ASAIO Journal最新文献_第4页

Hemodynamic Considerations of Distal Perfusion Catheters With Venoarterial Extracorporeal Membrane Oxygenation: A Dynamic Mock Loop Study. 远端灌注导管与静脉体外膜氧合的血流动力学考虑：动态模拟环研究。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-27 DOI: 10.1097/MAT.0000000000002494

Joshua G Crane, Gretel Monreal, Steven C Koenig, Mark S Slaughter

{"title":"Hemodynamic Considerations of Distal Perfusion Catheters With Venoarterial Extracorporeal Membrane Oxygenation: A Dynamic Mock Loop Study.","authors":"Joshua G Crane, Gretel Monreal, Steven C Koenig, Mark S Slaughter","doi":"10.1097/MAT.0000000000002494","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002494","url":null,"abstract":"There are conflicting clinical data on whether the use of a distal perfusion catheter (DPC) is beneficial for reducing the risk of limb ischemia in peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) patients. We investigated the hemodynamic effects of arterial cannula size, use of and size of a DPC, and ECMO flow (pump speed) on femoral artery hemodynamics in an adult peripheral VA-ECMO dynamic mock loop. The mock loop was tuned to heart failure conditions (cardiac output 3 L/min, arterial pressure 50 mm Hg, venous pressure 20 mm Hg). Three arterial cannulae (15Fr, 17Fr, 19Fr; right iliac) were each integrated into the loop with/without DPC (none, 5Fr, 8Fr; right superficial femoral artery [RSFA]), creating nine configurations tested. Hemodynamic pressures and flows were recorded over a range of pump speeds generating 0-3.5 L/min ECMO flow. The right femoral arteries demonstrated reduced flow, pressure, and pulsatility compared with the left across all cannula configurations and which worsened with increasing arterial cannula size and ECMO flow. Impaired right femoral hemodynamics were not improved with the use or size of DPC, suggesting that the increased resistance created by the presence of the arterial cannula and the DPC may be too great to overcome, thereby offsetting any potential flow benefits provided by the DPC.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504765","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

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 3.1 3区医学

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

Loic Gouriet, Nicolas de Prost, Paul Masi

引用次数: 0

Echo-Derived Right Ventricular Strain Identifies Pulmonary Hypertension in Pediatric Ventricular Assist Device Patients. 回声来源的右心室应变识别儿童心室辅助装置患者的肺动脉高压。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-27 DOI: 10.1097/MAT.0000000000002489

Ryan S Bishop, Tam T Doan, Claudia Lara, Lindsay F Eilers, Hari P Tunuguntla, Joseph A Spinner, Ricardo H Pignatelli, Anitha Parthiban, James C Wilkinson

{"title":"Echo-Derived Right Ventricular Strain Identifies Pulmonary Hypertension in Pediatric Ventricular Assist Device Patients.","authors":"Ryan S Bishop, Tam T Doan, Claudia Lara, Lindsay F Eilers, Hari P Tunuguntla, Joseph A Spinner, Ricardo H Pignatelli, Anitha Parthiban, James C Wilkinson","doi":"10.1097/MAT.0000000000002489","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002489","url":null,"abstract":"Identifying pulmonary hypertension in pediatric patients with continuous-flow ventricular assist device (cf-VAD) remains challenging, often relying on invasive hemodynamic assessment. We hypothesized that echocardiography-derived right ventricular global longitudinal strain (RV-GLS) may correlate with invasive pulmonary pressures, potentially guiding the timing of cardiac catheterization. We retrospectively reviewed pediatric cf-VAD patients (<21 years) implanted at our institution from 2011 to 2023 who underwent cardiac catheterization with concurrent echocardiography, excluding those with congenital heart disease. Uniplanar RV-GLS was measured from RV-focused views and compared with invasive hemodynamics, including mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVRi). Associations were evaluated by Spearman correlation and binomial logistic regression. Twenty-five patients were included (median age 14.8 years, weight 68 kg, VAD support duration 5 months). Right ventricular global longitudinal strain was measurable in 23 studies (median -13.3, interquartile range [IQR] [-14.3, -9.3]). Worse RV-GLS correlated with higher mPAP (p = 0.001) and higher PVRi (p = 0.014). Right ventricular global longitudinal strain was also associated with mPAP >20 mm Hg (odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.10-2.90). An RV-GLS cutoff of -10.6% identified pulmonary hypertension (mPAP >20 mm Hg) with 88% sensitivity and 80% specificity. Right ventricular global longitudinal strain may be useful in noninvasively identifying residual pulmonary hypertension and optimal catheterization timing for pediatric cf-VAD patients. Prospective studies are needed to validate these findings.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504764","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

Assembling, Priming, and Storing Circuits for Pediatric and Neonatal Extracorporeal Membrane Oxygenation. 装配，启动和储存电路的儿童和新生儿体外膜氧合。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-27 DOI: 10.1097/MAT.0000000000002483

Lasse J Strudthoff, Christian Bleilevens, Alexander Wallraff, Johanna C Clauser, Sebastian V Jansen, Marlene Schadow, Rolf Rossaint, Rüdger Kopp, Patrick Winnersbach

{"title":"Assembling, Priming, and Storing Circuits for Pediatric and Neonatal Extracorporeal Membrane Oxygenation.","authors":"Lasse J Strudthoff, Christian Bleilevens, Alexander Wallraff, Johanna C Clauser, Sebastian V Jansen, Marlene Schadow, Rolf Rossaint, Rüdger Kopp, Patrick Winnersbach","doi":"10.1097/MAT.0000000000002483","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002483","url":null,"abstract":"The storing of dry-assembled and primed extracorporeal membrane oxygenation (ECMO) circuits is common practice and endorsed by the Extracorporeal Life Support Organization (ELSO) for up to 30 days. We conducted an anonymous survey among chief perfusionists in German neonatal and pediatric ECMO centers to identify key parameters of the actual clinical practices. Ten of 15 (67%) participating centers do not pre-assemble and pre-prime circuits in apprehension of future patients. The average storing times in 33% of the centers exceed the ELSO recommended 30 days up to 150 days. Longer storing times may be the result of less annual cases compared with adult ECMO. The addition of concentrated erythrocytes in the priming fluid may be one reason for ad-hoc de-airing. None of the participating centers treats children exclusively, omitting the center's overall experience as reason for the different practices in adults and children. Nonetheless, the average time required for assembly and de-airing was extended by 40% compared with adult ECMO while the perceived urgency in emergency situations was increased. Overall, this study shows distinct differences between adult and neonatal/pediatric ECMO regarding circuit preassembly and prepriming that indicate the need for improved standard operating procedures and specific research.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504761","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

Direct Cardiac Compression Device for Short-Term Mechanical Circulatory Support. 用于短期机械循环支持的直接心脏压迫装置。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-27 DOI: 10.1097/MAT.0000000000002493

Kristof Sarosi, Thomas Kummer, Stijn Vandenberghe, Stefanos Demertzis, Patrick Jenny

{"title":"Direct Cardiac Compression Device for Short-Term Mechanical Circulatory Support.","authors":"Kristof Sarosi, Thomas Kummer, Stijn Vandenberghe, Stefanos Demertzis, Patrick Jenny","doi":"10.1097/MAT.0000000000002493","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002493","url":null,"abstract":"Patients requiring short-term ventricular assistance have limited options. While not all interventions necessarily require blood-contacting support, all current devices are invasive and interact with the bloodstream. Direct cardiac compression (DCC) devices offer a potential solution by providing mechanical circulatory support (MCS) without contact with the bloodstream. This proof-of-concept study compares a novel DCC patch device for short-term MCS to open-chest cardiac compression (OCCC) using an ex vivo ovine cardiac arrest (CA) heart model. Performance is evaluated by assessing pressure, flow rate, and valve functionality, as well as any damage to the tissue. In the CA model, the device achieves 1.5 L/min cardiac output and a mean aortic pressure of 55 mm Hg. Despite direct epicardial contact, the DCC patch device maintains effective valve function. This study demonstrates that the DCC patch device achieves comparable performance to OCCC, supporting previous in vitro findings. Our results suggest the potential for this novel DCC patch device to be applied across a range of short-term MCS scenarios.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504763","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

Age and In-Hospital Mortality in Patients With Acute Respiratory Distress Syndrome Undergoing Venovenous Extracorporeal Membrane Oxygenation. 经静脉-静脉体外膜氧合治疗急性呼吸窘迫综合征患者的年龄和住院死亡率。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-26 DOI: 10.1097/MAT.0000000000002491

Ryota Sato, Natsumi T Hamahata, Daisuke Hasegawa, Erick Itoman

{"title":"Age and In-Hospital Mortality in Patients With Acute Respiratory Distress Syndrome Undergoing Venovenous Extracorporeal Membrane Oxygenation.","authors":"Ryota Sato, Natsumi T Hamahata, Daisuke Hasegawa, Erick Itoman","doi":"10.1097/MAT.0000000000002491","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002491","url":null,"abstract":"Age is a known risk factor for mortality in acute respiratory distress syndrome (ARDS) patients receiving venovenous extracorporeal membrane oxygenation (VV ECMO), but an optimal age cutoff for patient selection remains unclear. This study evaluates the association between age and in-hospital mortality in ARDS patients undergoing VV ECMO using the National Inpatient Sample from 2019 to 2022. We included adults with ARDS treated with VV ECMO and applied logistic regression to assess mortality risk while adjusting for demographics, comorbidities, hospital settings, and socioeconomic factors. Among an estimated 510,175 ARDS hospitalizations, 13,150 patients received VV ECMO, with an in-hospital mortality rate of 43.4%. The predicted mortality increased linearly with age. Compared with patients aged 18-25 years, the odds ratios (ORs) for mortality were 1.01 (26-35 years), 1.47 (36-45 years), 1.96 (46-55 years), 2.79 (56-65 years), 3.72 (66-75 years), and 4.27 (≥76 years), with statistical significance for older groups. Our findings confirm age as a strong predictor of mortality in this population. However, the absence of a clear threshold suggests that strict age cutoffs may not be justified. Instead, ECMO candidacy should be individualized, emphasizing overall clinical status rather than age alone.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504760","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

Protein Loss With High-Flux and Medium Cut-Off Membranes: An Ex Vivo Comparative Analysis. 高通量和中等切断膜的蛋白质损失：离体比较分析。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-26 DOI: 10.1097/MAT.0000000000002486

Xiaoling Wang, Nadja Grobe, Colleen Fisher, Kylie Colvin, Chih-Hu Ho, Peter Kotanko

{"title":"Protein Loss With High-Flux and Medium Cut-Off Membranes: An Ex Vivo Comparative Analysis.","authors":"Xiaoling Wang, Nadja Grobe, Colleen Fisher, Kylie Colvin, Chih-Hu Ho, Peter Kotanko","doi":"10.1097/MAT.0000000000002486","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002486","url":null,"abstract":"Removal of middle-sized uremic toxins is one goal of hemodialysis. However, dialysis membranes are nonselective, raising the specter that salutary proteins may also be removed. To better understand the spectrum of proteins filtered by medium cut-off (MCO) and high-flux membranes, we conducted quantitative analyses of proteins in ultrafiltrates. We developed an ex vivo system that allows us to concurrently compare two dialyzers under the same conditions, using the same plasma source. We used this system to study the ultrafiltrate protein loss of two high-flux (Fresenius Optiflux F180NRe, USA; Fresenius FX CorAL80, Germany) and one MCO dialyzer (Baxter Theranova 400, Germany). Ultrafiltrates underwent analysis including gel electrophoresis, quantitative proteomics using liquid chromatography-tandem mass spectrometry, and immunoassays. We identified 244 proteins and semiquantified 113 of them, all of which were more prevalent in MCO compared with high-flux ultrafiltrate (MCO/Optiflux: median 8.25-fold; MCO/CorAL: median 9.14-fold). The protein distribution in MCO ultrafiltrate was skewed toward higher molecular mass. Notably, the ultrafiltered proteins include some with putative salutary functions. In conclusion, our data consistently show a higher protein loss with MCO membrane compared with high-flux dialyzers. The extent to which biological functions are impacted by the removal of proteins warrants bioinformatic analyses and clinical studies.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504769","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 3.1 3区医学

ASAIO Journal Pub 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

Impact of Extended Travel Distances on Outcomes of Donation After Cardiac Death Heart Transplant Using Machine Perfusion. 延长旅行距离对心脏死亡后机器灌注心脏移植捐献结果的影响。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-26 DOI: 10.1097/MAT.0000000000002495

Sooyun Caroline Tavolacci, Ameesh Isath, Gabrielle Amar, Junichi Shimamura, Steven Lansman, David Spielvogel, Suguru Ohira

{"title":"Impact of Extended Travel Distances on Outcomes of Donation After Cardiac Death Heart Transplant Using Machine Perfusion.","authors":"Sooyun Caroline Tavolacci, Ameesh Isath, Gabrielle Amar, Junichi Shimamura, Steven Lansman, David Spielvogel, Suguru Ohira","doi":"10.1097/MAT.0000000000002495","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002495","url":null,"abstract":"Machine perfusion (MP) is commonly used donors after circulatory death (DCD) heart transplants (HT) as direct procurement and perfusion technique, limited data exist regarding MP use for DCD donors from extended distances (ED). In the United Network for Organ Sharing (UNOS) database, 725 isolated DCD-HTs were identified between October 18, 2018, and December 31, 2023, excluding re-transplants and multi-organ transplants. Outcomes were compared according to travel distances: control (≤500 miles, n = 465) versus group ED (>500 miles, n = 260). Propensity score matching was performed (239 pairs). Travel distance was longer in group ED (224 [108-363] vs. 720 [576-903] miles; p < 0.001), as was time from cross-clamp to implantation (5.4 [3.8-6.3] vs. 6.8 [5.7-8] hours; p < 0.001). One year survival was comparable between groups (control, 92.4 ± 2.5% vs. group E, 91.8 ± 3.6%; p = 0.29). Extended distances donor was not associated with mortality (hazard ratio [HR] = 0.81, 95% confidence interval [CI] = 0.43-1.53; p = 0.51). Cross-clamp-to-implantation time >8 hours was associated with mortality (reference: 0-4 hours; HR = 4.04; 95% CI = 1.50-10.86; p = 0.006), while 4-8 hours was not (HR = 1.35; 95% CI = 0.57-3.2; p = 0.497). In conclusion, DCD-HT with donors from ED using MP showed similar transplant outcomes compared with DCD-HT with donors within 500 miles. However, donor cross-clamp to implantation time >8 hours was associated with worse survival, which may be considered for donor and recipient selection.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504766","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

Report of the Portable Ex Vivo Organ Perfusion Workforce Survey: Staffing Models and Clinical Trends. 便携式离体器官灌注劳动力调查报告：人员配备模式和临床趋势。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-06-26 DOI: 10.1097/MAT.0000000000002477

Blaine Johnson, William Riley, Michael Arcaro, Kristina Iwai, Rachel Nordgren, Maria Lucia Madariaga, Tae Song, Avery Tung

{"title":"Report of the Portable Ex Vivo Organ Perfusion Workforce Survey: Staffing Models and Clinical Trends.","authors":"Blaine Johnson, William Riley, Michael Arcaro, Kristina Iwai, Rachel Nordgren, Maria Lucia Madariaga, Tae Song, Avery Tung","doi":"10.1097/MAT.0000000000002477","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002477","url":null,"abstract":"Historically, organs recovered for transplant have been transported using static cold preservation. However, newer portable ex vivo organ perfusion (PEVOP) strategies allow warm organ perfusion during transport. Although PEVOP is a complex process requiring additional staffing resources, few publications address the staffing requirements for this technology. To clarify this issue, we surveyed all 35 United States institutions with PEVOP programs in 2020 and again in 2025 about organization, staffing, and training. We achieved a 100% response rate in both years. The number of institutions with active PEVOP programs decreased from 35 in 2020 to 31 in 2025, while the number of organ platforms increased from 52 to 56. The proportion of platforms operated by manufacturers surged from 17.3% to 96.4% ( p < 0.00001), while the percentage run by physicians dropped from 51.9% to 6.7% ( p = 0.00174). Challenges to adequate PEVOP staffing, including administrative and financial burdens, as well as staff reluctance, remained consistent across surveys and were significant barriers to its use. These findings may assist institutions in developing strategies to meet the future needs of the workforce while maximizing the safe and effective use of this innovative technology.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504790","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