Extracorporeal membrane oxygenation (ECMO) is a form of prolonged mechanical cardiopulmonary supportive therapy implemented for the survival of patients with refractory cardiac and respiratory dysfunction. Venovenous (VV) and venoarterial (VA) ECMO are both used to buy time in severe respiratory failure while VA ECMO also provides hemodynamic support. Unfortunately, the risk of developing circuit or cannula associated and systemic thrombosis in patients supported by ECMO and post circuit decannulation is a devastating complication, although the relationship between venous thromboembolism (VTE) and ECMO use has not been fully established. Due to the lack of knowledge and literature centered on this topic area, currently there are no official guidelines for prompt diagnosis by screening or to optimize prevention and treatment of VTE in this specific population. This review analyzes the relationship between ECMO and subsequent VTE. We also discuss pertinent prophylactic and therapeutic anticoagulation treatments in patients diagnosed with VTE while on ECMO along with the obstacles associated with them.
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http://dx.doi.org/10.1016/j.thromres.2022.02.015 | DOI Listing |
Gen Thorac Cardiovasc Surg Cases
January 2025
Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, 558-8558, Japan.
Background: Left atrial dissection is a rare and occasionally fatal complication of cardiac surgery and is defined as the creation of a false chamber through a tear in the mitral valve annulus extending into the left atrial wall. Some patients are asymptomatic, while others present with various symptoms, such as chest pain, dyspnea, and even cardiac arrest. Although there is no established management for left atrial dissection, surgery should be considered in patients with hemodynamic disruption.
View Article and Find Full Text PDFJ 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).
J R Stat Soc Ser A Stat Soc
January 2025
Biostatistics, University of Michigan, 1415 Washington Heights, Michigan 48109, USA.
Model integration refers to the process of incorporating a fitted historical model into the estimation of a current study to increase statistical efficiency. Integration can be challenging when the current model includes new covariates, leading to potential model misspecification. We present and evaluate seven existing and novel model integration techniques, which employ both likelihood constraints and Bayesian informative priors.
View Article and Find Full Text PDFAnesthesiology
February 2025
Strasbourg University Hospital, New Civil Hospital, Strasbourg, France (J.H.).
Anesthesiology
February 2025
University Hospital of Toulouse, Toulouse, France (F.L.).
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