Article
Medicine, General & Internal
Ryan P. Barbaro, Graeme MacLaren, Philip S. Boonstra, Alain Combes, Cara Agerstrand, Gail Annich, Rodrigo Diaz, Eddy Fan, Katarzyna Hryniewicz, Roberto Lorusso, Matthew L. Paden, Christine M. Stead, Justyna Swol, Theodore J. Iwashyna, Arthur S. Slutsky, Daniel Brodie
Summary: The study examined the use of ECMO for COVID-19 patients during 2020 globally, showing lower in-hospital mortality rates in early-adopting ECMO centres and higher rates in late-adopting centres.
Article
Critical Care Medicine
Anne Willers, Justyna Swol, Hergen Buscher, Zoe McQuilten, Sander M. J. van Kuijk, Hugo Ten Cate, Peter T. Rycus, Stephen McKellar, Roberto Lorusso, Joseph E. Tonna
Summary: Data on hospital outcomes in bleeding complications during extracorporeal life support (ECLS) have been lacking. This retrospective study analyzed data from 53,644 adult patients and found a steady decrease in bleeding complications over the past 20 years, mostly attributed to surgical and cannula-site-related bleeding. However, more data is needed to determine the exact reasons for the decrease in bleeding trends.
CRITICAL CARE MEDICINE
(2022)
Article
Medicine, General & Internal
Holger Thiele, Uwe Zeymer, Ibrahim Akin, Michael Behnes, Tienush Rassaf, Amir Abbas Mahabadi, Ralf Lehmann, Ingo Eitel, Tobias Graf, Tim Seidler, Andreas Schuster, Carsten Skurk, Daniel Duerschmied, Peter Clemmensen, Marcus Hennersdorf, Stephan Fichtlscherer, Ingo Voigt, Melchior Seyfarth, Stefan John, Sebastian Ewen, Axel Linke, Eike Tigges, Peter Nordbeck, Leonhard Bruch, Christian Jung, Jutta Franz, Philipp Lauten, Tomaz Goslar, Hans-Josef Feistritzer, Janine Poess, Eva Kirchhof, Taoufik Ouarrak, Steffen Schneider, Steffen Desch, Anne Freund, ECLS-SHOCK Investigators
Summary: In patients with acute myocardial infarction complicated by cardiogenic shock, early extracorporeal life support (ECLS) combined with standard medical treatment did not reduce mortality.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Critical Care Medicine
Matteo Di Nardo, Danilo Alunni Fegatelli, Marco Marano, Jacob Danoff, Hong K. Kim
Summary: This study described the use of extracorporeal membrane oxygenation (ECMO) in the management of pediatric poisoning in the United States and identified predictors of mortality. It found that ECMO can improve the hemodynamic and metabolic status of poisoned pediatric patients. Persistent hypotension, acidemia/acidosis, and elevated Pao(2) after 24 hours of ECMO were associated with mortality.
CRITICAL CARE MEDICINE
(2022)
Review
Critical Care Medicine
Alexandra Schou, Jesper Molgaard, Lars Willy Andersen, Soren Holm, Marc Sorensen
Summary: The past 50 years of extracorporeal life support (ECLS) has had a significant impact on modern medicine, presenting various ethical challenges. This study identified three main ethical discourses related to ECLS: trials and evidence of ECLS usage, ECLS allocation and decision-making, and death on ECLS and ECLS in organ donation. The findings highlight the importance of a shared decision-making approach at the limits of medical care.
Article
Critical Care Medicine
Mariusz Kowalewski, Kamil Zielinski, Giuseppe Maria Raffa, Paolo Meani, Valeria Lo Coco, Federica Jiritano, Dario Fina, Matteo Matteucci, Giovanni Chiarini, Anne Willers, Jorik Simons, Piotr Suwalski, Mario Gaudino, Michele Di Mauro, Jos Maessen, Roberto Lorusso
Summary: The study analyzed predictors of unfavorable outcomes in elderly patients (>= 70 yr) undergoing venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock. Despite high in-hospital mortality, the use of ECMO in elderly patients is still considered, as increasing age itself was not associated with higher mortality.
CRITICAL CARE MEDICINE
(2021)
Article
Critical Care Medicine
Mariusz Kowalewski, Kamil Zielinski, Daniel Brodie, Graeme MacLaren, Glenn Whitman, Giuseppe M. Raffa, Udo Boeken, Kiran Shekar, Yih-Sharng Chen, Christian Bermudez, David D'Alessandro, Xiaotong Hou, Jonathan Haft, Jan Belohlavek, Inga Dziembowska, Piotr Suwalski, Peta Alexander, Ryan P. Barbaro, Mario Gaudino, Michele Di Mauro, Jos Maessen, Roberto Lorusso
Summary: This study analyzed the trends in using venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock from 2010 to 2018, finding a significant increase in its use over the years, especially in older patients. The most common surgeries that necessitated venoarterial ECMO were coronary artery bypass and valvular surgery.
CRITICAL CARE MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Caroline M. Patterson, Aakash Shah, Joseph Rabin, Laura DiChiacchio, Marcelo Cypel, Konrad Hoetzenecker, Pedro Catarino, Christine L. Lau
Summary: The demand for lung transplant procedures is increasing, but there is a shortage of donor organs and high mortality among patients on waiting lists. Extracorporeal life support (ECLS) has emerged as a potential treatment option to support critically ill patients while they await a suitable organ match. This review explores the evolving landscape of ECLS as a bridge to lung transplantation, including patient selection criteria, survival predictors, pre and peri-transplant support methods, and the importance of a multidisciplinary approach to care. Innovations are being considered to improve the accessibility, safety, and effectiveness of ECLS for future lung transplant candidates.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Article
Critical Care Medicine
Shannon M. Fernando, Graeme Maclaren, Ryan P. Barbaro, Rebecca Mathew, Laveena Munshi, Purnema Madahar, Justin A. Fried, Kollengode Ramanathan, Roberto Lorusso, Daniel Brodie, Daniel I. Mcisaac
Summary: Among patients receiving V-A ECMO for cardiogenic shock, increasing age is strongly associated with increasing odds of death and complications, and this association emerges as early as 40 years of age.
INTENSIVE CARE MEDICINE
(2023)
Article
Critical Care Medicine
Darryl Abrams, Cara Agerstrand, Jeremy R. Beitler, Christian Karagiannidis, Purnema Madahar, Natalie H. Yip, Antonio Pesenti, Arthur S. Slutsky, Laurent Brochard, Daniel Brodie
Summary: Ultra-lung-protective ventilation is a strategy that aims to achieve lower airway pressures and tidal volumes. Some patients may benefit from this strategy, but its application is limited by respiratory acidosis and associated hematological complications. Only in very severe cases of acute respiratory distress syndrome, using extracorporeal membrane oxygenation to accomplish ultra-lung-protective ventilation may have a favorable risk-to-benefit profile.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Richa Asija, Justin A. Fried, Eric C. Siddall, Dana A. Mullin, Cara L. Agerstrand, Daniel Brodie, Joshua R. Sonett, Philippe H. Lemaitre, Darryl Abrams
Summary: Dual circulation is a physiological occurrence associated with ECMO, where competitive flow between heart ejection and retrograde flow from ECMO cannula creates a mixing point. The differential gas exchange within these circulations can have important clinical implications. Recognition and management of dual circulation, monitoring for differential gas exchange, and implementing appropriate strategies for resolving differential oxygenation and carbon dioxide are crucial.
Article
Cardiac & Cardiovascular Systems
Anne-Kristin Schaefer, Julia Riebandt, Martin H. Bernardi, Klaus Distelmaier, Georg Goliasch, Daniel Zimpfer, Gunther Laufer, Dominik Wiedemann
Summary: Post-cardiotomy extracorporeal life support (PC-ECLS) is a potentially life-saving resource for patients with cardiopulmonary failure after cardiac surgery. However, even in successfully weaned patients, adverse outcomes have been reported. This study aimed to assess the outcomes of patients weaned from PC-ECLS. The results showed that in-hospital mortality was high, and factors such as longer ECLS duration, older age, female gender, and low preoperative glomerular filtration rate were associated with higher mortality. However, the survival rate of patients discharged after PC-ECLS was encouraging.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Medicine, General & Internal
Angelo Justus, Aidan Burrell, Chris Anstey, George Cornmell, Daniel Brodie, Kiran Shekar
Summary: In patients supported by VA ECMO, hyperoxemia was common but not independently associated with increased mortality. Survivors received lower EBFR and had greater minute ventilation, but this was also not independently associated with survival. These findings highlight that interactions between EBFR, PaO2, and native lung ventilation may be more relevant than their individual association with survival.
FRONTIERS IN MEDICINE
(2021)
Article
Pharmacology & Pharmacy
Brenda Zylbersztajn, Suzanne Parker, Daniel Navea, Giannina Izquierdo, Paula Ortiz, Juan Pablo Torres, Cristian Fajardo, Rodrigo Diaz, Cristian Valverde, Jason Roberts
Summary: This study aimed to describe the primary pharmacokinetic/pharmacodynamic parameters of vancomycin and meropenem in pediatric patients undergoing ECMO, and analyze the dosing utilized to reach the PK/PD target. The study found that conventional doses of vancomycin partially achieved the PK/PD objectives, while higher dosing with extended infusion was needed for meropenem to reach the PK/PD target.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Medicine, General & Internal
Filip Bursa, Michal Frelich, Peter Sklienka, Ondrej Jor, Jan Maca
Summary: Although extracorporeal life support is an expensive and risky method, it is widely accepted for organ support. Veno-venous extracorporeal membrane oxygenation (ECMO) is the preferred method for severe respiratory failure when mechanical ventilation is insufficient. Improving oxygenation or acid-base balance alone does not guarantee improved outcomes, but it helps prevent potential negative effects of mechanical ventilation, which is crucial for complex care. Long-term mortality and quality of life should be considered for ECMO-surviving patients, who may experience physical and psychological health problems but can still return to everyday life with minimal respiratory limitations.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Critical Care Medicine
Ruofei (Trophy) Chen, Mandy Truong, Jason R. Watterson, Aidan Burrell, Pauline Wong
Summary: During the COVID-19 pandemic, the introduction of the ICU Family Liaison Nurse (FLN) role in an Australian hospital had a beneficial impact on patient and family communication from the perspectives of ICU healthcare professionals. The role improved the workflow and work experience of healthcare professionals, as well as facilitated communication with patients and their families.
AUSTRALIAN CRITICAL CARE
(2023)
Review
Emergency Medicine
Joseph P. Hogarty, Morgan E. Jones, Karishma Jassal, Daniel T. Hogarty, Biswadev Mitra, Andrew A. Udy, Mark C. Fitzgerald
Summary: Haemorrhagic shock after trauma is a significant cause of death worldwide, but there is a lack of high-quality or recent studies investigating the use of steroids for its treatment in English literature.
EMERGENCY MEDICINE AUSTRALASIA
(2023)
Article
Engineering, Biomedical
Kenneth R. Hoffman, Arne Diehl, Eldho Paul, Aidan J. C. Burrell
Summary: This study investigates the hematological changes that occur before and after ECMO circuit exchange in patients with severe respiratory failure on V-V ECMO. The results show significant changes in various hematological markers after ECMO circuit exchange, supporting the biologic plausibility of preventing complications with this procedure.
Article
Computer Science, Interdisciplinary Applications
Avishka Wickramarachchi, Mehrdad Khamooshi, Aidan Burrell, Vincent A. Pellegrino, David M. Kaye, Shaun D. Gregory
Summary: This study investigated the impact of tip position of single-stage (SS) and multi-stage (MS) venoarterial extracorporeal membrane oxygenation (VA ECMO) drainage cannulae on the risk of thrombosis. Computational fluid dynamics was used to model flow dynamics, and several factors were measured to assess the risk of thrombosis. The results showed that the tip position of the drainage cannula had a significant impact on thrombosis risk.
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE
(2023)
Article
Nutrition & Dietetics
Oana A. Tatucu-Babet, Arne Diehl, Caroline Kratzing, Kate Lambell, Aidan Burrell, Audrey Tierney, Ibolya Nyulasi, Michael Bailey, Jayne Sheldrake, Emma J. Ridley
Summary: This study aimed to determine the feasibility of using a modified indirect calorimetry protocol in patients receiving VA ECMO and compared the measured EE to control critically ill patients.
EUROPEAN JOURNAL OF CLINICAL NUTRITION
(2023)
Article
Public, Environmental & Occupational Health
Christiana Kartsonaki, J. Kenneth Baillie, Noelia Garcia Barrio, Joaquin Baruch, Abigail Beane, Lucille Blumberg, Fernando Bozza, Tessa Broadley, Aidan Burrell, Gail Carson, Barbara Wanjiru Citarella, Andrew Dagens, Emmanuelle A. Dankwa, Christl A. Donnelly, Jake Dunning, Loubna Elotmani, Martina Escher, Nataly Farshait, Jean-Christophe Goffard, Bronner P. Goncalves, Matthew Hall, Madiha Hashmi, Benedict Sim Lim Heng, Antonia Ho, Waasila Jassat, Miguel Pedrera Jimenez, Cedric Laouenan, Samantha Lissauer, Ignacio Martin-Loeches, France Mentre, Laura Merson, Ben Morton, Daniel Munblit, Nikita A. Nekliudov, Alistair D. Nichol, Budha Charan Singh Oinam, David Ong, Prasan Kumar Panda, Michele Petrovic, Mark G. Pritchard, Nagarajan Ramakrishnan, Grazielle Viana Ramos, Claire Roger, Oana Sandulescu, Malcolm G. Semple, Pratima Sharma, Louise Sigfrid, Emily C. Somers, Anca Streinu-Cercel, Fabio Taccone, Pavan Kumar Vecham, Bharath Kumar Tirupakuzhi Vijayaraghavan, Jia Wei, Evert-Jan Wils, Xin Ci Wong, Peter Horby, Amanda Rojek, Piero L. Olliaro, Ali Abbas
Summary: This study analyzed demographic features, treatments, and clinical outcomes of hospitalized COVID-19 patients in 52 countries from January 2020 to January 2022. Age and male sex were associated with a higher risk of death. Symptoms, co-morbidities, and treatments were associated with clinical outcomes. This comprehensive international study provides valuable information for prioritizing treatment for COVID-19 patients at higher risk of death.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2023)
Article
Medicine, General & Internal
Patrick R. Lawler, Lennie P. G. Derde, Frank L. van de Veerdonk, Bryan J. McVerry, David T. Huang, Lindsay R. Berry, Elizabeth Lorenzi, Roland van Kimmenade, Frank Gommans, Muthiah Vaduganathan, David E. Leaf, Rebecca M. Baron, Edy Y. Kim, Claudia Frankfurter, Slava Epelman, Yvonne Kwan, Richard Grieve, Stephen O'Neill, Zia Sadique, Michael Puskarich, John C. Marshall, Alisa M. Higgins, Paul R. Mouncey, Kathryn M. Rowan, Farah Al-Beidh, Djillali Annane, Yaseen M. Arabi, Carly Au, Abi Beane, Wilma van Bentum-Puijk, Marc J. M. Bonten, Charlotte A. Bradbury, Frank M. Brunkhorst, Aidan Burrell, Adrian Buzgau, Meredith Buxton, Maurizio Cecconi, Allen C. Cheng, Matthew Cove, Michelle A. Detry, Lise J. Estcourt, Justin Ezekowitz, Mark Fitzgerald, David Gattas, Lucas C. Godoy, Herman Goossens, Rashan Haniffa, David A. Harrison, Thomas Hills, Christopher M. Horvat, Nao Ichihara, Francois Lamontagne, Kelsey M. Linstrum, Daniel F. McAuley, Anna McGlothlin, Shay P. McGuinness, Zoe McQuilten, Srinivas Murthy, Alistair D. Nichol, David R. J. Owen, Rachael L. Parke, Jane C. Parker, Katrina M. Pollock, Luis Felipe Reyes, Hiroki Saito, Marlene S. Santos, Christina T. Saunders, Christopher W. Seymour, Manu Shankar-Hari, Vanessa Singh, Alexis F. Turgeon, Anne M. Turner, Ryan Zarychanski, Cameron Green, Roger J. Lewis, Derek C. Angus, Scott Berry, Anthony C. Gordon, Colin J. McArthur, Steve A. Webb
Summary: In patients with COVID-19, overactivation of the renin-angiotensin system (RAS) may have negative clinical outcomes. This study aimed to determine if initiating angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) could improve outcomes in hospitalized COVID-19 patients. The results showed that in critically ill patients, the use of ACE inhibitors or ARBs did not improve, and likely worsened, clinical outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Medicine, General & Internal
Courtney Cini, Ary S. Neto, Aidan Burrell, Andrew Udy, SPRINT-SARI Australia investigators
Summary: This study aimed to investigate the association between inter-hospital transfer and in-hospital mortality among patients with COVID-19 admitted to ICUs in Australia. The retrospective cohort study found that transferred patients required more intense interventions and had longer hospital stays compared to non-transferred patients, but their in-hospital mortality rates were not higher.
MEDICAL JOURNAL OF AUSTRALIA
(2023)
Article
Critical Care Medicine
Akif Undar, Allen R. R. Kunselman, Ryan P. P. Barbaro, Peta Alexander, Krishna Patel, Neal J. J. Thomas
Summary: This study aimed to investigate the outcomes of using conventional roller or centrifugal pumps during neonatal extracorporeal membrane oxygenation (ECMO). The primary hypothesis was that centrifugal pump use would be associated with higher survival rates compared to conventional roller pump use. Contrary to the hypothesis, the study found that conventional roller pump use was associated with higher odds of survival, while thrombosis and clots in circuit components were associated with lower odds of survival.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Graeme MacLaren, Ryan P. Barbaro, Matteo Di Nardo
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Peta M. A. Alexander, Victoria Habet, Ryan P. Barbaro
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Pediatrics
Kayla B. Phelps, Acham Gebremariam, Erica Andrist, Ryan P. Barbaro, Gary L. Freed, Erin F. Carlton
Summary: This study aimed to investigate the relationship between indicators of socioeconomic status and mortality, hospital length of stay, and readmission rates among children hospitalized with severe sepsis. The results showed no difference in hospital mortality rate or readmission rate across income quartiles. Among survivors, patients with lower income had a longer hospital stay, but this difference was not significant after adjusting for multiple covariates. Therefore, more sensitive metrics of socioeconomic status are needed to better understand health disparities in pediatric severe sepsis.
PEDIATRIC RESEARCH
(2023)
Letter
Critical Care Medicine
Aline B. Maddux, Ericka L. Fink, Brian Jackson, Ryan Barbaro
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Charlotte Z. Woods-Hill, Heather Wolfe, Sara Malone, Katherine M. Steffen, Asya Agulnik, Brian F. Flaherty, Ryan P. Barbaro, Maya Dewan, Sapna R. Kudchadkar
Summary: Implementation science (IS) is an innovative and increasingly popular approach that can address the issue of PICU patients failing to receive effective diagnostic and therapeutic interventions.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Blythe E. Pollack, Ryan P. Barbaro, Stephen M. Gorga, Erin F. Carlton, Michael Gaies, Joseph G. Kohne
Summary: This study examined the association between survival rate of children with cardiac arrest and the availability of pediatric extracorporeal membrane oxygenation (ECMO) at the treating hospital. The results showed that children who received treatment at ECMO-capable hospitals had a higher in-hospital survival rate.