scholarly journals 752: VIDEO EEG ABNORMALITIES AMONG NEONATES DURING EXTRACORPOREAL LIFE SUPPORT

2021 ◽  
Vol 50 (1) ◽  
pp. 370-370
Author(s):  
Leanna Laor ◽  
Ritesh Korumilli ◽  
Anuj Jayakar ◽  
Hugh Ladd ◽  
Keith Meyer ◽  
...  
2020 ◽  
Vol 99 (10) ◽  

Besides the conventional extracorporeal circulation, commonly used in cardiac surgery, the methods of extracorporeal life support (ECLS) have been applied ever more frequently in thoracic surgery in recent years. The most commonly used modalities of such supports include extracorporeal membrane oxygenation (ECMO) and the Novalung interventional lung assist device (iLA). Successful application of ECLS has led to its more frequent use in general thoracic surgery, especially as a tool to treat hypercapnia and to ensure oxygenation and haemodynamic support. However, these methods are essential in lung transplant programmes; without their help, in most cases, it would not be possible to perform the transplantatioz or prevent the severe complications associated with critical primary graft dysfunction. Additionally, the extracorporeal circulation also facilitates the performing of specific surgical procedures that would not be feasible under standard conditions or would be associated with an inadequate risk. The application of extracorporeal life supports can fundamentally increase the level of resection when treating advanced intrathoracic malignancies that are in close contact with the heart and large vessels or even directly extend into them. Without the possibility of resecting such structures en bloc, together with the tumour, and, thus, achieving an R0 resection, these malignant tumours are often directly contraindicated for surgery or are operated non-radically, i.e. unsuccessfully. Complete tumour resection is the most important prognostic factor in the surgery.


2014 ◽  
Vol 17 (5) ◽  
pp. 253 ◽  
Author(s):  
Sabina P W Guenther ◽  
Sven Peterss ◽  
Angela Reichelt ◽  
Frank Born ◽  
Matthias Fischer ◽  
...  

<p><b>Background:</b> Myocardial ischemia due to concomitant coronary artery disease (CAD) or coronary dissection in patients with acute aortic dissection type Stanford A (AADA) is associated with myocardial failure and poor outcomes. Preoperative coronary angiography in this group of patients is still debated. The use of CT scan to diagnose coronary affection along with the establishment of high-pitched dual-spiral CT protocols are essential for improving outcomes.</p><p><b>Methods:</b> We retrospectively analyzed six AADA patients with heart failure who were treated using extracorporeal life support (ECLS). Options for diagnosing coronary affection and different therapeutic strategies for postcardiotomy cardiogenic shock in this patient cohort are discussed.</p><p><b>Results:</b> Retrospective review of CT images showed coronary abnormalities in 83% (n = 5). Four patients (67%) underwent unplanned coronary artery bypass grafting (CABG). ECLS was instituted in 67% (n = 4) due to left heart failure and in 33% (n = 2) due to right heart failure. Thirty day mortality was 67% (n = 4). The two patients that received ECLS for right ventricular support survived and both had undergone CABG.</p><p><b>Conclusion:</b> Besides preoperative evaluation of the extent of the dissection, focus on coronary affection in CT-scans helps to triage the operative procedure. Hybrid operating rooms allow for immediate interventional and/or surgical treatment and enable for immediate control of revascularization results. The use of ECLS over other types of ventricular support systems may allow for myocardial recovery in selected cases.</p>


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