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Original Articles
- Thoracic Surgery
- How small is enough for the left heart decompression cannula during extracorporeal membrane oxygenation?
- Sua Kim, Jin Seok Kim, Jae Seung Shin, Hong Ju Shin
- Acute Crit Care. 2019;34(4):263-268. Published online November 29, 2019
- DOI: https://doi.org/10.4266/acc.2019.00577
- 6,262 View
- 139 Download
- 8 Web of Science
- 8 Crossref
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Abstract
PDF - Background
Left ventricular (LV) distension is a recognizable problem accompanied by subsequent complications during venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, no gold standard for LV decompression has been established, and no minimal flow requirement has been designated. Thus, we evaluated the efficacy of the 8-Fr Mullins sheath for left heart decompression during VA-ECMO in adult patients.
Methods
Left heart decompression was performed when severe pulmonary edema was detected on chest radiography or when no generation of pulse pressure followed severe LV dysfunction in patients receiving VA-ECMO. We punctured the interatrial septum and inserted an 8-Fr Mullins sheath into the left atrium via the femoral vein. The sheath was connected to the venous catheter used for ECMO. The catheter was maintained during VA-ECMO.
Results
The left heart decompression procedure was performed in seven of 35 patients who received VA-ECMO between February 2017 and June 2018. Three patients had acute myocardial infarction; three, fulminant myocarditis; and one, dilated cardiomyopathy. Four patients showed noticeable improvement of pulmonary edema within 3 days, and three patients with a pulse pressure of <10 mm Hg showed an increase in pulse pressure of >20 mm Hg within 24 hours from the left heart decompression procedure. All seven patients were successfully weaned from VA-ECMO. No complications related to the left heart decompression procedure occurred.
Conclusions
An 8-Fr sheath may be a possible option for left heart decompression in adult patients with LV distension under VA-ECMO who are expecting recovery of LV function. -
Citations
Citations to this article as recorded by
- Venting during venoarterial extracorporeal membrane oxygenation
Enzo Lüsebrink, Leonhard Binzenhöfer, Antonia Kellnar, Christoph Müller, Clemens Scherer, Benedikt Schrage, Dominik Joskowiak, Tobias Petzold, Daniel Braun, Stefan Brunner, Sven Peterss, Jörg Hausleiter, Sebastian Zimmer, Frank Born, Dirk Westermann, Holg
Clinical Research in Cardiology.2023; 112(4): 464. CrossRef - Hemodynamic Management During Veno-Arterial Extracorporeal Membrane Oxygenation in Patients with Cardiogenic Shock: A Review
Chengfen Yin, Lei Xu
Intensive Care Research.2023; 3(2): 131. CrossRef - Satisfactory outcome with activated clotting time <160 seconds in extracorporeal cardiopulmonary resuscitation
Beong Ki Kim, Jeong In Hong, Jinwook Hwang, Hong Ju Shin
Medicine.2022; 101(37): e30568. CrossRef - Outcomes of left ventricular unloading with a transseptal cannula during extracorporeal membrane oxygenation in adults
Ah‐Ram Kim, Hanbit Park, Sang‐Eun Lee, Jung‐Min Ahn, Duk‐Woo Park, Seung‐Whan Lee, Jae‐Joong Kim, Seung‐Jung Park, Jung Ae Hong, Pil‐Je Kang, Sung‐Ho Jung, Min‐Seok Kim
Artificial Organs.2021; 45(4): 390. CrossRef - Surgical minimal invasive left atrial decompression during venoarterial extracorporeal membrane oxygenation for pediatric acute fulminant myocarditis
Li Fen Ye, Qiang Shu, Chenmei Zhang, Yong Fan, Liyang Ying, Lijun Yang, Ru Lin
World Journal of Pediatric Surgery.2021; 4(4): e000291. CrossRef - Increasing venoarterial extracorporeal membrane oxygenation flow puts higher demands on left ventricular work in a porcine model of chronic heart failure
Pavel Hála, Mikuláš Mlček, Petr Ošťádal, Michaela Popková, David Janák, Tomáš Bouček, Stanislav Lacko, Jaroslav Kudlička, Petr Neužil, Otomar Kittnar
Journal of Translational Medicine.2020;[Epub] CrossRef - Advanced Pulmonary and Cardiac Support of COVID-19 Patients
Keshava Rajagopal, Steven P. Keller, Bindu Akkanti, Christian Bime, Pranav Loyalka, Faisal H. Cheema, Joseph B. Zwischenberger, Aly El Banayosy, Federico Pappalardo, Mark S. Slaughter, Marvin J. Slepian
Circulation: Heart Failure.2020;[Epub] CrossRef - Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO—A “Living Working Document”
Keshava Rajagopal, Steven P. Keller, Bindu Akkanti, Christian Bime, Pranav Loyalka, Faisal H. Cheema, Joseph B. Zwischenberger, Aly El Banayosy, Federico Pappalardo, Mark S. Slaughter, Marvin J. Slepian
ASAIO Journal.2020; 66(6): 588. CrossRef
- Venting during venoarterial extracorporeal membrane oxygenation
- Epidemiological Characteristics Based on the Underlying Diseases for the Deaths Related to Pandemic H1N1 Influenza in Korea
- Hagyung Lee, Yung A Kang, Hyun Su Kim, Su Yeun Shin, Jun Heung Kim, Jin Seok Kim, Sang Bum Hong
- Korean J Crit Care Med. 2010;25(2):83-88.
- DOI: https://doi.org/10.4266/kjccm.2010.25.2.83
- 3,106 View
- 62 Download
- 3 Crossref
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Abstract
PDF
- BACKGROUND
Since May 2009, a pandemic influenza A (H1N1) virus has emerged and spread nationwide. We describe the epidemiological characteristics of the confirmed deaths related with the 2009 H1N1 influenza pandemic in Korea from May 2009 to mid December 2009.
METHODS
This study was based on an analysis of the reports from the deaths of confirmed cases pandemic H1N1 virus until 7 December 2009 in Korea. These reports were compiled by the epidemic intelligence team at the Korea Centers for Disease Control & Prevention (KCDC) or at the provinces. The epidemic intelligence team used an identical, well-defined investigate form for reviewing the medical records and for interviewing the physicians in charge of the cases.
RESULTS
The first confirmed death occurred on August 15, 2009. Until December 7, 2009, 139 deaths had been reported. Eighty cases (57.6%) were individuals more than 60 years old. Sixty two cases (47.0%) were dead within 7 days from the onset of symptoms. One hundred three cases (74%) had underlying diseases, and cancer was the most common underlying disease. The proportion of patients using antivial medications before confirmation among the patients with underlying diseases was greater than the proportion of patients using antivial medications among the patients with no underlying diseases.
CONCLUSIONS
During the evaluation period, serious underlying diseases were present in nearly three quarters of the cases of confirmed death. We suggest that health providers consider using antiviral drugs before confirmation of pandemic H1N1 in hospitalized patients, and especially in those with underlying diseases. -
Citations
Citations to this article as recorded by- Clinical Features of Hospitalized Patients with Community Acquired Pneumonia during 2009 Influenza A (H1N1) Pandemic
Myung Jae Yun, Seong Tae Lee, Hye Jin Oh, Seung June Lee, Sook Hee Song, In Sohn, Jae Phil Choi, Su Hyun Kim
The Korean Journal of Critical Care Medicine.2011; 26(3): 162. CrossRef - Pandemic Influenza (H1N1 2009) among Pregnant Korean Women
Baek-Nam Kim, Yee Gyung Kwak, Chi-Sook Moon, Yeon-Sook Kim, Eu Suk Kim, Kkot Sil Lee, Chang-Seop Lee, Ji-An Hur
Infection & Chemotherapy.2011; 43(1): 55. CrossRef - A Fatal Case in Pregnant Woman Infected by H1N1 2009 in Korea
Ji An Hur
Infection and Chemotherapy.2011; 43(2): 225. CrossRef
- Clinical Features of Hospitalized Patients with Community Acquired Pneumonia during 2009 Influenza A (H1N1) Pandemic
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