Perfusion
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Extracorporeal membrane oxygenation (ECMO) in patients with severe pulmonary failure is able to keep patients alive until organ regeneration, until shunting out for further diagnostic and therapeutic options or until transportation to specialized centers. Nonetheless, extracorporeal techniques require a high degree of expertise, so that a confinement to specialized centers is meaningful. Following from this requirement, the need for inter-hospital transfer of patients with severely compromised pulmonary function is rising. ⋯ Our experience demonstrates that miniaturized, portable ECMO therapy allows location-independent, out-of-center stabilization of pulmonary compromised patients with consecutive inter-hospital transfer and further in-house treatment, so that sophisticated ECMO therapy can be offered to every patient, even in hospitals with primary healthcare.
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Extracorporeal membrane oxygenation (ECMO) is a means of life support for failing patients who require extreme life-saving measures due to failure of their heart, lungs or both organs. In a patient suffering cardiac arrest, the faster circulation via cardiopulmonary resuscitation (CPR) can be instituted the better the outcome is. If an ECMO circuit needs to be built and primed it may add significant minutes to the response time. ⋯ This, in turn, may lead to decreased response time, with an arrest and the placement of the arresting patient on ECMO. Five ECMO circuits were set up, primed and sampled for bacterial growth at 0, 24, 48 and 72 hours and then at one-week intervals, with an end point of four weeks. No bacterial growth was found at any point during the sampling process.
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Cerebral oxygenation monitoring via near-infrared spectroscopy (NIRS) during cardiopulmonary bypass (CPB) is increasingly becoming an accepted and valued component of intraoperative monitoring. In recent years, new devices have become available which all make different claims. The purpose of this study is to examine the research on these individual devices to establish the levels of evidence for each and formulate a research path for further evaluation of this technology in cardiac surgery. ⋯ At this time, there is limited high-level evidence available for all of the NIRS devices on the market despite significant outcomes found in these studies. Additional prospective randomized studies should be conducted in order to establish the potential role NIRS may play in patient monitoring as well as assessing the efficacy of the multiple devices on the market.