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Extracorporeal Cardiopulmonary Resuscitation: Outcomes Improve With Center Experience.
Ann Emerg Med
January 2025
Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address:
Study Objective: Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for selected patients when conventional cardiopulmonary resuscitation (CPR) fails. Current evidence suggests that the success of eCPR depends on well-structured in- and out-of-hospital protocols. This article describes the Vienna eCPR program, and the interventions implemented to improve clinical processes and patient outcomes.
View Article and Find Full Text PDFTreatment of Cardiogenic Shock: Inotropes, Vasopressors and Machines.
Br J Hosp Med (Lond)
December 2024
Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Cardiogenic shock (CS) is associated with significant mortality. Advances in pharmacological therapies and mechanical circulatory support (MCS) devices have markedly improved the therapeutic approach to CS, though treatment efficacy and safety vary. The recent DanGer shock trial showed a significant reduction in 6-month mortality for CS patients due to acute myocardial infarction.
View Article and Find Full Text PDFWe review the case of a 58-year-old female on extracorporeal membrane oxygenation (ECMO) support diagnosed with invasive pulmonary aspergillosis (IPA). Intravenous isavuconazole was started, requiring dose escalation to achieve isavuconazole trough concentration (ISA-Cmin) within the therapeutic range (2.5-5.
View Article and Find Full Text PDFThe ACTION VAD Registry: A Collective Five-Year Experience.
J Heart Lung Transplant
January 2025
Department of Pediatrics, Medical College of Wisconsin and Herma Heart Institute, Children's Wisconsin; Milwaukee, WI.
Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.
Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018-June 2023.
Quantifying the influence of combined lung and kidney support using a cardiovascular model and sensitivity analysis-informed parameter identification.
Comput Biol Med
January 2025
Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany.
The combination of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) pose complex hemodynamic challenges in intensive care. In this study, a comprehensive lumped parameter model (LPM) is developed to simulate the cardiovascular system, incorporating ECMO and CRRT circuit dynamics. A parameter identification framework based on global sensitivity analysis (GSA) and multi-start gradient-based optimization was developed and tested on 30 clinical data points from eight veno-arterial ECMO patients.
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