The International journal of artificial organs
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Left ventricular assist devices (LVAD) are an effective therapeutic option for end-stage heart failure (HF). Reduced heart rate variability (HRV) as a result of autonomic derangement is evident in chronic heart failure and several studies have established the independent prognostic value of HRV in chronic heart failure. ⋯ In end-stage heart failure patients autonomic imbalance indicated by severely reduced heart rate variability is restored after LVAD implantation with unloading of the failing heart.
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Growing clinical experience and improved technology have led to more widespread use of ventricular assist devices in patients with end-stage heart failure. ⋯ This is the first report describing successful clinical use of the AB5000 assist device in combination with the portable console. Furthermore, it underlines the potential of temporary circulatory support to induce permanent myocardial recovery even in cases of preexisting cardiomyopathy.
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To explore whether bioartificial kidney (BAK) ameliorates cytokine response and biochemical indices, and prolongs the survival time in acute uremic pigs with multiple organ dysfunction syndrome (MODS). ⋯ The addition of renal tubule cell therapy to hemofiltration in an acutely uremic animal model with MODS altered systemic cytokine balance, ameliorated MAP, and prolonged survival time.
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Randomized Controlled Trial Comparative Study
Clinical evaluation of five commercially available adult oxygenators in terms of pressure drop during normothermic and hypothermic cardiopulmonary bypass.
It is well documented that trans-membrane pressure drop (TMPD) of hollow-fiber membrane oxygenators (HFMO) may lead to hemolysis, damage to platelets, and systemic inflammatory response. The purpose of this study was to evaluate five commercially available adult oxygenators in terms of pressure drop during normothermic and hypothermic cardiopulmonary bypass (CPB). ⋯ These results suggest that the HFMOs in groups J and A produced significantly lower TMPDs and pre- and post-oxygenator extracorporeal circuit pressures during normothermic and hypothermic CPB.
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Adaptive support ventilation (ASV) is a microprocessor-controlled, closed-loop mode of mechanical ventilation that adapts respiratory rates and tidal volumes (V(T)s) based on the Otis least work of breathing formula. We studied calculated V(T)s in a computer simulation model, and V(T)s delivered in a test lung setting as well as in clinical practice. ⋯ The ASV performed as intended, bearing in mind that the ASV algorithm was originally designed to provide V(T)s between 8 and 12 ml/kg. However, the V(T)s that were calculated and delivered were frequently higher than those presently recommended in the guidelines. Considering the size of V(T) delivered in the setting of ALI using an open lung approach as well as in the setting of COPD, we feel caution should be taken when applying ASV in patients with these conditions.