Publications by authors named "M Kosmopoulos"
Background: Extracorporeal life support (ECLS) provides organ perfusion in refractory cardiac arrest but during the initiation of ECLS mean arterial pressure (MAP) and carotid flow may be suboptimal due to hypotension and/or insufficient flow. We hypothesized that cardiopulmonary resuscitation (CPR) in addition to ECLS may increase carotid flow and MAP compared to ECLS alone.
Methods: Observational pilot study comparing hemodynamic parameters before and after CPR cessation in pigs supported by ECLS for experimental refractory cardiac arrest.
Introduction: The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation.
Heart failure remains one of the leading causes of mortality and hospitalizations in the US that not only impacts quality of life but also poses a significant public health burden. The majority of affected patients are admitted with signs and symptoms of congestion. Despite the initial enthusiasm, traditional remote monitoring strategies focusing primarily on weight gain failed to improve clinical outcomes.
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- The study investigates how extracorporeal membrane oxygenation (ECMO) and percutaneous coronary interventions (PCI) affect the restoration of organized heart rhythms in patients experiencing out-of-hospital cardiac arrest (OHCA) with refractory shockable rhythms.
- Of 289 patients analyzed, 51% achieved an organized rhythm through advanced cardiac life support before reaching the hospital, while 30% did so after ECMO but before PCI, and only 13% did so after PCI.
- Patients with obstructive coronary artery disease had better outcomes when they achieved an organized rhythm before PCI, indicating that early effective treatment is critical for better neurological survival.
Background: The role of hypothermia in post-arrest neuroprotection is controversial. Animal studies suggest potential benefits with lower temperatures, but high-fidelity ECPR models evaluating temperatures below 30 °C are lacking.
Objectives: To determine whether rapid cooling to 24 °C initiated upon reperfusion reduces brain injury compared to 34 °C in a swine model of ECPR.