ASAIO Journal最新文献_第6页

Extracorporeal Membrane Oxygenation Combined With Embolectomy May Yield Better Outcomes Than Extracorporeal Membrane Oxygenation Alone or With Thrombolysis for Acute High-Risk Pulmonary Embolism. 体外膜氧合联合栓塞术治疗急性高危肺栓塞可能比单独体外膜氧合或溶栓治疗效果更好。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-11 DOI: 10.1097/MAT.0000000000002849

Ryo Fujimoto, Michael Z Mazur, John W O'Neill, Aly S Hassaballa, Andres Bermudez, Lauren Glassmoyer, James Schurr, Salim E Olia, Thomas J Richards, Steven C Pugliese, Christian A Bermudez

{"title":"Extracorporeal Membrane Oxygenation Combined With Embolectomy May Yield Better Outcomes Than Extracorporeal Membrane Oxygenation Alone or With Thrombolysis for Acute High-Risk Pulmonary Embolism.","authors":"Ryo Fujimoto, Michael Z Mazur, John W O'Neill, Aly S Hassaballa, Andres Bermudez, Lauren Glassmoyer, James Schurr, Salim E Olia, Thomas J Richards, Steven C Pugliese, Christian A Bermudez","doi":"10.1097/MAT.0000000000002849","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002849","url":null,"abstract":"Veno-arterial extracorporeal membrane oxygenation (ECMO) is used to support patients with high-risk pulmonary embolism (HR-PE) with cardiogenic shock, but data on mid- and long-term outcomes after reperfusion remain limited. We retrospectively compared outcomes after ECMO with embolectomy, ECMO with thrombolysis, or ECMO alone in patients with HR-PE supported at a tertiary-care hospital (2016-2024). Extracorporeal membrane oxygenation was used in 72 patients with HR-PE; 22 received ECMO with embolectomy, 28 received ECMO with thrombolysis, and 22 received ECMO alone. The median duration of ECMO support was 5 days (interquartile range: 4-6 days). In-hospital complications and support time did not differ significantly between groups. Weaning from ECMO was achieved significantly more often with embolectomy (n = 22, 100%) than with thrombolysis (n = 17, 60.7%) or ECMO alone (n = 8, 36.4%) (p < 0.01). Survival to hospital discharge was highest after ECMO with embolectomy (n = 18, 81.8%), as compared with ECMO with thrombolysis (n = 16, 57.1%) or ECMO alone (n = 4, 18.1%) (p < 0.01). One and 3 year survival was 81.8% and 72.7% after ECMO with embolectomy, 55.7% and 46.4% after ECMO with thrombolysis, and 18.2% and 18.2% after ECMO alone (p < 0.001). Extracorporeal membrane oxygenation with early percutaneous or surgical embolectomy may provide a survival benefit over ECMO alone in patients with HR-PE. Further prospective studies are warranted.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944021","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

Does Earlier Right Ventricular Assist Device Implant Confer a Survival Advantage? 早期右室辅助装置植入是否具有生存优势？

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-11 DOI: 10.1097/MAT.0000000000002838

Shannon Oliver, Mark Bleiweis, Matthew O'Connor, Steve Kindel, John C Dykes, Sabrina Law, Lindsay May, Aamir Jeewa, Matthew Zinn, Ryan Butts, Bethany Wisotzkey, Muhammad F Shezad, Jennifer Conway

{"title":"Does Earlier Right Ventricular Assist Device Implant Confer a Survival Advantage?","authors":"Shannon Oliver, Mark Bleiweis, Matthew O'Connor, Steve Kindel, John C Dykes, Sabrina Law, Lindsay May, Aamir Jeewa, Matthew Zinn, Ryan Butts, Bethany Wisotzkey, Muhammad F Shezad, Jennifer Conway","doi":"10.1097/MAT.0000000000002838","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002838","url":null,"abstract":"Biventricular assist device (BiVAD) use has decreased in the pediatric population, partly driven by concerns that survival may be inferior compared with that achieved with isolated left ventricular assist devices (LVAD). We aimed to address whether the timing of right ventricular assist device (RVAD) impacts these outcomes. A retrospective analysis of prospectively collected data of patients who underwent BiVAD implantation between April 2018 and December 2022 and were enrolled in the Advanced Cardiac Therapies Improving Outcomes Network Registry was performed. Baseline clinical and demographic characteristics were compared between the primary (RVAD implanted at the same surgery as LVAD) and delayed (RVAD implanted within 60 days of LVAD) RVAD cohorts, and survival analysis was performed. There were 223 included patients, with 186 (83.4%) having a primary RVAD. Median age at implant was 5.48 years (interquartile range: 1.10, 12.52), 45.7% were female, and 23.3% had congenital heart disease. Primary RVAD patients were more likely to be on dialysis at the time of implantation (p = 0.028) and to have previous sternotomies (p = 0.004). Primary RVAD patients had better 1 year survival (p = 0.023). This suggests that mortality is impacted by RVAD timing in patients requiring BiVAD support. There should be a low threshold for implanting an RVAD during the same surgery as the LVAD in patients displaying signs of right heart failure.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943991","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

C-Reactive Protein Predicts Outcomes in HeartMate 3 Left Ventricular Assist Device Recipients. c反应蛋白预测心脏伴侣3型左心室辅助装置受者的预后

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002846

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

{"title":"C-Reactive Protein Predicts Outcomes in HeartMate 3 Left Ventricular Assist Device Recipients.","authors":"Jonathan Eisenberger, Eyal Ran Nachum, Shmuel Somer, Sarit Malayev, Alexander Kogan, Leonid Sternik, Jeffrey A Morgan","doi":"10.1097/MAT.0000000000002846","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002846","url":null,"abstract":"C-reactive protein (CRP) is an inflammatory biomarker with prognostic value in heart failure, but its role in HeartMate 3 (HM3) left ventricular assist device recipients is unclear. We retrospectively analyzed 188 adult HM3 recipients (2016-2025), stratified by preoperative CRP into low-CRP (≤10 mg/L, n = 65) and high-CRP (>10 mg/L, n = 123) groups. High-CRP patients presented with a sicker phenotype, with higher INTERMACS profile 1/preoperative extracorporeal membrane oxygenation (ECMO) support (50% vs. 3%) and greater renal, hepatic, hematologic, and nutritional derangement. In-hospital and 30 day mortality were higher with high CRP (23% vs. 5%, p = 0.001; 19% vs 3%, p = 0.003); overall mortality did not differ (47% vs. 40%, p = 0.360). In a parsimonious multivariable model adjusted for age, preoperative CRP (odds ratio [OR], 1.05 per 10 mg/L, p = 0.006) and albumin (OR, 0.32 per g/dl, p = 0.003) independently predicted in-hospital mortality; a seven-variable model was unstable due to INTERMACS-ECMO collinearity. C-reactive protein discriminated in-hospital mortality (area under the curve [AUC] = 0.77); a 10 mg/L threshold was sensitive (90%) but not specific (40%). High CRP was also associated with a 4.5-fold increase in tracheostomy (36% vs. 8%, p < 0.001) and prolonged ventilation. Preoperative CRP, interpreted with albumin, is a practical risk signal identifying a high-risk inflammatory-nutritional phenotype with greater perioperative morbidity in HM3 recipients.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928952","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

Device Failure on Extracorporeal Life Support: Insights From the Manufacturer and User Facility Device Experience Database. 体外生命支持设备故障：来自制造商和用户设施设备体验数据库的见解。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002855

Leon Fan, James C Henderson, Tony Zhu, Ernesto Marin, Diane Alejo, Sung-Min Cho

引用次数: 0

Letter to the Editor: Side Port Resistance Limits Distal Perfusion Flow (Matsumoto et al.). 致编辑的信：侧端口阻力限制远端灌注流（Matsumoto等人）。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002851

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

引用次数: 0

Superior Vena Cava Syndrome During Femoro-Femoral Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report. 股-股静脉-静脉体外膜氧合时上腔静脉综合征1例。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002852

Thibaut Genty, Maïra Gaillard, Virgil Chevance, Saïda Rezaiguia-Delclaux, Jacques Thès, Sylvain Diop, François Stéphan

{"title":"Superior Vena Cava Syndrome During Femoro-Femoral Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report.","authors":"Thibaut Genty, Maïra Gaillard, Virgil Chevance, Saïda Rezaiguia-Delclaux, Jacques Thès, Sylvain Diop, François Stéphan","doi":"10.1097/MAT.0000000000002852","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002852","url":null,"abstract":"Superior vena cava (SVC) syndrome is a clinical condition caused by an obstruction of blood flow through the SVC, which may complicate veno-venous extracorporeal membrane oxygenation (V-V ECMO). We report a case occurring early after initiation of femoro-femoral V-V ECMO in a 69 year old patient with severe acute respiratory distress syndrome (ARDS). Clinical presentation included facial and upper body edema, markedly elevated central venous pressure, and high-pressure alarms on all infusion pumps. Computed tomography demonstrated retrograde flow from a reinfusion cannula positioned in the right atrium toward the SVC, causing functional obstruction of venous return without anatomical stenosis. Cannula repositioning led to rapid resolution of symptoms and hemodynamic improvement. This case highlights key technical considerations in femoro-femoral V-V ECMO: reinfusion cannula tip position must avoid directed flow toward the SVC, particularly when distal segments are non-radiopaque; cannula length and diameter significantly influence reinfusion pressure; and indirect signs such as elevated central venous pressure and infusion pump alarms may facilitate early diagnosis. Optimization of cannula selection and positioning is essential to prevent this rare but severe complication.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928655","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

Hybrid Respiratory Dialysis for Ultra-Low Blood-Flow Extracorporeal CO2 Removal. 混合呼吸透析用于超低血流量体外CO2去除。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002848

Nicholas X Williams, Cameron C Jones, Rene DeBrabander, Brian Y Chang, Steven P Keller

{"title":"Hybrid Respiratory Dialysis for Ultra-Low Blood-Flow Extracorporeal CO2 Removal.","authors":"Nicholas X Williams, Cameron C Jones, Rene DeBrabander, Brian Y Chang, Steven P Keller","doi":"10.1097/MAT.0000000000002848","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002848","url":null,"abstract":"Extracorporeal carbon dioxide removal (ECCO2R) has emerged as a promising therapeutic avenue to address the challenges of CO2 accumulation during chronic obstructive pulmonary disease (COPD) exacerbations. Current COPD exacerbation interventions rely on invasive mechanical ventilation to support respiration, which can rapidly induce diaphragmatic atrophy and frequently leaves patients indefinitely reliant on a ventilator. Extracorporeal carbon dioxide removal could be a suitable modality to stabilize these critically ill patients; however, current implementations rely on either purely bicarbonate dialysis, which does not address acidemia, or a gas exchanger, which necessitates high blood flow rates. Herein, we describe a custom hybrid system for combined bicarbonate and gaseous CO2 elimination, achieving 123 ± 4 ml/min CO2 removal with direct pH adjustment at blood flow rates of 250 ml/min. This is achieved through the combination of 101 ± 2 ml/min bicarbonate removal from a dialysis methodology and 21 ± 2 ml/min CO2 removal across a novel, custom-built gas exchange device. Hence, this system is for COPD patients with hypercapnic respiratory failure across the dynamic respiratory demands of an exacerbation event. This amalgamation not only amplifies CO2 removal rates but also enables a less invasive therapeutic approach.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928982","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

Response to the Letter to the Editor Regarding "Side Port Resistance Limits Distal Perfusion Flow". 关于“侧端口阻力限制远端灌注流”的致编辑信的回复。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-10 DOI: 10.1097/MAT.0000000000002850

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

引用次数: 0

Time to Pediatric Extracorporeal Membrane Oxygenation Circuit Failure: An Extracorporeal Life Support Organization Registry-Based Study. 儿科体外膜氧合回路失效的时间：一项基于体外生命支持组织注册的研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-09 DOI: 10.1097/MAT.0000000000002839

Adrian C Mattke, Kerry E Johnson, Supreet Marathe, Nelson Alphonso, Sarfaraz N Rahiman, Nitesh Singhal, Alexander D Hussey, Craig A McBride, Antje Blumenthal, Giles J Peek, Mari Takashima

{"title":"Time to Pediatric Extracorporeal Membrane Oxygenation Circuit Failure: An Extracorporeal Life Support Organization Registry-Based Study.","authors":"Adrian C Mattke, Kerry E Johnson, Supreet Marathe, Nelson Alphonso, Sarfaraz N Rahiman, Nitesh Singhal, Alexander D Hussey, Craig A McBride, Antje Blumenthal, Giles J Peek, Mari Takashima","doi":"10.1097/MAT.0000000000002839","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002839","url":null,"abstract":"Circuit thrombosis and mechanical failure are important complications during extracorporeal membrane oxygenation (ECMO), but expected circuit duration and predictors of circuit failure remain poorly defined. We performed a retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry, including patients aged less than 18 years supported with ECMO between January 2020 and December 2024. Circuit failure was defined as a mechanical complication requiring circuit or component replacement. Time to failure was analyzed using Cox proportional hazards models, and associations with mortality were analyzed using logistic regression and propensity score matching. A total of 20,124 patients with 21,294 runs and 26,318 circuits were included. Circuit failure occurred in 5,052 circuits (19.2%), with at least one replacement in 15.3% of runs. Median time to failure was 129.5 hours (interquartile range [IQR]: 55.0-262.5). Neonatal age, weight less than 3 kg, and higher center volume were associated with increased circuit failure, whereas older age was associated with lower risk. Extracorporeal membrane oxygenation pump flow was not associated with circuit failure. Circuit failure was associated with higher mortality (49.0% vs. 34.1%). In propensity score matching, circuit failure increased absolute mortality risk by 6.1 percentage points (p < 0.001), with the strongest effect in neonates. Circuit life warrants evaluation as a potential endpoint for future hemocompatibility and anticoagulation studies.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918279","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

Kinked Femoral Veno-Venous Extracorporeal Membrane Oxygenation Cannula Successfully Removed Using a Balloon-Assisted Percutaneous Approach: A Case Report. 用球囊辅助经皮入路成功取出缠绕的股静脉-静脉体外膜氧合套管1例。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-09-09 DOI: 10.1097/MAT.0000000000002845

Alessandro Ostini, Monika Fürholz, Nadja Schai, Thomas Pilgrim, Anna Sarah Messmer

{"title":"Kinked Femoral Veno-Venous Extracorporeal Membrane Oxygenation Cannula Successfully Removed Using a Balloon-Assisted Percutaneous Approach: A Case Report.","authors":"Alessandro Ostini, Monika Fürholz, Nadja Schai, Thomas Pilgrim, Anna Sarah Messmer","doi":"10.1097/MAT.0000000000002845","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002845","url":null,"abstract":"We report a case of safe percutaneous removal of a kinked venous access cannula from the inferior vena cava using a crossover balloon-assisted technique under fluoroscopic guidance in a patient receiving femoro-femoral veno-venous extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome following massive aspiration. After cessation of ECMO flow and clamping of both cannulas, a sheath-in-cannula technique was used by inserting 7F introducer sheaths into the access and return cannulas to maintain vascular access. A balloon catheter was advanced anterogradely into the proximal part of the kinked cannula to seal the fenestrations, and another balloon was inserted retrogradely in a crossover technique via the return cannula into the tip of the access cannula to facilitate redirection. Controlled balloon inflation enabled gentle traction and realignment across the iliac bifurcation, allowing safe extraction under continuous fluoroscopic guidance while avoiding injury to the inferior vena cava. This minimally invasive approach may represent an alternative to surgical removal of malpositioned ECMO cannulas in experienced centers.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918285","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