ASAIO journal : a peer-reviewed journal of the American Society for Artificial Internal Organs
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Although heart failure with reduced ejection fraction (HFrEF) is a common clinical syndrome and can be modified by the administration of appropriate medical therapy, there is no adequate tool available to perform reliable, economical, early-stage screening. To meet this need, we developed an interpretable artificial intelligence (AI) algorithm for HFrEF screening using electrocardiography (ECG) and validated its performance. This retrospective cohort study included two hospitals. ⋯ During the internal and external validation, the areas under the curves of the AI algorithm using a 12 lead ECG for detecting HFrEF were 0.913 (95% confidence interval, 0.902-0.925) and 0.961 (0.951-0.971), respectively, and the areas under the curves of the AI algorithm using a single-lead ECG were 0.874 (0.859-0.890) and 0.929 (0.911-0.946), respectively. The deep learning-based AI algorithm performed HFrEF detection well using not only a 12 lead but also a single-lead ECG. These results suggest that HFrEF can be screened not only using a 12 lead ECG, as is typical of a conventional ECG machine, but also with a single-lead ECG performed by a wearable device employing the AI algorithm, thereby preventing irreversible disease progression and mortality.
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The coronavirus disease 2019 (COVID-19) pandemic has placed extraordinary strain on global healthcare systems. Use of extracorporeal membrane oxygenation (ECMO) for patients with severe respiratory or cardiac failure attributed to COVID-19 has been debated due to uncertain survival benefit and the resources required to safely deliver ECMO support. We retrospectively investigated adult patients supported with ECMO for COVID-19 at our institution during the first 80 days following New York City's declaration of a state of emergency. ⋯ Twelve patients were discharged alive from the hospital (54.5%). Extracorporeal membrane oxygenation was used successfully in patients with respiratory and cardiac failure due to COVID-19. The continued use of ECMO, including ECMO transport, during crisis conditions was possible even at the height of the COVID-19 pandemic.
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Pediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared with the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe acute respiratory distress syndrome (ARDS) that necessitates admission to the intensive care unit (ICU) requiring a maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO). ⋯ The patient was also given thrombolytic therapy during the ECPR because of high clinical suspicion for pulmonary embolism. Venovenous-arterial ECMO was then continued and the patient was successfully weaned off both VA and VV ECMO and discharged home with full neurologic recovery. This encouraging result will hopefully lead to more consideration of this lifesaving therapy for severe cardiac and respiratory failure secondary to COVID-19 in pediatric patients.