ASAIO Journal最新文献_第9页

Dialoxygenation: A Preclinical Trial for Transforming the Artificial Kidney Into an Oxygenator. 透析氧合：将人工肾脏转化为氧合器的临床前试验。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-22 DOI: 10.1097/MAT.0000000000002260

Dilek Karacanoğlu, Esra Bedir, Özlem Saritaş Nakip, Selman Kesici, Hatice Duran, Benan Bayrakci

{"title":"Dialoxygenation: A Preclinical Trial for Transforming the Artificial Kidney Into an Oxygenator.","authors":"Dilek Karacanoğlu, Esra Bedir, Özlem Saritaş Nakip, Selman Kesici, Hatice Duran, Benan Bayrakci","doi":"10.1097/MAT.0000000000002260","DOIUrl":"10.1097/MAT.0000000000002260","url":null,"abstract":"Critically ill patients sometimes require tandem application of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) which is easier and cheaper. We aimed to transform the kidney membrane into a lung membrane by adding hydrogen peroxide (H 2 O 2 ) to the dialysate as the oxygen source. A solution containing H 2 O 2 and a dialysate fluid mixture was used as the final dialysate. Starting with 100% H 2 O 2 solution and gradually reducing the volume of H 2 O 2 , respectively: 50%, 10%, 5%, 4%, 3%, 2%, and 1%. PRISMAFLEX system, Prismaflex M60 set and a bag of packed red blood cells (pRBCs) were the prototype. blood flow rate was about 40 ml/minute and the dialysis rate was about 200 ml/m 2 /minute/1.73 m 2 . blood sampling times were; at the beginning ( T0 ), at 15th ( T1 ), 30th ( T2 ), 60th ( T3 ) minutes. Amongst eight attempts H 2 O 2 concentration that increased the partial oxygen pressure (pO 2 ) level significantly in a reasonable period, without any bubbles, was 3%. Methemoglobinemia was not observed in any trial. After the test with 3%, H 2 O 2 in the dialysate fluid decreased progressively without any H 2 O 2 detection at post-membrane blood. Three percent H 2 O 2 solution is sufficient and safe for oxygenation in CRRT systems. With this new oxy-dialysate solution, both pulmonary and renal replacement can be possible viaa single membrane in a simpler manner.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619214","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

Aortic Root Vortex Formation During Left Ventricular Assist Device Support. 左心室辅助装置支持过程中的主动脉根部涡流形成

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-22 DOI: 10.1097/MAT.0000000000002298

Chaztyn Pangelina, Vi Vu, Karen May-Newman

{"title":"Aortic Root Vortex Formation During Left Ventricular Assist Device Support.","authors":"Chaztyn Pangelina, Vi Vu, Karen May-Newman","doi":"10.1097/MAT.0000000000002298","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002298","url":null,"abstract":"The vortex that forms in the aortic sinus plays a vital role in optimizing blood flow. Disruption of the vortex can result in flow stagnation and activate thrombus formation in the aortic root, especially when aortic valve flow is reduced as during left ventricular assist device (LVAD) support. Our goal in this study was to visualize vortex formation in an experimental model of the aortic root as flow is progressively reduced. A mock circulatory loop that reproduces heart failure hemodynamics was combined with a HeartMate II LVAD and velocity measured in a transparent aortic root with a bioprosthetic valve. The aortic valve sinus vortices are clearly visible as counter-rotating structures in the velocity field at baseline and for all conditions with flow through the aortic valve. As LVAD speed increases, the central jet narrows but the vortices persist, disappearing only when the valve is completely closed. The vortices preserve fluid momentum and generate shear stress along the tissue surfaces which disrupts flow stasis. These features underscore the importance of maintaining \"intermittent\" aortic valve opening, as recommended for LVAD patients. This study is the first to report vortex formation in the aortic root during LVAD support, providing a motivation for further evaluation.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071925","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

Thoracoabdominal Normothermic Regional Perfusion Using Mobile Closed Extracorporeal Circuit in Circulatory Death Determination Heart Donors. 使用移动式封闭体外循环对循环死亡确定心脏捐献者进行胸腹腔常温区域灌注。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-14 DOI: 10.1097/MAT.0000000000002282

Marta Velia Antonini, Sofia Martin-Suàrez, Luca Botta, Alessandro Circelli, Erika Cordella, Gianluca Zani, Marina Terzitta, Vanni Agnoletti, Davide Pacini

{"title":"Thoracoabdominal Normothermic Regional Perfusion Using Mobile Closed Extracorporeal Circuit in Circulatory Death Determination Heart Donors.","authors":"Marta Velia Antonini, Sofia Martin-Suàrez, Luca Botta, Alessandro Circelli, Erika Cordella, Gianluca Zani, Marina Terzitta, Vanni Agnoletti, Davide Pacini","doi":"10.1097/MAT.0000000000002282","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002282","url":null,"abstract":"Thoracoabdominal normothermic regional perfusion (TA-NRP) is increasingly implemented in donation after circulatory determination of death (DCD). Thoracoabdominal normothermic regional perfusion allows thoracic and abdominal organs to be perfused with warm, oxygenated blood after declaration of death, interrupting ischemia. Evidence is accumulating supporting the use of TA-NRP to improve the outcome of grafts from DCD donors. Thoracoabdominal normothermic regional perfusion may restore and maintain a near-physiological environment during procurement. Moreover, during TA-NRP it is feasible to evaluate the heart in situ. Thoracoabdominal normothermic regional perfusion could be performed through different cannulation techniques, central or peripheral, and, with different extracorporeal circuits. The use of conventional cardiopulmonary bypass and extracorporeal life support (ECLS) devices equipped with open circuits has been described. We report the use of a fully mobile, closed ECLS circuit to implement TA-NRP. The procedure was successfully performed in a peripheral center without a cardiac surgery program through a percutaneous cannulation approach. This strategy resulted in combined heart, liver, and kidney recovery despite a significantly prolonged functional warm ischemia time. The feasibility of TA-NRP using modified but still closed fully mobile ECLS circuits could furtherly support the expansion of DCD programs, increasing the availability of heart for transplantation, and the quality of the grafts, improving recipients' outcome.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981570","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

In Response to Broman et al.: Time to Throw Out the Elephant in the Room: Proper Use of SvO2 in Extracorporeal Life Support. 回应 Broman et al：是时候扔掉房间里的大象了：在体外生命支持中正确使用 SvO2。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-09 DOI: 10.1097/MAT.0000000000002291

Kevin J John, Haval Chweich

引用次数: 0

Successful Extracorporeal Cardiopulmonary Resuscitation Despite Aortic Occlusion. 在主动脉闭塞的情况下成功进行体外心肺复苏。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-09 DOI: 10.1097/MAT.0000000000002295

Torben K Becker, John Bruno, Eric I Jeng, Jordan Phillips, Taylor N Smith, David L Roberts, Casey T Carr, Michol A Cooper, Martin R Back, R David Anderson, Marc O Maybauer

{"title":"Successful Extracorporeal Cardiopulmonary Resuscitation Despite Aortic Occlusion.","authors":"Torben K Becker, John Bruno, Eric I Jeng, Jordan Phillips, Taylor N Smith, David L Roberts, Casey T Carr, Michol A Cooper, Martin R Back, R David Anderson, Marc O Maybauer","doi":"10.1097/MAT.0000000000002295","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002295","url":null,"abstract":"We present the case of a 62-year-old man with severe coronary artery disease who presented to the hospital in refractory ventricular fibrillation cardiac arrest. He showed signs of life despite prolonged resuscitation. We thus decided to initiate extracorporeal cardiopulmonary resuscitation (ECPR). The patient had a known total occlusion of his infrarenal aorta that had been surgically bypassed with a bifemoral-axillary graft. We successfully initiated ECPR via the surgical graft, establishing blood flow to the central circulation through the axillary artery in a peripheral configuration while ensuring blood flow to the left leg via the femoral-femoral graft. The patient was extubated neurologically intact the following day and subsequently underwent coronary artery bypass graft surgery while on extracorporeal membrane oxygenation (ECMO) support. He was subsequently weaned off inotropic support and decannulated from ECMO. He was discharged home neurologically intact and independent in his activities of daily living. This case demonstrates that cannulation for ECPR via a surgical vascular graft is possible and that a total occlusion of the infrarenal aorta in the presence of a surgical bypass is not an absolute contraindication to ECMO.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905795","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

Pressure Support Ventilation During Extracorporeal Membrane Oxygenation Support in Patients With Acute Respiratory Distress Syndrome. 急性呼吸窘迫综合征患者体外膜氧合支持期间的压力支持通气。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-09 DOI: 10.1097/MAT.0000000000002285

Benedetta Fumagalli, Marco Giani, Michela Bombino, Denise Fumagalli, Milena Merelli, Gaia Chiesa, Roberto Rona, Giacomo Bellani, Emanuele Rezoagli, Giuseppe Foti

{"title":"Pressure Support Ventilation During Extracorporeal Membrane Oxygenation Support in Patients With Acute Respiratory Distress Syndrome.","authors":"Benedetta Fumagalli, Marco Giani, Michela Bombino, Denise Fumagalli, Milena Merelli, Gaia Chiesa, Roberto Rona, Giacomo Bellani, Emanuele Rezoagli, Giuseppe Foti","doi":"10.1097/MAT.0000000000002285","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002285","url":null,"abstract":"In the initial phases of veno-venous extracorporeal membrane oxygenation (VV ECMO) support for severe acute respiratory distress syndrome (ARDS), ultraprotective controlled mechanical ventilation (CMV) is typically employed to limit the progression of lung injury. As patients recover, transitioning to assisted mechanical ventilation can be considered to reduce the need for prolonged sedation and paralysis. This study aimed to evaluate the feasibility of transitioning to pressure support ventilation (PSV) during VV ECMO and to explore variations in respiratory mechanics and oxygenation parameters following the transition to PSV. This retrospective monocentric study included 191 adult ARDS patients treated with VV ECMO between 2009 and 2022. Within this population, 131 (69%) patients were successfully switched to PSV during ECMO. Pressure support ventilation was associated with an increase in respiratory system compliance (p = 0.02) and a reduction in pulmonary shunt fraction (p < 0.001). Additionally, improvements in the cardiovascular Sequential Organ Failure Assessment score and a reduction in pulmonary arterial pressures (p < 0.05) were recorded. Ninety-four percent of patients who successfully transitioned to PSV were weaned from ECMO, and 118 (90%) were discharged alive from the intensive care unit (ICU). Of those who did not reach PSV, 74% died on ECMO, whereas the remaining patients were successfully weaned from extracorporeal support. In conclusion, PSV is feasible during VV ECMO and potentially correlates with improvements in respiratory function and hemodynamics.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905794","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

Galectin-3 as a Prognostic Biomarker of Left Ventricular Assist Device Implantation Outcomes. 作为左心室辅助装置植入术预后生物标志物的Galectin-3

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-02 DOI: 10.1097/MAT.0000000000002292

Ryan Hoang, Mary E Acosta, Mark N Belkin, Nabeel F Rasheed, Umar Siddiqi, Jennifer M Cruz, Sydney E Lupo, Corinne R Stonebraker, Sara Kalantari, Jonathan Grinstein

{"title":"Galectin-3 as a Prognostic Biomarker of Left Ventricular Assist Device Implantation Outcomes.","authors":"Ryan Hoang, Mary E Acosta, Mark N Belkin, Nabeel F Rasheed, Umar Siddiqi, Jennifer M Cruz, Sydney E Lupo, Corinne R Stonebraker, Sara Kalantari, Jonathan Grinstein","doi":"10.1097/MAT.0000000000002292","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002292","url":null,"abstract":"We assessed the prognostic potential of Galectin-3 in a sample of 159 heart failure patients who received a left ventricular assist device (LVAD) implant from 2012 to 2020. Clinical outcomes included hemodynamic data, right heart failure (RHF), hemocompatibility-related adverse events (HRAEs), and mortality. Galectin-3 was compounded into Michigan-RVF and EUROMACS-RHF risk scores and compared to the noncompounded risk scores. Right heart failure was significantly correlated with Galectin (p = 0.004) on a continuous spectrum. Inotrope duration was significantly correlated to Galectin-3 (interquartile range [IQR]: 7.58-8.65, p < 0.001) along with INTERMACS score (IQR: 2.14-1.90, p < 0.001). Intensive care unit length of stay (median 8 days, p = 0.02), blood urea nitrogen (p < 0.001), creatinine (p < 0.001), and pulmonary artery pulsatility index (p = 0.05) were also significantly correlated with Galectin-3. In our c-statistic analysis, the predictive value for RHF improved when Galectin-3 was included for both the Michigan-RVF (0.80-0.86) and EUROMACS-RHF (0.77-0.82) risk scores. When elevated over a binary cutoff of 18.2 ng/ml, Galectin-3 significantly correlated with HRAEs (p = 0.014) and mortality (p = 0.031). Galectin-3 shows great promise as a predictive biomarker in patients implanted with durable LVADs. In addition to significant correlation with key clinical outcomes, Galectin-3 enhanced the Michigan-RVF and EUROMACS-RHF risk scores in predicting progression to RHF.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874069","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

Estimation of Absolute Blood Volume Using Online Dialysate Dilution: When and How to Measure? 使用在线透析液稀释估算绝对血容量：何时以及如何测量？

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-02 DOI: 10.1097/MAT.0000000000002284

Joachim Kron, Susanne Kron

引用次数: 0

Cannula-Associated Deep Vein Thrombosis Following Extracorporeal Membrane Oxygenation Decannulation: Incidence and Risk Factors. 体外膜氧封管术后的套管相关性深静脉血栓：发生率和风险因素。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-02 DOI: 10.1097/MAT.0000000000002289

Ngan Hoang Kim Trieu, Huy Minh Pham, Tuan Anh Mai, Dai Quang Huynh, Linh Thanh Tran, Xuan Thi Phan, Thao Thi Ngoc Pham

{"title":"Cannula-Associated Deep Vein Thrombosis Following Extracorporeal Membrane Oxygenation Decannulation: Incidence and Risk Factors.","authors":"Ngan Hoang Kim Trieu, Huy Minh Pham, Tuan Anh Mai, Dai Quang Huynh, Linh Thanh Tran, Xuan Thi Phan, Thao Thi Ngoc Pham","doi":"10.1097/MAT.0000000000002289","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002289","url":null,"abstract":"Thrombotic complications during and after extracorporeal membrane oxygenation (ECMO) are commonly observed clinically. The incidences of cannula-associated deep vein thrombosis (CaDVT) post-ECMO support have predominantly focused on Caucasian demographics. This study aims to determine the incidence and risk factors for CaDVT in Vietnamese patients following ECMO decannulation. The retrospective study from January 2019 to February 2020 observed ECMO weaning patients and screened for CaDVT using Doppler ultrasonography. Data were collected on patient demographics, ECMO parameters, and transfusion and coagulation profiles during ECMO support. Of the 82 patients successfully weaned ECMO, 89% were assessed for CaDVT. We observed a CaDVT incidence of 24.7%, and only one patient (5.6%) had a pulmonary embolism in the CaDVT group. Noteworthy is that the anticoagulation goals, transfusion during ECMO, and hospital mortality showed no significant difference between the CaDVT and non-CaDVT groups. The findings showed that the duration of ECMO support is a risk factor for CaDVT. The incidence of CaDVT following ECMO decannulation was 24.7%, and the diagnosis of CaDVT can be underestimated. Therefore, we suggest routine screening for CaDVT after cannula removal.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874067","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

In-Vivo Evaluation of a Novel Integrated Pediatric Pump Lung in a 30-Day Ovine Animal Model. 在 30 天绵羊动物模型中对新型集成式儿科泵肺进行体内评估。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-08-01 Epub Date: 2024-03-06 DOI: 10.1097/MAT.0000000000002173

Joshua L Leibowitz, Morcos A Awad, Dong Han, Aakash Shah, Wenji Sun, Jiafeng Zhang, Bartley P Griffith, Zhongjun J Wu

{"title":"In-Vivo Evaluation of a Novel Integrated Pediatric Pump Lung in a 30-Day Ovine Animal Model.","authors":"Joshua L Leibowitz, Morcos A Awad, Dong Han, Aakash Shah, Wenji Sun, Jiafeng Zhang, Bartley P Griffith, Zhongjun J Wu","doi":"10.1097/MAT.0000000000002173","DOIUrl":"10.1097/MAT.0000000000002173","url":null,"abstract":"Recently there has been increased use of mechanical circulatory support in pediatric patients as a bridge to cardiopulmonary recovery or transplantation. However, there are few devices that are optimized and approved for use in pediatric patients. We designed and prototyped a novel integrated pediatric pump lung (PPL) that underwent 30 day in-vivo testing in seven juvenile Dorset Hybrid sheep. Devices were implanted in a right atrial to pulmonary artery configuration. Six of seven sheep survived with a device functioning for 25-35 days. The device flow rate was maintained at 2.08 ± 0.34 to 2.54 ± 0.16 L/min with oxygen transfer of 109.8 ± 24.8 to 151.2 ± 26.2 ml/min over the study duration. Aside from a postoperative drop in hematocrit, all hematologic and blood chemistry test values returned to normal ranges after 1-2 weeks postoperatively. Similarly, lactate dehydrogenase increased postoperatively and returned to baseline. In two sheep, there were early device failures due to oxygenator thrombosis on postoperative days zero and five; they then had oxygenator exchanges with subsequent devices performing stably for 30 days. This study demonstrated that the integrated PPL device exhibited stable performance and acceptable biocompatibility in a 30 day ovine model.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"704-712"},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048607","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