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Unveiling Baseline Clinical Divergence in VA ECMO vs. ECPELLA: Tailoring Treatment for Distinct Patient Profiles. A Systematic Review and Meta-analysis.
J Cardiothorac Vasc Anesth
December 2024
Kore University, Enna, Italy and Centro Cuore GB Morgagni, Catania, Italy.
Objectives: The benefit of combining multiple mechanical circulatory support (MCS) systems in patients with cardiogenic shock (CS) is debated. This review examines patient characteristics across studies to identify differences and assesses if patients with a higher-risk clinical profile receive Impella unloading.
Design: A systematic review and meta-analysis was conducted to examine if there were significant differences in baseline clinical parameters among patients receiving MCS in addition to venoarterial extracorporeal membrane oxygenation (VA ECMO).
Severity of metabolic derangement predicts survival after out-of-hospital cardiac arrest and the likelihood of benefiting from extracorporeal life support.
Emergencias
December 2024
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seúl, República de Corea. Department of Digital Health, SAIHST, Sungkyunkwan University, Seúl, República de Corea.
Objective: To develop a Metabolic Derangement Score (MDS) based on parameters available after initial testing and assess the score's ability to predict survival after out-of hospital cardiac arrest (OHCA) and the likely usefulness of extracorporeal life support (ECLS).
Methods: A total of 5100 cases in the Korean Cardiac Arrest Research Consortium registry were included. Patients' mean age was 67 years, and 69% were men.
Artificial Liver Support Systems in Acute Liver Failure and Acute-on-Chronic Liver Failure: Systematic Review and Meta-Analysis.
Crit Care Explor
January 2025
eGenesis, Inc., Cambridge, MA.
Objectives: To systematically review the safety and efficacy of nonbiological (NBAL) or biological artificial liver support systems (BAL) and whole-organ extracorporeal liver perfusion (W-ECLP) systems, in adults with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF).
Data Sources: Eligible NBAL/BAL studies from PubMed/Embase searches were randomized controlled trials (RCTs) in adult patients with ALF/ACLF, greater than or equal to ten patients per group, reporting outcomes related to survival, adverse events, transplantation rate, and hepatic encephalopathy, and published in English from January 2000 to July 2023. Separately, we searched for studies evaluating W-ECLP in adult patients with ALF or ACLF published between January1990 and July 2023.
Tailored Approach to Temporary Mechanical Circulatory Support for Cardiogenic Shock: Strategies to Facilitate Patient Mobilization.
Curr Cardiol Rep
January 2025
Department of Cardiovascular & Thoracic Surgery, Sandra Atlas Bass Heart Hospital at North Shore University Hospital, Northwell Health, 300 Community Drive, 1 DSU, Manhasset, NY, 11030, USA.
Purpose Of Review: This article discusses a tailored approach to managing cardiogenic shock and temporary mechanical circulatory support (tMCS). We also outline specific mobilization strategies for patients with different tMCS devices and configurations, which can be enabled by this tailored approach to cardiogenic shock management.
Recent Findings: Safe and effective mobilization of patients with cardiogenic shock receiving tMCS can be accomplished.
Venoarterial Extracorporeal Membrane Oxygenation for Support of Vasodilatory Shock in Children Due to Toxicological Ingestions.
ASAIO J
January 2025
Division of Pediatric Cardiology, Department of Pediatrics, Heart Institute, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) may provide temporary hemodynamic support for patients with severe vasodilatory shock due to toxicologic ingestion. In a series of 10 cases of children less than 18 years of age who received VA ECMO support for toxicologic-induced vasodilatory shock, there were eight survivors and two nonsurvivors who died of significant neurologic injury. Upon initiation of ECMO support, survivors had decline in Vasoactive-Inotrope Scores (VIS).
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