11 results on '"Extracorporeal membrane oxygenation"'
Search Results
2. Veno-venous extracorporeal membrane oxygenation in patients with SARS-CoV-2 pneumonia in Brazil: a case series
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Lucas Mendes Cunha de Resende Brasil, Gabriel Nóbrega de Arruda, Gabriela Bezerra de Freitas Diniz, Dimas Tadahiro Ikeoka, Gustavo Niankowski Saliba, Camila Riberto Camargo, David José de Barros Machado, Felipe Aires Duarte, and Felipe Lourenço Fernandes
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Extracorporeal membrane oxygenation ,COVID-19 ,SARS-CoV-2 ,Respiratory distress syndrome ,Diseases of the respiratory system ,RC705-779 - Abstract
ABSTRACT Objective: The world has been suffering from the COVID-19 pandemic. Some COVID-19 patients develop severe viral pneumonia, requiring mechanical ventilation and measures to treat refractory hypoxemia, such as a protective ventilation strategy, prone positioning, and the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO). We describe a case series of 30 COVID-19 patients who needed VV-ECMO at the Hospital Alemão Oswaldo Cruz, located in the city of São Paulo, Brazil. Methods: We included all patients who required VV-ECMO due to COVID-19 pneumonia between March of 2020 and June of 2021. Results: Prior to VV-ECMO, patients presented with the following median scores: SOFA score, 11; APPS score, 7; Respiratory ECMO Survival Prediction score, 2; and Murray score, 3.3. The 60-day-in-hospital mortality was 33.3% (n = 10). Conclusions: Although our patients had a highly severe profile, our results were similar to those of other cohort studies in the literature. This demonstrates that VV-ECMO can be a good tool even in a pandemic situation when it is managed in an experienced center.
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- 2023
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3. Clinical characteristics and outcomes of patients with COVID-19 admitted to the intensive care unit during the first and second waves of the pandemic in Brazil: a single-center retrospective cohort study
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Thiago Domingos Corrêa, Thais Dias Midega, Ricardo Luiz Cordioli, Carmen Silvia Valente Barbas, Roberto Rabello Filho, Bruno Caldin da Silva, Moacyr Silva Júnior, Ricardo Kenji Nawa, Fabrício Rodrigues Torres de Carvalho, Gustavo Faissol Janot de Matos, Neide Marcela Lucinio, Rodrigo Dias Rodrigues, Raquel Afonso Caserta Eid, Bruno de Arruda Bravim, Adriano José Pereira, Bento Fortunato Cardoso dos Santos, João Renato Rebello Pinho, Andreia Pardini, Vanessa Damazio Teich, Claudia Regina Laselva, Miguel Cendoroglo Neto, Sidney Klajner, and Leonardo José Rolim Ferraz
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Coronavirus infections ,COVID-19 ,SARS-CoV-2 ,Respiration, artificial ,Noninvasive ventilation ,Extracorporeal membrane oxygenation ,Critical care outcomes ,Mortality ,Intensive care units ,Medicine - Abstract
ABSTRACT Objective To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic. Methods In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic. Results In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p
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- 2023
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4. Arrhythmogenic Left Ventricular Cardiomyopathy: A Successful Case of Extracorporeal Cardiopulmonary Resuscitation
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Mafalda Gama, Isabel Cardoso, Mónica Palma Anselmo, Sílvia Aguiar Rosa, Pedro Gaspar da Costa, and Philip Fortuna
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Arrhythmogenic Left Ventricular Cardiomyopathy ,Cardiopulmonary Resuscitation ,Extracorporeal Membrane Oxygenation ,Heart Arrest/therapy ,Medicine ,Medicine (General) ,R5-920 - Abstract
A 24-year-old man suffered a witnessed cardiac arrest after a padel game. Basic life support was immediately provided. The pre-hospital emergency services team continued the resuscitation efforts, and the patient was accepted for extracorporeal cardiopulmonary resuscitation. The return of spontaneous circulation was achieved in 45 minutes. The initial assessment revealed a ST-segment elevation in leads V4-V6 and a dilated left ventricle with severe systolic dysfunction. Coronary angiography was normal. An improvement in left ventricular systolic function was observed and extracorporeal cardiac support was discontinued after 48 hours. Cardiovascular magnetic resonance imaging demonstrated hypokinesia and subepicardial fatty infiltration of the left ventricle lateral wall. Genetic testing detected a variant of uncertain significance in the ANK2 gene. The diagnosis of arrhythmogenic left ventricular myocardiopathy did not fulfill all the current diagnostic criteria, but it is a very likely diagnosis. An implantable cardioverter-defibrillator was placed. The patient was discharged without physical or cognitive impairment.
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- 2023
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5. Extracorporeal Membrane Oxygenation in an Adolescent with Multisystem Inflammatory Syndrome in Children
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Cristina Gago, Cristina Lorenzo, Sara Pinto, Ana R. Sousa, Cristina Camilo, and Francisco Abecasis
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Adolescent ,COVID-19/complications ,Extracorporeal Membrane Oxygenation ,SARS-CoV-2 ,Shock, Cardiogenic ,Systemic Inflammatory Response Syndrome ,Medicine ,Medicine (General) ,R5-920 - Abstract
Multisystem inflammatory syndrome in children is a rare and potentially life-threatening disease that is associated with SARS-CoV-2 infection, characterized by hyperinflammation and multiorgan involvement. Cardiovascular involvement is common, including myocardial dysfunction often leading to cardiogenic shock. We present the case of a 17-year-old boy with fever, odynophagia, maculopapular rash and abdominal pain who developed a cardiogenic shock. Due to progressive deterioration of cardiac function despite optimized vasoactive support, veno-arterial extracorporeal membrane oxygenation support was initiated 12 hours after admission, with successful decannulation after seven days and discharge after 23 days, with normal cardiac function. The patient received corticosteroids and intravenous immunoglobulin. Early recognition and intensive care support are crucial for ensuring a successful outcome in severe cases of multisystem inflammatory syndrome. In cases of severe cardiogenic shock, extracorporeal membrane oxygenation support can be critical for survival and rapid recovery.
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- 2023
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6. Oxigenação por membrana extracorpórea de longa duração - da infecção por SARS-CoV-2 ao transplante pulmonar.
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Gama, Mafalda, Cabrita, Joana, Barrigoto, Cleide, Proença, Lúcia, and Fortuna, Philip
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EXTRACORPOREAL membrane oxygenation , *SARS-CoV-2 , *LUNG transplantation - Abstract
A healthy 55-year-old woman unvaccinated for SARS-CoV-2 was admitted to the hospital with a SARSCoV-2 infection with rapid clinical deterioration. On the 17th day of disease, she was intubated, and on the 24th day, the patient was referred and admitted to our extracorporeal membrane oxygenation center. Extracorporeal membrane oxygenation support was initially used to enable lung recovery and allow the patient to rehabilitate and improve her physical condition. Despite an adequate physical condition, the lung function was not adequate to discontinue extracorporeal membrane oxygenation, and the patient was considered for lung transplantation. The intensive rehabilitation program was implemented to improve and maintain the physical status throughout all phases. The extracorporeal membrane oxygenation run had several complications that ABSTRACT hindered successful rehabilitation: right ventricular failure that required venoarterial-venous extracorporeal membrane oxygenation for 10 days; six nosocomial infections, four with progression to septic shock; and knee hemarthrosis. To reduce the risk of infection, invasive devices (i.e., invasive mechanical ventilation, central venous catheter, and vesical catheter) were removed whenever possible, keeping only those essential for monitoring and care. After 162 days of extracorporeal membrane oxygenation support without other organ dysfunction, bilateral lobar lung transplantation was performed. Physical and respiratory rehabilitation were continued to promote independence in daily life activities. Four months after surgery, the patient was discharged. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Investigação da associação de dois oxigenadores em paralelo ou em série durante o suporte respiratório com oxigenação por membrana extracorpórea.
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Garcia Melro, Livia Maria, Pessoa dos Santos, Yuri de Albuquerque, Maia Cardozo Júnior, Luis Carlos, Maccagnan Pinheiro Besen, Bruno Adler, Zigaib, Rogério, Neves Forte, Daniel, Vitale Mendes, Pedro, and Park, Marcelo
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EXTRACORPOREAL membrane oxygenation , *DECARBOXYLATION , *HYPERCAPNIA - Abstract
Objective: To characterize the pressures, resistances, oxygenation, and decarboxylation efficacy of two oxygenators associated in series or in parallel during venous-venous extracorporeal membrane oxygenation support. Methods: Using the results of a swine severe respiratory failure associated with multiple organ dysfunction venousvenous extracorporeal membrane oxygenation support model and mathematical modeling, we explored the effects on oxygenation, decarboxylation and circuit pressures of in-parallel and in-series associations of oxygenators. Results: Five animals with a median weight of 80kg were tested. Both configurations increased the oxygen partial pressure after the oxygenators. The return cannula oxygen content was also slightly higher, but the impact on systemic oxygenation was minimal using oxygenators with a high rated flow (~ 7L/minute). Both configurations significantly reduced the systemic carbon dioxide partial pressure. As the extracorporeal membrane oxygenation blood flow increased, the oxygenator resistance decreased initially with a further increase with higher blood flows but with a small clinical impact. Conclusion: Association of oxygenators in parallel or in series during venous-venous extracorporeal membrane oxygenation support provides a modest increase in carbon dioxide partial pressure removal with a slight improvement in oxygenation. The effect of oxygenator associations on extracorporeal circuit pressures is minimal. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Flexible broncoscopy in patients in supportive therapy with oxygenation by extracorporeal membrane
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Camila França Redivo, Evelise Lima, Anarégia de Pontes Ferreira, Paulo Rogério Scordamaglio, Silvia Vidal Campos, Yeh-Li Ho, and Ascédio José Rodrigues
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Extracorporeal membrane oxygenation ,Bronchoscopy ,Respiratory distress syndrome ,Intensive care units ,Medicine - Abstract
ABSTRACT Objective: To report the experience of performing bronchoscopy in patients who underwent supportive therapy with extracorporeal membrane oxygenation in whom the bronchoscopy was performed. Methods: This was a review of medical records of patients diagnosed with extracorporeal membrane oxygenation and who required diagnostic or therapeutic bronchoscopy. Records included were related to patients admitted to the intensive care unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo, between 2014 and 2020. Results: During the study, 16 bronchoscopies were performed in 8 patients admitted to the intensive care unit and who underwent supportive therapy with extracorporeal membrane oxygenation. The mean age of patients was 28.37 years. Four patients were women (50%). A total of 5 (31.25%) therapeutic bronchoscopies and 11 (68.75%) diagnostics were performed. In 5 of patients, material was collected: 4 samples of bronchoalveolar lavage, three collections of transbronchial biopsies, and 1 of endobronchial biopsies. No patient had radiological worsening or hemodynamic complications. One patient (6.25%) had transient desaturation. There was moderate bleeding after transbronchial biopsy in 1 (6.25%) procedure, which was resolved endoscopically. Conclusion: Patients undergoing extracorporeal membrane oxygenation can safely perform diagnostic or therapeutic bronchoscopy provided that they have a detailed indication. Procedures were performed by a specialized bronchoscopy team in intensive care environment and with the assistance of a qualified multidisciplinary team in membrane oxygenation therapy extracorporeal.
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- 2022
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9. Case Report of a Neonate Born to a Mother with Severe SARS-CoV-2 Infection under ECMO
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Ana Sofia Vilardouro, Mafalda Castelão, Paula Costa, and Margarida Abrantes
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COVID-19 ,Extracorporeal Membrane Oxygenation ,Infant ,Newborn ,Osteomyelitis ,SARS-CoV-2 ,Medicine ,Medicine (General) ,R5-920 - Abstract
Neonatal SARS-CoV-2 infections are rare and although there is some evidence of vertical transmission, most newborns show no clinical signs or present with only mild clinical symptoms. Fetal survival is reported around 70% in mothers submitted to extracorporeal membrane oxygenation. We present a case of a male newborn born at 29 weeks from a mother under extracorporeal membrane oxygenation due to SARS-CoV-2 infection. There was no evidence of vertical transmission, polymerase chain reaction testing of nasopharyngeal/throat swab and polymerase chain reaction testing of blood sample for SARS-CoV-2 were both negative. On day 2, he developed signs of osteomyelitis of the distal femur extremity, which resolved after six weeks of antibiotic therapy, with no other significant events during admission. This case report depicts the favorable outcome of a live infant born to a mother with severe SARS-CoV-2infection under extracorporeal membrane oxygenation.
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- 2022
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10. Aeromedical interhospital transport of an adult with COVID-19 on extracorporeal membrane oxygenation: case report
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Vânia Paula de Carvalho, Bruno Gonçalves da Silva, Flávio Lopes Ferreira, André Alves Elias, Armando Sergio de Aguiar Filho, and Nelson Miguel Galindo Neto
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Coronavirus Infections ,Extracorporeal membrane oxygenation ,Inter-hospital transport ,Knowledge management ,Case Reports ,Public aspects of medicine ,RA1-1270 ,Nursing ,RT1-120 ,Mental healing ,RZ400-408 ,Education (General) ,L7-991 - Abstract
Abstract Objective: To describe the experience of aeromedical interhospital transport of an adult patient with severe hypoxemic respiratory failure due to SARS-CoV-2, on extracorporeal membrane oxygenation. Method: This is a case report, guided by the tool Case Report Guidelines, with a descriptive approach. Data were collected from the digital medical record and field notes after the approval by the Institution and the Human Research Ethics Committee. Results: The transport of a critically ill, unstable patient with acute respiratory syndrome 2 on extracorporeal oxygenation was an opportunity for the team to acquire new knowledge. The proper preparation of the fixed-wing aircraft and the profile of the team of specialist nurses contributed to the safety and quality in the three phases of flight: preflight, in-flight and post-flight. Conclusion: Air transport of adults on cardiopulmonary bypass to referral centers, under the care of an experienced multidisciplinary team, can contribute to positive results. The nurses’ autonomy, their leadership role and expertise in process management are highlighted. Thus, success was evidenced with the patient’s discharge after 45 days from the Intensive Care Unit.
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- 2022
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11. Clinical characteristics and outcomes of COVID-19 patients admitted to the intensive care unit during the first year of the pandemic in Brazil: a single center retrospective cohort study
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Thiago Domingos Corrêa, Thais Dias Midega, Karina Tavares Timenetsky, Ricardo Luiz Cordioli, Carmen Silvia Valente Barbas, Moacyr Silva Júnior, Bruno de Arruda Bravim, Bruno Caldin Silva, Gustavo Faissol Janot de Matos, Ricardo Kenji Nawa, Fabrício Rodrigues Torres de Carvalho, Verônica Neves Fialho Queiroz, Roberto Rabello Filho, Felipe Maia de Toledo Piza, Adriano José Pereira, Marcele Liliane Pesavento, Raquel Afonso Caserta Eid, Bento Fortunato Cardoso dos Santos, Andreia Pardini, Vanessa Damázio Teich, Claudia Regina Laselva, Miguel Cendoroglo Neto, Sidney Klajner, and Leonardo José Rolim Ferraz
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Coronavirus ,COVID-19 ,Coronavirus infections ,SARS-CoV-2 ,Betacoronavirus ,Intensive care units ,Respiration, artificial ,Noninvasive ventilation ,Extracorporeal membrane oxygenation ,Critical care outcomes ,Mortality ,Medicine - Abstract
ABSTRACT Objective: To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit. Methods: Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study. Patients were categorized between survivors and non-survivors according to hospital discharge. Results: During the study period, 1,296 patients [median (interquartile range) age: 66 (53-77) years] with COVID-19 were admitted to the intensive care unit. Out of those, 170 (13.6%) died at hospital (non-survivors) and 1,078 (86.4%) were discharged (survivors). Compared to survivors, non-survivors were older [80 (70-88) versus 63 (50-74) years; p
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- 2021
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