Article
Cardiac & Cardiovascular Systems
Jonathan Rilinger, Antonia M. Riefler, Xavier Bemtgen, Markus Jackel, Viviane Zotzmann, Paul M. Biever, Daniel Duerschmied, Christoph Benk, Georg Trummer, Klaus Kaier, Christoph Bode, Dawid L. Staudacher, Tobias Wengenmayer
Summary: In this analysis, pulse pressure (PP) was found to be a valuable parameter for estimating survival rate in eCPR patients, potentially supporting clinical decision making.
CLINICAL RESEARCH IN CARDIOLOGY
(2021)
Article
Critical Care Medicine
Mark Dennis, Timothy J. Southwood, Matthew Oliver, Alistair Nichol, Aidan Burrell, Carol Hodgson
Summary: This study conducted a survey among clinicians in Australia and New Zealand and found strong support for further research on optimizing the use of ECMO and ECPR. The results provide a framework for prioritizing future clinical trials and research agendas.
AUSTRALIAN CRITICAL CARE
(2023)
Article
Medicine, General & Internal
Yun Im Lee, Ryoung-Eun Ko, Jeong Hoon Yang, Yang Hyun Cho, Joonghyun Ahn, Jeong-Am Ryu
Summary: The optimal mean arterial pressure (MAP) for neurological recovery in ECPR patients was evaluated in this study. The results showed that patients with an average MAP around 75 mmHg had the lowest risk of neurological deterioration. In contrast, patients with average MAPs below 60 mmHg had a higher risk of poor neurological outcomes. This study suggests that maintaining an average MAP of around 75 mmHg may be important for neurological recovery after ECPR.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Sung-Min Cho, Joe Canner, Giorgio Caturegli, Chun Woo Choi, Eric Etchill, Katherine Giuliano, Giovanni Chiarini, Kate Calligy, Peter Rycus, Roberto Lorusso, Bo Soo Kim, Marc Sussman, Jose I. Suarez, Romergryko Geocadin, Errol L. Bush, Wendy Ziai, Glenn Whitman
Summary: This study found that approximately 5% of patients receiving venovenous extracorporeal membrane oxygenation experienced acute brain injury, with mortality rates doubling when ischemic or hemorrhagic strokes occurred. Risk factors such as lower pH, hypoxemia, and coagulation disturbances were associated with acute brain injury, highlighting the importance of further research on prevention and management strategies.
CRITICAL CARE MEDICINE
(2021)
Review
Medicine, General & Internal
Amandine De Charriere, Benjamin Assouline, Marc Scheen, Nathalie Mentha, Carlo Banfi, Karim Bendjelid, Raphael Giraud
Summary: ECMO is a complex and costly technique that must be applied in high-volume facilities, known as ECPR, can provide hemodynamic and respiratory stability to patients with refractory cardiac arrest. However, current evidence does not support the routine use of ECPR in all patients with refractory cardiac arrest, therefore appropriate selection of patients who may benefit is crucial.
JOURNAL OF CLINICAL MEDICINE
(2021)
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
Medicine, Research & Experimental
Patrick Bernhard, Berit Amelie Bretthauer, Sam Joe Brixius, Hannah Buegener, Johannes Elias Groh, Christian Scherer, Domagoj Damjanovic, Joerg Haberstroh, Georg Trummer, Christoph Benk, Friedhelm Beyersdorf, Oliver Schilling, Jan-Steffen Pooth
Summary: This study investigated the effects of cardiac arrest (CA), conventional cardiopulmonary resuscitation (CPR), and extracorporeal cardiopulmonary resuscitation (ECPR) on the serum proteome profiles in a pig model. The results showed significant changes in the serum proteome during resuscitation, including haemolysis, coagulation, inflammation, and cell-death processes. These findings contribute to a better understanding of the underlying mechanisms and may help improve therapeutic options for CA and resuscitation.
JOURNAL OF TRANSLATIONAL MEDICINE
(2022)
Article
Critical Care Medicine
Abdelaziz Farhat, Xilong Li, Beverley Huet, Jefferson Tweed, Michael C. Morriss, Lakshmi Raman
Summary: This study aims to describe brain injuries caused by extracorporeal membrane oxygenation in a large cohort of neonatal and pediatric patients. The study found that brain injuries are common in these patients, but the majority of survivors have favorable neurocognitive outcomes.
CRITICAL CARE MEDICINE
(2022)
Review
Critical Care Medicine
Mina Karami, Loes Mandigers, Dinis Dos Reis Miranda, Wim J. R. Rietdijk, Jan M. Binnekade, Wim K. Lagrand, Corstiaan A. den Uil, Jose P. S. Henriques, Alexander P. J. Vlaar
Summary: The study found insufficient evidence to support the improvement of short-term survival in patients with acute pulmonary embolism treated with VA-ECMO. Among patients undergoing VA-ECMO treatment, age over 60 years was associated with lower survival rates, while surgical embolectomy was associated with higher survival rates.
JOURNAL OF CRITICAL CARE
(2021)
Article
Engineering, Biomedical
Alexis Chenouard, Jean-Michel Liet, Pierre Maminirina, Manon Denis, Joseph Tonna, Peter Rycus, Nicolas Joram, Pierre Bourgoin
Summary: Cervical cannulation did not show any association with acute neurologic events (ANE) in children receiving VA-ECMO for severe sepsis or septic shock, while pre-ECMO acidosis was found to be an independent risk factor for the development of ANE in this young septic population.
Article
Critical Care Medicine
Giorgio Caturegli, Sung-Min Cho, Bartholomew White, Liam L. Chen
Summary: This retrospective cohort study analyzed the types and timing of acute brain injury in infants supported on extracorporeal membrane oxygenation, finding that 79% had acute brain injury, with hypoxic-ischemic brain injury being the most common type. Correlates of acute brain injury included low preextracorporeal membrane oxygenation oxygen saturation and elevated serum markers.
PEDIATRIC CRITICAL CARE MEDICINE
(2021)
Article
Medicine, Research & Experimental
Tai Yin, Lance B. Becker, Rishabh C. Choudhary, Ryosuke Takegawa, Muhammad Shoaib, Koichiro Shinozaki, Yusuke Endo, Koichiro Homma, Daniel M. Rolston, Shuhei Eguchi, Tadashi Ariyoshi, Asami Matsumoto, Kentaro Oka, Motomichi Takahashi, Tomoaki Aoki, Santiago J. Miyara, Mitsuaki Nishikimi, Junichi Sasaki, Junhwan Kim, Ernesto P. Molmenti, Kei Hayashida
Summary: This study demonstrated that the combination of H-2 gas with ECPR therapy improved survival rates in rats after CA/ECPR, enhanced brain electrical activity recovery, and alleviated endothelial damage. H-2 treatment also significantly improved brain tissue oxygenation during resuscitation and prevented an increase in central venous pressure post-ECPR.
JOURNAL OF TRANSLATIONAL MEDICINE
(2021)
Article
Biochemistry & Molecular Biology
Robert Greite, Johanna Stoermer, Faikah Gueler, Rasul Khalikov, Axel Haverich, Christian Kuehn, Nodir Madrahimov, Ruslan Natanov
Summary: This study explored the kidney injury patterns in mouse models of extracorporeal membrane oxygenation (ECMO) and renal ischemia-reperfusion injury (IRI). Both ECMO and IRI caused acute kidney injury (AKI), but with different injury patterns. Severe neutrophil infiltration and tubular transport impairment were observed after renal IRI, while these were not evident following ECMO. Besides, ECMO induced the expression of heme oxygenase-1 (HO-1) in tubular cells, while IRI led to HO-1 expression in infiltrating myeloid cells.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Cell Biology
Fiorella Calabrese, Federica Pezzuto, Francesco Fortarezza, Francesca Lunardi, Eleonora Faccioli, Giulia Lorenzoni, Annalisa Boscolo, Nicolo Sella, Dario Gregori, Marco Schiavon, Paolo Navalesi, Andrea Dell'Amore, Federico Rea
Summary: This study investigated tissue/molecular pathways and tissue injury in lung transplantation recipients supported by intraoperative VA-ECMO. The findings suggest lower lung tissue injury and decreased leukocyte margination in the ECMO group compared to the non-ECMO group.
Review
Medicine, General & Internal
Saikat Mitra, Ryan Ruiyang Ling, Chuen Seng Tan, Kiran Shekar, Graeme MacLaren, Kollengode Ramanathan
Summary: This systematic review and meta-analysis analyzed outcomes of patients receiving renal replacement therapy (RRT) on extracorporeal membrane oxygenation (ECMO) from January 2000 to September 2020. The study found that RRT on ECMO was associated with higher mortality rates and longer ICU/hospital stay compared to those without RRT. In the last five years, mortality decreased by 20% in patients receiving RRT, but there is still an increased risk of death. Future research should focus on minimizing renal dysfunction and determining the optimal timing for initiating RRT in ECMO patients.
JOURNAL OF CLINICAL MEDICINE
(2021)
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)
Article
Pediatrics
Numa P. Perez, Emily E. Witt, Peter T. Masiakos, Ilan Layman, Joseph E. Tonna, Gezzer Ortega, Faisal G. Qureshi
Summary: This study analyzed the neurologic complications of neonatal Veno-Venous ECMO using VVDL + V and VVDL cannulation. The results showed that compared to VVDL, patients with VVDL + V had higher mortality rates, higher conversion rates to VA ECMO, and higher rates of mechanical and hemorrhagic complications, but there were no differences in neurologic outcomes, pump flows, or mortality.
JOURNAL OF PEDIATRIC SURGERY
(2023)
Article
Critical Care Medicine
Giorgio Caturegli, Lucy Q. Zhang, Yunis Mayasi, Aaron M. Gusdon, Bahattin Ergin, Vladimir Ponomarev, Bo Soo Kim, Steven Keller, Romergryko G. Geocadin, Glenn J. R. Whitman, Sung-Min Cho, Wendy Ziai
Summary: This study reports the results of transcranial Doppler measurements of mean flow velocity and pulsatility index in a large ECMO population. The results suggest similar flow velocity and pulsatility index compared to a healthy population, but the absence of pulsatility index is associated with intraparenchymal hemorrhage. These findings require validation through a larger multicenter study.
NEUROCRITICAL CARE
(2023)
Article
Engineering, Biomedical
Neel Shah, Bing Xue, Ziqi Xu, Hanqing Yang, Eva Marwali, Heidi Dalton, Philip P. R. Payne, Chenyang S. Lu, Ahmed Said
Summary: In this study, several ECMO mortality prediction and severity of illness scores were validated for a large COVID-19 V-V ECMO cohort. The results showed inconsistent discrimination and calibration of these scores, highlighting the need for better clinically applicable decision support tools.
Article
Critical Care Medicine
Benjamin L. Shou, Christopher Wilcox, Isabella S. Florissi, Aravind Krishnan, Bo Soo Kim, Steven P. Keller, Glenn J. R. Whitman, Ken Uchino, Errol L. Bush, Sung-Min Cho
Summary: The incidence of acute stroke in lung transplant patients is increasing over time and is associated with significantly lower survival rates. Post-transplant extracorporeal membrane oxygenation is the strongest risk factor for stroke. Further research on stroke characteristics, prevention, and management strategies is crucial for this patient population.
Article
Critical Care Medicine
Jonathon Fanning, Natasha B. Weaver, Robert J. Fanning, Matthew Griffee, Sung-Min Cho, Mauro G. Panigada, Nchafatso M. Obonyo, Akram Zaaqoq, Hannah Rando, Yew Woon Chia, Bingwen Eugene Fan, Declan Sela, Davide Chiumello, Silvia Coppola, Ahmed Labib, Glenn J. R. C. Whitman, Rakesh S. Arora, Bo Kim, Anna Motos, Antoni Torres, Ferran Barbe, Giacomo Grasselli, Alberto Zanella, Eric Etchill, Asad Ali Usman, Maximilian M. Feth, Nicole Y. White, Jacky Suen, Gianluigi J. Li Bassi, Giles F. Peek, John Fraser, Heidi Dalton
Summary: A high prevalence of HECTOR complications (hemorrhage, disseminated intravascular coagulopathy, and thrombosis) was observed in ICU patients with severe COVID-19. Hemorrhagic complications were associated with increased ICU mortality, while thrombosis complications were associated with reduced mortality.
CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Akram Zaaqoq, Matthew Griffee, Thu-Lan Kelly, Jonathon Fanning, Silver Heinsar, Jacky Suen, Silvia Mariani, Gianluigi Li Bassi, Jeffrey Jacobs, Nicole White, John Fraser, Roberto Lorusso, Giles Peek, Sung-Min Cho
Summary: This study aims to characterize the prevalence and risk factors of stroke secondary to COVID-19 in patients on venovenous ECMO. The results showed that obesity and pre-ECMO vasopressor use were associated with an increased risk of stroke. In addition, stroke patients had a more significant relative decrease in Paco(2) and relative increase in Pao(2) within 48 hours after ECMO initiation compared to non-stroke patients, and they also had a higher in-hospital mortality rate.
CRITICAL CARE MEDICINE
(2023)
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)
Review
Clinical Neurology
Ritoban Mitra, Lavienraj Premraj, Tien K. Khoo
Summary: Parkinson's disease is characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, with neuromelanin playing a role in the disease's pathogenesis. While neuromelanin has neuroprotective functions, it can also contribute to cell death due to mitochondrial dysfunction and oxidative stress. Therapeutic strategies targeting neuromelanin and its effects, such as antioxidant therapy and immunotherapy, are being explored. This review provides an update on the link between neuromelanin and Parkinson's disease and the potential for future therapeutic interventions.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Medicine, General & Internal
Anna L. Ciullo, Richard Knecht, Nicholas M. Levin, Nathan Mitchell, Joseph E. Tonna
Summary: This study compared the outcomes of blood biomarkers and transmembrane filter pressures in patients on extracorporeal membrane oxygenation (ECMO) who required renal replacement therapy (RRT) through a dedicated hemodialysis (HD) catheter or direct connection to the ECMO circuit. The ECMO group showed a greater decline in serum BUN and higher platelet levels compared to the HD catheter access group. Utilizing the ECMO circuit as direct venous access for CRRT was associated with improved filtration proximal outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cell Biology
Shivalika Khanduja, Jiah Kim, Jin Kook Kang, Cheng-Yuan Feng, Melissa Ann Vogelsong, Romergryko G. Geocadin, Glenn Whitman, Sung-Min Cho
Summary: Extracorporeal membrane oxygenation (ECMO) carries a significant risk of hypoxic-ischemic brain injury (HIBI), which is one of the most common types of acute brain injury in ECMO patients. Various risk factors have been associated with the development of HIBI in ECMO patients, and the pathogenic mechanisms are complex and multifactorial. Current therapeutics focus on targeting pathological mechanisms and optimizing cerebral oxygenation and perfusion to improve neurological outcomes in ECMO patients and minimize the morbidity of HIBI.
Review
Cell Biology
Albert Leng, Manuj Shah, Syed Ameen Ahmad, Lavienraj Premraj, Karin Wildi, Gianluigi Li Bassi, Carlos A. Pardo, Alex Choi, Sung-Min Cho
Summary: The development of long-term symptoms of COVID-19, known as long COVID or PASC, can involve persistent neurological complications in up to one third of patients. These complications include fatigue, brain fog, headaches, cognitive impairment, and neuropsychiatric symptoms. The underlying pathological mechanisms behind these symptoms are still unclear, but hypotheses suggest involvement of nervous system and systemic factors such as viral persistence, abnormal immune response, and endothelial dysfunction. Current therapeutic approaches focus on antivirals, inflammation reduction, and olfactory epithelium regeneration.
Correction
Critical Care Medicine
Bairbre A. McNicholas, Emanuele Rezoagli, Andrew J. Simpkin, Sankalp Khanna, Jacky Y. Suen, Pauline Yeung, Daniel Brodie, Gianluigi Li Bassi, Tai Pham, Giacomo Bellani, John F. Fraser, John Laffey, Cccc Consortium
Article
Critical Care Medicine
Lavienraj Premraj, Christopher Camarda, Nicole White, Daniel Agustin Godoy, Brian H. Cuthbertson, Patricia R. M. Rocco, Paolo Pelosi, Chiara Robba, Jose I. Suarez, Sung-Min Cho, Denise Battaglini
Summary: This meta-analysis investigated the association between the timing of tracheostomy and mortality, neurological outcomes, and ICU/hospital length of stay in stroke patients. The results showed that the timing of tracheostomy was not associated with these outcomes.
