Abstract:
:Percutaneous femoral venoarterial (VA) or jugular venovenous (VV) extracorporeal membrane oxygenation (ECMO) can result in delivery of hypoxic blood to the brain, coronaries, and upper extremities. Additionally, VA-ECMO by percutaneous femoral artery cannulation may compromise perfusion to the lower limbs. Use of near-infrared spectroscopy (NIRS) detects regional ischemia and warns of impending hypoxic damage. We report the first known series with standardized monitoring of this parameter in adults on ECMO. This is an institutional review board-approved single institution retrospective review of patients with NIRS monitoring on ECMO from July 2010 until June 2011. Patients were analyzed for drops in NIRS tracings below 40 or >25% from baseline. VA-ECMO and VV-ECMO were initiated by percutaneous cannulation of the femoral vessels and the internal jugular vein, respectively. Sensors were placed on the patients' foreheads and on the lower limbs. NIRS tracings were recorded, analyzed, and correlated with clinical events. Twenty patients were analyzed (median age: 47.5 years): 17 patients were placed on VA-ECMO, and three patients on VV-ECMO. The median duration on ECMO was 7 days (range 2-26). One hundred percent of patients had a significant drop in bilateral cerebral oximetry tracings resulting in hemodynamic interventions, which involved increasing pressure, oxygenation, and/or ECMO flow. In 16 patients (80%), these interventions corrected the underlying ischemia. Four patients (20%) required further diagnostic intervention for persistent decreased bilateral and/or unilateral cerebral oximetry tracings, and were found to have a cerebrovascular accident (CVA). Six (30%) patients had persistent unilateral lower limb oximetry events, which resolved upon placement or replacement of a distal perfusion cannula. No patient was found to have either lower limb ischemia or a CVA with normal NIRS tracings. Use of NIRS with ECMO is important in detecting ischemic cerebral and peripheral vascular events. This allows for potential correction of the underlying process, thus preventing permanent ischemic damage.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Wong JK,Smith TN,Pitcher HT,Hirose H,Cavarocchi NCdoi
10.1111/j.1525-1594.2012.01496.xsubject
Has Abstractpub_date
2012-08-01 00:00:00pages
659-67issue
8eissn
0160-564Xissn
1525-1594journal_volume
36pub_type
杂志文章abstract::Left dominant biventricular failure is a common type of heart failure after cardiac surgery. We developed a biventricular bypass (BVB) system for treatment of postcardiotomy ventricular failure, and we previously reported that the clinical results of the BVB system were superior to those obtained with venoarterial byp...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06015.x
更新日期:1998-09-01 00:00:00
abstract::Activated clotting time (ACT) is the most commonly used laboratory test to control the heparin effect during extracorporeal techniques. The study was undertaken in order to test in vitro the influence of heparin, platelet count, hematocrit, platelet fragmentation, and platelet activation on ACT. Blood was drawn from v...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2000.06552.x
更新日期:2000-07-01 00:00:00
abstract::In this pilot study, we assessed the feasibility of using positron emission tomography (PET) imaging for in vivo measurement of skeletal muscle ventricle (SMV) tissue blood flow. In 4 dogs, with SMVs prepared from their latissimus dorsi muscle, we quantified SMV tissue blood flow by PET and related it to the tissue fl...
journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::In this study, a detection algorithm for suction and regurgitation of the centrifugal pump during left heart bypass without relying on external flow or pressure sensors was developed and evaluated in acute studies using adult goats. The detection scheme relies on power spectral density (PSD) analysis of the motor curr...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1999.06397.x
更新日期:1999-06-01 00:00:00
abstract::The aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12675
更新日期:2016-08-01 00:00:00
abstract::The present study aimed to determine the feasibility of constructing a reinforced autologous vascular graft by combining the advantages of fibrin gel as an autologous cell carrier material with the inherent mechanical strength of an integrated mesh structure. It was hypothesized that the mesh and dynamic culture condi...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2008.00601.x
更新日期:2008-10-01 00:00:00
abstract::An investigation has been made into whether charcoal hemoperfusion stimulates a hyperplastic response in the liver of the normal rat. Animals underwent hemoperfusion over Norit RBX1 (Strathclyde, Glasgow, U.K.) charcoal granules using a technique which allowed perfusion in the unrestrained and conscious state. Control...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1982.tb04080.x
更新日期:1982-05-01 00:00:00
abstract::For the development of a totally implantable ventricular assist system (VAS), we have been developing the vibrating flow pump (VFP), which can generate oscillated blood flow with a relative high frequency (10-50 Hz) for a totally implantable system. In this study, the effects of left ventricular assistance with this u...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1999.06288.x
更新日期:1999-01-01 00:00:00
abstract::Therapeutic means to lower Lp(a) are limited. The most effective method to reduce plasma Lp(a) concentration significantly is therapeutic apheresis, namely, low-density lipoprotein (LDL) lipoprotein(a) (Lp(a)) apheresis. A novel technique based on reusable LDL adsorber called Lipocollect 200 (Medicollect, Rimbach, Ger...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00959.x
更新日期:2009-12-01 00:00:00
abstract::The outgrowth of endothelial cells in an expanded polytetrafluoroethylene graft implanted in the canine inferior vena cava was studied by scanning electron microscopy. The adjacent endothelial cells of the vena cava started to invade the anastomotic area three days after the implantation and reached approximately the ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1981.tb04020.x
更新日期:1981-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12997
更新日期:2018-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12002
更新日期:2013-05-01 00:00:00
abstract::For introduction of a left atrial (LA) cannula by the transseptal puncture technique, we examined the feasibility of using biplane transesophageal echocardiography (B-TEE). A transseptal puncture was performed on 15 patients (3 male; 12 female; mean age, 48.9 +/- 11.2 years) by B-TEE guide during percutaneous transven...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1992.tb00537.x
更新日期:1992-08-01 00:00:00
abstract::From January 1980 through December 1990, implantation of a permanent pacemaker was performed in 34 patients following open heart surgery. The patients were divided into two groups according to the clinical indications for implantation of permanent pacemakers. Group 1 (9 patients) had surgical atrioventricular block, a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1993.tb00591.x
更新日期:1993-05-01 00:00:00
abstract::The characteristic depressed hemodynamic state and gradually declining circulatory function in Fontan patients necessitates alternative postoperative management strategies incorporating a system level approach. In this study, the single-ventricle Fontan circulation is modeled by constructing a practical in vitro bench...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00951.x
更新日期:2009-11-01 00:00:00
abstract::Hemodynamic control of left ventricular assist devices (LVADs) is generally a complicated problem due to diverse operating environments and the variability of the patients: both the changes in the circulatory and metabolic parameters as well as disturbances that require adjustment to the operating point. This challeng...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2007.00350.x
更新日期:2007-02-01 00:00:00
abstract::The purpose of this study was to characterize changes in hepatic venous pressures in patients with chronic hepatitis C. The histology and laboratory data from patients with chronic hepatitis C who underwent a transjugular liver biopsy (TJLB) and hepatic venous pressure gradient measurement were analyzed. Portal hypert...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00925.x
更新日期:2010-07-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) is used for severe acute respiratory distress syndrome. However, available ECMO systems are large and not well designed for fast delivery, emergency implantation, and interhospital transfer. Therefore, a new miniaturized oxygenator with integrated rotary blood pump (ILIAS) wa...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12611
更新日期:2016-07-01 00:00:00
abstract::The abdominal left ventricular assist device (ALVAD) is an order of magnitude more effective than conventional intra-aortic balloon pumping (IABP) in unloading and providing circulatory support to the failing left ventricle. This is a report of a unique case which demonstrates that in the absence of pulmonary vascular...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1978.tb01632.x
更新日期:1978-11-01 00:00:00
abstract::Many types of rotary blood pumps and pump control methods have recently been developed with the goal of clinical use. From experiments, we know that pump flow spontaneously increases during exercise without changing pump control parameters. The purpose of this study was to determine the hemodynamics associated with th...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1999.06426.x
更新日期:1999-08-01 00:00:00
abstract::To elucidate the precise mechanism of carpal tunnel syndrome (CTS), serum hyaluronic acid (HA), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were measured in 71 chronic hemodialysis patients with or without CTS and/or shoulder pain. Patients were divided into two gr...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb02227.x
更新日期:1994-06-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1984.tb04248.x
更新日期:1984-02-01 00:00:00
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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::Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of f...
journal_title:Artificial organs
pub_type: 杂志文章,多中心研究
doi:10.1111/aor.13016
更新日期:2018-04-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12250
更新日期:2014-10-01 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::Eight patients were studied during four sessions of acetate-free biofiltration (AFBF). AFBF is a new dialysis technique with no base replacement agents in the dialysate and with the addition in postdilution mode of bicarbonate (HCO3) solution directly into the extracorporeal blood circuit. In this study the effects on...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1989.tb01561.x
更新日期:1989-10-01 00:00:00
abstract::With the incidence of end-stage heart failure steadily increasing, the need for a practical total artificial heart (TAH) has never been greater. Continuous flow TAHs (CFTAH) are being developed using rotary blood pumps (RBPs), leveraging their small size, mechanical simplicity, and excellent durability. To completely ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13631
更新日期:2020-06-01 00:00:00
abstract::Malfunction of bileaflet mechanical heart valves in the mitral position could either be due to patient-prosthesis mismatch (PPM) or leaflet obstruction. The aim of this article is to investigate the validity of current echocardiographic criteria used for diagnosis of mitral prosthesis malfunction, namely maximum veloc...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12653
更新日期:2016-05-01 00:00:00
abstract::Patients with kidney failure can only survive with some form of kidney replacement (transplant or dialysis). Unfortunately, innovations in kidney replacement therapy lag behind many other medical fields. This study compiles expert opinions on candidate technologies for future kidney replacement therapies. A worldwide ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13784
更新日期:2020-07-22 00:00:00