ASAIO Journal最新文献_第8页

The Effects of Oxygen-Derived Free-Radical Scavengers During Normothermic Ex-Situ Heart Perfusion. 常温离体心脏灌注过程中氧自由基清除剂的作用

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI: 10.1097/MAT.0000000000002176

Xiao Qi, Sanaz Hatami, Sabin Bozso, Xiuhua Wang, Bruno Saleme, Jayan Nagendran, Evangelos Michelakis, Gopinath Sutendra, Darren H Freed

{"title":"The Effects of Oxygen-Derived Free-Radical Scavengers During Normothermic Ex-Situ Heart Perfusion.","authors":"Xiao Qi, Sanaz Hatami, Sabin Bozso, Xiuhua Wang, Bruno Saleme, Jayan Nagendran, Evangelos Michelakis, Gopinath Sutendra, Darren H Freed","doi":"10.1097/MAT.0000000000002176","DOIUrl":"10.1097/MAT.0000000000002176","url":null,"abstract":"Oxidative stress occurs during ex-situ heart perfusion (ESHP) and may negatively affect functional preservation of the heart. We sought to assess the status of key antioxidant enzymes during ESHP, and the effects of augmenting these antioxidants on the attenuation of oxidative stress and improvement of myocardial and endothelial preservation in ESHP. Porcine hearts were perfused for 6 hours with oxygen-derived free-radical scavengers polyethylene glycol (PEG)-catalase or PEG-superoxide dismutase (SOD) or with naive perfusate (control). The oxidative stress-related modifications were determined in the myocardium and coronary vasculature, and contractile function, injury, and endothelial integrity were compared between the groups. The activity of key antioxidant enzymes decreased and adding catalase and SOD restored the enzyme activity. Cardiac function and endothelial integrity were preserved better with restored catalase activity. Catalase and SOD both decreased myocardial injury and catalase reduced ROS production and oxidative modification of proteins in the myocardium and coronary vasculature. The activity of antioxidant enzymes decrease in ESHP. Catalase may improve the preservation of cardiac function and endothelial integrity during ESHP. While catalase and SOD may both exert cardioprotective effects, unbalanced SOD and catalase activity may paradoxically increase the production of reactive species during ESHP.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"741-749"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140064742","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

Unmasking the Impact of Oxygenator-Induced Hypocapnia on Blood Lactate in Veno-Arterial Extracorporeal Membrane Oxygenation. 揭示氧合器诱导的低碳酸血症对静脉-动脉体外膜氧合过程中血乳酸的影响

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-14 DOI: 10.1097/MAT.0000000000002191

Mousa Kharnaf, William A Abplanalp, Courtney Young, Cassandra Sprague, Leah Rosenfeldt, Reanna Smith, Dongfang Wang, Joseph S Palumbo, David L S Morales

{"title":"Unmasking the Impact of Oxygenator-Induced Hypocapnia on Blood Lactate in Veno-Arterial Extracorporeal Membrane Oxygenation.","authors":"Mousa Kharnaf, William A Abplanalp, Courtney Young, Cassandra Sprague, Leah Rosenfeldt, Reanna Smith, Dongfang Wang, Joseph S Palumbo, David L S Morales","doi":"10.1097/MAT.0000000000002191","DOIUrl":"10.1097/MAT.0000000000002191","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) is often associated with disturbances in acid/base status that can be triggered by the underlying pathology or the ECMO circuit itself. Extracorporeal membrane oxygenation is known to cause hypocapnia, but the impact of reduced partial pressure of carbon dioxide (pCO 2 ) on biomarkers of tissue perfusion during veno-arterial (VA)-ECMO has not been evaluated. To study the impact of low pCO 2 on perfusion indices in VA-ECMO, we placed Sprague-Dawley rats on an established VA-ECMO circuit using either an oxygen/carbon dioxide mixture (O 2 95%, CO 2 5%) or 100% O 2 delivered through the oxygenator (n = 5 per cohort). Animals receiving 100% O 2 developed a significant VA CO 2 difference (pCO 2 gap) and rising blood lactate levels that were inversely proportional to the decrease in pCO 2 values. In contrast, pCO 2 gap and lactate levels remained similar to pre-ECMO baseline levels in animals receiving the O 2 /CO 2 mixture. More importantly, there was no significant difference in venous oxygen saturation (SvO 2 ) between the two groups, suggesting that elevated blood lactate levels observed in the rats receiving 100% O 2 were a response to oxygenator induced hypocapnia and alkaline pH rather than reduced perfusion or underlying tissue hypoxia. These findings have implications in clinical and experimental extracorporeal support contexts.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"795-802"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130656","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

Extracorporeal Membrane Oxygenation Ouroboros: A Rare Cause of Mass Recirculation During Femoro-Jugular Venovenous ECMO. 体外膜肺氧合大出血：股静脉-颈静脉 ECMO 期间大量再循环的罕见原因。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-19 DOI: 10.1097/MAT.0000000000002180

Elliott Worku, Stuart Duffin, Sanjay Tarvade, Máté Rudas

引用次数: 0

Successful Pregnancy After Left Ventricular Assist Device Explantation for Myocardial Recovery. 左心室辅助装置拆卸后成功妊娠促进心肌恢复

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-01-31 DOI: 10.1097/MAT.0000000000002156

Juan D Linares Velandia, Diane Tran, Antoine E Sakr, Ruofan Yao, Uri Elkayam, Ajay S Vaidya, Aaron M Wolfson, Dmitry Abramov

引用次数: 0

Prone Positioning and Right Ventricular Protection During Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. 体外膜氧合治疗严重急性呼吸窘迫综合征期间的俯卧位和右心室保护。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-06-28 DOI: 10.1097/MAT.0000000000002261

Vasileios Zochios, Hakeem Yusuff, Marta Velia Antonini

引用次数: 0

Mechanical Analysis of a Novel Sternal Closure System in Static Tensile Loading. 新型胸骨闭合系统在静态拉伸载荷下的力学分析

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-11 DOI: 10.1097/MAT.0000000000002185

Gardner Yost, Jeffrey Plott, Amogh Angandi, Conor Locke, Thomas Marten, Jonathan W Haft

引用次数: 0

Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature. 中心静脉肺体外膜氧合：背景和标准化术语。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-05-20 DOI: 10.1097/MAT.0000000000002239

J Michael Brewer, Roberto Lorusso, L Mikael Broman, Steven A Conrad, Justyna Swol, Marc O Maybauer

引用次数: 0

Ventricular Arrhythmias and Sudden Cardiac Death in Left Ventricular Assist Device Patients Without Implantable Cardioverter Defibrillators. 无植入式心脏除颤器的左心室辅助装置患者的室性心律失常和心脏性猝死。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI: 10.1097/MAT.0000000000002177

Sanket Gokhale, Alexandra Malesz, Luke Masha

{"title":"Ventricular Arrhythmias and Sudden Cardiac Death in Left Ventricular Assist Device Patients Without Implantable Cardioverter Defibrillators.","authors":"Sanket Gokhale, Alexandra Malesz, Luke Masha","doi":"10.1097/MAT.0000000000002177","DOIUrl":"10.1097/MAT.0000000000002177","url":null,"abstract":"Patients with left ventricular assist devices (LVAD) can develop sustained ventricular arrhythmias (VA). The history and presentation of VA in implantable cardioverter defibrillator (ICD)-naive patients with LVAD is not well described in the literature and the risks/benefits of ICD implantation are unknown. This single-center retrospective cohort study included patients >18 years old who did not have an ICD during LVAD implantation from 2010 to 2022. The primary outcome was VA event rate per 100 patient-years. Two hundred thirty-seven patients underwent LVAD implantation and we identified 46 (19.4%) ICD naive patients. The etiology of heart failure in most patients was nonischemic cardiomyopathy (67.4%). Of all patients, only five were found to have documented VA. Only two episodes of VA occurred in the ambulatory setting. The estimated index VA rate was 5.89 events per 100 patient-years in our entire ICD-naive LVAD population. In the ambulatory ICD-naive population, the estimated VA rate was 2.42 events per 100 patient-years with no associated mortality. The rate of index VA in ICD-naive patients was below thresholds associated with benefits from ICD insertion. No ambulatory mortality from VA was seen and VA was well tolerated by the LVAD population. Perioperative VA in this population is associated with high mortality.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"773-777"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140064743","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

Deceased-Donor Kidney Transplant Outcome Prediction Using Artificial Intelligence to Aid Decision-Making in Kidney Allocation. 利用人工智能预测遗体捐献者肾移植结果，辅助肾脏分配决策。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-09-01 Epub Date: 2024-03-29 DOI: 10.1097/MAT.0000000000002190

Hatem Ali, Mahmoud Mohamed, Miklos Z Molnar, Tibor Fülöp, Bernard Burke, Arun Shroff, Sunil Shroff, David Briggs, Nithya Krishnan

{"title":"Deceased-Donor Kidney Transplant Outcome Prediction Using Artificial Intelligence to Aid Decision-Making in Kidney Allocation.","authors":"Hatem Ali, Mahmoud Mohamed, Miklos Z Molnar, Tibor Fülöp, Bernard Burke, Arun Shroff, Sunil Shroff, David Briggs, Nithya Krishnan","doi":"10.1097/MAT.0000000000002190","DOIUrl":"10.1097/MAT.0000000000002190","url":null,"abstract":"In kidney transplantation, pairing recipients with the highest longevity with low-risk allografts to optimize graft-donor survival is a complex challenge. Current risk prediction models exhibit limited discriminative and calibration capabilities and have not been compared to modern decision-assisting tools. We aimed to develop a highly accurate risk-stratification index using artificial intelligence (AI) techniques. Using data from the UNOS database (156,749 deceased kidney transplants, 2007-2021), we randomly divided transplants into training (80%) and validation (20%) sets. The primary measure was death-censored graft survival. Four machine learning models were assessed for calibration (integrated Brier score [IBS]) and discrimination (time-dependent concordance [CTD] index), compared with existing models. We conducted decision curve analysis and external validation using UK Transplant data. The Deep Cox mixture model showed the best discriminative performance (area under the curve [AUC] = 0.66, 0.67, and 0.68 at 6, 9, and 12 years post-transplant), with CTD at 0.66. Calibration was adequate (IBS = 0.12), while the kidney donor profile index (KDPI) model had lower CTD (0.59) and AUC (0.60). AI-based D-TOP outperformed the KDPI in evaluating transplant pairs based on graft survival, potentially enhancing deceased donor selection. Advanced computing is poised to influence kidney allocation schemes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"808-818"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326239","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

Pulse Pressure and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation: An Extracorporeal Life Support Organization Registry Analysis. 脉压与体外膜肺氧合中的急性脑损伤：体外生命支持组织登记分析。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-26 DOI: 10.1097/MAT.0000000000002294

Andrew Kalra, Jin Kook Kang, Christopher Wilcox, Benjamin L Shou, Patricia Brown, Peter Rycus, Marc M Anders, Akram M Zaaqoq, Daniel Brodie, Glenn J R Whitman, Sung-Min Cho

{"title":"Pulse Pressure and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation: An Extracorporeal Life Support Organization Registry Analysis.","authors":"Andrew Kalra, Jin Kook Kang, Christopher Wilcox, Benjamin L Shou, Patricia Brown, Peter Rycus, Marc M Anders, Akram M Zaaqoq, Daniel Brodie, Glenn J R Whitman, Sung-Min Cho","doi":"10.1097/MAT.0000000000002294","DOIUrl":"10.1097/MAT.0000000000002294","url":null,"abstract":"Low pulse pressure (PP) in venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a marker of cardiac dysfunction and has been associated with acute brain injury (ABI) as continuous-flow centrifugal pump may lead to endothelial dysregulation. We retrospectively analyzed adults (≥18 years) receiving \"peripheral\" VA-ECMO for cardiogenic shock in the Extracorporeal Life Support Organization Registry (January 2018-July 2023). Acute brain injury (our primary outcome) included central nervous system (CNS) ischemia, intracranial hemorrhage, brain death, and seizures. Multivariable logistic regressions were performed to examine whether PP ≤10 mm Hg was associated with ABI. Of 9,807 peripheral VA-ECMO patients (median age = 57.4 years, 67% = male), 8,294 (85%) had PP >10 mm Hg versus 1,513 (15%) had PP ≤10 mm Hg. Patients with PP ≤10 mm Hg experienced ABI more frequently versus PP >10 mm Hg (15% versus 11%, p < 0.001). After adjustment, PP ≤10 mm Hg was independently associated with ABI (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = 1.06-1.48, p = 0.01). Central nervous system ischemia and brain death were more common in patients with PP ≤10 versus PP >10 mm Hg (8% versus 6%, p = 0.008; 3% versus 1%, p < 0.001). Pulse pressure ≤10 mm Hg was associated with CNS ischemia (aOR = 1.26, 95% CI = 1.02-1.56, p = 0.03) but not intracranial hemorrhage (aOR = 1.14, 95% CI = 0.85-1.54, p = 0.38). Early low PP (≤10 mm Hg) at 24 hours of ECMO support was associated with ABI, particularly CNS ischemia, in peripheral VA-ECMO patients.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142043852","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