Circuit change during extracorporeal membrane oxygenation: single-center retrospective study of 48 changes.

Background: Bleeding and thrombosis induce major morbidity and mortality in patients under extracorporeal membrane oxygenator (ECMO). Circuit changes can be performed for oxygenation membrane thrombosis but are not recommended for bleeding under ECMO. The objective of this study was to evaluate the course of clinical, laboratory, and transfusion parameters before and after ECMO circuit changes warranted by bleeding or thrombosis.

Including Organ Dysfunctions in a Predictive Score for Nosocomial Pneumonia After Cardiothoracic Surgery.

Background: Clinical diagnosis of ICU-acquired pneumonia after cardiothoracic surgery is challenging. Johanson criteria (chest radiograph infiltrate, purulent tracheal secretions, fever, and leukocytosis) fail in half the cases. A high Clinical Pulmonary Infection Score (CPIS) and ≥ 2-point increase in Sequential Organ Failure Assessment (SOFA) score (SOFA↑ ≥ 2) may improve diagnosis.

Oxygenation versus driving pressure for determining the best positive end-expiratory pressure in acute respiratory distress syndrome.

Objective: The aim of this prospective longitudinal study was to compare driving pressure and absolute PaO/FiO ratio in determining the best positive end-expiratory pressure (PEEP) level.

Patients And Methods: In 122 patients with acute respiratory distress syndrome, PEEP was increased until plateau pressure reached 30 cmHO at constant tidal volume, then decreased at 15-min intervals, to 15, 10, and 5 cmHO. The best PEEP by PaO/FiO ratio (PEEP) was defined as the highest PaO/FiO ratio obtained, and the best PEEP by driving pressure (PEEP) as the lowest driving pressure.