Professor Stephen Westaby of John Radcliffe Hospital, Oxford, UK, gives an overview of the use of temporary mechanical support for postcardiotomy failure.
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Mechanical Circulatory Assistance
February 8, 2017
February 5, 2017
A review of particular interest for procurement (retrieval) of hearts after brain injury, especially subarachnoid bleeding, the commonest cause of death in DBD in our practice. The authors discuss, amongst other things, the early stress micro-infarcts that may limit the performance of the donated heart, especally in female donors with sub a
Temporary Mechanical Circulatory Support in Cardiac Critical Care: A State of the Art Review and Algorithm for Device Selection
January 31, 2017
The authors of this review article offer an approach to the utilization of a contempory mechanical circulatory support devices. They further provide insights of the key role that well-functioning interdisciplinary teams contribute to the success of a MCS program and future directions to consider as this field continues to rapidly evolve.
January 27, 2017
Rajamiyer Venkateswaran of Mythenshawe Hospital, Manchester, UK, discusses temporary mechanical circulatory support as a bridge to transplantation in cases of cardiogenic shock.
Cost-Effectiveness of Left Ventricular Assist Devices in Ambulatory Patients With Advanced Heart Failure
January 13, 2017
With the everpresent question of potentially extending LVAD therapy to ambulatory patients with advanced heart failure, the authors--using a Markov model--projected the incremental cost-efffectiveness ratio (ICER) of DT LVADs in this population as compared to conventional medical therapy.
Predictors of survival in adults undergoing extracorporeal membrane oxygenation with severe infections
November 23, 2016
An institutional registry of ECMO patients was surveyed to determine predictors of survival among patients receiving ECMO in the presence of sepsis. Among 151 studied patients, pneumonia was the most common cause of sepsis. Mortality was predicted by advanced age, longer door-to ECMO times, gram-negative sepsis, and sepsis due to infections other t
October 13, 2016
This single-center study explored the relationship between spontaneous echo contrast (SEC) and the incidence of thromboembolism and CVA in 98 patients undergoing peripheral VA ECMO. Twenty-two percent of patients had SEC while they were on ECMO. Those exhibiting SEC had significantly higher rates of intracardiac thrombus (46% v.
August 28, 2016
Operative and postoperative factors' relationship to intermediate term neurodevelopment were assessed in patients who underwent cardiac surgery on bypass at age 9 mos or less using the Psychomotor Development Index (PMI) and the Mental Development Index (MDI). Lower PDI and MDI were associated with longer interoperative support time, with use of ECM
Severe Thrombocytopenia in Adults with Severe Acute Respiratory Distress Syndrome: Impact of Extracorporeal Membrane Oxygenation Use.
July 24, 2016
The authors, using 2 groups of patients, 32 ECMO and 53 non-ECMO, both with a diagnosis of ARDS, describe the two groups' severity of illness, medication regimen and use or nonuse of ECMO therapy.
July 5, 2016
With the rapid expansion of mechanical circulatory support (MCS) in various contexts (CVICU, in-hospital cardiac arrest (E-CPR) and the ED), the authors have provided a very nice overview of the general principles of MCS options and management to assist the broader healthcare team involved with these complex patients.