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High Normocapnia and Better Functional Outcome in Patients Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation After Out-of-Hospital Cardiac Arrest.
Chest
January 2025
Department of Emergency Medicine, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan.
Background: The optimal target for partial pressure of arterial carbon dioxide (PaCO₂) remains uncertain in patients undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) following out-of-hospital cardiac arrest (OHCA).
Research Question: Are PaCO₂ levels associated with functional outcomes in patients receiving VA-ECMO after OHCA?
Study Design: and Methods: This multicenter, registry-based observational study, conducted from 2014 to 2020, included non-traumatic adult OHCA patients on VA-ECMO with PaCO₂ levels measured within six hours of initiation (initial PaCO₂ set) and at 18-30 hours post-initiation (24-hour PaCO₂ set). PaCO₂ levels were categorized into five groups: hypocapnia (<30 mmHg), low normocapnia (30-<40 mmHg), high normocapnia (40-<50 mmHg), mild hypercapnia (50-<60 mmHg), and moderate to severe hypercapnia (≥60 mmHg).
The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation.
BMC Pulm Med
January 2025
Department of Critical Care Medicine, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Background: Veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) are crucial support modalities during lung transplantation, yet their comparative effectiveness remains unclear.
Methods: We conducted an 8-year retrospective analysis of 62 lung transplant recipients who received intraoperative ECMO (29 V-A, 33 V-V). Baseline characteristics, surgical parameters, and clinical outcomes were compared.
Heparin-induced thrombocytopenia requiring VA-ECMO management during percutaneous coronary intervention for acute coronary syndrome: A case report.
J Cardiol Cases
October 2024
Department of Cardiovascular Medicine, Okayama City Hospital, Okayama, Japan.
Unlabelled: Heparin-induced thrombocytopenia (HIT) is an immune-mediated disease with severe thromboembolic complications. HIT during percutaneous coronary intervention (PCI) can be fatal without prompt treatment. We report an unusual case of HIT observed during PCI for acute coronary syndrome (ACS).
View Article and Find Full Text PDFCase Report: Recurrent cardiogenic shock caused by inter-arterial left coronary artery originating from the right coronary sinus, successfully rescued by mechanical circulatory support.
Front Cardiovasc Med
January 2025
Department of Intensive Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.
A young female patient suffered cardiogenic shock after undergoing surgery for an ectopic pregnancy. Coronary artery computed tomography angiography (CTA) revealed a left main artery (LM) originating from the right coronary sinus and traveling between the aorta and pulmonary artery. We successfully resuscitated the patient with mechanical circulatory support using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and an intra-aortic balloon pump (IABP).
View Article and Find Full Text PDFQuantifying 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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