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EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)                     

Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 36)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 9)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 16)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 7)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 126)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 13)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 279)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 10)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 23)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 3)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 48)
Journal of Critical Care Medicine     Open Access   (Followers: 18)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 53)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 25)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 6)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 54)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 2)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 46)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 2)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)

           

Similar Journals
Journal Cover
ASAIO Journal
Journal Prestige (SJR): 0.771
Citation Impact (citeScore): 2
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1058-2916 - ISSN (Online) 1538-943X
Published by LWW Wolters Kluwer Homepage  [297 journals]
  • Survival and Factors Associated with Survival with Extracorporeal Life
           Support During Cardiac Arrest: A Systematic Review and Meta-Analysis

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      Authors: Panagides; Vassili; Laine, Marc; Fond, Guillaume; Lebreton, Guillaume; Paganelli, Franck; Michelet, Pierre; Roch, Antoine; Boyer, Laurent; Bonello, Laurent
      Abstract: imageThe survival rate after cardiac arrest (CA) remains low. The utilization of extracorporeal life support is proposed to improve management. However, this resource-intensive tool is associated with complications and must be used in selected patients. We performed a meta-analysis to determine predictive factors of survival. Among the 81 studies included, involving 9256 patients, survival was 26.2% at discharge and 20.4% with a good neurologic outcome. Meta-regressions identified an association between survival at discharge and lower lactate values, intrahospital CA, and lower cardio pulmonary resuscitation (CPR) duration. After adjustment for age, intrahospital CA, and mean CPR duration, an initial shockable rhythm was the only remaining factor associated with survival to discharge (β = 0.02, 95% CI: 0.007–0.02; p = 0.0004).
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • First Use of a New Extracorporeal Membrane Oxygenation System in
           COVID19-Associated Adult Respiratory Distress Syndrome: The MobyBox Device
           

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      Authors: Kau; Miriam; Steltner, Jens C.; Lepper, Philipp M.; Omlor, Albert J.; Mang, Sebastian; Misic, Jovan; Peivandi, Ali A.; Muellenbach, Ralf M.; Reyher, Christian
      Abstract: imageIn late 2020, during the second wave of COVID-19 in Germany, we started using the MobyBox, which is a novel fully pneumatically driven ECMO device, on a regular basis to meet the increasing demand for ECMO therapy. In this case series, we performed a retrospective chart review of seven patients with severe COVID-19-related acute respiratory distress syndrome (ARDS) requiring veno-venous (vv)-ECMO support with the MobyBox. During ECMO treatments we have observed no disadvantages in comparison to conventional ECMO systems. There were no system failures or adverse events directly attributable to the MobyBox system. Our data support that providing vv-ECMO with the MobyBox device is safe and feasible. Furthermore, our findings suggest that the MobyBox device might represent an advantage in terms of biocompatibility. Therefore, more data on this issue is needed to better understand how the pneumatically driven pump affects cellular blood components.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Meet the Authors

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      Abstract: imageNo abstract available
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Extracorporeal Membrane Oxygenation Circuits in Parallel for Refractory
           Hypoxemia in COVID-19: A Case Series

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      Authors: Patel; Yatrik J.; Stokes, John W.; Gannon, Whitney D.; Francois, Sean A.; Wu, Wei Kelly; Rice, Todd W.; Bacchetta, Matthew
      Abstract: imageRefractory hypoxemia despite the use of extracorporeal membrane oxygenation (ECMO) for coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome remains a challenging problem. A single ECMO circuit may not provide adequate physiologic support in the setting of an elevated cardiac output, physiologic demand, and impaired gas exchange. In select patients with refractory hypoxemia, addition of a second ECMO circuit in parallel can improve oxygenation, facilitate lung protective ventilation, awakening, and physical rehabilitation. We report the largest case series to date of patients receiving ECMO circuits in parallel and the first to report this approach in COVID-19.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Tocilizumab Accelerates Recovery in Patients With Severe COVID-19
           Pneumonia on Venovenous Extracorporeal Membrane Oxygenation

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      Authors: Lewis; Tyler C.; Arnouk, Serena; Toy, Bridget; Geraci, Travis C.; Carillo, Julius A.; Chang, Stephanie H.; Moazami, Nader; Kon, Zachary N.; Smith, Deane E.
      Abstract: imageNo abstract available
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Injection of Recombinant Tissue Plasminogen Activator into Extracorporeal
           Membrane Oxygenators Postpones Oxygenator Exchange in COVID-19

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      Authors: Mang; Sebastian; Danziger, Guy; Metz, Carlos; Rixecker, Torben; Becker, André; Omlor, Albert J.; Jentgen, Christophe; Schmoll, Christian; Seiler, Frederik; Reyher, Christian; Muellenbach, Ralf M.; Bals, Robert; Lepper, Philipp M.
      Abstract: imageCoronavirus disease 2019 (COVID-19) has drastically increased the number of patients requiring extracorporeal life support. We investigate the efficacy and safety of low-dose recombinant tissue-type plasminogen activator (rtPA) injection into exhausted oxygenators to delay exchange in critically ill COVID-19 patients on veno-venous extracorporeal membrane oxygenation (V-V ECMO). Small doses of rtPA were injected directly into the draining section of a V-V ECMO circuit. We compared transmembrane pressure gradient, pump head efficiency, membrane arterial partial oxygen pressure, and membrane arterial partial carbon dioxide pressure before and after the procedure. Bleeding was compared with a matched control group of 20 COVID-19 patients on V-V ECMO receiving standard anticoagulation. Four patients received 16 oxygenator instillations with rtPA at 5, 10, or 20 mg per dose. Administration of rtPA significantly reduced transmembrane pressure gradient (Δpm = 54.8 ± 18.1 mmHg before vs. 38.3 ± 13.3 mmHg after, p < 0.001) in a dose-dependent manner (Pearson’s R −0.63, p = 0.023), allowing to delay oxygenator exchange, thus reducing the overall number of consumed oxygenators. rtPA increased blood flow efficiency η (1.20 ± 0.28 ml/revolution before vs. 1.24 ± 0.27 ml/r, p = 0.002). Lysis did not affect membrane blood gases or systemic coagulation. Minor bleeding occurred in 2 of 4 patients (50%) receiving oxygenator lysis as well as 19 of 20 control patients (95%). Lysis of ECMO oxygenators effectively delays oxygenator exchange, if exchange is indicated by an increase in transmembrane pressure gradient. Application of lysis did not result in higher bleeding incidences compared with anticoagulated patients on V-V ECMO for COVID-19.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Characterization and Development of Universal Ventricular Assist Device:
           Computational Fluid Dynamics Analysis of Advanced Design

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      Authors: Goodin; Mark S.; Showalter, Michael S.; Horvath, David J.; Kuban, Barry D.; Flick, Christine R.; Polakowski, Anthony R.; Fukamachi, Kiyotaka; Karimov, Jamshid H.
      Abstract: imageWe are developing a universal, advanced ventricular assist device (AVAD) with automatic pressure regulation suitable for both left and right ventricular support. The primary goal of this computational fluid dynamics (CFD) study was to analyze the biventricular performance of the AVAD across its wide range of operating conditions.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Oncostatin M: a Potential Biomarker to Predict Infection in Patients with
           Left Ventricular Assist Devices

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      Authors: Setiadi; Hendra; El-Banayosy, Ahmed M.; George, Susan; Schmidtke, David W.; El-Banayosy, Aly; Horstmanshof, Douglas A.; Long, James W.
      Abstract: imageInfection is a serious adverse event limiting left ventricular assist device (LVAD) therapy in advanced heart failure patients, but a reliable means to identify patients at increased risk of infection is still lacking. We hypothesized that preoperative elevated levels of plasma Oncostatin M (OSM), a cytokine marker of leukocyte activation and inflammation, would be predictive of subsequent infection. We measured plasma OSM in 41 LVAD patients one day before LVAD implantation and postoperatively over two months. Preoperative plasma OSM levels were normal in 27 patients (group A, 4.9 ± 3.2 pg/ml) but elevated in 14 patients (group B, 1649.0 ± 458.9 pg/ml) (p = 0.003). Early postoperative levels rose in both groups and declined rapidly in group A, with group B declining slowly over two months. Significantly more infections developed in group B than group A patients over two months postimplantation (p = 0.004). No other routine clinical assessment or laboratory testing afforded this differentiation. These findings suggest that preoperative plasma OSM levels may assist in identifying patients at increased risk of infections after LVAD implantation.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Characteristics and Outcomes of Candidemia in Patients with Durable Left
           Ventricular Assist Device Support

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      Authors: Broderick; Kaitlyn L.; Peters, Carli J.; Mazurek, Jeremy A.; Wald, Joyce; Zhang, Robert S.; Atluri, Pavan; Urgo, Kim; Goldberg, Lee; Blumberg, Emily A.; Weikert, Blair C.; Birati, Edo Y.
      Abstract: imageThere are limited data on the characteristics and clinical course of fungal infections in patients on durable left ventricular assist device (LVAD) support. We sought to further characterize the epidemiology and outcomes of LVAD patients with fungemia. We performed a retrospective review of patients receiving LVAD support from January 2012 through June 2020 at a large academic institution. Among 336 patients on LVAD support, five (1.4%) were diagnosed with fungemia during the study period. Three patients had diabetes with mean hemoglobin A1c 7.1% (R 6.6, 7.4). Fever and leukocytosis (mean white blood count 17.0 thousand/µL [R 12.5, 29.9]) were the most common symptoms. Fungemia was diagnosed early after LVAD implantation (mean 14.4 support days [R 2, 19]). All patients were infected with Candida species, and four isolates were susceptible to fluconazole. Central nervous system outcomes included an ischemic stroke, subarachnoid hemorrhage, and malignant hemorrhagic stroke. Two patients were successfully transplanted, and two patients on destination therapy remain on suppressive fluconazole. In conclusion, fungemia is a rare and severe complication in LVAD patients occurring early postimplant.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Colonization with Multidrug-resistant Organisms in Patients with
           Ventricular Assist Devices

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      Authors: Roberts; Scott C.; Nam, Hannah H.; Kumar, Rebecca N.; Wu, Tingqing; Harap, Rebecca S.; Pham, Duc Thinh; Rich, Jonathan D.; Stosor, Valentina
      Abstract: imageInfection is a leading cause of morbidity and mortality in patients with ventricular assist devices (VAD). The impact of colonization with multidrug-resistant organisms (MDRO) on outcomes in this cohort is unknown. Patients on VAD support from July 2008 to September 2018 at a single site were evaluated for MDRO colonization after implantation. MDROs included methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus species, and extended-spectrum beta-lactamase producing gram-negative bacteria. 378 patients with 433 VADs were included. 42.6% (n = 161) of patients were colonized with an MDRO throughout the duration of VAD support. Eighty-two VAD infections occurred, 74.4% (n = 61) of whom were MDRO colonized before infection. MDRO colonization was associated with an increased risk of a subsequent VAD infection (hazard ratio 3.704, p < 0.001). MDRO colonization is common after VAD implantation and is associated with future VAD infections. Further study is needed to determine best management strategies for VAD recipients with MDRO colonization given this increased risk.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Posttransplant Long-Term Outcomes for Patients with Ventricular Assist
           Devices on the Heart Transplant Waitlist

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      Authors: Whitbread; James J.; Etchill, Eric W.; Giuliano, Katherine A.; Suarez-Pierre, Alejandro; Lawton, Jennifer S.; Hsu, Steven; Sharma, Kavita; Choi, Chun W.; Higgins, Robert S. D.; Kilic, Ahmet
      Abstract: imageVentricular assist devices (LVADs) are commonly used in end-stage heart failure for mechanical circulatory support as a bridge to heart transplantation. However, LVADs’ long-term effects on posttransplant survival are unknown. We sought to compare long-term mortality after transplantation for patients with and without LVADs. Using the Organ Procurement and Transplantation Network database, we investigated LVADs’ impact on long-term (3 month, 1 year, 2 years, 5 years, and 8 years) posttransplant mortality risk for all heart transplant recipients between 2010 and 2019. Time-to-event regression analysis quantified mortality risk by LVAD status in both unconditional and conditional survival analyses. Of 20,113 transplant recipients, 8,999 (45%) had a LVAD while on the waitlist. Among those who died after transplantation, patients with LVADs on average died sooner (1.8 years) than patients without LVADs (3.0 years; p < 0.01). On multivariable analysis, patients with LVADs had a 44% higher mortality risk within the first 3 months posttransplant (HR = 1.44, p = 0.03). There was no significant difference in mortality risk between patients who did and did not have pretransplant LVADs after 1, 2, and 5 years of posttransplant conditional survival. While LVAD patients have a survival disadvantage in the first year posttransplant, conditional survival analysis demonstrated no difference in mortality risk between patients with and without LVADs beyond 1 year of follow up. Of the patients who died posttransplant, patients with LVADs on average died sooner than patients without LVADs.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Construction and Evaluation of a Bio-Engineered Pump to Enable
           Subpulmonary Support of the Fontan Circulation: A Proof-of-Concept Study

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      Authors: Broda; Christopher R.; Smith, P. Alex; Wang, Yaxin; Sriraman, Hamsini; Owuor, Peter S.; Sampaio, Luiz C.; Adachi, Iki; Taylor, Doris A.
      Abstract: imageOur objective was to create a bio-engineered pump (BEP) for subpulmonary Fontan circulation support capable of luminal endothelialization and producing a 2–6 mmHg pressure gradient across the device without flow obstruction. To accomplish this, porcine urinary bladder submucosa was decellularized to produce a urinary bladder matrix (UBM) which produced acellular sheets of UBM. The UBM was cultured with human umbilical vein endothelial cells producing a nearly confluent monolayer of cells with the maintenance of typical histologic features demonstrating UBM to be a suitable substrate for endothelial cells. A lamination process created bilayer UBM sheets which were formed into biologic reservoirs. BEPs were constructed by securing the biologic reservoir between inlet and outlet valves and compressed with a polyurethane balloon. BEP function was evaluated in a simple flow loop representative of a modified subpulmonary Fontan circulation. A BEP with a 92-mL biologic reservoir operating at 60 cycles per minute produced pulsatile downstream flows without flow obstruction and generated a favorable pressure gradient across the device, maintaining upstream pressure of 6 mm Hg and producing downstream pressure of 13 mm Hg. The BEP represents potential long-term assistance for the Fontan circulation to relieve venous hypertension, provide pulsatile pulmonary blood flow and maintain cardiac preload.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Novel Left Atrial Cannulation Technique for Attachment of a Pumpless
           Artificial Lung

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      Authors: Prater; Aaron R.; Fallon, Brian P.; Hirschl, Ronald B.; Drake, Daniel H.; Rojas-Pena, Alvaro
      Abstract: imageA pumpless artificial lung has the potential to provide a bridge to recovery or transplantation in children with respiratory failure. Pulmonary artery inflow and left atrial outflow are necessary for low-gradient, pumpless systems; however, long-term cannulation of the fragile left atrium remains problematic. In this technique, the left atrium and pulmonary artery were exposed through a left anterior thoracotomy. Inflow to the artificial lung was created using an end-to-side anastomosis with the pulmonary artery. Device outflow was established through the left atrium. A single-stage venous cannula was passed through a free PTFE graft. Using polypropylene with pledgets, two concentric purse-string sutures were placed in the dome of the left atrium. The venous cannula was inserted. The graft was slid down the cannula and circumferentially secured to the adjacent left atrial tissue and pledgets. The other end of the graft was secured to the cannula with silk ties. The procedure was successful in 10 sheep. Initial device blood flow was 969 ± 222 ml/min, which remained stable for up to 7 days with no anastomotic complications. This is an effective method of achieving secure, long-term left atrial cannulation without cardiopulmonary bypass for use in a low-resistance, pumpless artificial lung. And, most importantly, improves the ease and safety of cannula replacement and final decannulation when AL support is no longer required.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Impact of Age on Emergency Resource Utilization and Outcomes in Pediatric
           and Young Adult Patients Supported with a Ventricular Assist Device

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      Authors: Edwards; Jonathan J.; Edelson, Jonathan B.; Mondal, Antara; Katcoff, Hannah; Reza, Nosheen; Griffis, Heather; Burstein, Danielle S.; Wittlieb-Weber, Carol A.; O’Connor, Matthew J.; Rossano, Joseph W.; Ravishankar, Chitra; Mascio, Christopher; Birati, Edo Y.; Lin, Kimberly Y.
      Abstract: imageThere are minimal data describing outcomes in ambulatory pediatric and young adult ventricular assist device (VAD)-supported patient populations. We performed a retrospective analysis of encounter-level data from 2006 to 2017 Nationwide Emergency Department Sample (NEDS) to compare emergency department (ED) resource utilization and outcomes for pediatric (≤18 years, n = 494) to young adult (19–29 years, n = 2,074) VAD-supported patient encounters. Pediatric encounters were more likely to have a history of congenital heart disease (11.3% vs. 4.8%). However, Pediatric encounters had lower admission/transfer rates (37.8% vs. 57.8%) and median charges ($3,334 (IQR $1,473–$19,818) vs. $13,673 ($3,331–$45,884)) (all p < 0.05). Multivariable logistic regression modeling revealed that age itself was not a predictor of admission, instead high acuity primary diagnoses and medical complexity were: (adjusted odds ratio; 95% confidence intervals): cardiac (3.0; 1.6–5.4), infection (3.4; 1.7–6.5), bleeding (3.9; 1.7–8.8), device complication (7.2; 2.7–18.9), and ≥1 chronic comorbidity (4.1; 2.5–6.7). In this largest study to date describing ED resource use and outcomes for pediatric and young adult VAD-supported patients, we found that, rather than age, high acuity presentations and comorbidities were primary drivers of clinical outcomes. Thus, reducing morbidity in this population should target comorbidities and early recognition of VAD-related complications.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Thrombosis in Extracorporeal Membrane Oxygenation (ECMO) Circuits

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      Authors: Figueroa Villalba; Cristina A.; McMullan, David M.; Reed, Robyn C.; Chandler, Wayne L.
      Abstract: imageThrombosis in extracorporeal membrane oxygenation (ECMO) circuits remains a frequent complication. We characterize the location, extent, structure, and clinical implications of thrombi in 53 ECMO circuits from 46 pediatric patients. The tubing, pump, and oxygenator were examined for visible thrombi. Representative samples of thrombi were collected for histologic, immunofluorescence, and immunohistochemical analysis. Thrombi were found in 81% of ECMO circuits. The most clinically significant were inflow oxygenator membrane surface thrombi (11% of circuits), arterial tubing thrombi (30%), and venous tubing (26%) or connector thrombi (26%). Oxygenator membrane surface thrombi resulted in rapidly increasing delta pressure across the oxygenator over 1–2 days, oxygenator failure, and circuit replacement. Oxygenator membrane surface thrombi were associated with intravascular venous thrombosis and bacterial infection before starting ECMO. Arterial cannula/tubing thrombi led in one case to aortic and mesenteric artery thrombosis followed by bowel infarction. In 11% of cases, venous tubing thrombi grew large enough to break off and embolize to the pump, resulting in increased hemolysis. Antifibrinolytic therapy during ECMO was associated with an increased risk of pump thromboembolism. Other less clinically significant thrombi included pump axle thrombi with thrombus fragments trapped in the oxygenator (45%), and deep oxygenator membrane thrombi (15%). Examination of ECMO circuits after removal is a useful quality improvement tool that can elucidate the cause of circuit problems, indicate patients at increased risk of thrombosis, and suggest areas for possible improvements.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • What Determines the Arterial Partial Pressure of Carbon Dioxide on
           Venovenous Extracorporeal Membrane Oxygenation'

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      Authors: Joyce; Christopher J.; Udy, Andrew; Weeden, Mark; Shekar, Kiran; Cook, David A.
      Abstract: imageRapid reductions in PaCO2 during extracorporeal membrane oxygenation (ECMO) are associated with poor neurologic outcomes. Understanding what factors determine PaCO2 may allow a gradual reduction, potentially improving neurologic outcome. A simple and intuitive arithmetic expression was developed, to describe the interactions between the major factors determining PaCO2 during venovenous ECMO. This expression was tested using a wide range of input parameters from clinically feasible scenarios. The difference between PaCO2 predicted by the arithmetic equation and PaCO2 predicted by a more robust and complex in-silico mathematical model, was
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • A Simple Technique for Reliable Donor Organ Temperature Management With
           the SherpaPak System

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      Authors: Kawabori; Masashi; Posawatz, David A.; Chen, Frederick Y.; Couper, Gregory S.
      Abstract: imageHere, we present our technique for thermoregulation of cardiac preservation solution with the SherpaPak device before heart transplantation. If it is above the ideal range (5–10°C) to avoid organ injury and ensure proper function, the cardiac preservation solution bag should be placed in ice water to bring down temperature until the ideal range is achieved. SherpaPak has limitation in immediately correcting initial temperatures outside of the normal range, so we believe this simple step should be included into standard SherpaPak procedure to ensure its effectiveness and to preserve the best organ function.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Electrical Impedance Tomography to Set Positive End Expiratory Pressure
           During Pediatric Extracorporeal Membrane Oxygenation for Respiratory
           Failure... Is it Feasible'

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      Authors: Di Nardo; Matteo; Fischer, Maximilian; Ranieri, Vito M.
      Abstract: imageNo abstract available
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
  • Left Ventricular Assist Device Reinsertion for Recurrence of End-Stage
           Heart Failure Eleven Years after Device Removal: Case Report

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      Authors: Akay; Mehmet H.; Salas De Armas, Ismael; Patel, Manish K.; Nathan, Sriram; Kar, Biswajit; Gregoric, Igor D.
      Abstract: imageAfter demonstrated myocardial recovery in patients with durable left ventricular assist device (LVAD) support, the device may occasionally be explanted. A 38-year-old female with nonischemic cardiomyopathy underwent implantation of an LVAD as a bridge-to-transplant therapy. After one year, the patient demonstrated sufficient myocardial recovery allowing the LVAD to be explanted. A Teflon felt strip plug was created and placed within the apical sewing ring to occlude the opening into the left ventricle. Eleven years later, the patient presented with recurrence of severe heart failure. Due to morbid obesity, the patient was not a heart transplant candidate. Therefore, a second LVAD was implanted with a concomitant gastric sleeve procedure. When the plug was surgically removed from the sewing ring, no thrombus was observed; however, the ventricular surface was completely endothelialized. The patient recovered without any complications, was discharged from the hospital, and is currently listed for a heart transplant. This case demonstrates remission from heart failure lasting for more than a decade. If a second LVAD is needed due to exacerbation of severe heart failure, it can be safely introduced through the previous sewing ring after removing the Teflon plug.
      PubDate: Mon, 01 Aug 2022 00:00:00 GMT-
       
 
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