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In Response to Broman et al .: Time to Throw Out the Elephant in the Room: Proper Use of SvO 2 in Extracorporeal Life Support. 回应 Broman et al:是时候扔掉房间里的大象了:在体外生命支持中正确使用 SvO2。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-08-08 DOI: 10.1097/MAT.0000000000002291
Kevin J John, Haval Chweich
{"title":"In Response to Broman et al .: Time to Throw Out the Elephant in the Room: Proper Use of SvO 2 in Extracorporeal Life Support.","authors":"Kevin J John, Haval Chweich","doi":"10.1097/MAT.0000000000002291","DOIUrl":"10.1097/MAT.0000000000002291","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e19"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905793","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 Postoperative Changes in Von Willebrand Factor Activity Are Associated With Future Bleeding and Stroke in HeartMate 3 Patients. Von Willebrand因子活性的术后早期变化与HeartMate 3患者未来的出血和中风有关。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-06-19 DOI: 10.1097/MAT.0000000000002250
Parsa Jahangiri, Kevin M Veen, Iris van Moort, Jeroen H Bunge, Alina Constantinescu, Jelena Sjatskig, Moniek de Maat, Jolanda Kluin, Frank Leebeek, Kadir Caliskan
{"title":"Early Postoperative Changes in Von Willebrand Factor Activity Are Associated With Future Bleeding and Stroke in HeartMate 3 Patients.","authors":"Parsa Jahangiri, Kevin M Veen, Iris van Moort, Jeroen H Bunge, Alina Constantinescu, Jelena Sjatskig, Moniek de Maat, Jolanda Kluin, Frank Leebeek, Kadir Caliskan","doi":"10.1097/MAT.0000000000002250","DOIUrl":"10.1097/MAT.0000000000002250","url":null,"abstract":"<p><p>Hemocompatibility-related adverse events (HRAEs), particularly gastrointestinal bleeding, remain a frequent complication after left ventricular assist device (LVAD) implantation. The current study sought to describe and analyze whether early (<60 days) postoperative von Willebrand factor (VWF) activity assays predict the risk of gastrointestinal bleeding and stroke. A prospective single-center study including 74 HeartMate 3 device recipients between 2016 and 2023 was undertaken. The postoperative trajectory of the VWF profile was analyzed using linear mixed-effect models and Cox models were used to quantify associations between an early postoperative dip (≤0.7) in VWF activity assay measurements and late outcomes. Preoperatively, the mean VWF:Activity (Act)/Antigen (Ag) and VWF:Collagen Binding (CB)/Ag ratios were 0.94 (95% confidence interval [CI] = 0.81-1.02) and 0.95 (95% CI = 0.80-1.03), respectively, decreasing to 0.66 (95% CI = 0.57-0.73) and 0.67 (95% CI = 0.58-0.74) within 40 days ( p < 0.05). In patients with VWF:CB/Ag and VWF:Act/Ag ratios ≤0.7 significantly more gastrointestinal bleeding (hazard ratio [HR]: 2.53; 95% CI = 1.1-5.8, and HR: 3.7; 95% CI = 1.5-9.2, respectively) and hemorrhagic stroke events (HR: 3.5; 95% CI = 1.6-7.6 and HR: 4.9; 95% CI = 2.1-11.7, respectively) were observed throughout the entire late (>60 days) postoperative period. In patients with VWF:Act/Ag ratio ≤0.7 less ischemic stroke events were observed (HR: 0.11; 95% CI = 0.01-0.85). In conclusion, VWF:Act/Ag and VWF:CB/Ag ratios ≤0.7 in the early postoperative phase can be used as biomarkers to predict HRAEs during long-term LVAD support.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"27-35"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426245","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
Systematic Review of Ex Vivo and In Vivo Pharmacokinetic Studies of Drugs Commonly Used During Extracorporeal Membrane Oxygenation. 体外膜氧合过程中常用药物的体内和体外药代动力学研究的系统综述。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-10-14 DOI: 10.1097/MAT.0000000000002326
Anita Dabirzadeh, Elizabeth Decary, Cajetan Nkong Fobisong, Samuel D F Wasserman, Davinia Withington
{"title":"Systematic Review of Ex Vivo and In Vivo Pharmacokinetic Studies of Drugs Commonly Used During Extracorporeal Membrane Oxygenation.","authors":"Anita Dabirzadeh, Elizabeth Decary, Cajetan Nkong Fobisong, Samuel D F Wasserman, Davinia Withington","doi":"10.1097/MAT.0000000000002326","DOIUrl":"10.1097/MAT.0000000000002326","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment for critically ill patients in cardiac or respiratory failure refractory to conventional treatment. Patients on an ECMO circuit (pump, oxygenator, tubing) require numerous medications including sedatives, analgesics, cardioactive medications, and anticonvulsants. Currently, there are few dosing guidelines to optimize pharmacotherapy in this situation. A systematic review was conducted to describe pharmacokinetics (PK) of medications commonly used during ECMO. MEDLINE, Embase, Cochrane, BIOSIS, PubMed, and Web of Science databases were searched. All articles presenting ex vivo, animal, and human data on the PK of the subject medications in the ECMO circuit were included. Three authors independently examined citation titles and abstracts. Four authors extracted relevant details from included studies into standardized data extraction forms. Methodological quality was assessed using the ClinPK guidelines and the Joanna Briggs Institute Checklist. Forty-four studies examining 30 medications were included, 26 ex vivo studies (mostly adult circuits) and 18 observational studies (mainly neonatal patients). Pharmacokinetics varied depending on the medication's characteristics, study type, and population. Study quality was variable, limiting the possibility of deriving hard dosing guidelines from this available literature. Further population PK studies are needed to adequately determine dosing guidelines in adults and children requiring ECMO.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":"71 1","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891841","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
Routine Versus Selective Distal Perfusion Catheter Use in Venoarterial Extracorporeal Membrane Oxygenation. 在静脉体外膜氧合中常规使用远端灌注导管与选择性使用远端灌注导管的对比。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-06-28 DOI: 10.1097/MAT.0000000000002264
Kevin G Buda, Emilie C Robinson, Jessica Titus, Peter M Eckman, Ivan Chavez, Ellen Cravero, Larissa Stanberry, Katarzyna Hryniewicz
{"title":"Routine Versus Selective Distal Perfusion Catheter Use in Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Kevin G Buda, Emilie C Robinson, Jessica Titus, Peter M Eckman, Ivan Chavez, Ellen Cravero, Larissa Stanberry, Katarzyna Hryniewicz","doi":"10.1097/MAT.0000000000002264","DOIUrl":"10.1097/MAT.0000000000002264","url":null,"abstract":"<p><p>Although current studies support the use of prophylactic distal perfusion catheters (DPCs) to decrease limb ischemia in patients on venoarterial extracorporeal membrane oxygenation (VA ECMO), methods for monitoring limb ischemia differ between studies. We evaluated the safety of a selective rather than prophylactic DPC strategy at a single center with a well-established protocol for limb ischemia monitoring. Distal perfusion catheters were placed selectively if there was evidence of hypoperfusion at any point until decannulation. All patients were followed daily by vascular surgery with continuous regional saturation monitoring. Of 188 patients supported with VA ECMO, there were no significant differences in baseline characteristics between patients with upfront, delayed, and no DPC. Thirty day mortality was highest in patients with an upfront DPC (56% in the upfront DPC group, 19% in the delayed DPC group, and 22% in the no-DPC group, p < 0.001). The incidence of major bleeding, fasciotomy, and amputation in the entire cohort was 3.7%, 3.7%, and 0%, respectively. With strict adherence to a protocol for limb ischemia monitoring, a selective rather than prophylactic DPC strategy is safe and may obviate the risks of an additional arterial catheter.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"36-39"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465975","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 Extracellular Matrix Injury on the Calcification of Artificial Bovine Pericardial Leaflets: An Experimental Study. 细胞外基质损伤对人工牛心包叶钙化的影响:一项实验研究
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-07-24 DOI: 10.1097/MAT.0000000000002274
Honghuan Yu, Xinfeng Yang, Long Wang, Kai Xing, Tao Zhang, Xiaochun Ma, Xiaolin Liu, Zhengjun Wang
{"title":"Impact of Extracellular Matrix Injury on the Calcification of Artificial Bovine Pericardial Leaflets: An Experimental Study.","authors":"Honghuan Yu, Xinfeng Yang, Long Wang, Kai Xing, Tao Zhang, Xiaochun Ma, Xiaolin Liu, Zhengjun Wang","doi":"10.1097/MAT.0000000000002274","DOIUrl":"10.1097/MAT.0000000000002274","url":null,"abstract":"<p><p>To investigate the role of extracellular matrix (ECM) injury in bioprosthetic valve calcification, we constructed an ECM damage model by applying a 15 N stress to the bovine pericardium sample in both transverse and longitudinal directions after tissue cross-linking, whereas no stress was applied in the control group. Then we implanted two pieces of bovine pericardium on both sides of the dorsal midline in Wistar rats from both groups and measured the calcium content of the implanted bovine pericardium. The results showed that the calcium content of experimental group was significantly higher than that of control group ( p < 0.05). Second, we implanted prosthetic valves made from bovine pericardium in the experimental and control groups into small-tailed Han sheep ( Ovis aries ). After 180 days, the prosthetic valve was removed for gross and histopathological observation as well as quantitative analysis of calcium. We found a higher average calcium content in bovine pericardium from the experimental group than that from controls. Furthermore, calcium salt deposition was detected on the ventricular surface of valves along with roughened valve leaflets in the experimental group. Our data support the hypothesis that the bovine pericardium with ECM injury is more prone to calcification.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"61-67"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750949","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 Devil Is in the Details: A Proof of Concept Study for Pulsatile Perfusion During Cardiopulmonary Bypass. 细节决定成败:心肺旁路期间搏动性灌注的概念验证研究。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-06-24 DOI: 10.1097/MAT.0000000000002263
Les James, Michael P Dorsey, Deane E Smith
{"title":"The Devil Is in the Details: A Proof of Concept Study for Pulsatile Perfusion During Cardiopulmonary Bypass.","authors":"Les James, Michael P Dorsey, Deane E Smith","doi":"10.1097/MAT.0000000000002263","DOIUrl":"10.1097/MAT.0000000000002263","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e16"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445311","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
Outcomes After Heartmate 3 Left Ventricular Assist Device Implantation Using a 10 mm Outflow Graft. 使用 10 毫米流出导管植入 Heartmate 3 左心室辅助装置后的效果。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-12-24 DOI: 10.1097/MAT.0000000000002249
Berhane Worku, Alice Vinogradsky, Aminat Ibrahim, Camilla Sofia Rossi, Charles Mack, Ivancarmine Gambardella, Ankur Srivastava, Koji Takeda, Yoshifumi Naka
{"title":"Outcomes After Heartmate 3 Left Ventricular Assist Device Implantation Using a 10 mm Outflow Graft.","authors":"Berhane Worku, Alice Vinogradsky, Aminat Ibrahim, Camilla Sofia Rossi, Charles Mack, Ivancarmine Gambardella, Ankur Srivastava, Koji Takeda, Yoshifumi Naka","doi":"10.1097/MAT.0000000000002249","DOIUrl":"10.1097/MAT.0000000000002249","url":null,"abstract":"<p><p>The presence of adhesions and patent bypass grafts may create challenges for standard 14 mm outflow graft placement during left ventricular assist device implantation. We retrospectively describe our experience using a 10 mm Bioline Fusion graft (Getinge, Goteborg, Sweden) as the outflow graft in patients undergoing primary Heartmate 3 (Abbott, Abbott Park, IL) implantation. One hundred one patients underwent Heartmate 3 left ventricular assist device implantation, 80% via a thoracotomy approach, with the standard 14 mm outflow graft (78) or a 10 mm Bioline Fusion outflow graft (23). Initial postoperative rotor speed-to-flow ratio (the revolutions per minutes (RPMs) required to achieve a given flow) was significantly higher in 10 mm graft patients (1,472 vs. 1,283 RPM/L/min; p = 0.03), suggesting elevated resistance in the smaller graft. Furthermore, the initial postoperative vasoactive-inotrope score was higher in the 10 mm graft patients (24.1 vs. 17.6; p = 0.022). Postoperative outcomes were similar between groups. In conclusion, the use of a 10 mm graft was associated with higher RPMs needed to generate a given flow and a higher vasoactive-inotrope score, but these differences were not associated with increased right ventricular failure or mortality.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"21-26"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320401","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
Enhancing Heart Failure Care: Deep Learning-Based Activity Classification in Left Ventricular Assist Device Patients. 加强心衰护理:基于深度学习的左心室辅助装置患者活动分类。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-09-04 DOI: 10.1097/MAT.0000000000002299
Laurenz Berger, Max Haberbusch, Christoph Gross, Francesco Moscato
{"title":"Enhancing Heart Failure Care: Deep Learning-Based Activity Classification in Left Ventricular Assist Device Patients.","authors":"Laurenz Berger, Max Haberbusch, Christoph Gross, Francesco Moscato","doi":"10.1097/MAT.0000000000002299","DOIUrl":"10.1097/MAT.0000000000002299","url":null,"abstract":"<p><p>Accurate activity classification is essential for the advancement of closed-loop control for left ventricular assist devices (LVADs), as it provides necessary feedback to adapt device operation to the patient's current state. Therefore, this study aims at using deep neural networks (DNNs) to precisely classify activity for these patients. Recordings from 13 LVAD patients were analyzed, including heart rate, LVAD flow, and accelerometer data, classifying activities into six states: active, inactive, lying, sitting, standing, and walking. Both binary and multiclass classifiers have been trained to distinguish between active and inactive states and to discriminate the remaining categories. The models were refined by testing several architectures, including recurrent and convolutional layers, optimized via hyperparameter search. Results demonstrate that integrating LVAD flow, heart rate, and accelerometer data leads to the highest accuracy in both binary and multiclass classification. The optimal architectures featured two and three bidirectional long short-term memory layers for binary and multiclass classifications, respectively, achieving accuracies of 91% and 84%. In this study, the potential of DNNs has been proven for providing a robust method for activity classification that is vital for the effective closed-loop control of medical devices in cardiac care.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"52-60"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131726","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
Blood Volume Analysis of Total Artificial Heart Recipients: A Case Series. 全人工心脏受者的血容量分析:病例系列
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-05-20 DOI: 10.1097/MAT.0000000000002234
Zachary T Wilson, Francisco A Arabia, Radha S Gopalan, Marc A Silver
{"title":"Blood Volume Analysis of Total Artificial Heart Recipients: A Case Series.","authors":"Zachary T Wilson, Francisco A Arabia, Radha S Gopalan, Marc A Silver","doi":"10.1097/MAT.0000000000002234","DOIUrl":"10.1097/MAT.0000000000002234","url":null,"abstract":"<p><p>Blood volume analysis provides a quantitative volume assessment in patients with equivocal or discordant clinical findings. Reports on its use in mechanical circulatory support are limited and it has never been described in patients with a total artificial heart. Our series demonstrates that patients supported with total artificial heart as a bridge to transplant have significant reductions in red blood cell volume and heterogeneous adaptations in their total blood volume and plasma volume. Pathologic derangements in our patient's total blood volume were targeted to restore euvolemia.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e5-e7"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070154","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 to Throw Out the Elephant in the Room: Proper Use of S v O 2 in Extracorporeal Life Support. 是时候把房间里的大象扔出去了:在体外生命支持中正确使用 SvO2。
IF 3.1 3区 医学
ASAIO Journal Pub Date : 2025-01-01 Epub Date: 2024-07-30 DOI: 10.1097/MAT.0000000000002290
Lars Mikael Broman, J Michael Brewer, Roberto Lorusso, Mirko Belliato, Marc O Maybauer, Michael Broomé
{"title":"Time to Throw Out the Elephant in the Room: Proper Use of S v O 2 in Extracorporeal Life Support.","authors":"Lars Mikael Broman, J Michael Brewer, Roberto Lorusso, Mirko Belliato, Marc O Maybauer, Michael Broomé","doi":"10.1097/MAT.0000000000002290","DOIUrl":"10.1097/MAT.0000000000002290","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e17-e18"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854622","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
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