Extracorporeal membrane oxygenation support in refractory cardiogenic shock: treatment strategies and analysis of risk factors.

Two centrifugal pumps, the RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA), used in central or peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated, in terms of double-center experience, as treatment for patients with refractory cardiogenic shock (CS). Between January 2006 and December 2012, 228 consecutive adult patients were supported on RotaFlow (n=213) or CentriMag (n=15) ECMO, at our institutions (155 men; age 58.3±10.

Weaning from venovenous extracorporeal membrane oxygenation without anticoagulation: is it possible?

A 19-year-old man affected with severe acute respiratory distress syndrome that was unresponsive to medical treatment was successfully weaned without anticoagulation therapy from venovenous extracorporeal membrane oxygenation (ECMO) because of life-threatening bleeding. The patient received venovenous ECMO with double peripheral cannulation. Heparin infusion was discontinued on day 10 for severe bleeding from thoracic and mediastinal drainages until the ECMO was removed.

Severe intra-aortic balloon pump complications: a single-center 12-year experience.

Objective: An intra-aortic balloon pump (IABP) is used routinely in high-risk patients undergoing cardiac surgery to prevent or treat low-cardiac-output syndrome and to reduce perioperative mortality. The insertion and management of IABP carry the risk of major vascular complications. The authors reviewed their database to ascertain the incidence of IABP-related severe complications.

Peripheral extracorporeal membrane oxygenation system as salvage treatment of patients with refractory cardiogenic shock: preliminary outcome evaluation.

The novel Permanent Life Support (PLS; Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) as peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support system has been investigated as treatment for patients with refractory cardiogenic shock (CS). Between January 2007 and July 2011, 73 consecutive adult patients were supported on peripheral PLS ECMO system at our institution (55 men; age 60.3 ± 11.

Integrated strategies for allogeneic blood saving in major elective surgery.

Background: Large use of allogeneic red blood cell concentrates (RBCc), albeit necessary in major surgery, may influence patients' outcome.

Design And Methods: We introduced an integrated strategy including patients' evaluation and supplementation associated with autologous blood collection and saving to support major elective surgery at our hospital since 2008. After 2 years of stabilization of this approach, we analyzed the results obtained in 2010 in terms of allogeneic blood usage and reduction of transfusion of stored RBCc.

[Carotid endarterectomy: evaluation of a "combined" technique of general anesthesia].

Introduction: The literature suggests several techniques to ensure the optimal anesthetic procedure for carotid surgery. The aim of our study is to combine, in the carotid endarterectomy, a model of general anesthesia with the loco-regional anesthesia in order to test the safety of the method, the eventual brain damage and hemodynamic stability. We also wanted to test whether the immediate postoperative analgesia was adequate.

Levosimendan versus intra-aortic balloon pump in high-risk cardiac surgery patients.

Objective: Patients with severe left ventricular dysfunction receive inotropic and mechanical circulatory support with an intra-aortic balloon pump (IABP) during the perioperative phase of cardiac surgery. The authors performed the first comparison of levosimendan versus an IABP in patients with poor left ventricular function undergoing cardiac surgery.

Design: A case-matched study.

Video-assisted minimally invasive mitral valve surgery: external aortic clamp versus endoclamp techniques.

Objective: : Video-assisted minimally invasive mitral valve surgery can be performed through different approaches. The aim of the study was to report our early results and compare the external transthoracic aortic clamping with the endoaortic balloon occlusion techniques according to our experience.

Methods: : Between January 2000 and March 2010, 138 patients (103 women, aged 58.

An on line technique to detect cardiac output variations and cardiovascular performances during abdominal aortic surgery.

Cardiac output (CO) is a parameter usually requested to assess hemo dynamic status of patient and efficacy of therapy especially in critically ill patients. This paper, in line with other research activities and new market availability, intends to correlate a parameter derived from data already acquired in standard patient monitoring (systemic arterial pressure--Pas) in order to identify CO trends and, more generally, to obtain information on the efficiency of cardiovascular system of the patient in examination. Attention has been focussed on patients undergoing abdominal aneurysm aortic (AAA) surgery with combined anaesthesia (epidural and light general).