Publications by authors named "Erwin de Troy"
Successful clinical transplantation of hearts donated after circulatory death using direct procurement followed by hypothermic oxygenated perfusion: A report of the first 3 cases.
J Heart Lung Transplant
November 2024
Background: Extracorporeal life support (ECLS) is not routinely used at our center during sequential single-lung transplantation (LTx), but is restricted to anticipate and overcome hemodynamic and respiratory problems occurring peri-operatively. In this retrospective descriptive cohort study, we aim to describe our single-center experience with ECLS in LTx, analyzing ECLS-related complications.
Methods: All transplantations with peri-operative ECLS use [2010-2020] were retrospectively analyzed.
Background: Randomized, controlled trials have shown both benefit and harm from tight blood-glucose control in patients in the intensive care unit (ICU). Variation in the use of early parenteral nutrition and in insulin-induced severe hypoglycemia might explain this inconsistency.
Methods: We randomly assigned patients, on ICU admission, to liberal glucose control (insulin initiated only when the blood-glucose level was >215 mg per deciliter [>11.
Article Synopsis
- Existing research on RBC transfusion in VA ECMO patients is limited, mostly consisting of small-scale studies that hinder broader understanding.
- This study involved an international survey and retrospective data collection from 16 centers to assess transfusion practices and outcomes in VA ECMO patients.
- Results showed that a high percentage of patients (89%) received RBC transfusions, with factors like lower hemoglobin and longer ECMO duration influencing the need for transfusions, but overall survival did not significantly differ based on transfusion status.
Plasma Transfusion and Procoagulant Product Administration in Extracorporeal Membrane Oxygenation: A Secondary Analysis of an International Observational Study on Current Practices.
Crit Care Explor
August 2023
Article Synopsis
- The study examines the use of various blood products (plasma, fibrinogen concentrate, TXA, and PCC) in patients on extracorporeal membrane oxygenation (ECMO) to achieve better blood clotting balance.
- It analyzes data from a multicenter retrospective study involving adult patients on VA-ECMO and VV-ECMO, identifying complications related to bleeding and thrombosis.
- Results indicate a higher use of transfusions in patients with bleeding complications, revealing trends in treatment that suggest a need for reevaluation of current transfusion practices in ECMO patients.
The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation: a multicenter observational study.
Crit Care
August 2023
Article Synopsis
- Thrombocytopenia (low platelets) and bleeding are common problems for patients on a special machine called VA ECMO that helps with heart and lung issues.
- A study looked at 419 patients and found that almost all of them developed low platelets, with many having severe cases, and more than half needed platelet transfusions.
- The research showed that having severe low platelets makes it much more likely to need a platelet transfusion, especially if the patient is also bleeding.
Unlabelled: Although venovenous extracorporeal membrane oxygenation (VV ECMO) has been used in case of COVID-19 induced acute respiratory distress syndrome (ARDS), outcomes and criteria for its application should be evaluated.
Objectives: To describe patient characteristics and outcomes in patients receiving VV ECMO due to COVID-19-induced ARDS and to assess the possible impact of COVID-19 on mortality.
Design Setting And Participants: Multicenter retrospective study in 15 ICUs worldwide.
While euthanasia has been legalized in a growing number of countries, organ donation after euthanasia is only performed in Belgium, the Netherlands, Spain, and Canada. Moreover, the clinical practice of heart donation after euthanasia has never been reported before. We describe the first case of a heart donated after euthanasia, reconditioned with thoraco-abdominal normothermic regional perfusion, preserved using cold storage while being transported to a neighboring transplant center, and then successfully transplanted following a procurement warm ischemic time of 17 min.
View Article and Find Full Text PDFArticle Synopsis
- In the critical care setting, a restrictive blood transfusion strategy is generally safe, but patients on venovenous extracorporeal membrane oxygenation (ECMO) often receive more liberal transfusions, which prompts the need for better understanding of current practices.
- This study involved a mixed methods approach, including a retrospective analysis of patient data from 16 ICUs worldwide, focusing on those who underwent ECMO from January 2018 to July 2019.
- Results showed that a high percentage (88%) of patients received at least one red blood cell (RBC) transfusion, with average hemoglobin levels decreasing significantly during ECMO, and those with a threshold hemoglobin of over 9 g/dL received more transf
Article Synopsis
- Primary graft dysfunction (PGD) significantly impacts early recovery and survival rates after lung transplantation (LTx), with this study investigating the role of prolonged anastomosis time (AT) as a risk factor for PGD.
- Data from 427 patients who underwent double lung transplants between 2008 and 2016 revealed that 30.2% developed severe PGD3 within 72 hours, and longer AT was independently linked to increased risk of PGD3.
- The findings emphasize the importance of minimizing AT during LTx procedures and ensuring proper lung cooling to reduce the incidence of PGD and related complications.
Background: To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO.
Methods: We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected.