The International journal of artificial organs
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Severe acute pancreatitis (SAP) is associated with systemic inflammation, immunoparalysis, and sepsis, and may lead to vital organ failure and death. We evaluated the efficacy of serum interleukin 17 (IL-17) concentration for predicting eventual SAP severity and the clinical benefits of removing IL-17 by continuous veno-venous hemofiltration (CVVH). ⋯ Earlier and higher serum IL-17 elevation predicted prolonged hospitalization, organ failure, and death, possibly by disrupting gut barrier function. CVVH can remove inflammatory cytokines from serum, including IL-17 and IL-6, thereby attenuating the inflammatory response and diminishing associated systemic complications.
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Miniaturization and surgical progress in the field of ventricular assist device (VAD) therapy will lead to an increasing use in grown-up patients with congenital heart disease (GUCH). VAD implantation in such patients, especially biventricular VAD (BVAD) placement, can be very challenging, potentially associated with high morbidity and mortality. ⋯ We present our institutional strategy for VAD selection in these patients and highlight intra-corporeal VAD implantation technique.