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7. Extracorporeal membrane oxygenation during pregnancy and peripartal. An international retrospective multicenter study.

Author

Malfertheiner, S Fill, Brodie, D, Burrell, A, Taccone, FS, Broman, LM, Shekar, K, Agerstrand, C L, Serra, A L, Fraser, J, and Malfertheiner, MV

Subjects
*RESEARCH, *PNEUMONIA, *PULMONARY embolism, *CARDIOMYOPATHIES, *EXTRACORPOREAL membrane oxygenation, *RETROSPECTIVE studies, *POPULATION geography, *ADULT respiratory distress syndrome, *DESCRIPTIVE statistics, *PERINATAL period, *LONGITUDINAL method, *HEMORRHAGE, *AMNIOTIC fluid embolism
Abstract

Introduction: Extracorporeal Membrane Oxygenation (ECMO) may be used in the setting of pregnancy or the peripartal period, however its utility has not been well-characterized. This study aims to give an overview on the prevalence of peripartel ECMO cases and further assess the indications and outcomes of ECMO in this setting across multiple centers and countries. Methods: A retrospective, multicenter, international cohort study of pregnant and peripartum ECMO cases was performed. Data were collected from six ECMO centers across three continents over a 10-year period. Results: A total of 60 pregnany/peripartal ECMO cases have been identified. Most frequent indications are acute respiratory distress syndrome (n = 30) and pulmonary embolism (n = 5). Veno-venous ECMO mode was applied more often (77%). ECMO treatment during pregnancy was performed in 17 cases. Maternal and fetal survival was high with 87% (n = 52), respectively 73% (n = 44). Conclusions: Various emergency scenarios during pregnancy and at time of delivery may require ECMO treatment. Peripartal mortality in a well-resourced setting is rare, however emergencies in the labor room occur and knowledge of available rescue therapy is essential to improve outcome. Obstetricians and obstetric anesthesiologists should be aware of the availability of ECMO resource at their hospital or region to ensure immediate contact when needed. [ABSTRACT FROM AUTHOR] more...

Published
2023
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8. Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Author

Li Bassi, G., Gibbons, K., Suen, J. Y., Dalton, H. J., White, N., Corley, A., Shrapnel, S., Hinton, S., Forsyth, S., Laffey, J. G., Fan, E., Fanning, J. P., Panigada, M., Bartlett, R., Brodie, D., Burrell, A., Chiumello, D., Elhazmi, A., Esperatti, M., Grasselli, G., Hodgson, C., Ichiba, S., Luna, C., Marwali, E., Merson, L., Murthy, S., Nichol, A., Ogino, M., Pelosi, P., Torres, A., P. Y., Ng, Fraser, J. F., Al-Dabbous, T., Alfoudri, H., Shamsah, M., Elapavaluru, S., Berg, A., Horn, C., Mayasi, Y., Schroll, S., Meyer, D., Velazco, J., Ploskanych, L., Fikes, W., Bagewadi, R., Dao, M., White, H., Ehlers, A., Shalabi-McGuire, M., Witt, T., Grazioli, L., Lorini, L., Grandin, E. W., Nunez, J., Reyes, T., Obriain, D., Hunter, S., Ramanan, M., Affleck, J., Veerendra, H. H., Rai, S., Russell-Brown, J., Nourse, M., Joseph, M., Mitchell, B., Tenzer, M., Abe, R., Cho, H. J., Jeong, I. S., Rahman, N., Kakar, V., Brozzi, N., Mehkri, O., Krishnan, S., Duggal, A., Houltham, S., Graf, J., Diaz, R., Orrego, R., Delgado, C., Gonzalez, J., Sanchez, M. S., Piagnerelli, M., Sarrazin, J. V., Zabert, A. /P. G., Espinosa, L., Delgado, P., Delgado, V., Rincon, D. F. B., Yanten, A. M. M., Duque, M. B., Al-Hudaib, A., Callahan, M., Taufik, M. A., Wardoyo, E. Y., Gunawan, M., Trisnaningrum, N. S., Irawany, V., Rayhan, M., Pesenti, A., Zanella, A., Leone, M., Coppola, S., Colombo, S., Antonelli, M., Carelli, S., Grieco, D. L., Asaki, M., Hoshino, K., Salazar, L., Duarte, L., Laffey, J., Mcnicholas, B., Cosgrave, D., Mccaffrey, J., Bone, A., Hakeem, Y., Winearls, J., Tallott, M., Thomson, D., Arnold-Day, C., Cupido, J., Fanie, Z., Miller, M., Seymore, L., van Straaten, D., Hssain, A. A., Aliudin, J., Alqahtani, A. -R., Mohamed, K., Mohamed, A., Tan, D., Villanueva, J., Zaqout, A., Kurtzman, E., Ademi, A., Dobrita, A., El Aoudi, K., Segura, J., Giwangkancana, G., Ohshimo, S., Hitoshi, S., Osatnik, J., Joosten, A., Yang, M., Motos, A., Arancibia, F., Williams, V., Noel, A., Luque, N., Trung, T. H., Yacoub, S., Fantini, M., Garcia, R. N. J., Alvarez, E. C., Greti, A., Ceccato, A., Sanchez, A., Vazquez, A. L., Roche-Campo, F., Franch-Llasat, D., Tuazon, D., Amato, M., Cassimiro, L., Pola, F., Ribeiro, F., Fonseca, G., Dalton, H., Desai, M., Osborn, E., Deeb, H., Arcadipane, A., Martucci, G., Panarello, G., Vitiello, C., Bianco, C., Occhipinti, G., Rossetti, M., Cuffaro, R., Cho, S. -M., Shimizu, H., Moriyama, N., Kim, J. -B., Kitamura, N., Gebauer, J., Yokoyama, T., Al-Fares, A., Buabbas, S., Alamad, E., Alawadhi, F., Alawadi, K., Tanaka, H., Hashimoto, S., Yamazaki, M., T. -H., Oh, Epler, M., Forney, C., Kruse, L., Feister, J., Williamson, J., Grobengieser, K., Gnall, E., Golden, S., Caroline, M., Shapiro, T., Karaj, C., Thome, L., Sher, L., Vanderland, M., Welch, M., Mcdermott, S., Brain, M., Mineall, S., Kimura, D., Brazzi, L., Sales, G., Ogston, T., Nagpal, D., Fischer, K., Lorusso, R., Rangappa, R., Appu, A., Carton, E. G., Sen, A., Palacios, A., Rainey, D., Samoukoviv, G., Campisi, J., Durham, L., Neumann, E., Seefeldt, C., Falcucci, O., Emmrich, A., Guy, J., Johns, C., Potzner, K., Zimmermann, C., Espinal, A., Buchtele, N., Schwameis, M., Stecher, S. -S., Singh, D., Barnikel, M., Arenz, L., Zaaqoq, A., Galloway, L. A., Merley, C., Csete, M., Quesada, L., Saba, I., Kasugai, D., Hiraiwa, H., Tanaka, T., Purnama, Y., Dewayanti, S. R., Ardiyan, Juzar, D. A., Siagian, D., Chen, Y. -S., Ratsep, I., Oigus, G., Erikson, K., Post, A. -M., Enneveer, L., Sillaots, P., Manetta, F., Mihelis, E., Sarmiento, I. C., Narasimhan, M., Varrone, M., Komats, M., Garcia-Diaz, J., Harmon, C., Satyapriya, S. V., Bhatt, A., Mokadam, N. A., Uribe, A., Gonzalez, A., Shi, H., Mckeown, J., Pasek, J., Fiorda, J., Echeverria, M., Moreno, R., Zakhary, B., Cavana, M., Cucino, A., Foti, G., Giani, M., Russotto, V., Castagna, V., Dellamore, A., Navalesi, P., Shum, H. -P., Vuysteke, A., Usman, A., Acker, A., Smood, B., Mergler, B., Sertic, F., Subramanian, M., Sperry, A., Rizer, N., Burhan, E., Rasmin, M., Akmal, E., Sitompul, F., Lolong, N., Naivedh, B., Erickson, S., Barrett, P., Dean, D., Daugherty, J., Loforte, A., Khan, I., Abraar Quraishi, M., Desantis, O., So, D., Kandamby, D., Mandei, J. M., Natanael, H., Yudhalantang, E., Lantang, A., Wijaya, S. O., Jung, A., Ng, G., W. Y., Ng, Fang, S., Tabah, A., Ratcliffe, M., Duroux, M., Adachi, S., Nakao, S., Blanco, P., Prieto, A., Sanchez, J., Nicholson, M., Butt, W., Serratore, A., Delzoppo, C., Janin, P., Yarad, E., Totaro, R., Coles, J., Pujo, B., Balk, R., Vissing, A., Kapania, E., Hays, J., Fox, S., Yantosh, G., Mishin, P., Yuliarto, S., Hari Santoso, K., Djajalaksana, S., Fatoni, A. Z., Fukuda, M., Liu, K., Battaglini, D., Jimenez, J. F. M., Bastos, D., Gaiao, S., Rusmawatiningtyas, D., Buchner, J., Cho, Y. -J., Lee, S. H., Kawasaki, T., Munshi, L., Sakiyalak, P., Nitayavardhana, P., Seitz, T., Arora, R., Kent, D., Marino, D., Parwar, S., Cheng, A., Miller, J., Fujitani, S., Shimizu, N., Madhok, J., Owyang, C., Buscher, H., Reynolds, C., Maasikas, O., Beljantsev, A., Mihnovits, V., Akimoto, T., Aizawa, M., Horibe, K., Onodera, R., Young, M., George, T., Shekar, K., Mcguinness, N., Irvine, L., Flynn, B., Endo, T., Sugiyama, K., Shimizu, K., Exconde, K., Lussier, L., Lotz, G., Malfertheiner, M., Maier, L., Dreier, E., Kusumastuti, N. P., Mccloskey, C., Dabaliz, A. -A., Elshazly, T. B., Smith, J., Szuldrzynski, K. S., Bielanski, P., Wille, K., Parhar, K. K. S., Fiest, K. M., Codan, C., Shahid, A., Fayed, M., Evans, T., Garcia, R., Gutierrez, A., Song, T., Rose, R., Bennett, S., Richardson, D., Peek, G., Arora, L., Rappapport, K., Rudolph, K., Sibenaller, Z., Stout, L., Walter, A., Herr, D., Vedadi, N., Thompson, S., Sindt, L., Rajnic, S., Ewald, C., Hoffman, J., Ying, X., Kennedy, R., Griffee, M., Ciullo, A., Kida, Y., Roca, R. F., Riera, J. I., Contreras, S., Alegre, C., Kay, C., Fischer, I., Renner, E., Taniguci, H., Fraser, J., Bassi, G. L., Suen, J., Barnett, A., Pearse, I., Abbate, G., Hassan, H., Heinsar, S., Karnik, V. A., Ki, K., Oneill, H. F., Obonyo, N., Pimenta, L. P., Reid, J. D., Sato, K., Vuorinen, A., Wildi, K. S., Wood, E. S., Yerkovich, S., Lee, J., Plotkin, D., Citarella, B. W., Hartley, E., Lubis, B., Ikeyama, T., Bhaskar, B., Jung, J. -S., Mcguinness, S., Eastwood, G., Marta, S. R., Guarracino, F., Gerle, S., Coxon, E., Claro, B., Loverde, D., Patil, N., Parrini, V., Mcbride, A., Negaard, K., Ratsch, A., Abdelaziz, A., Uribe, J. D., Peris, A., Sanders, M., Emerson, D., Kamal, M., Povoa, P., Francis, R., Cherif, A., Joseph, S., Di Nardo, M., Heard, M., Kyle, K., Blackwell, R. A., Biston, P., Jeong, H. W., Smith, R., Prawira, Y., Montrucchio, G., Garcia, A. H., Salterain, N., Meyns, B., Moreno, M., Walia, R., Mehta, A., Schweda, A., Supriatna, M., Kirakli, C., Williams, M., Kim, K. H., Assad, A., Giraldo, E., Karolak, W., Balik, M., Pocock, E., Gajkowski, E., Masafumi, K., Barrett, N., Takeyama, Y., Park, S., Amin, F., Andriyani, F. M., Sudakevych, S., Vera, M., Cornejo, R., Schwarz, P., Mardini, A. C., de Paula, T., Neto, A. S., Villoldo, A., Colafranceschi, A. S., Iglesias, A. U., Granjean, J., Melro, L. M. G., Romualdo, G. F., Gaia, D., Souza, H., Galas, F., Mendiluce, R. M., Sosa, A., Martinez, I., Kurosawa, H., Salgado, J., Hugi-MayrCharbonneau, B. E., Barzilai, V. S., Monteiro, V., de Souza, R. R., Harper, M., Suzuki, H., Adams, C., Brieva, J., Nyale, G., Eltatar, F. S., Fatani, J., Baeissa, H., Masri, A. A., Rabie, A., Hui, M. Y., Yamane, M., Jung, H., Margaret, A. M., Nacpil, N., Ruck, K., Bakken, R., Jara, C., Felton, T., Berra, L., Shah, B., Chakraborty, A., Cardona, M., Capatos, G., Akkanti, B., Orija, A., Jain, H., Ito, A., Housni, B., Low, S., Iihara, K., Chavez, J., Ramanathan, K., Zabert, G., Naidoo, K., Seppelt, I., Vandyk, M., Macdonald, S., Mcgregor, R., Siebenaler, T., Flynn, H., Lofton, K., Aokage, T., Shigemitsu, K., Moscatelli, A., Fiorentino, G., Baumgaertel, M., Mba, S. E., Assy, J., Hutahaean, A., Roush, H., Sichting, K. A., Alessandri, F., Burns, D., Salt, G., Garabedian, C. P., Millar, J., Sim, M., Mattke, A., Mcauley, D., Tadili, J., Frenzel, T., Bar-Lavie, Y., Ortiz, A. B., Stone, J., Attokaran, A., Farquharson, M., Patel, B., Gunning, D., Baillie, K., Watson, P., Tamai, K., Sajinadiyasa, G. K., Kanyawati, D., Salgado, M., Sassine, A., Yudo, B., Mccaul, S., Lee, B., Lee, S. M., Afek, A., Iwashita, Y., Semedi, B. P., Metiva, J., Van Belle, N., Martin-Loeches, I., Ivatt, L., Woon, C. Y., Kang, H. M., Smith, T., James, E., Al-Rawas, N., Iwasaki, Y., King-Chung, K. C., Gudzenko, V., Hugi-Mayr, B., Taccone, F., Perdhana, F., Lamarche, Y., Ribeiro, J. M., Bradic, N., Van den Bossche, K., Lansink, O., Singh, G., Debeuckelaere, G., Stelfox, H. T., Yi, C., Elia, J., Tribble, T., Shankar, S., Padmanabhan, R., Hallinan, B., Paoletti, L., Leyva, Y., Fykuda, T., Badulak, J., Koch, J., Hackman, A., Janowaik, L., Hernandez, D., Osofsky, J., Donadello, K., Lawang, A., Fine, J., Davidson, B., Vazquez, A. O. R., COVID-19 Critical Care Consortium, and Consortium, COVID-19 Critical Care more...

Subjects
Male, Respiratory Distress Syndrome, COVID-19, Intensive care unit, Mechanical ventilation, Neuromuscular blocking agent, SARS-CoV-2, Aged, Female, Humans, Intensive Care Units, Middle Aged, Propensity Score, Respiration, Artificial, Neuromuscular Blocking Agents, Respiration, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Settore MED/41 - Anestesiologia, Critical Care and Intensive Care Medicine, COVID-19 Drug Treatment, Artificial, Human medicine
Abstract

Background The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). Conclusions In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting. more...

Published
2022
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12. Invasive mechanical ventilation in patients with acute respiratory distress syndrome receiving extracorporeal support: a narrative review of strategies to mitigate lung injury.

Author

Zochios, V., Brodie, D., Shekar, K., Schultz, M. J., and Parhar, K. K. S.

Abstract

Summary: Veno‐venous extracorporeal membrane oxygenation is indicated in patients with acute respiratory distress syndrome and severely impaired gas exchange despite evidence‐based lung protective ventilation, prone positioning and other parts of the standard algorithm for treating such patients. Extracorporeal support can facilitate ultra‐lung‐protective ventilation, meaning even lower volumes and pressures than standard lung‐protective ventilation, by directly removing carbon dioxide in patients needing injurious ventilator settings to maintain sufficient gas exchange. Injurious ventilation results in ventilator‐induced lung injury, which is one of the main determinants of mortality in acute respiratory distress syndrome. Marked reductions in the intensity of ventilation to the lowest tolerable levels under extracorporeal support may be achieved and could thereby potentially mitigate ventilator‐induced lung injury and theoretically patient self‐inflicted lung injury in spontaneously breathing patients with high respiratory drive. However, the benefits of this strategy may be counterbalanced by the use of continuous deep sedation and even neuromuscular blocking drugs, which may impair physical rehabilitation and impact long‐term outcomes. There are currently a lack of large‐scale prospective data to inform optimal invasive ventilation practices and how to best apply a holistic approach to patients receiving veno‐venous extracorporeal membrane oxygenation, while minimising ventilator‐induced and patient self‐inflicted lung injury. We aimed to review the literature relating to invasive ventilation strategies in patients with acute respiratory distress syndrome receiving extracorporeal support and discuss personalised ventilation approaches and the potential role of adjunctive therapies in facilitating lung protection. [ABSTRACT FROM AUTHOR] more...

Published
2022
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16. Emergency forage crops

Author

Brodie, D. A. (David Arthur), 1867-1951, U.S. Department of Agriculture, National Agricultural Library, and Brodie, D. A. (David Arthur), 1867-1951

Subjects
Forage plants

17. Determinants of the effect of extracorporeal carbon dioxide removal in the SUPERNOVA trial: implications for trial design

Author

Goligher, E. C., Combes, A., Brodie, D., Ferguson, N. D., Pesenti, A. M., Ranieri, V. M., Slutsky, A. S., Beale, R., Brochard, L., Chiche, J. -D., Fan, E., de Backer, D., Francois, G., Laffey, J., Mercat, A., Mcauley, D. F., Muller, T., Quintel, M., Vincent, J. -L., Taccone, F. S., Peperstraete, H., Morimont, P., Schmidt, M., Levy, B., Diehl, J. -L., Guervilly, C., Capelier, G., Vieillard-Baron, A., Messika, J., Karagiannidis, C., Moerer, O., Urbino, R., Antonelli, M., Mojoli, F., Alessandri, F., Grasselli, G., Donker, D., Ferrer, R., Mancebo, J., Fanelli, V., Pham, T., Goligher E.C., Combes A., Brodie D., Ferguson N.D., Pesenti A.M., Ranieri V.M., Slutsky A.S., Beale R., Brochard L., Chiche J.-D., Fan E., de Backer D., Francois G., Laffey J., Mercat A., McAuley D.F., Muller T., Quintel M., Vincent J.-L., Taccone F.S., Peperstraete H., Morimont P., Schmidt M., Levy B., Diehl J.-L., Guervilly C., Capelier G., Vieillard-Baron A., Messika J., Karagiannidis C., Moerer O., Urbino R., Antonelli M., Mojoli F., Alessandri F., Grasselli G., Donker D., Ferrer R., Mancebo J., Fanelli V., and Pham T. more...

Subjects
Artificial ventilation, Adult, Male, medicine.medical_specialty, Extracorporeal Circulation, Organ Dysfunction Scores, medicine.medical_treatment, Acute respiratory distress syndrome, Extracorporeal carbon dioxide removal, Predictive enrichment, Ventilator-induced lung injury, Pilot Projects, Aged, Blood Gas Analysis, Carbon Dioxide, Extracorporeal Membrane Oxygenation, Female, Humans, Linear Models, Middle Aged, ROC Curve, Simplified Acute Physiology Score, Treatment Outcome, Critical Care and Intensive Care Medicine, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Linear regression, Extracorporeal membrane oxygenation, medicine, Journal Article, Respiratory system, Tidal volume, business.industry, Extracorporeal circulation, 030208 emergency & critical care medicine, respiratory system, 030228 respiratory system, Sample size determination, Cardiology, medicine.symptom, business
Abstract

Purpose To describe the variability and determinants of the effect of extracorporeal CO2 removal (ECCO2R) on tidal volume (V-t), driving pressure (Delta P), and mechanical power (Power(RS)) and to determine whether highly responsive patients can be identified for the purpose of predictive enrichment in ECCO2R trial design. Methods Using data from the SUPERNOVA trial (95 patients with early moderate acute respiratory distress syndrome), the independent effects of alveolar dead space fraction (ADF), respiratory system compliance (Crs), hypoxemia (PaO2/FiO(2)), and device performance (higher vs lower CO2 extraction) on the magnitude of reduction in V-t, Delta P, and Power(RS) permitted by ECCO2R were assessed by linear regression. Predicted and observed changes in Delta P were compared by Bland-Altman analysis. Hypothetical trials of ECCO2R, incorporating predictive enrichment and different target CO2 removal rates, were simulated in the SUPERNOVA study population. Results Changes in V-t permitted by ECCO2R were independently associated with ADF and device performance but not PaO2/FiO(2). Changes in Delta P and Power(RS) were independently associated with ADF, Crs, and device performance but not PaO2/FiO(2). The change in Delta P predicted from ADF and Crs was moderately correlated with observed change in Delta P (R-2 0.32, p < 0.001); limits of agreement between observed and predicted changes in Delta P were +/- 3.9 cmH(2)O. In simulated trials, restricting enrollment to patients with a larger predicted decrease in Delta P enhanced the average reduction in Delta P, increased predicted mortality benefit, and reduced sample size and screening size requirements. The increase in statistical power obtained by restricting enrollment based on predicted Delta P response varied according to device performance as specified by the target CO2 removal rate. Conclusions The lung-protective benefits of ECCO2R increase with higher alveolar dead space fraction, lower respiratory system compliance, and higher device performance. ADF and Crs, rather than severity of hypoxemia, should be the primary factors determining whether to enroll patients in clinical trials of ECCO2R. more...

Published
2019

28. Research in Extracorporeal Life Support: A Call to Action

Author

Brodie, D., Vincent, J. -L., Brochard, L. J., Combes, A., Ferguson, N. D., Hodgson, C. L., Laffey, J. G., Mercat, A., Pesenti, A., Quintel, M., Slutsky, A. S., Ranieri, V. M., International ECMO Network (ECMONet), Brodie, D., Vincent, J.-L., Brochard, L.J., Combes, A., Ferguson, N.D., Hodgson, C.L., Laffey, J.G., Mercat, A., Pesenti, A., Quintel, M., Slutsky, A.S., Ranieri, V.M., and International ECMO Network (ECMONet) more...

Subjects
extracorporeal circulation, extracorporeal oxygenation, evidence, evidence based practice, international cooperation, cardiogenic shock, respiratory failure, heart failure, adult respiratory distress syndrome, extracorporeal life support, Article, outcomes research, research networks, priority journal, consensu, human, ECLS, chronic obstructive lung disease, patient selection
Abstract

[No abstract available]

Published
2018

32. Feasibility and safety of extracorporeal CO 2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study

Author

Combes, A, Fanelli, V, Pham, T, Ranieri, Vm, Goligher, Ec, Brodie, D, Pesenti, A, Beale, R, Brochard, L, Chiche, Jd, Fan, E, de Backer, D, Francois, G, Ferguson, N, Laffey, J, Mercat, A, Mcauley, Df, Muller, T, Quintel, M, Vincent, Jl, Taccone, Fs, Peperstraete, H, Morimont, P, Schmidt, M, Levy, B, Diehl, Jl, Guervilly, C, Capelier, G, Vieillard-Baron, A, Messika, J, Karagiannidis, C, Moerer, O, Urbino, R, Antonelli, Massimo, Mojoli, F, Alessandri, F, Grasselli, G, Donker, D, Ferrer, R, Mancebo, J, Slutsky, As, Combes, Alain, Fanelli, Vito, Pham, Tai, and Ranieri, V Marco more...

Subjects
Male, Adult, Canada, ARDS, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Extracorporeal, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Mechanical ventilation, Settore MED/41 - ANESTESIOLOGIA, Extracorporeal carbon dioxide removal, Journal Article, Extracorporeal membrane oxygenation, medicine, Humans, Prospective Studies, Adverse effect, Acute respiratory distress syndrome, Ventilator-induced lung injury, Acidosis, Respiratory, Aged, Analysis of Variance, Carbon Dioxide, Europe, Feasibility Studies, Female, Middle Aged, Respiration, Artificial, Respiratory Distress Syndrome, Adult, Respiratory Distress Syndrome, business.industry, Respiration, 030208 emergency & critical care medicine, medicine.disease, Confidence interval, 030228 respiratory system, Pneumothorax, Anesthesia, Artificial, Respiratory, Breathing, Acidosis, business
Abstract

Purpose: We assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO 2 R) to facilitate ultra-protective ventilation (V T 4 mL/kg and P PLAT ≤ 25 cmH 2 O) in patients with moderate acute respiratory distress syndrome (ARDS). Methods: Prospective multicenter international phase 2 study. Primary endpoint was the proportion of patients achieving ultra-protective ventilation with PaCO 2 not increasing more than 20% from baseline, and arterial pH > 7.30. Severe adverse events (SAE) and ECCO 2 R-related adverse events (ECCO 2 R-AE) were reported to an independent data and safety monitoring board. We used lower CO 2 extraction and higher CO 2 extraction devices (membrane lung cross-sectional area 0.59 vs. 1.30 m 2 ; flow 300–500 mL/min vs. 800–1000 mL/min, respectively). Results: Ninety-five patients were enrolled. The proportion of patients who achieved ultra-protective settings by 8 h and 24 h was 78% (74 out of 95 patients; 95% confidence interval 68–89%) and 82% (78 out of 95 patients; 95% confidence interval 76–88%), respectively. ECCO 2 R was maintained for 5 [3–8] days. Six SAEs were reported; two of them were attributed to ECCO 2 R (brain hemorrhage and pneumothorax). ECCO 2 R-AEs were reported in 39% of the patients. A total of 69 patients (73%) were alive at day 28. Fifty-nine patients (62%) were alive at hospital discharge. Conclusions: Use of ECCO 2 R to facilitate ultra-protective ventilation was feasible. A randomized clinical trial is required to assess the overall benefits and harms. Clinicaltrials.gov: NCT02282657. more...

Published
2019

36. Delivering extracorporeal membrane oxygenation for patients with COVID-19: what, who, when and how?

Author

Zochios, V., Brodie, D., Charlesworth, M., and Parhar, K. K.

Subjects
*EXTRACORPOREAL membrane oxygenation, *COVID-19, *CARDIOGENIC shock, *EMERGING infectious diseases, *MERS coronavirus, *MIDDLE East respiratory syndrome
Abstract

Keywords: COVID-19; decision making; extracorporeal membrane oxygenation; ventilation EN COVID-19 decision making extracorporeal membrane oxygenation ventilation 997 1001 5 07/17/20 20200801 NES 200801 On 11 March 2020, the World Health Organization (WHO) declared novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a worldwide pandemic. Insights from a trial investigating the use of ECMO for ARDS suggested that patients who were hypercapnic despite maximising lung-protective ventilation were the group of patients with the greatest mortality benefit. However, in-house ECMO cannulation is resource intensive, and delaying the decision until the patient is within the centre itself enables ECMO clinicians to better assess and personalise potentially life-saving interventions short of ECMO. [Extracted from the article] more...

Published
2020
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37. OSHA Whistleblower Claims Are Up: Are Employers Prepared?

Author

Erwin, Brodie D.

Subjects
United States. Occupational Safety and Health Administration -- Powers and duties, Occupational safety and health -- Laws, regulations and rules, Corporate corruption -- Laws, regulations and rules, Whistleblowing -- Laws, regulations and rules, Employers -- Laws, regulations and rules, Safety regulations -- Analysis, Workers, Military personnel, Commercial vehicles, Fraud, Consumer protection, Accounting fraud, Health, Accounting, Wall Street, Government regulation, Business, international, Clean Air Act, Consumer Product Safety Improvement Act of 2008, Sarbanes-Oxley Act of 2002, Surface Transportation Assistance Act of 1982
Abstract

The Occupational Safety and Health Administration (OSHA) is the government agency responsible for enforcing the whistleblower retaliation provisions of numerous laws protecting workers in a wide-range of industries. The Sarbanes-Oxley [...] more...

Published
2019

40. The Common Law Employment Relationship A Comparative Study

Author

Anderson, G, Brodie, D, and Riley, J

Abstract

This book examines how the development of the common law under the influence of contemporary social and economic pressures has caused this contract to evolve.

Published
2017

45. LACK OF AGREEMENT BETWEEN GAS EXCHANGE VARIABLES MEASURED BY TWO METABOLIC SYSTEMS

Author

Professor Djordje Jakovljevic, Nunan, D., Donovan, G., Hodges, L. D., Sandercock, G. R. H., and Brodie, D. A.

Subjects
lcsh:Sports, lcsh:GV557-1198.995, minute ventilation, Bruce protocol, lcsh:Sports medicine, lcsh:RC1200-1245, oxygen consumption, Research Article, Metabolic system, carbon dioxide production
Abstract

The purpose of this study was to assess the agreement and consistency between gas exchange variables measured by two online metabolic systems during an incremental exercise test. After obtaining local ethics approval and informed consent, 15 healthy subjects performed an incremental exercise test to volitional fatigue using the Bruce protocol. The Innocor (Innovision, Denmark) and CardiO2 (Medical Graphics, USA) systems were placed in series, with the Innocor mouthpiece attached to the pneumotach of the CardiO2. Metabolic data were analysed during the last 30 seconds of each stage and at peak exercise. There were non- significant differences (p > 0.05) between the two systems in estimation of oxygen consumption (VO2) and in minute ventilation (VE). Mean Cronbach's alpha for VO2 and VE were 0.88 and 0.92. The Bland-Altman analysis revealed that limits of agreement were -0.52 to 0.55 l.min(-1) for VO2, and -8.74 to 10.66 l.min(-1) for VE. Carbon dioxide production (VCO2) and consequently respiratory exchange ratio (RER) measured by the Innocor were significantly lower (p < 0.05) through all stages. The CardiO2 measured fraction of expired carbon dioxide (FeCO2) significantly higher (p < 0.05). The limits of agreement for VO2 and VE are wide and unacceptable in cardio-pulmonary exercise testing. The Innocor reported VCO2 systematically lower. Therefore the Innocor and CardiO2 metabolic systems cannot be used interchangeably without affecting the diagnosis of an individual patient. Results from the present study support previous suggestion that considerable care is needed when comparing metabolic data obtained from different automated metabolic systems. Key pointsThere is general concern regarding the limited knowledge available about the accuracy of a number of commercially available systems.Demonstrated limits of agreement between key gas exchange variables (oxygen consumption and minute ventilation) as measured by the two metabolic systems were wide and unacceptable in cardio-pulmonary exercise testing.Considerable care is needed when comparing metabolic data obtained from different automated metabolic systems. more...

Published
2008

46. a-Si:F and a-Si:F:H prepared by ion-beam-assisted reactive deposition.

Author

Zhang, S. and Brodie, D. E.

Subjects
*THIN films, *AMORPHOUS substances, *SILICON, *ION bombardment
Abstract

Presents a study that analyzed the preparation of nonhydrogenated amorphous silicon fluoride films and hydrogenated amorphous silicon fluoride films by ion-beam assisted reactive deposition. Details on the experiments; Results of the study; Conclusion. more...

Published
1992
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50. Abstracts of papers presented at the annual meeting, canadian anaesthetists’ society, june 13-17, 1981

Author

Macllvaine, William, Boulanger, Marcel, Paiement, Bernard, Maille, Jean-Guy, Taillefer, Jean, Turnbull, K. W., Allison, J., Dodds, W. A., Jenkins, L. C., Tyers, G. F. O., Walmsley, B., Moffitt, E., Sethna, D., Gray, R., Bussell, J., Conklin, C., Matloff, J., Finlayson, D. C., Kaplan, J. A., Hope, Charles E., Love, James A., Bevan, J. C., Rosenblatt, D. S., Clow, C. L., Chapman, V. A., Raymond, M., Havasi, George, Gintauias, Jonas, Havasi, Ilona, Racz, Gabor B., Sugioka, Kenneth, Woodley, Charles, Dunn, G. L., Morison, D. H., Fargas-Babjak, A., Brodie, D. P., Morison, D. H., Dunn, G. L., Johnson, A. deGraft, Finucane, Brendan T., Maltby, J. R., Hamilton, R. C., Morgan, G. A., Steward, D. J., Steward, D. J., Green, Cloid D., Masoud, Pamela J., Havasi, George, Havasi, Ilona, Ginlautas, Jonas, Racz, Gabor B., Spoerel, W. E., White, I. W. C., Knill, R. L., Varkey, G., Ong, B. Y., Pickering, B. C., Palahniuk, R. J., Cumming, M., Writer, W. D. R., Dewan, D. M., James, F. M., Dewan, D. M., Writer, D. R., Wheeler, A. S., James, F. M., Floyd, H. M., Bogard, T. D., Rhyne, A. L., Coombs, D. W., Porter, J. G., Cate, C., Pageau, M., Webber, T. J., Cunningham, Anthony J., Albert, Odette, Watson, A. G., Cameron, J., Carswell, D. J., Varkey, G. P., Drake, C. G., Dodgson, Bruce G., Knill, R. L., Clement, J. L., Donali, François, Dyke, G., Manson, H., Kieraszewicz, H., Knill, R. L., Clement, J. L., Martineau, R., Kay, J. C., Noble, W. H., Jane Mitchell, Mary, Godin, David V., and Sounders, Brian more...

Published
1981
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