The Journal of extra-corporeal technology
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J Extra Corpor Technol · Jun 2007
Case ReportsGround transportation of a pediatric patient on ECMO support.
Extracorporeal membrane oxygenation (ECMO) is a technique for providing cardiac and/or pulmonary support. Many hospitals worldwide practice ECMO at some time, yet few centers are able to offer a portable ECMO service, with the United Kingdom being of no exception. ⋯ A modified Falcon series 2 patient stretcher was used to transport the patient and house the ECMO hardware, consisting of a Levitronix Centri-Mag pump system, a Hico-variotherm 550 heater/cooler unit, and an oxygen supply. Design limitations and future technical recommendations of the portable ECMO system subsequent to clinical experience are discussed.
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J Extra Corpor Technol · Mar 2007
Comparative StudyHemoglobin test result variability and cost analysis of eight different analyzers during open heart surgery.
The purpose of this study was to compare the variation in hemoglobin (Hgb) values among various point-of-care (POC) analyzers available on the market. Eight analyzers (Gem 3000, ABL 720, ABL 77, Rapidpoint 405, IL 682, GemOPL, Hb 201+, and manual/centrifugation) were compared with the Hgb values from the Beckman Coulter LH750. A total of 72 patient samples were analyzed on each test instrument. ⋯ Some of the methodologies have previously been shown to be affected during hemodilution, hypoproteinemia, and/or after blood transfusion. There is variability among methodologies, which can give rise to statistically different Hgb values, and one should consider the "ideal" instrument based on this and many other factors. Based on our results, the rank order of closest approximation to the Coulter LH750 measurement was Rapidpoint 405, Hb 201+, IL 682, ABL 720, ABL 77, manual/centrifugation, GemOPL, and Gem 3000.
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J Extra Corpor Technol · Dec 2006
Heparin sensitivity test for patients requiring cardiopulmonary bypass.
Anticoagulation for the open heart surgery patient undergoing cardiopulmonary bypass (CPB) is achieved with the use of heparin. The industry standard of activated clotting time (ACT) was used to measure the effect of heparin. The commonly acceptable target time of anticoagulation adequacy is 480 seconds or greater. ⋯ Testing of patient blood before the time of incision for sensitivity to heparin is a way to avoid a delay that can be critical in the care of the patient. Commercial tests are available, but efficacy data are limited, and they lead to added inventory expense. This method of titrating a diluted heparin additive, mixed with patient blood in a familiar ACT test, has proven to be an inexpensive and reliable test to predict patient's sensitivity to heparin.
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J Extra Corpor Technol · Dec 2006
Perfusion techniques for pulmonary thromboendarterectomy under deep hypothermia circulatory arrest: a case series.
Pulmonary thromboendarterectomy (PTE) is a complicated surgical procedure that is an effective treatment in reducing pulmonary artery pressure and pulmonary vascular resistance for chronic thromboembolic pulmonary hypertension. Chronic thromboembolic pulmonary hypertension usually results from incomplete lysis of a large organized thrombus in the main pulmonary artery and secondary branches, leading to pulmonary hypertension, right ventricular failure, and subsequent death because of heart failure. Between March 1997 and April 2005, 30 PTE operations were performed in Fuwai Hospital, Beijing, China. ⋯ PTE is an effective treatment for chronic thromboembolic pulmonary hypertension. The key to success is to adopt synthesized measures to protect the vital organ under deep hypothermic circulatory arrest (DHCA) from ischemia and reperfusion injury. Appropriate patient selection, perioperative management, improved techniques, and experience can optimize outcome.