ASAIO Journal最新文献_第8页

The Impact of Preoperative Right Ventricular Dysfunction and Ventricular Arrhythmias on Left Ventricular Assist Device Outcomes.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-20 DOI: 10.1097/MAT.0000000000002402

Douglas Hall, Rahul A Chhana, Bin Q Yang, Elena Deych, Christopher T Sparrow, Praveen Rao, Michael E Nassif, Shane J LaRue, Joel D Schilling

{"title":"The Impact of Preoperative Right Ventricular Dysfunction and Ventricular Arrhythmias on Left Ventricular Assist Device Outcomes.","authors":"Douglas Hall, Rahul A Chhana, Bin Q Yang, Elena Deych, Christopher T Sparrow, Praveen Rao, Michael E Nassif, Shane J LaRue, Joel D Schilling","doi":"10.1097/MAT.0000000000002402","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002402","url":null,"abstract":"Ventricular arrhythmias (VA) are common in patients being evaluated for left ventricular assist devices (LVADs) but the impact of comorbid right ventricular dysfunction (RVD) on outcomes after LVAD is not known. We performed a single-center, retrospective cohort study of patients undergoing LVAD implantation from 2005 to 2021. Patients were stratified by VA history before LVAD into no VA, low burden VA (LBVA), or clinically significant VA (CSVA) groups. Right ventricular function was assessed by baseline echo. Time-to-event analyses were used with a primary outcome of all-cause mortality. Secondary outcomes were implantable cardioverter-defibrillator (ICD) shock, rehospitalization, and postoperative complications related to RV failure. A total of 761 patients were included, of which 442 (58%) had no VA, 120 (16%) had LBVA, and 199 (26%) had CSVA. The mean age was 57 and 584 (77%) of patients were male. Within the CSVA group, mortality was higher in those with baseline RVD (hazard ratio [HR] = 1.6, confidence interval [CI] = 1.1-2.5). Clinically significant VA and renal dysfunction were associated with mortality on Cox proportional hazards modeling. Implantable cardioverter-defibrillator shocks after LVAD were more common in those with LBVA or CSVA. There was no difference in 6-month rehospitalization between groups. Patients with a history of CSVA undergoing LVAD implantation are at increased risk for mortality and this risk is predominantly seen in those with comorbid RVD.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466787","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

Evaluating Concordance Between Complete Blood Count and Point-of-Care Tests in Pediatric Extracorporeal Membrane Oxygenation.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-20 DOI: 10.1097/MAT.0000000000002400

Jordan R Lull, Louisa M Sethi, Robin Alexander, Kathleen K Nicol, Jennifer A Muszynski

{"title":"Evaluating Concordance Between Complete Blood Count and Point-of-Care Tests in Pediatric Extracorporeal Membrane Oxygenation.","authors":"Jordan R Lull, Louisa M Sethi, Robin Alexander, Kathleen K Nicol, Jennifer A Muszynski","doi":"10.1097/MAT.0000000000002400","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002400","url":null,"abstract":"The accuracy of point-of-care (POC) hemoglobin (Hgb) and hematocrit (Hct) testing in pediatric patients on extracorporeal membrane oxygenation (ECMO) is unknown. Point-of-care testing uses less blood volume and could decrease iatrogenic anemia. However, inaccurate results could lead to repeat testing or increased risk of red blood cell (RBC) transfusions. We performed a single-center, retrospective study to quantify agreement between laboratory and POC tests for Hgb and Hct in pediatric ECMO. Patients were included if laboratory and POC values were recorded within 5 minutes of each other. Discordance was defined as discrepancy of >0.5 g/dl (Hgb) or >1.5% (Hct). Exclusion criteria included >18 years of age, cannulated at outside hospital, or ECMO support <24 hours. One hundred thirty-six patients with an average age of 2 months were included. Fifty-one percent were female. Sixty-six percent were supported with VA ECMO. Two hundred seventy-nine values compared laboratory with inline and 59 compared laboratory with blood gas analyzer. Forty-one percent of values were discordant, with the majority of discordant POC value less than the lab value. Our findings suggest that using POC values could increase RBC transfusions, though further study is needed to determine the effects of POC tests on transfusion burden and to evaluate factors predictive of discordance.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466778","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

A Biophysics-Based Mathematical Model of Shear-Induced Platelet Activation and Receptor Shedding: Re-Examining Previous Experimental Data.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-19 DOI: 10.1097/MAT.0000000000002399

Dong Han, Anik Tarafder, Bartley P Griffith, Zhongjun J Wu

{"title":"A Biophysics-Based Mathematical Model of Shear-Induced Platelet Activation and Receptor Shedding: Re-Examining Previous Experimental Data.","authors":"Dong Han, Anik Tarafder, Bartley P Griffith, Zhongjun J Wu","doi":"10.1097/MAT.0000000000002399","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002399","url":null,"abstract":"The power-law model, originally developed for shear-induced hemolysis, has been used to predict shear-induced platelet activation and receptor shedding. However, its empirical nature lacks mechanistic explanations and violates physical reality by not imposing an upper limit, often leading to inaccuracies. Recent studies suggest that the mechanical pulling of platelet GPIb-IX complex triggers the unfolding of its mechanosensitive domain, a crucial process to platelet activation, which can be explained by Bell's model of bond unbinding under force. Motivated by these findings, we propose a novel mathematical model for shear-induced platelet activation (P-selectin) and shear-induced platelet receptor (glycoprotein Ibα [GPIbα], GPVI, and GPIIb/IIIa) shedding based on the principle of bond unbinding. The model was examined using experimental data from previous studies in which blood samples were exposed to different combinations of constant shear stress and exposure time. The new model demonstrated an excellent fit with experimental data with an overall coefficient of determination R2 >0.8, mapping the trends in platelet activation and receptor shedding (except for GPIIb/IIIa) across a range of shear conditions. This new model not only addresses the intrinsic upper bound error in the power-law model but also provides a theoretical foundation into blood damage under shear stress.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448002","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

A New Multifunction Oxygenator With a Dual-Chamber Gas Exchanger to Reduce Dependence on Oxygen Supply.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-19 DOI: 10.1097/MAT.0000000000002396

Dong Han, Jiafeng Zhang, Aakash Shah, Bartley P Griffith, Zhongjun J Wu

{"title":"A New Multifunction Oxygenator With a Dual-Chamber Gas Exchanger to Reduce Dependence on Oxygen Supply.","authors":"Dong Han, Jiafeng Zhang, Aakash Shah, Bartley P Griffith, Zhongjun J Wu","doi":"10.1097/MAT.0000000000002396","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002396","url":null,"abstract":"Although extracorporeal membrane oxygenation (ECMO) systems have been used to provide temporary support for patients with severe respiratory or cardiac failure, they are often bedridden, in part because of their bulky size which relies solely on an unlimited source of wall oxygen. However, there is an unmet clinical need for ambulatory ECMO which necessitates downsizing the ECMO system. We sought to develop a new oxygenator to reduce the dependence on the oxygen supply source. The proposed oxygenator features a dual-chamber gas exchangers, with one chamber primarily responsible for carbon dioxide removal using ambient air and a subsequent chamber primarily responsible for oxygen transfer using pure oxygen. Computational fluid dynamics was used to analyze the blood flow field to avoid adverse stagnation and optimize gas exchange performance. Bovine blood was used for in vitro gas transfer test. This new oxygenator demonstrated the capability to provide adequate respiratory support (both carbon dioxide removal and oxygen transfer) to adult patients at blood rate of 4-6 L/min with an oxygen supply of only 2 L/min. The reduced use of oxygen with this new oxygenator may pave the way for the development of potable ECMO systems.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448004","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 Multistage Cannula on Recirculation in Various Venovenous Extracorporeal Membrane Oxygenation Cannulation Strategies.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-18 DOI: 10.1097/MAT.0000000000002384

Yong Chae Jung, Yooyoung Chong, Sung Joon Han, Sang-Jun Park, Yujin Kwak, Sang Yoon Kim, Man-Shik Shim

{"title":"Impact of Multistage Cannula on Recirculation in Various Venovenous Extracorporeal Membrane Oxygenation Cannulation Strategies.","authors":"Yong Chae Jung, Yooyoung Chong, Sung Joon Han, Sang-Jun Park, Yujin Kwak, Sang Yoon Kim, Man-Shik Shim","doi":"10.1097/MAT.0000000000002384","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002384","url":null,"abstract":"We aimed to compare recirculation of venovenous extracorporeal membrane oxygenation (V-V ECMO) administered with various cannula placements for femoro-femoral (F-F) and femoro-jugular (F-J) configurations in patients with respiratory failure. This single-center retrospective study included 58 consecutive patients who underwent V-V ECMO between January 2021 and December 2023. Ultrasonic dilution technology was used to quantify the flow of recirculation. The drain cannula placements were categorized into three positions: right atrium and superior and inferior venae cavae. The primary outcome was the difference in recirculation according to the configuration of the V-V ECMO and cannula tip placement. The secondary outcomes were the correlations between recirculation and distance between cannula tips and recirculation difference after cannula adjustment. The recirculation fractions for all types of F-J (27.18%) and F-F (29.33%) configurations were not significantly different. No significant correlation (r = 0.14) was observed between recirculation and the distance between the drain and return cannula tips in chest radiography. The configuration and placement of the drain cannula may have limited effects on recirculation when using a multistage continuous cannula while applying V-V ECMO.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439848","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

A Smart Computational Tool for Personalized Coronary Blood Flow Settings During Normothermic Ex Situ Heart Perfusion.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-18 DOI: 10.1097/MAT.0000000000002394

Jorik H Amesz, Niki L Lupgens, Dirk J Duncker, Lisa E Sluijter-Rozendaal, Dwight Dumay, Olivier C Manintveld, Yannick J H J Taverne

引用次数: 0

Early Extracorporeal Membrane Oxygenation Initiation May Improve Outcomes in Select Patients With Primary Pulmonary Hypertension: An Extracorporeal Life Support Organization Registry Analysis.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-18 DOI: 10.1097/MAT.0000000000002390

Benjamin Smood, Charles R Vasquez, Salim E Olia, Jason J Han, Amit Iyengar, William L Patrick, Mark R Helmers, John J Kelly, Thomas Richards, Asad Usman, Edward Cantu, Koji Takeda, Nathaniel Langer, Marisa Cevasco

{"title":"Early Extracorporeal Membrane Oxygenation Initiation May Improve Outcomes in Select Patients With Primary Pulmonary Hypertension: An Extracorporeal Life Support Organization Registry Analysis.","authors":"Benjamin Smood, Charles R Vasquez, Salim E Olia, Jason J Han, Amit Iyengar, William L Patrick, Mark R Helmers, John J Kelly, Thomas Richards, Asad Usman, Edward Cantu, Koji Takeda, Nathaniel Langer, Marisa Cevasco","doi":"10.1097/MAT.0000000000002390","DOIUrl":"10.1097/MAT.0000000000002390","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) utilization for primary pulmonary hypertension (PPHTN) remains controversial. This multicenter, retrospective analysis of the Extracorporeal Life Support Organization Registry evaluated 221 PPHTN patients placed on ECMO in 2000-2019. Survival by ECMO indications and cannulation strategies were compared with Kaplan-Meier analyses. ECMO mortality risk factors were analyzed using Cox proportional hazards regressions. The overall rate of survival to ECMO decannulation was 140/221 (63.3%), of which 112/140 (80.0%) survived to hospital discharge. Survival to decannulation increased between 2000-2009 (14/30, 46.7%) and 2010-2019 (126/191, 66.0%, p = 0.041) alongside survival to hospital discharge (9/30, 30.0% vs. 103/191, 53.9%, p = 0.015). Survival to decannulation was similar when patients were supported with either venovenous-ECMO (VV-ECMO; 39/54, 72.2%) or venoarterial-ECMO (VA-ECMO) for respiratory failure (43/71, 60.6%, p = 0.174), although VV-ECMO was associated with fewer complications (25/54, 46% vs. 25/71, 35%, respectively, p = 0.039) and increased survival to hospital discharge (34/54, 63.0% vs. 33/71, 46.5%, p = 0.067). The strongest independent predictor of ECMO morality was isolated vasopressor use before cannulation (hazard ratio [HR]: 3.37 [95% confidence interval {CI95%}: 1.16-9.81], p = 0.026). Extracorporeal membrane oxygenation mortality risk was lower among patients bridged-to-transplantation (HR: 0.37 [CI95%: 0.14-0.97], p = 0.043), and was inversely correlated with pre-ECMO pH (HR: 0.03 [CI95%: 0.00-0.49], p = 0.013). Extracorporeal membrane oxygenation use for PPHTN has grown alongside improved outcomes. Early ECMO initiation may improve outcomes in select individuals with PPHTN.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439846","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

A New Technique for Anticoagulation and Prevention of Bleeding During Impella 5.5 Left Ventricular Assist Device Implantation.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-18 DOI: 10.1097/MAT.0000000000002401

Hannah Copeland, Asim Mohammed, John Morton

引用次数: 0

First-Day Platelet Count Is Associated With In-Hospital Mortality in Adult Postcardiotomy Extracorporeal Membrane Oxygenation.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-14 DOI: 10.1097/MAT.0000000000002393

Jing Wang, Sizhe Gao, Tianlong Wang, Han Zhang, Luyu Bian, Shujie Yan, Bingyang Ji

{"title":"First-Day Platelet Count Is Associated With In-Hospital Mortality in Adult Postcardiotomy Extracorporeal Membrane Oxygenation.","authors":"Jing Wang, Sizhe Gao, Tianlong Wang, Han Zhang, Luyu Bian, Shujie Yan, Bingyang Ji","doi":"10.1097/MAT.0000000000002393","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002393","url":null,"abstract":"To investigate the relationship between platelet counts within the first 24 hours of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support and in-hospital mortality in postcardiotomy ECMO patients. Adult patients undergoing postcardiotomy V-A ECMO from 2017 to 2021 were included and divided into survivors and non-survivors. Logistic regression evaluated the association between the first-day platelet counts and in-hospital mortality. Spearman's correlation assessed the correlations between clinical factors and the platelet hourly % decrease within 24 hours of ECMO support. The study included 72 patients, with an in-hospital mortality of 51.4%. For every 10 ×109/L decrease in the lowest platelet count at 0-24, 0-12, and 12-24 hours of ECMO support, the odds of in-hospital mortality increased by 21.7% (adjusted odds ratios [aOR], 1.217; 95% confidence intervals [CI], 1.045-1.358), 20.6% (aOR, 1.206; 95% CI, 1.058-1.332), and 17.4% (aOR, 1.174; 95% CI, 1.034-1.294), respectively. Platelet hourly % decrease was positively correlated with peak lactate, alanine aminotransferase, D-dimer, fibrinogen degradation products, and ECMO flow rate variation. In postcardiotomy V-A ECMO patients, platelet counts within the first 24 hours of ECMO support are independently associated with higher in-hospital mortality. Potential factors related to decreasing rate of platelet count included thrombosis, ECMO flow fluctuation, tissue ischemia, and hypoxia.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413298","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

Mortality and Complications in Hybrid Extracorporeal Membrane Oxygenation: A Meta-Analysis of Initial Use Versus Transition.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-14 DOI: 10.1097/MAT.0000000000002392

Irin Shin, Haein Ryu, Yujeong Hou, Mi Sung Kim, Sandy Jeong Rhie

{"title":"Mortality and Complications in Hybrid Extracorporeal Membrane Oxygenation: A Meta-Analysis of Initial Use Versus Transition.","authors":"Irin Shin, Haein Ryu, Yujeong Hou, Mi Sung Kim, Sandy Jeong Rhie","doi":"10.1097/MAT.0000000000002392","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002392","url":null,"abstract":"Hybrid extracorporeal membrane oxygenation (ECMO), containing additional ECMO cannulations in addition to conventional ECMO, is increasingly used for the treatment of serious cardiopulmonary conditions. Patients initiating non-hybrid ECMO may transition to hybrid ECMO as their condition worsens. This study compared mortality rates between patients initially on hybrid ECMO and those who transitioned from non-hybrid to hybrid ECMO. We also examined complications related to hybrid ECMO, comparing them with those of non-hybrid ECMO. Data from PubMed, Embase, and Cochrane databases were analyzed using Peto odds ratios and 95% confidential intervals (CIs), with an additional safety comparison to the Extracorporeal Life Support Organization registry to overcome the small number of selected studies. A meta-analysis was performed using review manager. The mortality rate did not differ significantly between whether the hybrid ECMO was used initially or transitioned from non-hybrid ECMO during treatment. Renal-related complications were the most frequent in both hybrid and non-hybrid ECMO cases, with overall higher complication rates in hybrid ECMO. The study concludes that transitioning to hybrid ECMO during treatment does not increase mortality compared to starting with hybrid ECMO, but potential complications, especially with commodity conditions, should be considered. This study provides valuable guidance for clinicians choosing ECMO modalities in clinical practice.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413299","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