The International journal of artificial organs
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Miniaturisation of VADs can offer important benefits, including less invasive implantation techniques and more versatility in patient selection. The aim of this work was to reduce the weight, size, and energy consumption of the Sputnik VAD. ⋯ The pump weight was reduced from 246 to 205 g, the pump length was decreased from 82 to 66 mm, and the pump diameter was decreased from 32 to 29 mm. The total energy consumption of the pump was reduced by 15%.
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Data on prolonged extracorporeal membrane oxygenation (ECMO) usage in influenza associated acute respiratory distress syndrome (ARDS) are lacking. Furthermore, no consensus exists on when to terminate ECMO treatment in refractory cases. This report highlights additional treatment measures and complications in prolonged ECMO therapy and discusses associated ethical burdens. ⋯ Our experience suggests that prolonged ECMO therapy may be provided as long as only 1-organ failure exists and no lung fibrosis occurs. Active physical therapy, facilitated by ECMO treatment, is crucial and should be performed as early as possible.
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In current rotary blood pumps, complications related to blood trauma due to shear stresses are still frequently observed clinically. Reducing the rotor tip speed might decrease blood trauma. Therefore, the aim of this project was to design a two-stage rotary blood pump leading to lower shear stresses. ⋯ Hence, blood trauma might be reduced with this design. Based on these encouraging results, future in vitro investigations to investigate actual blood damage are intended.
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Low cardiac output syndrome is associated with significant mortality. In patients with refractory low cardiac output left ventricular assist devices (VAD) are used to re-establish cardiac output and to prevent death. However, long-term LVAD implantation in these is complicated by a high rate of right heart failure and mortality. Therefore, our strategy is to implant a short-term VAD (left or biventricular) as a bridge to decission. ⋯ Thanks to its capacity for full ventricular support, short-term univentricular or biventricular LevotronixCentriMag VAD currently represents an ideal solution for bridge-to-decision.
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Case Reports
Veno-veno-arterial ECMO support for acute myocarditis combined with ARDS: a case report.
In patients who developed a combined situation of severe acute respiratory distress syndrome with refractory hypoxemia and acute cardiac failure with circulatory collapse, traditional veno-venous or veno-arterial extracorporeal membrane oxygenation approach alone may not be sufficient enough to maintain both an acceptable range of gas exchange and a hemodynamic stability. ⋯ Although there is no consensus about the veno-veno-arterial mode of extracorporeal membrane oxygenation, this combined mode can be helpful in patients with acute refractory respiratory and cardiac failure, as shown in the present case. We need further experience and improvements in the circuit system used in the veno-veno-arterial mode of ECMO.