Minerva anestesiologica
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Minerva anestesiologica · Nov 2014
THE ROLE OF EXTRACORPOREAL MEMBRANE OXYGENATION IN DONATION AFTER CIRCULATORY R DEATH.
Donor scarcity and the increased need for organ transplantation has prompted the development of an alternative source of donors to the more conventional brain dead donor. While in a Beating-Heart donor, abdominal and intrathoracic organs are perfused, in a non-beating heart donor (NHBD, or DCD), perfusion should be maintained, after confirmation of death, by means of ECMO and inflation of intra-aortic balloon accordingly to the localization of the organs that should be transplanted. ⋯ Despite the fact that available studies suffer from methodological limitations (small cohorts, retrospective analysis, not always comparative), they all reach the same conclusion: the concept of extracorporeal support with oxygenation in DCD seems very promising since it has been reported to increase the available organ supply by approximately 20% to 25%2 by increasing the number of donors by approximately 33%. Centres with ECMO facilities should implement local programmes for donation after cardiac death (both in the emergency department and intensive care) using ECMO taking into account that this technique has been proven to increase donor pool.
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Minerva anestesiologica · Nov 2014
Experimental validation of frequent used echocardiographic right ventricular impedance parameters.
Aim of the study was to validate commonly used bedside right-ventricular (RV) impedance parameters, which are utilized in determining heart-lung interactions during mechanical ventilation. ⋯ ACmean is a reliable parameter of RV impedance that can be used to study the heart-lung interactions during mechanical ventilation.