Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Korea.
Published: June 2011
AI Article Synopsis
Article Abstract
Indication for extracorporeal membrane oxygenation (ECMO) has been extended as the experience of ECMO in various clinical settings accumulates and the outcome after ECMO installation improves. We report two cases of successful mitral valve surgery for severe ischemic mitral regurgitation in patients on ECMO support for cardiogenic shock which developed upon coronary angiography.
Background: Percutaneous extracorporeal membrane oxygenation (ECMO) is administered to pediatric patients with cardiogenic shock or cardiac arrest. The traditional method uses focal echocardiography to complete the left ventricular measurement. However, echocardiographic determination of the ejection fraction (EF) by manual tracing of the endocardial borders is time consuming and operator dependent.
Introduction: Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still in the focus of research, in which pigs are commonly involved. During VA-ECMO, cardiovascular parameters are artificially manipulated and therefore not reliable indicators of nociception. Nociceptive withdrawal reflex (NWR) thresholds can be a suitable alternative in such a context.
Levosimendan is a positive inotrope and vasodilator used in patients with acute and chronic decompensated heart failure. It is metabolized into OR-1855 (inactive metabolite), which is further acetylated into OR-1896 (active metabolite having a prolonged half-life, hence a sustained effect). Levosimendan represents a valuable alternative to traditional inotropes with broad clinical applications in critically ill patients with cardiogenic shock, advanced heart failure and post-cardiac surgery.
Up to 50% of patients with pulmonary embolism (PE) experience hemodynamic instability and approximately 70% of patients who die of PE experience an accelerated cascade of symptoms within the first hours of onset of symptoms, thus necessitating rapid evaluation and intervention. Venoarterial extracorporeal membrane oxygenation and other ventricular assist devices, depending on the hemodynamic derangements present, may be used to stabilize patients with massive PE refractory to initial therapies or with contraindications to other interventions. Given the abnormalities in both pulmonary circulation and gas exchange caused by massive PE, venoarterial extracorporeal membrane oxygenation may be considered the preferred form of mechanical circulatory support for most patients.
Background: We retrospectively analyzed the patients who underwent prone positioning (PP) for acute respiratory failure after pulmonary endarterectomy (PEA).
Methods: One hundred twenty five patients underwent PEA and the outcome related to patients who underwent PP for acute respiratory failure after surgery was analyzed.
Results: Thirteen patients (10%) underwent PP at the mean duration of 28.
