scholarly journals Low Flow Venoarterial ECMO Support Management in Postcardiac Surgery Patient

2021 ◽  
Vol 5 (02) ◽  
pp. 103-107
Author(s):  
Ritu Airan ◽  
Sandeep Sharan ◽  
Poonam Malhotra Kapoor ◽  
Ujjwal Chowdhury ◽  
V. Devagourou ◽  
...  
Keyword(s):  
Tissue Oxygenation ◽  
Low Flow ◽  
Extended Form ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Surgery Patient ◽  
Short And Long Term ◽  
Va Ecmo ◽  
Adequate Tissue ◽  
Made In

AbstractVenoarterial extracorporeal membrane oxygenation (VA ECMO) aims to fully support heart and lung function in postcardiac patients, ensuring end-organ perfusion and allowing time for possible heart recovery. VA ECMO is considered the modified and extended form of cardiopulmonary bypass (CPB), which is used to provide adequate tissue oxygenation. ECMO and the associated management protocols will mechanically support the patient and allow for the optimization of all aspects of care for the period of time necessary for the recovery of native cardiac or respiratory function. Significant technical advancements have been made in the equipment and the clinical management available for short- and long-term ECMO application. There are various parameters that have to be considered to evaluate whether the level of perfusion in patients on VA ECMO is adequate, and the outcomes of patients depend on them.

Corporate hypocrisy

2021 ◽  
Author(s):  
Manuel Alfonso Garzón Castrillón
Keyword(s):  
Two Dimensions ◽  
Review Article ◽  
Moral Hypocrisy ◽  
Brand Reputation ◽  
Short And Long Term ◽  
Corporate Social ◽  
Temporal Direction ◽  
Practical Implications ◽  
Made In

This review article aimed to contribute to the understanding of the importance of coherence between saying and acting to prevent companies from being perceived from the perspective of business hypocrisy and affecting the brand, reputation, trust and credibility in the company. It was carried out based on the Methodi Ordinatio, addressing its theoretical origins and then approaching the concept, later venturing into the different studies that have approached it from corporate social responsibility (CSR), ethics; reputation, interest groups (stakeholders), and communication, subsequently in relation to the consequences that it generates in world-known organizations, their statements and the criticism made, subsequently an analysis of three aspects or facets is made in which it is presented namely: moral hypocrisy; behavioral hypocrisy and how to attribute business hypocrisy, the next point presents a typology that involves two dimensions: an orientation that refers to the attention span, in the short and long term of participants when making or responding to accusations of hypocrisy and a temporal direction, which refers to the point of comparison, past or future, finally reaches some conclusions, and some practical implications.

scholarly journals Post-COVID-19 Pulmonary Fibrosis: Report of Two Cases

2021 ◽  
Author(s):  
Saurabh Karmakar ◽  
Priya Sharma ◽  
Ameet Harishkumar ◽  
Deependra Kumar Rai
Keyword(s):  
Respiratory Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Pulmonary Fibrosis ◽  
Restrictive Lung Disease ◽  
Hospitalised Patients ◽  
Short And Long Term ◽  
Remarkable Progress ◽  
Made In

COVID-19 caused by severe acute respiratory syndrome coronavirus 2 has led to a pandemic situation worldwide. However, remarkable progress has been made in evolving policies, strengthening healthcare efforts, and pharmacotherapy. As more patients are recovering from COVID-19, clearer concepts about possible short- and long-term complications are emerging. Respiratory failure is the most common morbidity in hospitalised patients, and post-COVID-19 pulmonary fibrosis is the most common respiratory complication after recovery. The authors report two cases of COVID-19 pneumonia with respiratory failure who were cured but developed pulmonary fibrosis with restrictive lung disease in the follow-up period.

scholarly journals Survival after refractory cardiogenic shock is comparable in patients with Impella and veno-arterial extracorporeal membrane oxygenation when adjusted for SAVE score

2018 ◽  
Vol 8 (4) ◽  
pp. 329-337 ◽  
Author(s):  
Petter Schiller ◽  
Laila Hellgren ◽  
Per Vikholm
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Disease Severity ◽  
Term Survival ◽  
Long Term Survival ◽  
Membrane Oxygenation ◽  
Refractory Cardiogenic Shock ◽  
Short And Long Term ◽  
Va Ecmo

Objectives: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. Methods: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included. Data were analysed to assess short and long-term survival and complications. The SAVE score was calculated for the two groups and outcome was compared adjusted for the SAVE score. Results: There was no difference between VA-ECMO patients ( n=46) and Impella patients ( n=48) in mean age or renal failure. ECMO patients were more often intubated and had lower diastolic blood pressure at device implantation. ECMO patients had a lower SAVE score (–0.4 (6.5)) compared to Impella patients (4.1 (5.4)). There was no difference in intensive care unit survival between ECMO patients 65% (52–80) or Impella patients 63% (55–79), or long-term survival between groups. When stratified into worse (III–IV) or better SAVE class (I–II) there was no difference in survival between the groups. Conclusions: Short and long-term survival is not measurably different among patients treated with Impella or VA-ECMO due to refractory cardiogenic shock, after adjustment for disease severity through the SAVE score.

Cost Analysis of Geothermal Energy Development in Tengchong, China

2014 ◽  
Vol 1030-1032 ◽  
pp. 2544-2546
Author(s):  
Ru Liu ◽  
Yan Jun Liu ◽  
Xiao Qing Dong
Keyword(s):  
Cost Analysis ◽  
Geothermal Energy ◽  
Clean Energy ◽  
Energy Development ◽  
Short And Long Term ◽  
The Cost ◽  
Made In

Geothermal energy project in Tengchong has to be economically feasible to be implemented. The cost analysis is necessary to be made in order to obtain a vision for the investors, so that they could find out if the project is advisable regarding cost in short and long term. As a new kind of clean energy contributing to the electricity, geothermal energy development in Tengchong will be a long-term strategy.

scholarly journals Qualitative Assessment of Basel III Liquidity Standards and its Application in the UAE

2020 ◽  
Vol 4 (2) ◽  
pp. 118-129
Author(s):  
Manoj Kapur ◽  
Arindam Banerjee ◽  
Kunjana Malik
Keyword(s):  
Banking Sector ◽  
Financial Statements ◽  
Jel Classification ◽  
Qualitative Assessment ◽  
Basel Iii ◽  
Coverage Ratio ◽  
Disclosure Requirements ◽  
Short And Long Term ◽  
Made In

The Basel Committee for Banking and Supervision (BCBS) introduced two key liquidity ratios to strengthen the short- and long-term liquidity positions of the banks around the globe. These ratios were designed to achieve two key distinct objectives. Firstly, to encourage banks' short-term resilience to the liquidity risks by ensuring there are sufficient high-quality liquid assets to survive a significant stress which may last for 30 days. Calculation of this ratio is called as Liquidity Coverage Ratio (LCR). Secondly, to promote bank resilience over a longer time horizon, at least annually, by creating additional incentives for banks to fund their activities with more stable sources of funding. This led to creation of Net Stable Funding Ratio (NSFR). While these structural ratios are mostly quantitative, the underlying factors that are needed to calculate these ratios include qualitative factors as well. The paper analyzed the implementation of Basel III standards for the banking sector in the UAE. In particular, the timelines specified by the Central bank of the UAE and its implementation by the Domestic-Systemically Important Banks (D-SIBs) in the UAE was tracked by this paper. The study found a disconnect between the disclosure requirements by Basel III and disclosure made in the published annual financial statements of the banks. The study also discussed the extent of disclosures made by the D-SIBs and how relevant disclosures may improve the transparency of the liquidity risk management of the bank. JEL Classification Codes: E58, G32, G38.                        

Abstract 112: Short- and Long-term Survival of Patients Supported on Venoarterial and Veno-venous Extracorporeal Membrane Oxygenation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Ioana Florea ◽  
Kunal Kotkar ◽  
Ralph Damiano ◽  
Marc R Moon ◽  
Akinobu Itoh ◽  
...  
Keyword(s):  
Ischemic Cardiomyopathy ◽  
Multiple Comparisons ◽  
Ecmo Support ◽  
Term Survival ◽  
Kaplan Meier ◽  
Short And Long Term ◽  
Va Ecmo ◽  
Acute Pe ◽  
Vv Ecmo

Introduction: Use of both venoarterial (VA) and veno-venous (VV) extracorporeal membrane oxygenation (ECMO) has broadened to an expanded set of indications for supporting patients in shock, but outcome data by these indications remains limited. This study examines survival of VA and VV ECMO patients by indication. Methods: A retrospective review of adults supported by ECMO at a single center for cardiogenic shock between January 2010 - November 2018 was conducted. VA ECMO patients (n=449) and VV ECMO patients (n=91) were classified according to indication for ECMO support. Kaplan-Meier analysis was used to construct survival curves at 30 days and 1 year and compared using log-rank test. Post-hoc Tukey test was used to adjust for multiple comparisons. Results: The subgroups of indication for VA-ECMO support were Acute Pulmonary Embolism (PE, n=14), Ischemic Cardiomyopathy or Myocardial Infarction (ICM or MI, n=108), Non-Ischemic Cardiomyopathy (NICM, n=82), Post-Cardiotomy (n=129), Transplant (Tx, n=32), and Other (n=84). Kaplan-Meier estimates of survival stratified by indication at 30 days and 1 year were significant (30d: p=0.006, 1y: p=0.009, Figure 1). Multiple comparisons at 30 days and 1 year were significant for Acute PE v Post-Cardiotomy (30d: p=0.044, 1y: p=0.029), NICM v Post-Cardiotomy (30d: p=0.016, 1y: p=0.025), and Tx v Post-Cardiotomy (30d: p=0.01, 1y: p=0.022). Among VV-ECMO patients, the subgroups of indication were ARDS: Influenza (n=25), ARDS: Other Infection (n=24), and ARDS: Non-Infectious (n=42). No statistically significant difference in survival was appreciated between these indications either at 30 days (p=0.742) or 1 year (p=7.82). Conclusions: Patients who require Post-Cardiotomy VA-ECMO support have worse short- and long-term survival compared to patients who require support for Acute PE, NICM, or Transplant indications. Among VV-ECMO patients, however, no survival difference is appreciated by indication.

scholarly journals Regional Tissue Oximetry Reflects Changes in Arterial Flow in Porcine Chronic Heart Failure Treated With Venoarterial Extracorporeal Membrane Oxygenation

2016 ◽  
pp. S621-S631 ◽  
Author(s):  
P. HÁLA ◽  
M. MLČEK ◽  
P. OŠŤÁDAL ◽  
D. JANÁK ◽  
M. POPKOVÁ ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Chronic Heart Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Tissue Oxygenation ◽  
Arterial Flow ◽  
Arterial Blood Flow ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Va Ecmo

Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in treatment of decompensated heart failure. Our aim was to investigate its effects on regional perfusion and tissue oxygenation with respect to extracorporeal blood flow (EBF). In five swine, decompensated low-output chronic heart failure was induced by long-term rapid ventricular pacing. Subsequently, VA ECMO was introduced and left ventricular (LV) volume, aortic blood pressure, regional arterial flow and tissue oxygenation were continuously recorded at different levels of EBF. With increasing EBF from minimal to 5 l/min, mean arterial pressure increased from 47±22 to 84±12 mm Hg (P<0.001) and arterial blood flow increased in carotid artery from 211±72 to 479±58 ml/min (P<0.01) and in subclavian artery from 103±49 to 296±54 ml/min (P<0.001). Corresponding brain and brachial tissue oxygenation increased promptly from 57±6 to 74±3 % and from 37±6 to 77±6 %, respectively (both P<0.01). Presented results confirm that VA ECMO is a capable form of heart support. Regional arterial flow and tissue oxygenation suggest that partial circulatory support may be sufficient to supply brain and peripheral tissue by oxygen.

scholarly journals On the Basic Preconditions of Non-Neutrality of Money in Economic Theory

2021 ◽  
Vol 13 (1) ◽  
pp. 006-019
Author(s):  
Vladimir I. Maevsky ◽  
Keyword(s):  
Economic Growth ◽  
Capacity Utilization ◽  
Theoretical Studies ◽  
Short Term ◽  
Equilibrium Pricing ◽  
Nominal Rigidity ◽  
Theoretical Approaches ◽  
Short And Long Term ◽  
Made In

Based on the experimental calculations carried out with the help of the shifting mode reproduction model, as well as on the theoretical studies of Marx, Schumpeter, Keynes and his followers - representatives of the post-Keynesian direction, two conclusions were made in the article. First, that non-neutrality of money takes place in both short- and long-term periods, and second, that each of these periods has its own basic preconditions for non-neutrality. For the short term, it is a "phenomenon of nominal rigidity", and for the long term, it is a "phenomenon of capitalization of money". The thesis is justified that the "phenomenon of nominal rigidity" manifests itself mainly within the framework of the existing production, when the economic growth caused by the increase in money supply is achieved by increasing capacity utilization and engagement of idle labor. Accordingly, the "phenomenon of capitalization of money" manifests itself through the conversion of issued money into investments in fixed capital and, through the growth of this capital (and capacities), affects the GDP growth. It is shown that behind the two considered basic prerequisites there are fundamentally different theoretical approaches. Behind the short-term "phenomenon of nominal rigidity" there is an orthodox vision of economy focused on the equilibrium pricing mechanism. Behind the long-term "phenomenon of capitalization of money" there is a heterodox vision related to the mechanism of money circulation, emission and economic growth caused by it. It has been concluded that in case of probable increase of competition between these theoretical approaches it is unacceptable if short-term basic preconditions of non-neutrality of money are used in the analysis of long-term processes and long-term preconditions are used in the analysis of short-term growth cases.

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