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
Multidisciplinary Sciences
Rene Rissel, Sascha Koelm, Markus Schepers, Daniel-Sebastian Dohle, Joerg Albers, Mehmet Oezkur, Marc Kriege, Marc Bodenstein
Summary: This study aimed to explore the correlation between lactate peak concentration and clearance in the blood, and mortality during extracorporeal life support (ECLS) therapy. The results showed that higher lactate peak levels and poor lactate clearance were associated with increased mortality during ECLS therapy. Additionally, deceased patients had higher SAPSII scores, received more transfusions, and had higher rates of epinephrine usage.
Article
Medicine, General & Internal
Mioko Kobayashi, Masahiro Kashiura, Hideto Yasuda, Kazuhiro Sugiyama, Yuichi Hamabe, Takashi Moriya
Summary: There was no significant association between hyperoxia at 24 hours after admission and 30-day survival in OHCA patients who underwent ECPR.
FRONTIERS IN MEDICINE
(2022)
Article
Anesthesiology
Fanni Toivonen, Fausto Biancari, Magnus Dalen, Angelo M. Dell'Aquila, Kristjan Jonsson, Antonio Fiore, Giovanni Mariscalco, Zein El-Dean, Giuseppe Gatti, Svante Zipfel, Andrea Perrotti, Karl Bounader, Khalid Alkhamees, Antonio Loforte, Andrea Lechiancole, Marek Pol, Cristiano Spadaccio, Matteo Pettinari, Dieter De Keyzer, Henryk Welp, Artur Lichtenberg, Diyar Saeed, Vito G. Ruggieri, Sigurdur Ragnarsson
Summary: This study aimed to investigate the frequency, predictors, and outcomes of neurologic injury in adults treated with postcardiotomy extracorporeal membrane oxygenation (PC-ECMO). The results showed that neurologic injury was common and associated with a dismal prognosis in patients. There was significant interinstitutional variation in the proportion of neurologic injury in PC-ECMO-treated adults.
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2021)
Article
Cardiac & Cardiovascular Systems
Nikolaos Kalampokas, Nihat Firat Sipahi, Hug Aubin, Payam Akhyari, Georgi Petrov, Alexander Albert, Ralf Westenfeld, Artur Lichtenberg, Diyar Saeed
Summary: This study analyzed all VA-ECMO implantations for PCS from January 2011 to December 2017 in a single center and compared the outcomes of patients with PCS supported by central vs. peripheral cannulation. The study found that complication rates and outcomes were similar regardless of the cannulation strategy in postcardiotomy patients requiring VA-ECMO support.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Medicine, General & Internal
Yu Jin, Peng Gao, Peiyao Zhang, Liting Bai, Yixuan Li, Wenting Wang, Zhengyi Feng, Xu Wang, Jinping Liu
Summary: In assessing the predictive capabilities and risk factors for in-hospital mortality in pediatric postcardiotomy VA-ECMO patients, ECMO scoring systems have shown some validity.
FRONTIERS IN MEDICINE
(2022)
Article
Engineering, Biomedical
Takuya Ogami, Hiroo Takayama, Andrew Melehy, Lucas Witer, Yuji Kaku, Justin Fried, Amirali Masoumi, Daniel Brodie, Koji Takeda
Summary: Postcardiotomy shock (PCS) has historically been associated with high morbidity and mortality rates. A retrospective study of 60 PCS patients found that a standardized approach with a dedicated ECMO team is feasible and may improve outcomes. Most patients required vasopressors and inotropes during ECMO treatment, with 80% receiving peripheral ECMO support.
Article
Cardiac & Cardiovascular Systems
Anne-Kristin Schaefer, Klaus Distelmaier, Julia Riebandt, Georg Goliasch, Martin H. Bernardi, Daniel Zimpfer, Gunther Laufer, Dominik Wiedemann
Summary: The influence of primary arterial access in patients receiving peripheral postcardiotomy extracorporeal life support was assessed. The study found that the axillary artery group had a higher risk of stroke, while the femoral artery group was more prone to limb ischemia.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
George Gill, Jignesh K. Patel, Diego Casali, Georgina Rowe, Hongdao Meng, Dominick Megna, Joanna Chikwe, Puja B. Parikh
Summary: Factors such as age, gender, income level, presence of ventricular arrhythmia, undergoing percutaneous coronary intervention, and use of therapeutic hypothermia were found to be independently associated with mortality in patients with cardiac arrest receiving ECMO. Identification of these predictors could help in decision-making regarding the implementation of ECMO in this population. Further larger-scale studies are needed to assess appropriate candidates for ECMO in cardiac arrest.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Medicine, General & Internal
Dengbang Hou, Hong Wang, Feng Yang, Xiaotong Hou
Summary: This study aimed to describe the prevalence of neurologic complications and hospital outcome in adult post-cardiotomy cardiogenic shock patients receiving V-A ECMO support. Neurologic complications were frequent in these patients and associated with higher in-hospital mortality. Identified risk factors of neurologic complications might help improve ECMO management and reduce their occurrence.
FRONTIERS IN MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Jean Bonnemain, Marco Rusca, Zied Ltaief, Aurelien Roumy, Piergiorgio Tozzi, Mauro Oddo, Matthias Kirsch, Lucas Liaudet
Summary: The study retrospectively analyzed 44 cardiac arrest patients treated with ECPR, finding an association between high PaO2 levels and increased mortality, possibly leading to death by promoting circulatory collapse or delayed neurological damage.
BMC CARDIOVASCULAR DISORDERS
(2021)
Article
Critical Care Medicine
Catherine E. Beni, Samuel E. Rice-Townsend, Ivie D. Esangbedo, Tim Jancelewicz, Adam M. Vogel, Christopher Newton, Laura Boomer, David H. Rothstein
Summary: This study retrospectively analyzed the use of ECPR in pediatric patients without CHD and found that obesity and trauma were associated with increased in-hospital mortality. The study also identified variables such as White race, ventricular tachycardia as initial arrest rhythm, return of spontaneous circulation before cannulation, and acquired cardiac disease that were associated with decreased odds of mortality. Respiratory disease was associated with increased odds of severe neurologic complications.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Silvia Mariani, I-wen Wang, Bas C. T. van Bussel, Samuel Heuts, Dominik Wiedemann, Diyar Saeed, Iwan C. C. van der Horst, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Jeroen J. H. Bunge, Hergen Buscher, Leonardo Salazar, Bart Meyns, Daniel Herr, Sacha Matteucci, Sandro Sponga, Kollengode Ramanathan, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, Jose P. Garcia, Kiran Shekar, Glenn Whitman, Roberto Lorusso
Summary: Intraoperative and postoperative ECMO implantations are associated with different patient characteristics and outcomes, with greater complications and in-hospital mortality after postoperative ECMO.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Nutrition & Dietetics
Gui-Yang Lu, Hao Xu, Jian-Hua Li, Jing-Ke Chen, Yao-Gui Ning
Summary: This study investigated the benefits and risks of early enteral nutrition in patients receiving extracorporeal membrane oxygenation (ECMO). The results showed that early enteral nutrition reduced in-hospital mortality and was well-tolerated. It is recommended to start enteral nutrition with hypocaloric doses within 48 hours of ECMO initiation.
CLINICAL NUTRITION
(2023)
Article
Cardiac & Cardiovascular Systems
Silvia Mariani, Bas C. T. van Bussel, Justine M. Ravaux, Maaike M. Roefs, Maria Elena De Piero, Michele Di Mauro, Anne Willers, Patrique Segers, Thijs Delnoij, Iwan C. C. van der Horst, Jos Maessen, Roberto Lorusso
Summary: The in-hospital and postdischarge mortality rates after postcardiotomy ECMO in adults are high in the Netherlands. Older age and higher body mass index are associated with higher in-hospital mortality, while postoperative renal failure, respiratory failure, and re-thoracotomy are associated with 12-month postdischarge mortality.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Chin Siang Ong, Eric Etchill, Jie Dong, Benjamin L. Shou, Leah Shelley, Katherine Giuliano, Mais Al-Kawaz, Eva K. Ritzl, Romergryko G. Geocadin, Bo Soo Kim, Errol L. Bush, Chun Woo Choi, Glenn J. R. Whitman, Sung-Min Cho
Summary: The study aimed to investigate the application of standardized neurological monitoring methods in patients receiving ECMO. The results showed that standardized neuromonitoring was associated with the detection of acute brain injury (ABI) and improved patient outcomes.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Lauren J. Taylor, Sarah E. Jolley, Chintan Ramani, Kirby P. Mayer, Eric W. Etchill, Matthew F. Mart, Shoaib Fakhri, Skyler Peterson, Kathryn Colborn, Carla M. Sevin, Alexandra Kadl, Kyle Enfield, Glenn J. R. Whitman, Joseph B. Zwischenberger, Jessica Y. Rove
Summary: Survivors of COVID-19 may experience significant physical, psychological, and cognitive deficits following intensive care unit admission. Patients treated with venovenous ECMO have similar survival rates at discharge and outcomes within 120 days compared to other mechanically ventilated patients.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Anesthesiology
Denise Battaglini, Lavienraj Premraj, Samuel Huth, Jonathon Fanning, Glenn Whitman, Rakesh C. Arora, Judith Bellapart, Diego Bastos Porto, Fabio S. Taccone, Jacky Y. Suen, Gianluigi Li Bassi, John F. Fraser, Sung-Min Cho, Chiara Robba
Summary: This systematic review investigates the use of noninvasive multimodal neuromonitoring in critically ill adult patients with COVID-19. The findings suggest that alterations in cerebral hemodynamics, brain compliance, brain oxygenation, pupillary response, and brain electrophysiological activity are common in these patients, but they are not clearly associated with worse outcome or the development of new neurological complications.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2023)
Review
Critical Care Medicine
Shaurya Taran, Sung-Min Cho, Robert D. Stevens
Summary: This narrative review summarizes the existing evidence for mechanical ventilation in patients with traumatic brain injury (TBI). It emphasizes the importance of ventilation strategies and highlights the knowledge gaps that require further research.
NEUROCRITICAL CARE
(2023)
Article
Critical Care Medicine
Benjamin L. Shou, Christopher Wilcox, Isabella Florissi, Andrew Kalra, Giorgio Caturegli, Lucy Q. Zhang, Errol Bush, Bo Kim, Steven P. Keller, Glenn J. R. Whitman, Sung-Min Cho
Summary: This study explored the impact of early low pulse pressure on the occurrence of acute brain injury (ABI) in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO). The results showed that low pulse pressure was independently associated with ABI. The study also suggested that low pulse pressure may serve as a marker for ABI risk, highlighting the importance of close neuromonitoring for early detection.
NEUROCRITICAL CARE
(2023)
Review
Cardiac & Cardiovascular Systems
Aaron Shoskes, Tracey H. Fan, Randall C. Starling, Sung-Min Cho
Summary: The use of left ventricular assist devices (LVADs) has significantly improved the care of patients with advanced heart failure, increasing their survival rate before heart transplantation and providing enhanced quality of life for those unable to undergo transplantation. However, the use of LVADs is associated with neurological complications. This review discusses the incidence, risk factors, and management of these complications among LVAD patients. While guidelines for the evaluation and management of neurological complications in LVAD patients are limited, early detection through heightened awareness can lead to improved overall neurological outcomes. A better understanding of the effects of continuous circulatory flow on systemic and cerebral vasculature is crucial in reducing the occurrence of neurological complications in this population.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Article
Respiratory System
Armaan Akbar, Benjamin Shou, Cheng-Yuan Feng, David Zhao, Bo Soo Kim, Glenn Whitman, Errol Bush, Sung-Min Cho, HERALD Investigators
Summary: This study examined the relationship between arterial oxygen tension and carbon dioxide tension and acute brain injury in patients receiving veno-venous extracorporeal membrane oxygenation. The results showed that lower post-cannulation oxygen tension was associated with intracranial hemorrhage. Therefore, further investigation is needed to understand the role of arterial blood gas changes during the procedure for better management of these patients.
Review
Clinical Neurology
Benjamin Claytor, Sung-Min Cho, Yuebing Li
Summary: Myasthenic crisis (MC) is a life-threatening manifestation of myasthenia gravis (MG) characterized by respiratory insufficiency. It occurs in 15%-20% of MG patients, usually within the first 2 to 3 years of the disease. The majority of MC cases have specific triggers, with respiratory infections being the most common. Immediate treatment focuses on airway management and addressing triggers. Plasmapheresis is preferred over intravenous immune globulin for MC treatment.
Review
Critical Care Medicine
Denise Battaglini, Elisa Gouvea Bogossian, Pasquale Anania, Lavienraj Premraj, Sung-Min Cho, Fabio Silvio Taccone, Mypinder Sekhon, Chiara Robba
Summary: Cardiac arrest is a sudden event that often leads to brain injury and high mortality rates. Brain tissue oxygenation (PbtO(2)) is a tool used to monitor brain oxygen levels, but its effectiveness is still unclear. A systematic review was conducted to understand the role of PbtO(2) in monitoring brain oxygenation in patients with cardiac arrest and the impact of targeted PbtO(2) therapy on outcomes.
NEUROCRITICAL CARE
(2023)
Article
Cardiac & Cardiovascular Systems
Fausto Biancari, Alexander Kaserer, Andrea Perrotti, Vito G. Ruggieri, Sung-Min Cho, Jin Kook Kang, Magnus Dalen, Henryk Welp, Kristjan Jonsson, Sigurdur Ragnarsson, Francisco J. Hernandez Perez, Giuseppe Gatti, Khalid Alkhamees, Antonio Loforte, Andrea Lechiancole, Stefano Rosato, Cristiano Spadaccio, Matteo Pettinari, Giovanni Mariscalco, Timo Makikallio, Sebastian D. Sahli, Camilla L'Acqua, Amr A. Arafat, Monirah A. Albabtain, Mohammed M. AlBarak, Mohamed Laimoud, Ilija Djordjevic, Ihor Krasivskyi, Robertas Samalavicius, Lina Puodziukaite, Marta Alonso-Fernandez-Gatta, Donat R. Spahn, Antonio Fiore
Summary: This study evaluated the association between pre-V-A-ECMO arterial lactate level and in-hospital mortality in postcardiotomy patients. The results showed that increased arterial lactate level before V-A-ECMO initiation was associated with higher in-hospital mortality. Therefore, arterial lactate level may be useful in guiding the decision-making process and timing of initiation of postcardiotomy V-A-ECMO.
Article
Engineering, Biomedical
Anna Peeler, Patricia M. Davidson, Kelly T. Gleason, R. Scott Stephens, Betty Ferrell, Bo Soo Kim, Sung-Min Cho
Summary: This study investigated the application of palliative care (PC) in patients on extracorporeal membrane oxygenation (ECMO). The findings showed that PC is underused in this population, despite its important role in improving patients' quality of life.
Article
Engineering, Biomedical
Henry Shu, Sung-min Cho, Andrew Harris, Meghana L. Jami, Benjamin J. Shou, Matthew M. Griffee, Akram J. Zaaqoq, Christopher Wilcox, Marc Anders, Peter Rycus, Glenn Whitman, Bo Soo Kim, Babar Shafiq
Summary: The study aimed to investigate whether fasciotomy is associated with increased mortality in patients with acute compartment syndrome (ACS) on extracorporeal cardiopulmonary resuscitation (ECPR). The retrospective study analyzed data from adult ECPR patients diagnosed with ACS between 2013 and 2021. The results showed no significant difference in mortality between ACS patients with and without fasciotomy. Body mass index (BMI) and 24-hour mean blood pressure were identified as independent risk factors for mortality. Prospective studies are needed to confirm these findings and guide surgical decision-making for ACS patients after ECPR.
Article
Critical Care Medicine
Merry Huang, Aron Gedansky, Catherine E. Hassett, Aaron Shoskes, Abhijit Duggal, Ken Uchino, Sung-Min Cho, Andrew B. Buletko
Summary: This study retrospectively analyzed the structural brain injuries detected by brain MRI among patients with ARDS at a single tertiary center in the United States from January 2010 to October 2018 (pre-COVID era). The results showed that bilateral globus pallidus infarcts and diffuse rather than focal hemorrhage were more common in patients with ARDS. The study suggests that structural brain injuries exist in patients with ARDS.
NEUROCRITICAL CARE
(2023)
Article
Critical Care Medicine
Sung-Min Cho, Chiara Robba, Michael N. Diringer, Daniel F. Hanley, J. Claude Hemphill, Janneke Horn, Ariane Lewis, Sarah L. Livesay, David Menon, Tarek Sharshar, Robert D. Stevens, James Torner, Paul M. Vespa, Wendy C. Ziai, Marcus Spann, Raimund Helbok, Jose Suarez
Summary: To address the lack of knowledge regarding clinical trial design for patients with disorders of consciousness (DoC), a research group conducted a gap analysis and proposed optimal clinical trial designs for DoC studies.
NEUROCRITICAL CARE
(2023)
Review
Critical Care Medicine
Jin Kook Kang, Andrew Kalra, Syed Ameen Ahmad, Arjun Kumar Menta, Hannah J. Rando, Ifeanyi Chinedozi, Zachary Darby, Marcus Spann, Steven P. Keller, Glenn J. R. Whitman, Sung-Min Cho
Summary: A review of ECPR models investigating neurological outcomes found a lack of standardized protocols and evaluation methods. Among 20 identified studies, only 10% used both sexes and there was significant heterogeneity in experimental protocols. Most studies used peripheral VA-ECMO cannulation and focused on survival, with ventricular fibrillation being the most common method for inducing cardiac arrest. Only a few studies employed multimodal tools to evaluate cerebral blood flow. Recommendations include using large animals with both sexes and standardized protocols, evaluating neurological outcomes using multimodal methods, and ensuring animal survival after experiments.
RESUSCITATION PLUS
(2023)