As mortality relating to severe acute burn injury improves, patients are surviving longer into the critical care phase, which is commonly complicated by multisystem organ failure. Extracorporeal organ support (ECOS) represents a set of potential therapeutic technologies for managing patients with organ-specific complications. This article provides a comprehensive review of the existing literature, focusing on the use of continuous kidney replacement therapy, extracorporeal membrane oxygenation, extracorporeal carbon dioxide removal, and extracorporeal blood purification. Though promising, many of these technologies are in the early phases of implementation and are restricted to well-resourced medical systems, limiting their use in large scale casualty and austere scenarios.
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http://dx.doi.org/10.3390/ebj5020006 | DOI Listing |
Crit Care Explor
January 2025
eGenesis, Inc., Cambridge, MA.
Objectives: To systematically review the safety and efficacy of nonbiological (NBAL) or biological artificial liver support systems (BAL) and whole-organ extracorporeal liver perfusion (W-ECLP) systems, in adults with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF).
Data Sources: Eligible NBAL/BAL studies from PubMed/Embase searches were randomized controlled trials (RCTs) in adult patients with ALF/ACLF, greater than or equal to ten patients per group, reporting outcomes related to survival, adverse events, transplantation rate, and hepatic encephalopathy, and published in English from January 2000 to July 2023. Separately, we searched for studies evaluating W-ECLP in adult patients with ALF or ACLF published between January1990 and July 2023.
Can J Cardiol
January 2025
Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada; Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada. Electronic address:
Patients with cardiogenic shock (CS) present with critical hemodynamic compromise with low cardiac output (CO) resulting in end-organ dysfunction. Prognosis is closely related to the severity of shock and treatment of patients with CS is resource intensive. In this review, we consider the current treatment paradigms alongside the evidence that underpins them.
View Article and Find Full Text PDFCurr Cardiol Rep
January 2025
Department of Cardiovascular & Thoracic Surgery, Sandra Atlas Bass Heart Hospital at North Shore University Hospital, Northwell Health, 300 Community Drive, 1 DSU, Manhasset, NY, 11030, USA.
Purpose Of Review: This article discusses a tailored approach to managing cardiogenic shock and temporary mechanical circulatory support (tMCS). We also outline specific mobilization strategies for patients with different tMCS devices and configurations, which can be enabled by this tailored approach to cardiogenic shock management.
Recent Findings: Safe and effective mobilization of patients with cardiogenic shock receiving tMCS can be accomplished.
JTCVS Open
December 2024
Thoracic and Cardiovascular Surgery Department, Sorbonne Université, APHP, Groupe Hospitalier Pitié-Salpétrière, Institute of Cardiology, Paris, France.
Objective: The study objective was to evaluate outcomes of patients directly bridged with venoarterial extracorporeal membrane oxygenation to heart transplantation.
Methods: A single-center retrospective study was performed on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with an extracorporeal membrane oxygenation to transplantation (extracorporeal membrane oxygenation group, n = 317) were compared with standard cohorts of patients (no extracorporeal membrane oxygenation group, n = 835).
Nat Med
January 2025
Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Following our previous experience with cardiac xenotransplantation of a genetically modified porcine heart into a live human, we sought to achieve improved results by selecting a healthier recipient and through more sensitive donor screening for potential zoonotic pathogens. Here we transplanted a 10-gene-edited pig heart into a 58-year-old man with progressive, debilitating inotrope-dependent heart failure due to ischemic cardiomyopathy who was not a candidate for standard advanced heart failure therapies. He was maintained on a costimulation (anti-CD40L, Tegoprubart) blockade-based immunomodulatory regimen.
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