Abstract:
:The determination of when to stop extracorporeal membrane oxygenation (ECMO) rests upon demonstration of the return of adequate cardiac function to support vital organs and permit subsequent recovery. In general, patients with myocardial stun will recover function within several days. Factors that limit recovery include elevated end diastolic pressures leading to marginal myocardial perfusion, ongoing organ damage, massive anasarca, or progressive deterioration in lung function. Following a trial of slow weaning of ECMO support to condition the heart to take over the entire system flow requirements, decannulation can be accomplished in a standard fashion. When weaning is not successful and additional time does not lead to adequate recovery of cardiac function, physicians and nurses must be prepare to realistically advise families regarding such options as cardiac transplantation or withdrawal of support. It is critically important to provide an open and nonjudgmental environment for families to make these difficult decisions. The greatest difficulties involve ethical and emotional decisions that need to be made in a timely fashion to prevent undo burden on the patient when further ECMO support is futile.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Steinhorn DMdoi
10.1046/j.1525-1594.1999.06445.xsubject
Has Abstractpub_date
1999-11-01 00:00:00pages
1026-30issue
11eissn
0160-564Xissn
1525-1594pii
aor6445journal_volume
23pub_type
杂志文章abstract::The aim of this study is to evaluate the effect of temperature on cerebral oxygen metabolism at total body flow bypass and antegrade cerebral perfusion (ACP). Neonatal piglets were put on cardiopulmonary bypass (CPB) with the initial flow rate of 200mL/kg/min. After cooling to 18°C (n=6) or 25°C (n=7), flow was reduce...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2010.01131.x
更新日期:2010-11-01 00:00:00
abstract::Plasma levels of granulocyte elastase in complex with alpha 1-proteinase inhibitor (E-alpha 1-PI) increased during hemodialysis from 110 +/- 10 to 506 +/- 66 micrograms/L using dialyzers made of polyamide, from 95 +/- 2.2 to 211 +/- 54 micrograms/ml with hemophane and from 114 +/- 10 to 203 +/- 25 using dialyzers made...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1989.tb02842.x
更新日期:1989-04-01 00:00:00
abstract::The major restrictions to the transport of solute and solvent across the peritoneum are the limited peritoneal blood flow, area and permeability. Recent investigations have demonstrated that several vasoactive drugs influence transport parameters. Isoproterenol, nitroprusside, dipyridamole and dopamine exemplify drugs...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1979.tb01052.x
更新日期:1979-08-01 00:00:00
abstract::Chronic kidney disease is increasing in both developed and emerging countries with progressive encroachment on health services budgets. In spite of the lack of accurate registries, we tried to focus on the magnitude of the problem on different continents. Prevention of progression has been a remote but reachable goal....
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2006.00251.x
更新日期:2006-07-01 00:00:00
abstract::Protein adsorption and platelet adhesion are two important biological processes arising at the blood prosthetic interface. The effect of certain antibiotics, namely, neomycin, gentamicin, ampicillin, penicillin-G, and streptomycin to modulate the albumin polycarbonate surface interaction was investigated using 125I al...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02747.x
更新日期:1988-04-01 00:00:00
abstract::ABO incompatible allogeneic bone marrow transplants can be performed successfully to treat patients with leukemia or aplastic anemia. These transplants carry no great risk of rejection or graft-versus-host disease, however, some method must be used to avoid acute hemolysis at the time of infusion of ABO incompatible m...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1981.tb03998.x
更新日期:1981-08-01 00:00:00
abstract::Right ventricular (RV) function immediately after left ventricular assist device (LVAD) implantation is a crucial prognostic factor. RV failure is linked to increased mortality and worse outcome. A phosphodiesterase 5 inhibitor, sildenafil, was shown to decrease pulmonary vascular resistance and pulmonary artery press...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12277
更新日期:2014-11-01 00:00:00
abstract::Continuous and intermittent high shear were loaded to red blood cells in a cone and a plate rheoscope. The mechanical damage to red cells was compared for continuous and intermittent shear. The intermittent shear was achieved by alternately starting and stopping shear repeatedly. In the case of intermittent shear load...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2007.00408.x
更新日期:2007-06-01 00:00:00
abstract::Ventricular assist devices (VADs) are considered the standard of care for end-stage heart failure (HF) patients. Despite increasing confidence in the technology, evidence data, endorsement by scientific societies and guidelines, the number of implants reached a steady state and is not increasing at the expected pace. ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13714
更新日期:2020-04-23 00:00:00
abstract::One hundred eighty-eight Mitroflow pericardial valves, implanted on 166 patients from March 1983 to December 1986, have been followed for a total of 4316 patients x months. Mortality rate in the first three postoperative months is approximately 10% related to noncardiac complications. One hundred forty-nine patients a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02781.x
更新日期:1988-08-01 00:00:00
abstract::This paper discussed issues of ethical assessment and moral concern associated with organ replacement and physical enhancement: research, allocation, organ donation, artificial organs, xenografts, biomaterials, and neuromaterials. While emphasizing the medical and moral benefits over associated risks, it calls for a b...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1995.tb02362.x
更新日期:1995-05-01 00:00:00
abstract::This work introduces a new Lagrangian strain-based model to predict the shear-induced hemolysis in biomedical devices. Current computational models for device-induced hemolysis usually utilize empirical fitting of the released free hemoglobin (Hb) in plasma from damaged red blood cells (RBCs). These empirical correlat...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13663
更新日期:2020-08-01 00:00:00
abstract::Recent reports suggest a survival advantage for dialysis patients treated by postdilutional online hemodiafiltration (OL-HDF) who achieve higher volume convective exchanges. As such, the factors associated with achieving higher convective volume exchange were determined. The convective exchange volumes during the midw...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12709
更新日期:2016-12-01 00:00:00
abstract::Capillary membrane filters are devices commonly used for plasmapheresis and recirculating detoxification systems, including plasmaseparation units. Besides clinical trials and case reports, research on plasmafiltration techniques is carried out using in vitro systems. Notably, such hemoperfused in vitro systems requir...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2003.07132.x
更新日期:2003-07-01 00:00:00
abstract::Bone marrow mesenchymal stem cells (MSCs) have demonstrated their pluripotency to differentiate into different cell lineages and may be an alternative cell source for vascular tissue engineering. The objective of this study is to create small diameter vessels by seeding and culture of genetically modified MSCs onto a ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2006.00322.x
更新日期:2006-12-01 00:00:00
abstract::Four methods of cleaning hollow-fiber artificial kidneys (HFAKs) for reuse were compared in a prospective study. Each cleaning method was randomly assigned and HFAKs were reused until volume loss was greater than or equal to 15 ml, unless discarded for other reasons. HFAKs cleaned with 0.3 M sodium hydroxide averaged ...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1525-1594.1986.tb02602.x
更新日期:1986-12-01 00:00:00
abstract::Patients with end-stage renal failure and peripheral vascular disease pose a difficult management problem in establishing long-term angioaccess for hemodialysis. In 4 patients with access problems, we created axillary artery to contralateral axillary vein Goretex grafts. The grafts were cannulated regularly for period...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1111/j.1525-1594.1995.tb02291.x
更新日期:1995-12-01 00:00:00
abstract::This study aimed to clarify the role of peritoneal T-lymphocytes in peritoneal immune defense mechanisms. This study was designed to examine the changes in T-cell subpopulations during peritonitis in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Our observations were correlated to responses t...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00802.x
更新日期:2009-12-01 00:00:00
abstract::This work presents results of preliminary studies concerning application of magnetic bearing in a ventricular assist device (VAD) being developed by Dante Pazzanese Institute of Cardiology-IDPC (São Paulo, Brazil). The VAD-IDPC has a novel architecture that distinguishes from other known VADs. In this, the rotor has a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2008.00551.x
更新日期:2008-04-01 00:00:00
abstract::Centrifugal pumps have been used widely as the main pump in open heart surgery to reduce damage to blood elements and to reduce the activation of the coagulation system. The purpose of this study was the evaluation and comparison of the effects of two types of centrifugal pumps and of one type of roller pump on blood ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb04507.x
更新日期:1996-05-01 00:00:00
abstract::A rise in intracellular calcium concentration in erythrocytes has multiple effects on these cells. The purpose of this study was to determine the changes of calcium content in red blood cells (RBCs) and of echinocyte percentages in uremic patients during hemodialysis sessions. In 30 uremic patients under hemodialysis,...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2001.025006486.x
更新日期:2001-06-01 00:00:00
abstract::Cardiopulmonary bypass (CPB) requirement in infants presents a unique challenge because of the large prime volume-to-blood volume ratio. Packed red blood cells (PRBCs) tend to deteriorate with long-term storage owing to their unphysiological composition and osmolality. Given that blood priming is inevitable in neonate...
journal_title:Artificial organs
pub_type: 杂志文章,随机对照试验
doi:10.1111/aor.13559
更新日期:2020-03-01 00:00:00
abstract::Early in 1956, the first model of a biological artificial liver, using a live dog's liver incorporated in a cross-hemodialyzer, was placed in an experimental animal with portocaval encephalopathy. This "biological artificial liver," a hybrid artificial liver in the present terminology, was the first in the world. In O...
journal_title:Artificial organs
pub_type: 历史文章,杂志文章
doi:10.1111/j.1525-1594.1986.tb02548.x
更新日期:1986-06-01 00:00:00
abstract::Magnevad II is an improved version of Magnevad I and both are fourth-generation axial flow left ventricular assist devices. A major simplification has been implemented and tested. Magnevad I used a magnetically suspended rotor requiring active axial control. Magnevad II is completely passive but otherwise similar. A s...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2005.29113.x
更新日期:2005-10-01 00:00:00
abstract::Centrifugal blood pumps are considered to be generally superior to the traditionally used roller pumps in cardiopulmonary bypass. In our institute a new lightweight centrifugal sealless blood pump with a unique spherical thrust bearing and with a magnetic coupling was developed, the HiFlow. The small design makes the ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb03754.x
更新日期:1997-07-01 00:00:00
abstract::The effect of blood hematocrit (HCT) on a noninvasive flow estimation algorithm was examined in a centrifugal implantable rotary blood pump (iRBP) used for ventricular assistance. An average flow estimator, based on three parameters, input electrical power, pump speed, and HCT, was developed. Data were collected in a ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2007.00339.x
更新日期:2007-01-01 00:00:00
abstract::In vitro cardiovascular device performance evaluation in a mock circulation loop (MCL) is a necessary step prior to in vivo testing. A MCL that accurately represents the physiology of the cardiovascular system accelerates the assessment of the device's ability to treat pathological conditions. To serve this purpose, a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2010.01088.x
更新日期:2011-04-01 00:00:00
abstract::This article reports preliminary results of pilot studies of a new implantable two channel drop foot stimulator. The stimulator consists of an externally worn transmitter inductively coupled to an implanted receiver unit located in the lower leg, lateral and distal to the knee. The receiver is connected to electrodes ...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1046/j.1525-1594.2002.06949.x
更新日期:2002-03-01 00:00:00
abstract::Hemodialysis vascular access (VA) stenosis remains a frequent complication. However, early detection is challenging and costly. The aim of this in vitro study was to assess a new detection method based on pulse pressure analysis at the hemodialysis needle. A silicon model of a radiocephalic arteriovenous fistula was b...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00772.x
更新日期:2010-02-01 00:00:00
abstract::The aim of this study was to assess the in vivo performance of a new microaxial rotary blood pump developed for long-term intraportal implantation. The pump, measuring 7 mm in diameter, has a single stage impeller and is powered by a microelectric motor. The pump was implanted into the portal vein in 13 large white pi...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2001.06772.x
更新日期:2001-05-01 00:00:00