ASAIO Journal最新文献_第3页

Machine Learning Assisted Stroke Prediction in Mechanical Circulatory Support: Predictive Role of Systemic Mitochondrial Dysfunction. 机械循环支持中的机器学习辅助卒中预测：系统线粒体功能障碍的预测作用

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-23 DOI: 10.1097/MAT.0000000000002340

Jacob P Scioscia, Ivan Murrieta-Alvarez, Shiyi Li, Zicheng Xu, Guangyao Zheng, Jason Uwaeze, Carl P Walther, Zachary Gray, Katherine V Nordick, Vladimir Braverman, Alexis E Shafii, Gabriel Loor, Camila Hochman-Mendez, Ravi K Ghanta, Subhasis Chatterjee, O Howard Frazier, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

{"title":"Machine Learning Assisted Stroke Prediction in Mechanical Circulatory Support: Predictive Role of Systemic Mitochondrial Dysfunction.","authors":"Jacob P Scioscia, Ivan Murrieta-Alvarez, Shiyi Li, Zicheng Xu, Guangyao Zheng, Jason Uwaeze, Carl P Walther, Zachary Gray, Katherine V Nordick, Vladimir Braverman, Alexis E Shafii, Gabriel Loor, Camila Hochman-Mendez, Ravi K Ghanta, Subhasis Chatterjee, O Howard Frazier, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal","doi":"10.1097/MAT.0000000000002340","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002340","url":null,"abstract":"Stroke continues to be a major adverse event in advanced congestive heart failure (CHF) patients after continuous-flow left ventricular assist device (CF-LVAD) implantation. Abnormalities in mitochondrial oxidative phosphorylation (OxPhos) have been critically implicated in the pathogenesis of neurodegenerative diseases and cerebral ischemia. We hypothesize that prior stroke may be associated with systemic mitochondrial OxPhos abnormalities, and impaired more in post-CF-LVAD patients with risk of developing new stroke. We studied 50 CF-LVAD patients (25 with prior stroke, 25 without); OxPhos complex proteins (complex I [C.I]-complex V [C.V]) were measured in blood leukocytes. Both at baseline (pre-CF-LVAD) and postoperatively (post-CF-LVAD), the prior-stroke group had significantly lower C.I, complex II (C.II), complex IV (C.IV), and C.V proteins when compared to the no-prior-stroke group. Oxidative phosphorylation proteins were significantly decreased in prior-stroke group at post-CF-LVAD compared to pre-CF-LVAD. Machine learning Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest modeling identified six prognostic factors that predicted postoperative stroke with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.93. Oxidative phosphorylation protein reduction appeared to be associated with the new stroke after implantation. Our study found for the first time the existence of mitochondrial dysfunction at the peripheral level in CHF patients with prior ischemic stroke even before CF-LVAD implantation. The changes in OxPhos protein expression could serve as biomarkers in predicting new post-CF-LVAD strokes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493968","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

HeartMate 3 Ventricular Assist Device in a Single-Ventricle and Single-Lung Patient Palliated With a Bidirectional Glenn. HeartMate 3 心房辅助装置在使用双向格伦治疗的单室单肺患者中的应用。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-21 DOI: 10.1097/MAT.0000000000002333

Luiz Fernando Caneo, Carolina Vieira de Campos, Marcelo Biscegli Jatene, João Gabriel Guedes da Cunha Mello, Isabela Guersoni Menna Barreto, Fabio Biscegli Jatene

引用次数: 0

Multiple Pediatric Extracorporeal Membrane Oxygenation Runs and Futility. What Are the Limits? 多次小儿体外膜氧合运行与无用论。极限是什么？

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-18 DOI: 10.1097/MAT.0000000000002325

Justus G Reitz, Areen Almarkhan, Rittal Mehta, Arif Selcuk, Dana Harrar, Manan Desai, Guillermo Herrera, In Hye Park, Aybala Tongut, Yves d'Udekem, Sarah Schlatterer

{"title":"Multiple Pediatric Extracorporeal Membrane Oxygenation Runs and Futility. What Are the Limits?","authors":"Justus G Reitz, Areen Almarkhan, Rittal Mehta, Arif Selcuk, Dana Harrar, Manan Desai, Guillermo Herrera, In Hye Park, Aybala Tongut, Yves d'Udekem, Sarah Schlatterer","doi":"10.1097/MAT.0000000000002325","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002325","url":null,"abstract":"Despite high mortality rates, pediatric extracorporeal membrane oxygenation (ECMO) redeployments are frequently discussed in everyday clinical care. We aim to investigate predictors of mortality in those patients. Clinical data from a single pediatric center were retrospectively analyzed. Patients with multiple ECMO runs between 2010 and 2023 were included. A total of 70 (13%) patients required multiple ECMO runs. Of those, 56 (80%) died before discharge; late mortality was 89% at a median of 1.6 (1.0-3.9) years. A total of 47 (67%) patients had neurologic findings. Only one (1%) survivor had a normal neurodevelopmental follow-up. Duration of the first ECMO run (odds ratio [OR]: 2.63, 1.08-7.96), total duration on ECMO (OR: 4.72, 1.29-23.54), neurologic findings at any time (OR: 7.94, 1.46-43.24), need for renal replacement therapy (OR: 4.79, 1.06-25.58), and lactate values correlated with late mortality. All 19 (27%) patients with neurologic findings before the second run died. The frequency of multiple-run ECMOs increased within the study period. Outcomes in pediatric patients with multiple ECMO runs are disheartening. Given all patients in our cohort with neurological findings before the second ECMO run died, neurological findings should be taken into consideration when determining the utility of further ECMO support.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457086","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

Is the Delivery of Hydrogen-Peroxide With Dialysate for Oxygenation of Blood Efficient and Safe? 用透析液输送过氧化氢来为血液充氧是否高效安全？

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-18 DOI: 10.1097/MAT.0000000000002335

Daniel Schneditz

引用次数: 0

Functional and Social Recovery and Outcomes After Extracorporeal Membrane Oxygenation Support in COVID-19 Patients. COVID-19 患者体外膜氧合支持术后的功能和社交能力恢复及疗效。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-16 DOI: 10.1097/MAT.0000000000002337

Mustafa Mert Ozgur, Ece Altinay, Halide Ogus, Rezzan Deniz Acar, Pinar Atagun Guney, Kaan Kirali

{"title":"Functional and Social Recovery and Outcomes After Extracorporeal Membrane Oxygenation Support in COVID-19 Patients.","authors":"Mustafa Mert Ozgur, Ece Altinay, Halide Ogus, Rezzan Deniz Acar, Pinar Atagun Guney, Kaan Kirali","doi":"10.1097/MAT.0000000000002337","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002337","url":null,"abstract":"With the COVID pandemic, veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was implanted in many patients around the world. Data regarding follow-up and recovery of patients who are placed on ECMO support after COVID-related acute respiratory distress syndrome (ARDS) or ARDS for any other reason are limited. In our study, we share the 1 year follow-up results and cardiopulmonary exercise test results of the discharged patients. Between April 2020 and February 2022, a total of 29 patients who were supported with VV ECMO due to coronavirus disease 2019 (COVID-19)-related ARDS, weaned successfully and discharged to home, and who came for regular follow-up after discharge from the hospital and underwent examinations were included in the study. A total of 35 patients weaned successfully. Thirty patients were discharged to home. Mean age of the patients was 37.1 (±10.3) and 16 (55%) patients were male. Mean ECMO support time was 49.1 (±22.3) days. One year of survival after discharge was 100%. None of the patients had mobilization problems at the end of 12 month follow-up. Mean VO2 max was 18.9 at the end of 12 months. Return to work rate was 90%. We think that starting rehabilitation in the early period, and including patients in post-ECMO follow-up programs by ECMO centers will contribute significantly not only to the functional recovery of patients but also to their integration into social life.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457082","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

Pulsatile Flow During Venoarterial-Extracorporeal Membrane Oxygenation: A Topic in Need of Attention. 静脉-体外膜氧合过程中的搏动性血流：需要关注的话题。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-15 DOI: 10.1097/MAT.0000000000002338

Tianlong Wang, Jing Wang, Han Zhang, Bingyang Ji

引用次数: 0

Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death. 循环死亡和脑死亡后捐献多器官心脏移植的结果。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-15 DOI: 10.1097/MAT.0000000000002329

Toyokazu Endo, Jaimin R Trivedi, Stephanie Moore, Sheng Fu, Rohan Samson, Michele Gallo, Siddharth Pahwa, Mark S Slaughter, Erin M Schumer

{"title":"Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death.","authors":"Toyokazu Endo, Jaimin R Trivedi, Stephanie Moore, Sheng Fu, Rohan Samson, Michele Gallo, Siddharth Pahwa, Mark S Slaughter, Erin M Schumer","doi":"10.1097/MAT.0000000000002329","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002329","url":null,"abstract":"There is insufficient data on the outcomes of donation after circulatory death (DCD) multiorgan transplant that includes heart. The primary objective of this study is to compare the overall survival outcomes of DCD and donation after brain death (DBD) multiorgan transplants. We identified all heart transplant patients from 2019 to June of 2023 using the United Network for Organ Sharing (UNOS) Database who also received an additional organ (kidney, liver, and lungs). A total of 1,844 DBD and 91 DCD multiorgan transplants occurred within the study period, the majority being combined heart-kidney transplantation. More patients were listed at a higher status in the DBD group (p < 0.05) and were in the intensive care unit (ICU) before transplant (p < 0.05). Despite the higher ischemia time in the DCD group (p < 0.05), the overall unmatched survival did not differ between the two groups (p < 0.05). Within the heart-kidney transplants, the overall survival between DBD and DCD heart-kidney transplants did not differ in either unmatched or matched groups (unmatched p = 0.5, matched p = 0.5). In conclusion, the data on the outcomes of DCD multiorgan transplants are limited. Still, our analysis of the currently available data suggests that the overall survival is comparable in the DCD multiorgan transplants.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457088","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

Hemodynamic Support With the Impella 5.5 Acute Mechanical Circulatory Support Device. Impella 5.5 急性机械循环支持设备的血流动力学支持。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-15 DOI: 10.1097/MAT.0000000000002331

James W Schurr, Adrian Pearson, Matthew S Delfiner, Alyson Brown, Mary Frances Quinn, Yoav Karpenshif, Juan Ortega-Legaspi, Aditya Parikh, Marisa Cevasco, Joyce W Wald

{"title":"Hemodynamic Support With the Impella 5.5 Acute Mechanical Circulatory Support Device.","authors":"James W Schurr, Adrian Pearson, Matthew S Delfiner, Alyson Brown, Mary Frances Quinn, Yoav Karpenshif, Juan Ortega-Legaspi, Aditya Parikh, Marisa Cevasco, Joyce W Wald","doi":"10.1097/MAT.0000000000002331","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002331","url":null,"abstract":"The Impella 5.5 is increasingly used as a bridge to recovery or heart replacement therapies despite lack of clinical trial evidence. We report real-world outcomes and hemodynamic effects of 150 consecutive patients from a single, high-volume center. Primary outcome was incidence of recovery, durable left ventricular assist device (LVAD), or heart transplant compared with incidence of death at 90 days. Secondary outcomes included hemodynamic trends and upgrade to veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. The composite endpoint occurred in 59.3% and death in 18.8% of patients (incidence rate ratio: 8.1 [95% confidence interval {CI}: 5.4-12.2], p < 0.001). Decreases in pulmonary artery diastolic pressure (PADP) (p = 0.026), estimated pulmonary effective arterial elastance (Ea) (p < 0.001), and vasoactive-inotropic score (VIS) (p < 0.001) occurred during Impella 5.5 support. Pulmonary artery diastolic pressure correlated with estimated Ea (p < 0.001), suggesting improved right ventricle (RV) afterload with left ventricle (LV) unloading. Veno-arterial extracorporeal membrane oxygenation upgrade occurred in 11.3% of patients who had higher baseline right atrial pressure (RAP) (16.0 [9.0-20.5] vs. 9.0 [7.0-12.0], p = 0.022), PADP (28.5 [25.0-31.0] vs. 23.0 [18.0-28.0], p = 0.011), and lower pulmonary artery pulsatility index (PAPi) (1.45 [0.82-3.45] vs. 2.5 [1.65-3.86], p = 0.029). Upgrade patients had higher repeated measures trends in RAP (p < 0.001) and PADP (p = 0.015). The Impella 5.5 improved hemodynamics and effectively bridged to recovery or heart replacement therapies. Co-existing RV dysfunction can be supported on Impella 5.5 with careful hemodynamic trend monitoring.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457084","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

Neonatal Outcomes Following Maternal Antepartum Extracorporeal Life Support. 产妇产前体外生命支持术后的新生儿预后。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-10 DOI: 10.1097/MAT.0000000000002323

Benjamin D Seadler, Ashanti Johnson, Britton B Donato, Weston G Andrews, Adhitya Ramamurthi, Adam Ubert, Lucian A Durham

{"title":"Neonatal Outcomes Following Maternal Antepartum Extracorporeal Life Support.","authors":"Benjamin D Seadler, Ashanti Johnson, Britton B Donato, Weston G Andrews, Adhitya Ramamurthi, Adam Ubert, Lucian A Durham","doi":"10.1097/MAT.0000000000002323","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002323","url":null,"abstract":"Cases of antepartum respiratory failure or cardiogenic shock treated successfully with extracorporeal life support (ECLS) with high rates of survival for both mother and fetus are well documented. In contrast, there is a paucity of literature on the outcomes of these neonates after delivery. We report a single-center retrospective study of all adult cases of antepartum ECLS from February 2015 to April 2023 with neonatal follow-up. Seven patients met inclusion criteria with a maternal age of 32.0±5.5 years (median ± interquartile range [IQR]), primarily due to respiratory failure in six (86%) patients, with ECLS initiation at 27.0±3.0 weeks gestation. All mothers and fetuses survived to delivery at a gestational age of 29.0±4.5 weeks. All neonates survived to discharge home with the most common comorbidities being prematurity in seven (100%) patients and bronchopulmonary dysplasia in three (43%). In a follow-up period of 1.4±1.2 years; four (57%) patients underwent formal neurodevelopmental testing and two (50%) had identified delays, both related to speech/language. These results suggest that children exposed to antenatal ECLS demonstrate high rates of survival without significant morbidity, but that follow-up for neurodevelopmental delays may be warranted.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457087","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

Highlights of the 2024 ELSO Consensus Guidelines on Neurological Monitoring and Management for Adult ECMO. 2024 年 ELSO 成人 ECMO 神经监测和管理共识指南要点。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-10-04 DOI: 10.1097/MAT.0000000000002324

Sung-Min Cho, Marta V Antonini, Graeme MacLaren, Akram M Zaaqoq, Roberto Lorusso

引用次数: 0