Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions.

Short-term mechanical support by veno-arterial extracorporeal membrane oxygenation (VA ECMO) is more and more applied in patients with severe cardiogenic shock. A major shortcoming of VA ECMO is its variable, but inherent increase of left ventricular (LV) mechanical load, which may aggravate pulmonary edema and hamper cardiac recovery. In order to mitigate these negative sequelae of VA ECMO, different adjunct LV unloading interventions have gained a broad interest in recent years.

Extracorporeal organ support (ECOS) in critical illness and acute kidney injury: from native to artificial organ crosstalk.

The complex nature of single organ failure potentially leading to multiple organ dysfunction syndrome (MODS) in critically ill patients necessitates integrated supportive therapy. Rather than a primary disease, acute kidney injury (AKI) is considered a window to a potentially serious underlying systemic disease, which may partially explain the high morbidity and mortality rates associated with the condition. Renal replacement therapy (RRT) has been routinely used for more than a decade in various intensive care settings and there has also been an increase in the use of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal.

Meta-Analysis of Peripheral or Central Extracorporeal Membrane Oxygenation in Postcardiotomy and Non-Postcardiotomy Shock.

Background: Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) application in postcardiotomy shock (PCS) and non-PCS is increasing. VA-ECMO plays a critical role in the management of these patients, yet may be associated with serious complications.

Methods: A systematic review of all available reports in the literature of patients receiving VA-ECMO, either directly or indirectly, comparing central cannulation (right atrial to ascending aorta) versus peripheral cannulation (femoral vein to femoral artery or axillary artery) were analyzed.

Increasing Opportunity for Lung Transplant in Interstitial Lung Disease With Pulmonary Hypertension.

Background: Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation for end-stage interstitial lung disease (ILD) and pulmonary hypertension (PH) has varying results based on ECMO configuration. We compare our experience using venovenous (VV) and venoarterial (VA) ECMO bridge to transplantation for ILD with PH on survival to successful transplantation.

Methods: A single-center retrospective review was done of patients with ILD and secondary PH who were placed on either VV or VA ECMO as bridge to transplantation from 2010 to 2016.

Improved stratification of ALS clinical trials using predicted survival.

Introduction: In small trials, randomization can fail, leading to differences in patient characteristics across treatment arms, a risk that can be reduced by stratifying using key confounders. In ALS trials, riluzole use (RU) and bulbar onset (BO) have been used for stratification. We hypothesized that randomization could be improved by using a multifactorial prognostic score of predicted survival as a single stratifier.

Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment.

Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually.

Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years.

Outcomes and Mortality Prediction Model of Critically Ill Adults With Acute Respiratory Failure and Interstitial Lung Disease.

Background: We aimed to examine short- and long-term mortality in a mixed population of patients with interstitial lung disease (ILD) with acute respiratory failure, and to identify those at lower vs higher risk of in-hospital death.

Methods: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an ICU for respiratory failure at a tertiary care hospital between 2010 and 2014 and who did not undergo lung transplantation during their hospitalization. We examined associations of ICU-day 1 characteristics with in-hospital and 1-year mortality, using Poisson regression, and examined survival using Kaplan-Meier curves.

Update on pulmonary arterial hypertension research: proceedings from a meeting of experts.

Background: While pulmonary arterial hypertension (PAH) remains a progressive, symptomatic condition characterized by increased pulmonary vascular resistance, ultimately leading to right heart failure, great strides have been made in its understanding and treatment over the past two decades.

Review: Continued research in pre-clinical, clinical, and health economic areas of research, in addition to registry analyses and technology advances, is critical for understanding the pathophysiology of the disease and devising the best ways to monitor and manage patients. On December 3, 2016, the latest pre-clinical, clinical, health economic outcome, and registry data on PAH was presented in a symposium sponsored by Actelion.

Adolescent-Parent Dyad Descriptions of the Decision to Start the HPV Vaccine Series.

Study Objective: To examine how adolescent-parent dyads describe decision-making regarding initiation of the human papillomavirus (HPV) vaccine series, specifically who they viewed as making the final decision.

Design: Semistructured interviews with adolescent-parent dyads were audio-recorded and transcribed. Responses to the question: "How did you make a decision about whether or not to receive the HPV vaccine series?" were content-coded for each individual member of the dyad.

Dizziness Handicap Inventory Score Is Highly Correlated With Markers of Gait Disturbance.

Objective: To evaluate the association between Dizziness Handicap Inventory-Screening version (DHI-S) score and spatiotemporal gait parameters using SoleSound, a newly developed, inexpensive, portable footwear-based gait analysis system.

Study Design: Cross-sectional.

Patients: One hundred eighteen patients recruited from otology clinic.

Adult newborn neurons interfere with fear discrimination in a protocol-dependent manner.

Introduction: Significant enhancement of neurogenesis is known to occur in response to a variety of brain insults such as traumatic brain injury. Previous studies have demonstrated that injury-induced newborn neurons are required for hippocampus-dependent spatial learning and memory tasks like the Morris water maze, but not in contextual fear conditioning that requires both the hippocampus and amygdala. Recently, the dentate gyrus, where adult hippocampal neurogenesis occurs, has been implicated in processing information to form specific memory under specific environmental stimuli in a process known as pattern separation.