattaneo, Stefano Benussi

{"title":"Clinical Practice With Preprimed Extracorporeal Membrane Oxygenation: Safety, Sterility, and Functionality.","authors":"Mauro Renghini, Debora Maddinelli, Anna Papeo, Carmine Puglia, Andrea Montisci, Sergio Cattaneo, Stefano Benussi","doi":"10.1097/MAT.0000000000002361","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002361","url":null,"abstract":"This 5 year retrospective study presents the clinical experience with preprimed extracorporeal membrane oxygenation (ECMO) circuits used in a Single Hub Center Hospital, focusing on sterility, functionality, and safety. The ECMO program has been active since 2019, with a total of 223 circuits managed. Our preassembled and preprimed ECMO circuits were stored in a sterile environment and continuously circulated until implantation. Sterility and functionality testing was performed at the end of circuit preparation, every 7 days, and before implantation. Our results show that only 2 (0.3%) of the 570 samples tested positive for bacteria, and all implanted devices demonstrated satisfactory gas transfer performance. None of the ECMO devices demonstrated any loss of early functionality after implantation. The longest storage period of a preprimed circuit was 73 days, with no positive culture results. Our study highlights the importance of preassembled and preprimed ECMO circuits in improving clinical practice in emergency situations, highlighting their safety and potential to improve clinical practice. Furthermore, our findings suggest that standardizing guidelines for prepriming and storage of ECMO circuits can help minimize the risk of contamination.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827233","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

Closed-Loop Automated Control System of Extracorporeal Membrane Oxygenation and Left Ventricular Assist Device Support in Cardiogenic Shock. 心源性休克中体外膜氧合和左心室辅助装置支持的闭环自动控制系统。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-12-17 DOI: 10.1097/MAT.0000000000002359

Takashi Unoki, Kazunori Uemura, Shohei Yokota, Hiroki Matsushita, Midori Kakuuchi, Hidetaka Morita, Kei Sato, Yuki Yoshida, Kazumasu Sasaki, Yasuyuki Kataoka, Takuya Nishikawa, Masafumi Fukumitsu, Toru Kawada, Kenji Sunagawa, Joe Alexander, Keita Saku

{"title":"Closed-Loop Automated Control System of Extracorporeal Membrane Oxygenation and Left Ventricular Assist Device Support in Cardiogenic Shock.","authors":"Takashi Unoki, Kazunori Uemura, Shohei Yokota, Hiroki Matsushita, Midori Kakuuchi, Hidetaka Morita, Kei Sato, Yuki Yoshida, Kazumasu Sasaki, Yasuyuki Kataoka, Takuya Nishikawa, Masafumi Fukumitsu, Toru Kawada, Kenji Sunagawa, Joe Alexander, Keita Saku","doi":"10.1097/MAT.0000000000002359","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002359","url":null,"abstract":"Venoarterial extracorporeal membrane oxygenation (VA-ECMO) benefits patients with cardiogenic shock (CS) but can increase left ventricular afterload and exacerbate pulmonary edema. Adding a percutaneous left ventricular assist device (LVAD) to VA-ECMO can optimize the hemodynamics. Because managing VA-ECMO and LVAD simultaneously is complex and labor-intensive, we developed a closed-loop automated control system for VA-ECMO and LVAD. Based on the circulatory equilibrium framework, this system automatically adjusts VA-ECMO and LVAD flows and cardiovascular drug and fluid dosages to achieve target arterial pressure (AP, 70 mm Hg), left atrial pressure (PLA, 14 mm Hg), and total systemic flow (Ftotal, 120-140 ml/min/kg). In seven anesthetized dogs with CS, VA-ECMO significantly increased AP and PLA from 24 (23-27) to 71 (63-77) mm Hg and 20.1 (16.3-22.1) to 43.0 (25.7-51.4) mm Hg, respectively. Upon system activation, PLA was promptly reduced. At 60 min postactivation, the system-controlled AP to 69 (65-74) mm Hg, PLA to 12.5 (12.0-13.4) mm Hg, and Ftotal to 117 (114-132) ml/min/kg while adjusting VA-ECMO flow to 59 (12-60) ml/min/kg, LVAD flow to 68 (54-78) ml/min/kg, and cardiovascular drug and fluid dosages. This system automatically optimizes VA-ECMO and LVAD hemodynamics, making it an attractive tool for rescuing patients with CS.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833715","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