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The right ventricle is susceptible to changes in preload, afterload, and contractility. The answer is its dilation with dysfunction/ acute failure; filling is limited to the left ventricle and cardiac output. Systemic venous congestion is retrograde to the right heart, it is involved in the genesis of cardiogenic shock due to right ventricle involvement. This form of shock is less well known than that which occurs due to left ventricular failure, therefore, treatment may differ. Once the primary treatment has been carried out, since no response is obtained, supportive treatment aimed at ventricular pathophysiology will be the next option. It is suggested to evaluate the preload for the reasoned indication of liquids, diuretics or even ultrafiltration. Restore or maintain heart rate and sinus rhythm, treat symptomatic bradycardia, arrhythmias that make patients unstable, use of temporary pacing or cardioversion procedures. Improving contractility and vasomotility, using vasopressors and inotropes, alone or in combination, the objective will be to improve right coronary perfusion pressure. Balance the effect of drugs and maneuvers on preload and/or afterload, such as mechanical ventilation, atrial septostomy and pulmonary vasodilators. And the increasing utility of mechanical support of the circulation that has become a useful tool to preserve/restore right heart function. [ABSTRACT FROM AUTHOR]

Nutritional support in adult patients receiving extracorporeal membrane oxygenation (ECMO) therapy is controversial. Althou-gh there are guidelines for the NS (Nutritional support) in pediatric patients with ECMO, in adults these guidelines are not available for the use, type, route and timing of nutritional therapy. In critically ill patients it is well known that early enteral nutrition is beneficial, however there is the possibility that in patients with ECMO early enteral nutrition leads to gastrointes-tinal complications. Likewise, there have not been established caloric targets, proteins and doses or types of micronutrients to use for this specific population being a challenge for the clinician. In addition, patients with ECMO are some of the most seriously ill in intensive care units, where malnutrition is associated with increased morbidity and mortality. Regarding the use of parenteral nutrition (NP) it has not been described if it implies a risk of circuit failure at the time of introducing lipids to the oxygenator. Therefore, a correct evaluation and specific nutritional intervention by experts in the field is imperative to impro-ve the prognosis and quality of life in this population, which is a primary goal in the care of adult patients receiving extracor-poreal membrane oxygen. [ABSTRACT FROM AUTHOR]

Extracorporeal Membrane Oxygenation (ECMO) corresponds to a form of mechanical cardiopulmonary support used to treat severe respiratory failure, since it allows extracorporeal gas exchange. Additionally, in patients with severe heart failure, or experiencing cardiorespiratory arrest, this technique also provides systemic circulation. Nevertheless, ECMO carries some risks, such as clot formation. It is in this context that the nurse has a key role. Objective: To map the available scientific evidence about the nurses' approach to the critically ill person subjected to ECMO. Method: We conducted a scoping review, using databases accessed through the EBSCOhost platform and following the methodology proposed by the Joanna Briggs Institute. Through the combination of appropriate MesH descriptors, we selected articles published between 2009 and 2019, written in Portuguese or English. Results: Five studies were included in the review. Their analysis allowed us to verify that the nurse's approach focuses on the monitoring, surveillance, management and coordination of the care provided to critically ill patients subjected to ECMO. It was also found that the adoption of adequate protocols, the training of the multidisciplinary teams and an efficient communication between team members contributed to an effective, safe and high-quality performance when facing patients subjected to ECMO. Conclusion: An appropriate nursing approach is essential to ensure the provision of care with quality, and safety, to the patient subjected to ECMO. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation (ECMO) is an important procedure because it provides assistance to patients suffering from some type of cardiac and/or respiratory condition that prevents them from proper blood circulation. There are mainly two types of ECMO, veno-venous and venoarterial, the first being used in patients with purely respiratory problems. With regard to its evolution, numerous advances have shown an increase in its efficiency in relation to the riskbenefit of the affected, as well as its application in people with acute respiratory diseases such as Acute Respiratory Distress Syndrome (ARDS), which cannot be solved through regular techniques. Basically it is a procedure that is carried out to prevent the cardiopulmonary system from failing, after complications that can make this condition intractable through traditional methods. In relation to ECMO therapy, ARDS is one of the situations that has most led to studies due to its complications that endanger the life of the individual, several analyzes show that this technique is indeed effective as evidenced by the CESAR test, improving the survival of the patient and in general refining the mortality rates. The results of this method have been encouraging, implying a great improvement against mechanical ventilation, however, not everything is positive because it also has difficulties linked to bleeding and nosocomial infection. In general, it is concluded that this technique seeks and in a significant proportion of cases it manages to optimize the condition of life of the person. [ABSTRACT FROM AUTHOR]

Myocarditis is an inflammatory disease of the myocardium. Viral infections are the most common cause, although it can also be due to hypersensitivity reactions and autoimmune etiology, among other causes. The clinical spectrum of the disease is varied, from an asymptomatic course, followed by chest pain, arrhythmias and acute heart failure, to fulminant picture. The term fulminant refers to the development of cardiogenic shock with the need for vasopressor support, inotropic or assisted circulation devices either extracorporeal membrane oxygenation (ECMO) or intra-aortic counterpulsation balloon. About 10% of cases of heart failure due to myocarditis correspond to fulminant myocarditis. Influenza myocarditis has been considered an infrequent condition, however, its incidence has increased since 2009 as a result of the AH1N1 pandemic; otherwise, myocarditis due to Influenza type B remains an infrequent entity. We describe the experience in a cardiovascular center of 2 confirmed cases of fulminant myocarditis due to Influenza B that required circulatory assistance devices. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal membrane oxygenation is a technique indicated in cases of severe respiratory failure or in situations where pump failure or heart failure is refractory to conventional medical treatment. The results of a patient with chronic Chagas dilated cardiomyopathy treated with extracorporeal membrane oxygenation as bridging therapy for heart transplantation are shown. Case report: A 62-year-old male with a history of Chagas disease and severe ventricular failure who underwent veno-arterial extracorporeal membrane oxygenation as bridging therapy for heart transplantation, with satisfactory clinical evolution. Conclusion: Extracorporeal membrane oxygenation is a temporary, viable, safe and effective alternative for patients with severe heart failure refractory to treatment who will undergo transplantation. [ABSTRACT FROM AUTHOR]

Introduction: Mechanical circulatory support provides oxygen to the tissues in patients with cardiac and/or respiratory reversible disease refractory to conventional treatments. Objective: The aim of this study is to show our initial results of mechanical circulatory support in children with heart disease. Method: Retrospective cohort between March 2006 and March 2012. Demographic data (age, sex, weight, cardiac diagnosis), surgery (technique, pump, aortic cross clamping time) and mechanical circulatory support (type of assistance, indication, duration, complications and outcome) were collected. Results: Thirty-three patients were supported (1.3% of all surgeries), extracorporeal membrane oxygenation 32 cases and one ventricular assist device. The median age 7.4 months (one day-18 years) and weight 6 kg (2.3-75). The most frequent cardiac malformations supported were the transpositions of the great arteries associated with other anomalies and the corrected transpositions (ventricular inversion or double discordance). The most common reason for admission was post-cardiotomy biventricular dysfunction. Twenty-eight patients were supported in the postoperative period, 4 in the preoperative period and in one with myocarditis. Median days of support were 3 days (1-10). The most common complications were infection (21%), bleeding (21%). Elective decannulation was achieved in 94% of cases. Hospital discharge survival: 52%. Conclusions: The mechanical circulatory support in our institution is a safe and standard procedure. We have been using it in a small number of cases with a similar survival to that reported internationally. This complex procedure is widely justified because it allows for the recovery of more than half of the patients who otherwise would have died. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation is considered a rescue therapy and complex vital support with benefits in cardiorespiratory diseases during neonatal period that fulfil the characteristics of being reversible in neonates older than 34 weeks. The criteria for patient selection and its prompt use are critical for the final result. Even though new alternatives for management of hypoxemic respiratory failure in full term and almost full term neonates have decreased its use, congenital diaphragmatic hernia continues being a complex disease where it can have some applicability. Even though our experience is beginning, constant training will make of extracorporeal membrane oxygenation an option for complex patients in whom maximum therapy fails. This is a report of the first neonatal cases of hypoxemic respiratory failure managed at Fundación Cardiovascular de Colombia. [ABSTRACT FROM AUTHOR]