A Case of Acute Mechanical Mitral Valve Thrombosis Management With Venoarterial Extracorporeal Membrane Oxygenation.

Mechanical prosthetic valve thrombosis (PVT) and obstruction are rare and dangerous events often related to inappropriate anticoagulant therapy. High mortality rates occur because of delayed diagnosis, hemodynamic instability, multiple organ failure (MOF), and high perioperative risk. Surgical repair is a first-line treatment for obstructive PVT with hemodynamic instability but is often not readily available or safely performed.

Adding Extracorporeal Membrane Oxygenation to Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest Due to Pulmonary Embolism: A Case Report.

We present a challenging cardiopulmonary resuscitation scenario of an out-of-hospital cardiac arrest (OHCA) in a 21-year-old healthy woman recovering from a lower limb fracture who collapsed during a rehabilitation session at a community center. The combination of witnessed arrest, administration of immediate cardiopulmonary resuscitation, and effective communication to emergency services enabled a timely cannulation of extracorporeal membrane oxygenation in a cardiopulmonary resuscitation reference center. The cause of the cardiac arrest was pulmonary embolism, and the intensive care unit team opted for thrombolysis when she arrived after 40 minutes of cardiopulmonary resuscitation.

Arrhythmogenic Left Ventricular Cardiomyopathy: A Successful Case of Extracorporeal Cardiopulmonary Resuscitation.

A 24-year-old man suffered a witnessed cardiac arrest after a padel game. Basic life support was immediately provided. The pre-hospital emergency services team continued the resuscitation efforts, and the patient was accepted for extracorporeal cardiopulmonary resuscitation.

Complications during transport of adult patients on extracorporeal membrane oxygenation.

Introduction: Transport on extracorporeal membrane oxygenation (ECMO) is a risky and complex procedure. Although most published data support the feasibility of interhospital transport on ECMO, data concerning intra-facility transportation and frequency and severity of complications during ECMO transport of adult patients are still scarce. The aim of this study was to assess transport arrangements and complications during intra and interhospital ECMO-supported patients transport at a high-volume ECMO center.

Long-term extracorporeal membrane oxygenation - from SARS-CoV-2 infection to lung transplantation.

A healthy 55-year-old woman unvaccinated for SARS-CoV-2 was admitted to the hospital with a SARS-CoV-2 infection with rapid clinical deterioration. On the 17th day of disease, she was intubated, and on the 24th day, the patient was referred and admitted to our extracorporeal membrane oxygenation center. Extracorporeal membrane oxygenation support was initially used to enable lung recovery and allow the patient to rehabilitate and improve her physical condition.

Comparative outcomes of extracorporeal membrane oxygenation for COVID-19 delivered in experienced European centres during successive SARS-CoV-2 variant outbreaks (ECMO-SURGES): an international, multicentre, retrospective cohort study.

Background: To inform future research and practice, we aimed to investigate the outcomes of patients who received extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) due to different variants of SARS-CoV-2.

Methods: This retrospective study included consecutive adult patients with laboratory-confirmed SARS-CoV-2 infection who received ECMO for ARDS in 21 experienced ECMO centres in eight European countries (Austria, Belgium, England, France, Germany, Italy, Portugal, and Spain) between Jan 1, 2020, and Sept 30, 2021. We collected data on patient characteristics, clinical status, and management before and after the initiation of ECMO.

Cytokine Adsorption Therapy during Extracorporeal Membrane Oxygenation in Adult Patients with COVID-19.

Respiratory failure and systemic inflammation are paramount features of severe SARS-CoV-2 disease (COVID-19). Extracorporeal membrane oxygenation (ECMO) therapy has a potential role in patients with refractory disease. An inflammatory response due to blood contact with hemofilters, functioning as a synergic inflammatory stimulus, can lead to a hyperinflammatory state, relatable to cytokine release syndromes.

Time of admission to intensive care unit, strained capacity, and mortality: A retrospective cohort study.

Purpose: We sought to study the association between afterhours ICU admission and ICU mortality considering measures of strained ICU capacity.

Materials And Methods: Retrospective analysis of 4141 admissions to 2 ICUs in Lisbon, Portugal (06/2016-06/2018). Primary exposure was ICU admission on 20:00 h-07:59 h.

Acute-on-Chronic Liver Failure: A Portuguese Single-Center Reference Review.

Unlabelled: Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of a patient with cirrhosis, frequently associated with multi-organ failure and a high short-term mortality rate. We present a retrospective study that aims to characterize the presentation, evolution, and outcome of patients diagnosed with ACLF at our center over the last 3 years, with a comparative analysis between the group of patients that had ACLF precipitated by infectious insults of bacterial origin and the group of those with ACLF triggered by a nonbacterial infectious insult; the incidence of acute kidney injury and its impact on the prognosis of ACLF was also analyzed. Twenty-nine patients were enrolled, the majority of them being male (89.

Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-A multicenter prospective cohort study.

Purpose: Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score.

Materials: National, multicenter, prospective, observational study conducted in 15 polyvalent Portuguese intensive care unit (ICU), during 6 months. Adult patients were eligible.

Unexpected triggers for pheochromocytoma-induced recurrent heart failure.

Pheochromocytoma crisis typically presents as paroxysmal episodes of headache, tachycardia, diaphoresis or hypertension. We describe an uncommon case of recurrent non-hypertensive heart failure with systolic dysfunction in a young female due to pheochromocytoma compression. It presented as acute pulmonary oedema while straining during pregnancy and later on as cardiogenic shock after a recreational body massage.

Drug therapy for chronic heart failure due to left ventricular systolic dysfunction: a review. III. Angiotensin-converting enzyme inhibitors.

The role of angiotensin-converting enzyme inhibitors (ACEIs) in heart failure (HF), which act primarily by inhibiting the renin-angiotensin-aldosterone system, has been thoroughly studied in different subgroups. This article reviews the most valid and recent evidence available concerning the use of ACEIs in HF due to left ventricular systolic dysfunction. The administration of ACEIs leads to statistically and clinically significant reductions in mortality (20 to 23%), risk of myocardial infarction (20 to 21%), hospitalization for heart failure (33%) and symptoms (as measured by NYHA classification).

Drug therapy for chronic heart failure due to left ventricular systolic dysfunction. II. Diuretics.

Diuretics (particularly loop diuretics) are usually considered the first-line treatment for patients with chronic heart failure (CHF). The aldosterone antagonists, spironolactone and eplerenone, which are not unanimously classified as diuretics, have recently been included in therapy for CHF. Diuretics are the only drugs able to reduce fluid retention in CHF, although they are unable to maintain clinical stability for long periods of time when used in isolation.