A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.
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http://dx.doi.org/10.5090/kjtcs.2015.48.4.289 | DOI Listing |
Clin Pharmacokinet
December 2024
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Background And Objective: Vancomycin is a glycopeptide antibiotic used for the treatment of severe gram-positive infections. Despite decades of clinical experience, optimized dosing for vancomycin in pediatric populations still warrants further investigation. Patients admitted to the pediatric intensive care unit (PICU) after cardiac surgery are often treated with vancomycin in case of (suspected) infection.
View Article and Find Full Text PDFSemin Cardiothorac Vasc Anesth
December 2024
NHS Wales Joint Commissioning Committee, Pontypridd, UK.
Background: While several studies have summarised the clinical effectiveness evidence for extracorporeal membrane oxygenation (ECMO), there are no evidence syntheses of the impact of centres' ECMO patient volume on patient outcomes or the impact of bedside ECMO care being delivered by either a perfusionist or a nurse. There is also limited information on the cost-effectiveness of ECMO.
Purpose: This review was carried out to evaluate the clinical effectiveness and cost of different service delivery models of pulmonary ECMO to inform NHS Wales commissioning policy.
Anaesth Crit Care Pain Med
December 2024
Sorbonne University, GRC 29, Assistance Publique-Hôpitaux de Paris, DMU DREAM, Department of Anesthesiology and critical care, Pitié-Salpêtrière Hospital, Paris, France. Electronic address:
Background: Indications for Veno-venous (VV) or veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after trauma rely on poor evidence. The main aims were to describe the population of trauma patients requiring either VV or VA ECMO and report their clinical management and outcomes.
Methods: An observational multicentre retrospective study was conducted in 17 Level 1 trauma centres in France between January 2010 and December 2021.
J Crit Care
December 2024
Université Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France; École Nationale Vétérinaire d'Alfort, IMRB, AfterROSC Network, F-94700 Maisons-Alfort, France; Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Créteil, France.; Faculté de Santé, Université Paris Est Créteil, 94010 Créteil, France. Electronic address:
Background: The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a cardiocirculatory support has tremendously increased in critically ill patients. Although fluid therapy is an essential component of the hemodynamic management of VA-ECMO patients, the optimal fluid resuscitation strategy remains controversial. We performed a scoping review to map out the existing knowledge on fluid management in terms of fluid type, dosing and the impact of fluid balance on VA-ECMO patient outcomes.
View Article and Find Full Text PDFJ Echocardiogr
December 2024
Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan.
Purpose: Few investigational reports have evaluated the status of cardiovascular manifestations of coronavirus disease 2019 (COVID-19) during the Omicron dominance period. In this study, we aimed to investigate the cardiac function parameters and clinical outcomes of patients with COVID-19 before and after the Omicron variant (OV) propagation.
Methods: We retrospectively analyzed the data of 88 adult patients with COVID-19 who underwent clinically indicated standard transthoracic echocardiography (TTE) in intensive care wards.
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