extracorporeal life support
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ASAIO Journal ◽  
2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Krista N. Grennan ◽  
Timothy M. Maul ◽  
Jennifer S. Nelson

Author(s):  
Peter Paal ◽  
Mathieu Pasquier ◽  
Tomasz Darocha ◽  
Raimund Lechner ◽  
Sylweriusz Kosinski ◽  
...  

Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available. Hypothermic patients with risk factors for imminent cardiac arrest (temperature < 30 °C in young and healthy patients and <32 °C in elderly persons, or patients with multiple comorbidities), ventricular dysrhythmias, or systolic blood pressure < 90 mmHg) and hypothermic patients who are already in cardiac arrest, should be transferred directly to an extracorporeal life support (ECLS) centre. If a hypothermic patient arrests, continuous cardiopulmonary resuscitation (CPR) should be performed. In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed and asystolic cardiac arrest. Mechanical CPR devices should be used for prolonged rescue, if available. In severely hypothermic patients in cardiac arrest, if continuous or mechanical CPR is not possible, intermittent CPR should be used. Rewarming can be accomplished by passive and active techniques. Most often, passive and active external techniques are used. Only in patients with refractory hypothermia or cardiac arrest are internal rewarming techniques required. ECLS rewarming should be performed with extracorporeal membrane oxygenation (ECMO). A post-resuscitation care bundle should complement treatment.


Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 43
Author(s):  
Julia Riebandt ◽  
Thomas Haberl ◽  
Klaus Distelmaier ◽  
Martin H. Bernardi ◽  
Anne-Kristin Schaefer ◽  
...  

Background and objectives: Extracorporeal life support (ECLS) is a widely accepted and effective strategy for use in patients presenting with refractory cardiogenic shock. Implantation in awake and non-intubated patients allows for optimized evaluation of further therapy options while avoiding potential side effects associated with the need for sedation and intubation. The aim of the study was the assessment of safety and feasibility of awake ECLS implementation and of outcomes in patients treated with this concept. Materials and Methods: We retrospectively reviewed the concept of awake ECLS implantation in 16 consecutive patients (mean age 58 ± 8 years; male: 88%; ischemic cardiomyopathy: 50%) from 02/2017 to 01/2021. Study endpoints were survival to weaning or bridging to durable support or organ replacement and development of end-organ function and hemodynamic parameters on ECLS. Results: Fourteen patients (88%) were able to be successfully transitioned to definite therapy options. ECLS support stabilized end-organ function, led to a decrease in mean lactate levels (5.3 ± 3.7 mmol/L at baseline to 1.9 ± 1.3 mmol/L 12 h after ECLS start; p = 0.01) and improved hemodynamics (median central venous pressure 20 ± 5 mmHg vs. 10 ± 2 mmHg, p = 0.001) over a median duration of two days (1–8 days IQR). Two patients (13%) died on ECLS support due to multi-organ dysfunction syndrome. Survival to discharge of initially successfully bridged or weaned patients was 64%. Conclusions: Awake ECLS implantation is feasible and safe with the key advantage of omitting or delaying general anesthesia and intubation, with their associated risks in cardiogenic-shock patients, facilitating further decision making.


ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christina M. Theodorou ◽  
Timothy M. Guenther ◽  
Kaitlyn L. Honeychurch ◽  
Laura Kenny ◽  
Stephanie N. Mateev ◽  
...  

2021 ◽  
Vol 50 (1) ◽  
pp. 431-431
Author(s):  
Danielle Green ◽  
Carina Imburgia ◽  
Joseph Rower ◽  
Autumn McKnite ◽  
Walter Kelley ◽  
...  

2021 ◽  
Vol 50 (1) ◽  
pp. 121-121
Author(s):  
Alicia Lew ◽  
Tisha Spence ◽  
Ashley Siems ◽  
Anthony Sochet ◽  
David Kays ◽  
...  

2021 ◽  
Vol 50 (1) ◽  
pp. 585-585
Author(s):  
Sneha Kolli ◽  
Cydney Opolka ◽  
Carrie Mason ◽  
Anne Fitzpatrick ◽  
Jocelyn Grunwell

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

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