ASAIO journal : a peer-reviewed journal of the American Society for Artificial Internal Organs
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The purpose of this study was to retrospectively summarize and analyze the data of 99 cases with the application of consecutive extracorporeal membrane oxygenation (ECMO) from December 2004 to August 2008 in Fuwai Hospital. The intersurface of the ECMO equipment system was completely heparin coated. All patients received venoarterial ECMO, and the activated clotting time was maintained between 120 and 180 seconds. ⋯ Total discharge rate was 54.5%. ECMO is an effective mechanical assistant therapy for cardiac and pulmonary failure after cardiac surgery. Earlier use of ECMO for heart lung failure patients and avoidance of irreversible damage to the main organs are still the key points in the success of ECMO.
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Transfusion for hemorrhagic shock can improve oxygenation, but immunoreactions may induce inflammation. Artificial oxygen carriers have been developed to address clinical concerns of infection and stability, but whether an artificial oxygen carrier might induce inflammation is not well known. To address this question, we compared inflammatory reactions after resuscitation with hemoglobin vesicles (HbVs) or red blood cells (RBCs) in a hemorrhagic shock rat model. ⋯ In rats resuscitated with HbVs, mRNA levels of TNF-alpha and HO-1 2 h after resuscitation were significantly higher than those in the rat RBC group, but the levels at 24 h were similar in both groups. The expression of iNOS and ICAM-1, second messengers of inflammation, was not affected, and inflammatory levels after 24 h with HbVs are similar to rat RBC transfusion. The rat RBC group did not show an expected inflammatory reaction related to a transfusion-induced lung injury, and a clinical relevance concerning this level of transient inflammatory reaction induced by HbVs is not known; however, attention to the early stage of resuscitation in ongoing studies of HbV is required.