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5. Using machine learning to predict neurologic injury in venovenous extracorporeal membrane oxygenation recipients: An ELSO Registry analysis

Author

Kim, Bo Soo, Hager, David, Keller, Steven P., Bush, Errol L., Stephens, R. Scott, Khanduja, Shivalika, Kang, Jin Kook, Chinedozi, Ifeanyi David, Darby, Zachary, Rando, Hannah J., Brown, Trish, Kim, Jiah, Wilcox, Christopher, Leng, Albert, Geeza, Andrew, Akbar, Armaan F., Feng, Chengyuan Alex, Zhao, David, Sussman, Marc, Mendez-Tellez, Pedro Alejandro, Sun, Philip, Capili, Karlo, Riojas, Ramon, Alejo, Diane, Stephen, Scott, Flaster, Harry, Kalra, Andrew, Bachina, Preetham, Shou, Benjamin L., Hwang, Jaeho, Barshay, Meylakh, Kulkarni, Shreyas, Sears, Isaac, Eickhoff, Carsten, Bermudez, Christian A., Brodie, Daniel, Ventetuolo, Corey E., Whitman, Glenn J.R., Abbasi, Adeel, and Cho, Sung-Min

Published
2024
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6. Acute brain injury risk prediction models in venoarterial extracorporeal membrane oxygenation patients with tree-based machine learning: An Extracorporeal Life Support Organization Registry analysis

Author

Kim, Bo Soo, Hager, David, Keller, Steven P., Bush, Errol L., Stephens, R. Scott, Khanduja, Shivalika, Kang, Jin Kook, Chinedozi, Ifeanyi David, Darby, Zachary, Rando, Hannah J., Brown, Trish, Kim, Jiah, Wilcox, Christopher, Leng, Albert, Geeza, Andrew, Akbar, Armaan F., Feng, Chengyuan Alex, Zhao, David, Sussman, Marc, Mendez-Tellez, Pedro Alejandro, Sun, Philip, Capili, Karlo, Riojas, Ramon, Alejo, Diane, Stephen, Scott, Flaster, Harry, Kalra, Andrew, Bachina, Preetham, Shou, Benjamin L., Hwang, Jaeho, Barshay, Meylakh, Kulkarni, Shreyas, Sears, Isaac, Eickhoff, Carsten, Bermudez, Christian A., Brodie, Daniel, Ventetuolo, Corey E., Whitman, Glenn J.R., Abbasi, Adeel, and Cho, Sung-Min

Published
2024
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9. Extracorporeal Membrane Oxygenation Physiological Factors Influence Pulse Oximetry and Arterial Oxygen Saturation Discrepancies

Author

Leng, Albert, Geeza, Andrew, Menta, Arjun Kumar, Akbar, Armaan F., Brodie, Daniel, Hager, David, Alejo, Diane, Bush, Errol L., Rando, Hannah J., Flaster, Harry, Chinedozi, Ifeanyi David, Hwang, Jaeho, Kim, Jiah, Kang, Jin Kook, Capili, Karlo, Sussman, Marc, Mendez-Tellez, Pedro Alejandro, Sun, Philip, Stephens, R. Scott, Rojas, Ramon, Stephen, Scott, Khanduja, Shivalika, Kapoor, Shrey, Feng, Chengyuan Alex, Brown, Trish, Darby, Zachary, Kalra, Andrew, Shou, Benjamin L., Zhao, David, Wilcox, Christopher, Keller, Steven P., Kim, Bo Soo, Whitman, Glenn J.R., and Cho, Sung-Min

Published
2024
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10. Lower Oxygen Tension and Intracranial Hemorrhage in Veno-venous Extracorporeal Membrane Oxygenation

Author

Akbar, Armaan F., Shou, Benjamin L., Feng, Cheng-Yuan, Zhao, David X., Kim, Bo Soo, Whitman, Glenn, and Bush, Errol L.

Subjects
Brain -- Hemorrhage -- Injuries, Blood gases -- Analysis, Health
Abstract

Introduction and Methods We examined the relationship between 24-h pre- and post-cannulation arterial oxygen tension (PaO.sub.2) and arterial carbon dioxide tension (PaCO.sub.2) and subsequent acute brain injury (ABI) in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) with granular arterial blood gas (ABG) data and institutional standardized neuromonitoring. Results Eighty-nine patients underwent VV-ECMO (median age = 50, 63% male). Twenty (22%) patients experienced ABI; intracranial hemorrhage (ICH) was the most common diagnosis (n = 14, 16%). Lower post-cannulation PaO.sub.2 levels were significantly associated with ICH (66 vs. 81 mmHg, p = 0.007) and a post-cannulation PaO.sub.2 level < 70 mmHg was more frequent in these patients (71% vs. 33%, p = 0.007). PaCO.sub.2 parameters were not associated with ABI. By multivariable logistic regression, hypoxemia post-cannulation increased the odds of ICH (OR = 5.06, 95% CI:1.41-18.17; p = 0.01). Conclusion In summary, lower oxygen tension in the 24-h post-cannulation was associated with ICH development. The precise roles of peri-cannulation ABG changes deserve further investigation, as they may influence the management of VV-ECMO patients., Author(s): Armaan F. Akbar [sup.1], Benjamin L. Shou [sup.1], Cheng-Yuan Feng [sup.1] [sup.2] [sup.3] [sup.4], David X. Zhao [sup.1] [sup.2] [sup.3] [sup.4], Bo Soo Kim [sup.3], Glenn Whitman [sup.1], Errol [...]

Published
2023
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16. Early posthospitalization recovery after extracorporeal membrane oxygenation in survivors of COVID-19

Author

Montgomery-Yates, Ashley A., Parker, Ann M., Teman, Nicholas R., Hoffman, Jordan, Bartels, Karsten, Kim, Bo Soo, Cho, Sung-Min, Hippensteel, Joseph A., Taylor, Lauren J., Jolley, Sarah E., Ramani, Chintan, Mayer, Kirby P., Etchill, Eric W., Mart, Matthew F., Fakhri, Shoaib, Peterson, Skyler, Colborn, Kathryn, Sevin, Carla M., Kadl, Alexandra, Enfield, Kyle, Whitman, Glenn J.R., Zwischenberger, Joseph B., and Rove, Jessica Y.

Published
2023
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24. Transcranial Doppler microemboli and acute brain injury in extracorporeal membrane oxygenation: A prospective observational study

Author

Zhang, Lucy Q., Mayasi, Yunis, Gusdon, Aaron, Ergin, Bahattin, Keller, Steven, Acton, Matthew, Rando, Hannah, Alejo, Diane, Calligy, Kate, Anderson, Scott, Shou, Benjamin, Mendez-Tellez, Pedro A., Chang, Henry, Sussman, Marc, Wilcox, Christopher, Brown, Patricia, Peeler, Anna, Caturegli, Giorgio, Kapoor, Shrey, Ponomarev, Vladimir, Kim, Bo Soo, Whitman, Glenn J.R., Ziai, Wendy, and Cho, Sung-Min

Published
2022
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26. Translational design for limited resource settings as demonstrated by Vent-Lock, a 3D-printed ventilator multiplexer

Author

Xun, Helen, Shallal, Christopher, Unger, Justin, Tao, Runhan, Torres, Alberto, Vladimirov, Michael, Frye, Jenna, Singhala, Mohit, Horne, Brockett, Kim, Bo Soo, Burke, Broc, Montana, Michael, Talcott, Michael, Winters, Bradford, Frisella, Margaret, Kushner, Bradley S., Sacks, Justin M., Guest, James K., Kang, Sung Hoon, and Caffrey, Julie

Published
2022
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28. Challenges in determining death by neurologic criteria in extracorporeal membrane oxygenation – A single center experience.

Author

Zhao, David X, Caturegli, Giorgio, Wilcox, Christopher, Stephens, R Scott, Kim, Bo Soo, Keller, Steven, Geocadin, Romergryko G, Suarez, Jose I, Whitman, Glenn JR, and Cho, Sung-Min

Subjects
NEUROLOGIC examination, PEARSON correlation (Statistics), EXTRACORPOREAL membrane oxygenation, PATIENT safety, RESEARCH funding, SCIENTIFIC observation, ELECTROENCEPHALOGRAPHY, TERMINATION of treatment, TERTIARY care, RETROSPECTIVE studies, MANN Whitney U Test, CHI-squared test, DESCRIPTIVE statistics, BRAIN death, LONGITUDINAL method, TRANSCRANIAL Doppler ultrasonography, MEDICAL records, ACQUISITION of data, LIFE support systems in critical care, DIAGNOSIS of brain abnormalities, PATIENT monitoring, DATA analysis software, ADULTS
Abstract

Introduction: Apnea test (AT) in patients on extracorporeal membrane oxygenation (ECMO) support is challenging, leading to variation in determining death by neurologic criteria (DNC). We aim to describe the diagnostic criteria and barriers for DNC in adults on ECMO in a tertiary care center. Methods: A retrospective review of a prospective observational standardized neuromonitoring study was conducted in adult VA- and VV-ECMO patients at a tertiary center from June 2016 to March 2022. Brain death was defined according to the 2010 American Academy of Neurology guidelines and following the 2020 World Brain Death Project recommendations for performing AT in ECMO patients. Results: Eight (2.7%) ECMO patients (median age = 44 years, 75% male, 50% VA-ECMO) met criteria for DNC, six (75%) of whom were determined with AT. In the other two patients who did not undergo AT due to safety concerns, ancillary tests (transcranial doppler and electroencephalography) were consistent with DNC. An additional seven (2.3%) patients (median age = 55 years, 71% male, 86% VA-ECMO) were noted to have absent brainstem reflexes but failed to complete determination of DNC as they underwent withdrawal of life-sustaining treatment (WLST) before a full evaluation was completed. In these patients, AT was never performed, and ancillary tests were inconsistent with either neurological exam findings and/or neuroimaging supporting DNC, or with each other. Conclusion: AT was used safely and successfully in 6 of the 8 ECMO patients diagnosed with DNC and was always consistent with the neurological exam and imaging findings, as opposed to ancillary tests alone. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Detection of Acute Brain Injury in Intensive Care Unit Patients on ECMO Support Using Ultra-Low-Field Portable MRI: A Retrospective Analysis Compared to Head CT

Author

Cho, Sung-Min, primary, Khanduja, Shivalika, additional, Kim, Jiah, additional, Kang, Jin Kook, additional, Briscoe, Jessica, additional, Arlinghaus, Lori R., additional, Dinh, Kha, additional, Kim, Bo Soo, additional, Sair, Haris I., additional, Wandji, Audrey-Carelle N., additional, Moreno, Elena, additional, Torres, Glenda, additional, Gavito-Higuera, Jose, additional, Choi, Huimahn A., additional, Pitts, John, additional, Gusdon, Aaron M., additional, and Whitman, Glenn J., additional

Published
2024
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33. Using machine learning to predict neurologic injury in venovenous extracorporeal membrane oxygenation recipients: An ELSO Registry analysis

Author

Kalra, Andrew, Bachina, Preetham, Shou, Benjamin L., Hwang, Jaeho, Barshay, Meylakh, Kulkarni, Shreyas, Sears, Isaac, Eickhoff, Carsten, Bermudez, Christian A., Brodie, Daniel, Ventetuolo, Corey E., Whitman, Glenn J.R., Abbasi, Adeel, Cho, Sung-Min, Kim, Bo Soo, Hager, David, Keller, Steven P., Bush, Errol L., Stephens, R. Scott, Khanduja, Shivalika, Kang, Jin Kook, Chinedozi, Ifeanyi David, Darby, Zachary, Rando, Hannah J., Brown, Trish, Kim, Jiah, Wilcox, Christopher, Leng, Albert, Geeza, Andrew, Akbar, Armaan F., Feng, Chengyuan Alex, Zhao, David, Sussman, Marc, Mendez-Tellez, Pedro Alejandro, Sun, Philip, Capili, Karlo, Riojas, Ramon, Alejo, Diane, Stephen, Scott, and Flaster, Harry

Abstract

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with acute brain injury (ABI), including central nervous system (CNS) ischemia (defined as ischemic stroke or hypoxic-ischemic brain injury [HIBI]) and intracranial hemorrhage (ICH). Data on prediction models for neurologic outcomes in VV-ECMO are limited.

Published
2024
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34. Extracorporeal Membrane Oxygenation Physiological Factors Influence Pulse Oximetry and Arterial Oxygen Saturation Discrepancies.

Author

Kalra, Andrew, Shou, Benjamin L., Zhao, David, Wilcox, Christopher, Keller, Steven P., Kim, Bo Soo, Whitman, Glenn J.R., and Cho, Sung-Min

Abstract

Cannulation strategy, vasopressors, and hemolysis are important physiological factors that influence hemodynamics in extracorporeal membrane oxygenation (ECMO). We hypothesized these factors influence the discrepancy between oxygen saturation measured by pulse oximetry (Sp o 2) and arterial blood gas (Sa o 2) in patients on ECMO. We retrospectively analyzed adults (aged ≥18 years) on venoarterial or venovenous ECMO at a tertiary academic ECMO center. Sp o 2 −Sa o 2 pairs with oxygen saturation ≥70% and measured within 10 minutes were included. Occult hypoxemia was defined as Sa o 2 ≤88% with a time-matched Sp o 2 ≥92%. Adjusted linear mixed-effects modeling was used to assess the Sp o 2 −Sa o 2 discrepancy with preselected demographics and time-matched laboratory variables. Vasopressor use was quantified by vasopressor dose equivalences. Of 139 venoarterial-ECMO and 88 venovenous-ECMO patients, we examined 20,053 Sp o 2 −Sa o 2 pairs. The Sp o 2 −Sa o 2 discrepancy was greater in venovenous-ECMO (1.15%) vs venoarterial-ECMO (−0.35%, P <.001). Overall, 81 patients (35%) experienced occult hypoxemia during ECMO. Occult hypoxemia was more common in venovenous-ECMO (65%) than in venoarterial-ECMO (17%, P <.001). In linear mixed-effects modeling, Sp o 2 underestimated Sa o 2 by 9.48% in central vs peripheral venoarterial-ECMO (95% CI, −17.1% to −1.79%; P =.02). Higher vasopressor dose equivalences significantly worsened the Sp o 2 −Sa o 2 discrepancy (P <.001). In linear mixed-effects modeling, Sp o 2 overestimated Sa o 2 by 25.43% in single lumen–cannulated vs double lumen–cannulated venovenous-ECMO (95% CI, 5.27%-45.6%; P =.03). Higher vasopressor dose equivalences and lactate dehydrogenase levels significantly worsened the Sp o 2 −Sa o 2 discrepancy (P <.001). Venovenous-ECMO patients are at higher risk for occult hypoxemia compared with venoarterial-ECMO. A higher vasopressor requirement and different cannulation strategies (central venoarterial-ECMO; single-lumen venovenous-ECMO) were significant factors for clinically significant Sp o 2 −Sa o 2 discrepancy in both ECMO modes. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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35. Resting Energy Expenditure of Patients on Venovenous Extracorporeal Membrane Oxygenation for Adult Respiratory Distress Syndrome: A Pilot Study

Author

Ong, Chin Siang, Brown, Patricia, Shou, Benjamin L., Wilcox, Christopher, Cho, Sung-Min, Mendez-Tellez, Pedro Alejandro, Kim, Bo Soo, Whitman, Glenn J. R., Whitman, Glenn J. R., Cho, Sung-Min, Acton, Matthew, Rando, Hannah, Alejo, Diane, Calligy, Kate, Anderson, Scott, Sussman, Marc, and Wilcox, Christopher

Published
2022
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36. Clinical Use of Bedside Portable Low-field Brain Magnetic Resonance Imaging in Patients on ECMO: The Results from Multicenter SAFE MRI ECMO Study

Author

Cho, Sung-Min, primary, Khanduja, Shivalika, additional, Wilcox, Christopher, additional, Dinh, Kha, additional, Kim, Jiah, additional, Kang, Jin Kook, additional, Chinedozi, Ifeanyi David, additional, Darby, Zachary, additional, Acton, Matthew, additional, Rando, Hannah, additional, Briscoe, Jessica, additional, Bush, Errol, additional, Sair, Haris I, additional, Pitts, John, additional, Arlinghaus, Lori R, additional, Wandji, Audrey-Carelle N, additional, Moreno, Elena, additional, Torres, Glenda, additional, Akkanti, Bindu, additional, Gavito-Higuera, Jose, additional, Keller, Steven, additional, Choi, HuiMahn A, additional, Kim, Bo Soo, additional, Gusdon, Aaron, additional, and Whit, Glenn JR, additional

Published
2024
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38. Characterizing the Racial Discrepancy in Hypoxemia Detection in VV-ECMO: An ELSO Registry Analysis

Author

Kalra, Andrew, primary, Wilcox, Christopher, additional, Holmes, Sari D, additional, Tonna, Joseph E, additional, Jeong, In Seok, additional, Rycus, Peter, additional, Anders, Marc M, additional, Zaaqoq, Akram M, additional, Lorusso, Roberto, additional, Brodie, Daniel, additional, Keller, Steven P., additional, Kim, Bo Soo, additional, Whitman, Glenn J R, additional, and Cho, Sung-Min, additional

Published
2023
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39. Continuous Monitoring of Cerebral Autoregulation in Adults Supported by Extracorporeal Membrane Oxygenation

Author

Zhang, Lucy Q, primary, Chang, Henry, additional, Kalra, Andrew, additional, Humayun, Mariyam, additional, Rosenblatt, Kathryn R, additional, Shah, Vishank A, additional, Geocadin, Romergryko G, additional, Brown, Charles H, additional, Kim, Bo Soo, additional, Wh, Glenn J.R., additional, Rivera-Lara, Lucia, additional, and Cho, Sung-min, additional

Published
2023
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41. Extracorporeal Membrane Oxygenation Physiological Factors Influence Pulse Oximetry and Arterial Oxygen Saturation Discrepancies

Author

Kalra, Andrew, primary, Shou, Benjamin L., additional, Zhao, David, additional, Wilcox, Christopher, additional, Keller, Steven P., additional, Kim, Bo Soo, additional, Whitman, Glenn J.R., additional, Cho, Sung-Min, additional, Leng, Albert, additional, Geeza, Andrew, additional, Menta, Arjun Kumar, additional, Akbar, Armaan F., additional, Brodie, Daniel, additional, Hager, David, additional, Alejo, Diane, additional, Bush, Errol L., additional, Rando, Hannah J., additional, Flaster, Harry, additional, Chinedozi, Ifeanyi David, additional, Hwang, Jaeho, additional, Kim, Jiah, additional, Kang, Jin Kook, additional, Capili, Karlo, additional, Sussman, Marc, additional, Mendez-Tellez, Pedro Alejandro, additional, Sun, Philip, additional, Stephens, R. Scott, additional, Rojas, Ramon, additional, Stephen, Scott, additional, Khanduja, Shivalika, additional, Kapoor, Shrey, additional, Feng, Chengyuan Alex, additional, Brown, Trish, additional, and Darby, Zachary, additional

Published
2023
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42. Early posthospitalization recovery after extracorporeal membrane oxygenation in survivors of COVID-19

Author

Taylor, Lauren J., primary, Jolley, Sarah E., additional, Ramani, Chintan, additional, Mayer, Kirby P., additional, Etchill, Eric W., additional, Mart, Matthew F., additional, Fakhri, Shoaib, additional, Peterson, Skyler, additional, Colborn, Kathryn, additional, Sevin, Carla M., additional, Kadl, Alexandra, additional, Enfield, Kyle, additional, Whitman, Glenn J.R., additional, Zwischenberger, Joseph B., additional, Rove, Jessica Y., additional, Montgomery-Yates, Ashley A., additional, Parker, Ann M., additional, Teman, Nicholas R., additional, Hoffman, Jordan, additional, Bartels, Karsten, additional, Kim, Bo Soo, additional, Cho, Sung-Min, additional, and Hippensteel, Joseph A., additional

Published
2023
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45. Risk Factors of Ischemic and Hemorrhagic Strokes During Venovenous Extracorporeal Membrane Oxygenation: Analysis of Data From the Extracorporeal Life Support Organization Registry

Author

Cho, Sung-Min, Canner, Joe, Caturegli, Giorgio, Choi, Chun Woo, Etchill, Eric, Giuliano, Katherine, Chiarini, Giovanni, Calligy, Kate, Rycus, Peter, Lorusso, Roberto, Kim, Bo Soo, Sussman, Marc, Suarez, Jose I., Geocadin, Romergryko, Bush, Errol L., Ziai, Wendy, and Whitman, Glenn

Published
2021
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47. Racial and ethnical discrepancy in hypoxemia detection in patients on extracorporeal membrane oxygenation

Author

Kalra, Andrew, primary, Shou, Benjamin L., additional, Zhao, David, additional, Wilcox, Christopher, additional, Keller, Steven P., additional, Whitman, Glenn J.R., additional, Kim, Bo Soo, additional, Cho, Sung-Min, additional, Calligy, Kate, additional, Brown, Patricia, additional, Alejo, Diane, additional, Anderson, Scott, additional, Acton, Matthew, additional, Rando, Hannah, additional, and Chang, Henry, additional

Published
2023
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48. Ketamine infusion for sedation in a patient on extracorporeal membrane oxygenation (ECMO).

Author

Farrokh, Salia, Kim, Bo Soo, and Cho, Sung-Min

Subjects
*DRUG efficacy, *PROPOFOL, *INTRAVENOUS therapy, *ANESTHESIA, *RESPIRATORY insufficiency, *CRITICALLY ill, *EXTRACORPOREAL membrane oxygenation, *AGITATION (Psychology), *PATIENTS, *SURGERY, *LUNG tumors, *THORACOTOMY, *SURGICAL complications, *FENTANYL, *IMIDAZOLES, *KETAMINE, *DRUG therapy, *TERMINATION of treatment, *VECURONIUM bromide, *EVALUATION
Abstract

Introduction: we sought to explore the efficacy of ketamine in a patient on extracorporeal membrane oxygenation (ECMO) receiving ketamine for sedation by investigating the utility of plasma ketamine concentrations. Case report: retrospective chart review of one critically ill patient on ECMO Discussion: This was a descriptive review of serial plasma ketamine concentrations in an ECMO patient. Although no reference plasma concentrations exist in ECMO patients, ketamine levels appeared to be lower than those seen in surgical patients not on ECMO. Conclusion: At this point, no reference plasma concentrations exist for ketamine in ECMO patients, further research may help understand the effects of ECMO on ketamine disposition and that lower ketamine concentrations may be used for effective analgesia or sedation. [ABSTRACT FROM AUTHOR]

Published
2024
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50. National Trends, Risk Factors, and Outcomes of Acute In-hospital Stroke After Lung Transplantation in the United States: Analysis of the United Network for Organ Sharing Registry

Author

Shou, Benjamin L., primary, Wilcox, Christopher, additional, Florissi, Isabella, additional, Krishnan, Aravind, additional, Kim, Bo Soo, additional, Keller, Steven P., additional, Whitman, Glenn J.R., additional, Uchino, Ken, additional, Bush, Errol L., additional, and Cho, Sung-Min, additional

Published
2023
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