Heart : official journal of the British Cardiac Society
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Review
Extracorporeal membrane oxygenation for severe acute respiratory failure in adults: NICE guidance.
Extracorporeal membrane oxygenation (ECMO) is a modified form of cardiopulmonary bypass that allows short-term support for potentially reversible severe acute respiratory and/or cardiac failure in critically ill adults and children. There is increasing interest in veno-venous (VV) ECMO for severe acute respiratory failure in adults. The National Institute for Health and Clinical Excellence has recently updated its interventional procedure guidance, which summarises available data on efficacy and safety of this procedure and provides guidance for clinicians wishing to undertake VV ECMO. The authors summarise and reflect on the guidelines and discuss some recent developments in technology and clinical practice of VV ECMO.
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To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases. ⋯ A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure.