Artificial organs
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The utility of extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) of noninfectious origin remains unclear. Data on patients with ARDS of noninfectious origin who underwent ECMO were reviewed retrospectively. We compared the pre-ECMO characteristics and hospital outcomes of patients with traumatic and nontraumatic ARDS. ⋯ Additionally, a history of hypertension and an elevated pre-ECMO SAPS II were significant risk factors for serious neurological outcomes among hospital survivors (n = 18). In conclusion, ECMO support can be associated with favorable outcomes in patients with ARDS of noninfectious origin, irrespective of whether the ARDS is associated with trauma. The pre-ECMO SAPS II and a history of hypertension may be independent risk factors for poor outcomes.
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Currently, blood pressure (BP) measurement is obtained noninvasively in patients with continuous flow left ventricular assist device (LVAD) by placing a Doppler probe over the brachial or radial artery with inflation and deflation of a manual BP cuff. We hypothesized that replacing the Doppler probe with a finger-based pulse oximeter can yield BP measurements similar to the Doppler derived mean arterial pressure (MAP). We conducted a prospective study consisting of patients with contemporary continuous flow LVADs. ⋯ In phase I, the average MAP measured by pulse oximeter was closer to arterial line MAP rather than Doppler (P = 0.06) or ABP (P < 0.01). In phase II, pulse oximeter MAP (96.6 mm Hg) was significantly closer to Doppler MAP (96.5 mm Hg) when compared to ABP (82.1 mm Hg) (P = 0.0001). Pulse oximeter derived blood pressure measurement may be as reliable as Doppler in patients with continuous flow LVADs.