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The Korean Organ Transplant Registry (KOTRY): Third Official Adult Heart Transplant Report.
Korean Circ J
October 2024
Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background And Objectives: The Korean Organ Transplant Registry (KOTRY) provided data for this third official report on adult heart transplantation (HT), including information from 709 recipients.
Methods: Data from HTs performed at seven major centers in Korea between March 2014 and December 2020 were analyzed, focusing on immunosuppression, acute rejection, cardiac allograft vasculopathy (CAV), post-transplant survival, and mechanical circulatory support (MCS) usage.
Results: The median ages of the recipients and donors were 56.
Article Synopsis
- - CCB toxicity poses a serious risk of death, making effective treatments like ECMO crucial; this study examines ELSO registry data to evaluate outcomes in adults with CCB toxicity treated with ECMO.
- - The research analyzed data from January 2016 to April 2023, focusing on factors like patient demographics and clinical indicators (e.g., pH levels) to determine mortality rates and predictors among those treated with ECMO.
- - Findings revealed a mortality rate of 40.6% for ECMO-treated patients, with severe acidosis and prior need for kidney treatment identified as significant mortality predictors; further studies are suggested to explore the impact of timely ECMO initiation.
Implementation of an arterial blood gas indication algorithm in cardiac surgery.
J Vasc Nurs
March 2024
University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD, United States. Electronic address:
Problem: Arterial blood gasses (ABGs) account for an estimated 10-20% of all costs during an ICU stay. Non-clinically indicated ABGs increased costs of care, lengths of stay, ventilator days, and line days, increasing the risk of adverse outcomes in already vulnerable critically ill patients. A cardiac surgery intensive care unit (CSICU) within a large urban mid-Atlantic academic medical center accounted for 31% of the entire institution's ABG analyses between 2018-2019, was identified as a top utilizer due to inappropriate ordering practices compared to current guidelines.
View Article and Find Full Text PDFEndotoxic Septic Shock: Diagnosis and Treatment.
Int J Mol Sci
November 2023
Spectral Medical Inc., Toronto, ON M9C 1C2, Canada.
Endotoxin, also referred to as lipopolysaccharide (LPS), is a potent stimulator of the inflammatory cascade which may progress to sepsis and septic shock. The term endotoxic septic shock has been used for patients who have a clinical phenotype that is characterized by high endotoxin activity in addition to a high burden of organ failure; especially a pattern of organ failure including hepatic dysfunction, acute kidney injury, and various forms of endothelial dysfunction. Endotoxic septic shock has been a target for drug therapy for decades with no success.
View Article and Find Full Text PDFWithdrawing extra corporeal membrane oxygenation (ECMO) against a family's wishes: Three permissible scenarios.
J Heart Lung Transplant
July 2023
Department of Cardiovascular Anesthesia, Weill Cornell Medical College, New York, New York; Intensivist Cardiovascular Surgical ICU, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.
The ethical permissibility of unilaterally withdrawing life-sustaining technologies has been a perennial topic in transplant and critical care medicine, often focusing on CPR and mechanical ventilation. The permissibility of unilateral withdrawal of extracorporeal membrane oxygenation (ECMO) has been discussed sparingly. When addressed, authors have appealed to professional authority rather than substantive ethical analysis.
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