Academic literature on the topic 'Extracorporeal Life Support'

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Journal articles on the topic "Extracorporeal Life Support"

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Park, Pauline K. "Extracorporeal Life Support." Critical Care Medicine 45, no. 12 (December 2017): 2106–7. http://dx.doi.org/10.1097/ccm.0000000000002726.

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Wang, Chih-Hung, Yih-Sharng Chen, and Matthew Huei-Ming Ma. "Extracorporeal life support." Current Opinion in Critical Care 19, no. 3 (June 2013): 202–7. http://dx.doi.org/10.1097/mcc.0b013e32836092a1.

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Patton, Mary Lou, and Linwood R. Haith. "Extracorporeal Life Support." Journal of Burn Care & Research 31, no. 6 (November 2010): 965. http://dx.doi.org/10.1097/bcr.0b013e3181f93a9d.

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Skinner, Sean C., Ronald B. Hirschl, and Robert H. Bartlett. "Extracorporeal life support." Seminars in Pediatric Surgery 15, no. 4 (November 2006): 242–50. http://dx.doi.org/10.1053/j.sempedsurg.2006.07.003.

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Douflé, Ghislaine, Francesca Facchin, and Eddy Fan. "Extracorporeal Life Support." American Journal of Respiratory and Critical Care Medicine 192, no. 4 (August 15, 2015): 515–17. http://dx.doi.org/10.1164/rccm.201504-0755rr.

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Crowley, Mark. "Extracorporeal Life Support." Chest 124, no. 6 (December 2003): 2410–11. http://dx.doi.org/10.1378/chest.124.6.2410-a.

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Lick, Scott D., and Joseph B. Zwischenberger. "Extracorporeal life support." Annals of Thoracic Surgery 73, no. 6 (June 2002): 1816. http://dx.doi.org/10.1016/s0003-4975(02)03566-x.

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Goretsky, Michael J., Tory A. Meyer, and Brad W. Warner. "Extracorporeal life support." Current Opinion in Otolaryngology & Head and Neck Surgery 3, no. 1 (December 1995): 408–15. http://dx.doi.org/10.1097/00020840-199512000-00012.

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Bartlett, Robert H., Dietrich W. Roloff, Joseph R. Custer, John G. Younger, and Ronald B. Hirschl. "Extracorporeal Life Support." JAMA 283, no. 7 (February 16, 2000): 904. http://dx.doi.org/10.1001/jama.283.7.904.

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Bartlett, Robert H., Alain Combes, and Giles J. Peek. "Extracorporeal Life Support." Annals of the American Thoracic Society 11, no. 6 (July 2014): 992. http://dx.doi.org/10.1513/annalsats.201404-182le.

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Dissertations / Theses on the topic "Extracorporeal Life Support"

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Fiusco, Francesco. "Hemodynamics of artificial devices used in extracorporeal life support." Licentiate thesis, KTH, Teknisk mekanik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-301039.

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Extracorporeal Membrane Oxygenation (ECMO) is a life-saving therapy usedfor support in critical heart and/or lung failure. Patient’s blood is pumped viaan artificial lung for oxygenation outside of the body. The circuit is composedof a blood pump, cannulae for drainage and reinfusion, a membrane lung,tubing and connectors. Its use is associated with thromboembolic complicationsand hemolytic damage. Detailed numerical studies of two blood pumps anda lighthouse tip drainage cannula were undertaken to characterize the flowstructures in different scenarios and their link to platelet activation. The pumpsimulations were modelled according to manufacturer’s proclaimed use but alsoin off-design conditions with flow rates used in adult and neonatal patients.Lagrangian Particle Tracking (LPT) was used to simulate the injection ofparticles similar in size to platelets to compute platelet activation state (PAS).The results indicated that low flow rates impacted PAS similarly to high flowrates due to increased residence time leading to prolonged exposure to shearstress despite the fact that shear per se was lower at low flow rate. Regardingthe cannula, the results showed that a flow pattern similar to a jet in crossflowdeveloped at the side holes. A parameter study was conducted to quantifydrainage characteristics in terms of flow rate distribution across the holes wheninput variables of flow rate, modelled fluid, and hematocrit were altered. Thefindings showed, across all the cases, that the most proximal hole row drainedthe largest fraction of fluid. The effects due to the non-Newtonian nature ofblood were confined to regions far from the cannula holes and the flow structuresshowed very limited dependence on the hematocrit. A scaling law was found tobridge the global drainage performance of fluid between water and blood.

QC 210906

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Noh, Minkyun. "Homopolar bearingless slice motors with magnet-free rotors for extracorporeal life support." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/120259.

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Thesis: Ph. D., Massachusetts Institute of Technology, Department of Mechanical Engineering, 2018.
Cataloged from PDF version of thesis. Pages 224, 230 and 231 in the original document contain text that runs off the edge of the page.
Includes bibliographical references (pages 257-262).
Extracorporeal life support (ECLS) is a medical therapy that uses an external blood pump and oxygenator to provide cardiac or cardiopulmonary support. One common system-related challenge is to reduce blood damage, e.g., hemolysis, which is primarily caused by the stress and heat from the pump impeller's bearing surface. Another challenge is to reduce the cost of the impeller module that is disposed after each use and therefore incurs a repeated cost. This thesis presents two types of new homopolar bearingless slice motors that levitate and rotate disk-shaped solid iron rotors. Our first bearingless motor uses a ring-shaped D2 steel rotor which generates a driving torque via hysteresis coupling. Our second bearingless motor uses a low-carbon steel rotor with surface saliencies which, in conjunction with a homopolar bias flux, makes the resulting torque-current relation similar to that of permanent-magnet synchronous machines. For both machines, permanent magnets are located on the stator to provide a homopolar bias flux to the magnet-free rotors. The bias flux passively stabilizes the rotor's axial translation and out-of-plane tilts, thereby reducing the required number of sensors and power electronics. In particular, the second bearingless motor stator includes Halbach magnet arrays for homopolar flux-biasing, which significantly improves the passive stiffness and also simplifies the design of the flux-biasing structure. The rotor's radial translation is actively stabilized by superposing a two-pole suspension flux on the homopolar bias flux. The homopolar bias flux enables us to design a winding scheme that physically decouples the torque generation and suspension force generation mechanisms. This characteristic reduces the complexity of the control algorithms. We have built the two bearingless motor prototypes, developed the associated control systems, and conducted performance tests, including pumping tests with water saline, and bovine blood. The first prototype driving a D2 steel rotor achieves a maximum rotational speed of 1730 rpm in air, where the limit comes from the position sensor's noise and the resulting power amplifier saturation and suspension failure. The second prototype driving a reluctance rotor achieves a maximum rotational speed of 5500 rpm in air, where the limit comes from the power amplifier bus voltage saturation. Based on functional requirements for ECLS, we have chosen the second bearingless motor for integration into a prototype pump module. Pumping tests are conducted with various liquids including water, saline water, and freshly obtained bovine blood. With the bovine blood, the prototype pump achieves a maximum flowrate of 2.17 L/min and maximum pump head of 120 mmHg at low flow. The blood sampled after a circulation test at 1 L/min demonstrated satisfactory hemodynamic performance including low levels of hemolysis. Integrated into extracorporeal blood pumps, the levitated magnet-free rotors are advantageous to develop low-cost disposable pump modules exhibiting a low level of hemolysis. Also, the ruggedness of the magnet-free rotors shows promise in high-speed applications, such as centrifuges and turbo-molecular pumps, and high-temperature applications, such as steam turbines and turbochargers in vehicles.
by Minkyun Noh.
Ph. D.
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Pozzi, Matteo. "Extracorporeal life support dans la prise en charge du choc cardiogénique et arrêt cardiaque réfractaire." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1002/document.

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L’insuffisance cardiaque aigue est une émergence médicale qui nécessite une prise en charge multidisciplinaire. L’Extracorporeal Life Support (ECLS) peut être envisagé comme option thérapeutique pour les formes d’insuffisance cardiaque aigue réfractaire au traitement conventionnel. L’objectif de ce projet de recherche clinique est de fournir une vue d’ensemble de l’ECLS dans la prise en charge du choc cardiogénique et de l’arrêt cardiaque réfractaire. L’intoxication médicamenteuse et la myocardite sont les meilleures indications à l’implantation de l’ECLS en considération de leur potentiel de récupération myocardique très élevé. La défaillance primaire du greffon après transplantation cardiaque et l’infarctus du myocarde présentent des résultats plus mitigés avec l’ECLS en raison d’une physiopathologie plus complexe. Le choc cardiogénique postcardiotomie après une intervention de chirurgie cardiaque montre des résultats décevants en raison du profile préopératoire des patients. L’arrêt cardiaque aussi exige une prise en charge immédiate et l’ECLS peut être considéré comme une solution thérapeutique de sauvetage. Une meilleure sélection des patients s’impose afin d’améliorer les résultats de l’ECLS pour l’arrêt cardiaque réfractaire intrahospitalier. Les résultats de l’ECLS pour l’arrêt cardiaque réfractaire extrahospitalier sont dictés principalement par le temps de réanimation cardio-pulmonaire et le rythme cardiaque. Les rythmes non choquables pourraient être considérés comme une contre-indication formelle à l’utilisation de l’ECLS autorisant une concentration de nos efforts sur les rythmes choquables où les chances de survie sont plus importantes
Acute heart failure is a clinical situation requiring a prompt multidisciplinary approach. Extracorporeal Life Support (ECLS) could represent a therapeutic option for acute heart failure refractory to standard maximal treatment. The aim of this report is to offer an overview of ECLS in the management of refractory cardiogenic shock and cardiac arrest. Drug intoxication and myocarditis are the best indications of ECLS in consideration of their high potential of myocardial recovery. Primary graft dysfunction after heart transplantation and acute myocardial infarction show reduced survival rates owing to their more complex pathophysiology. Postcardiotomy cardiogenic shock after cardiac surgery operations displays poor outcomes due to the preoperative profile of the patients. ECLS could be also considered as a rescue solution for refractory cardiac arrest. A better selection of in-hospital cardiac arrest patients is mandatory to improve ECLS outcomes. In-hospital cardiac arrest patients with a reversible cause like drug intoxication and acute coronary syndrome should benefit from ECLS whereas end-stage cardiomyopathy and postcardiotomy patients with an unclear cause of cardiac arrest should be contraindicated to avoid futile support. ECLS for refractory out-ofhospital cardiac arrest should be limited in consideration of its poor, especially neurological, outcome and the results are mainly limited by the low-flow duration and cardiac rhythm. Nonshockable rhythms could be considered as a formal contraindication to ECLS for refractory out-of-hospital cardiac arrest allowing a concentration of our efforts on the shockable rhythms, where the chances of success are substantial
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Kracke, Markus [Verfasser], and Andreas [Akademischer Betreuer] Hoffmeier. "Extracorporeal Life Support (ECLS) - Therapie bei Patienten mit kardiogenem Schock / Markus Kracke ; Betreuer: Andreas Hoffmeier." Münster : Universitäts- und Landesbibliothek Münster, 2018. http://d-nb.info/1163662887/34.

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Demarest, Caitlin T. "Prolonging the Useful Lifetime of Artificial Lungs." Research Showcase @ CMU, 2017. http://repository.cmu.edu/dissertations/870.

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Over 26 million Americans suffer from pulmonary disease, resulting in more than 150,000 deaths annually. Lung transplantation remains the only definitive treatment for many patients, but has meager survival rates and only approximately 1,700 of the 2,200 patients added to the lung transplant wait list each year are transplanted. Extracorporeal gas exchangers have been used as an alternative to mechanical ventilation in acute respiratory failure and as a bridge to transplantation in chronic respiratory failure. Current gas exchangers are limited by their high resistance and low biocompatibility that lead to patient complications and device clot formation. Therefore, there exists a dire need for improved devices that can act as destination therapy. To accomplish the goal of destination therapy, this dissertation discusses three studies that were performed to pave the way. First, I examined clot formation and failure patterns of two common clinical devices (Maquet’s CardioHelp (CH) and Quadrox (Qx)) to further our understanding of their limitations with respect to long-term support. Overall, it was demonstrated that the Qx devices fail earlier and more frequently than CH devices and result in a significantly greater reduction in platelet count, and that a four-inlet approach is beneficial. Next, I determined the optimal sweep gas nitric oxide (NO) concentration that minimizes platelet binding and activation while ensuring that blood methemoglobin (metHb) concentrations increase less than 5%. Miniature artificial lungs were attached to rabbits in a pumped veno-venous configuration and run for 4 h with NO added to the sweep gases in concentrations of 0, 100, 250, and 500 ppm (n=8 ea.). 100 ppm significantly reduced the amount of platelet consumption (p < 0.05), reduced platelet activation as measured by soluble p-selectin (p < 0.05), and had negligible increases in metHb and will thus be used in future experiments. Last, I tested the Pulmonary Assist Device (PAD) which was designed for long term use as a bridge to transplantation and destination therapy. Benchtop experiments were performed that confirmed that it meets our design and performance goals. From here, we are equipped to commence with 30-day PAD testing in sheep.
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Peek, Giles John. "An investigation into new materials for extracorporeal life support including mechanical properties, blood surface interactions and the inflammatory response to bypass." Thesis, University of Leicester, 1998. http://hdl.handle.net/2381/29554.

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INTRODUCTION: Extracorporeal Membrane Oxygenation (ECMO) causes coagulation and inflammation. Also pump tubing can rupture. Therefore new tubing is needed. AIMS: To compare mechanical properties and biocompatability of two potential ECMO tubings (LVA and SRT) with Tygon (current tubing). To develop a novel porcine veno-venous ECMO model. To review ECMO results at Glenfield Hospital. METHODS:. I) Mechanical: Durability; roller pump and test rig. Wear; electron microscopy. Spallation; laser diode particle counter. II) In-Vivo Biocompatability: 5 pigs for each material, 48 hours veno-venous perfusion, samples: Blood count, blood gases, Prothrombin, Thrombin and Activated Partial Thromboplastin times, Lactoferrin, C3adesarg and Thromboxane B2. Lung neutrophil immunohistochemistry, histology and lung water. III) In-Vitro Biocompatability: a) 5 circuits of each material recirculated for 6 hours, human blood. Samples as above plus fibrinogen, C5b-9 instead of C3adesarg. b) I125Fibrinogen uptake with and without albumin washing. IV) Clinical Review: Retrospective. RESULTS:;I) Mechanical: Tygon was unpredictable, but better than LVA and SRT. II) In-Vivo Biocompatability: The porcine model was successfully established. The only significant difference between groups was higher haemolysis with Tygon compared to SRT. Animals developed "ARDS" and thrombocytopenia. III) In-Vitro Biocompatability: a) SRT and LVA, increased coagulation. LVA increased haemolysis. b) Untreated Tygon, lower fibrinogen uptake, no differences after albumin. IV) Clinical Review: (n) and % survival: Respiratory; Adult (99) 63%, Paediatric (81) 77%, Neonatal (134) 75%. Cardiac; Adult (8) 38%, and Paediatric (28) 61%. Results for the first 50 adult respiratory patients: mean PaO2/FIO2. 65 36.9 mmHg, mean Murray score 3.4 0.5 and 66% survival. Compared to historical controls (55.6% & 42% survival) p=0.036 & p=0.0006. CONCLUSIONS: Neither SRT nor LVA are mechanically adequate for ECMO. SRT and LVA are less biocompatable than Tygon, causing more coagulation and haemolysis. The porcine model was technically successful but needs larger numbers to discriminate between materials.
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Debaty, Guillaume. "Physiopathologie cardio-pulmonaire sur un modèle porcin d'arrêt cardiaque réfractaire en hypothermie profonde traité par assistance circulatoire." Thesis, Université Grenoble Alpes (ComUE), 2015. http://www.theses.fr/2015GREAS041/document.

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Introduction : L’hypothermie accidentelle est associée à un taux important de morbidité et de mortalité, notamment en cas d’hypothermie accidentelle sévère où le risque d’arrêt cardiaque est très élevé. L’Extracorporeal Life Support (ECLS) est le traitement de référence dans le cas d’hypothermie avec arrêt cardiaque ou instabilité hémodynamique réfractaire. Il n’existe pas de recommandations concernant les modalités optimales de réchauffement.L’objectif de ce travail était de développer un modèle expérimental porcin d’arrêt cardiaque en hypothermie profonde afin d’étudier la réponse physiopathologique cardiaque et pulmonaire pendant le refroidissement et le réchauffement par ECLS. Nous avons également évalué l’impact de différentes stratégies de réchauffement (en terme de débit d’ECLS et de delta de température entre l’ECLS et la température centrale) sur les lésions cardiaques et pulmonaires.Méthode : Deux protocoles expérimentaux ont été réalisés. Les animaux ont été canulés pour ECLS, refroidis jusqu’à l’obtention d’un arrêt cardiaque (AC) en hypothermie profonde et soumis à 30 minutes d’ischémie complète. Protocole A (n = 24) : durant la phase de réchauffement, les animaux étaient randomisés en 4 groupes selon un plan factoriel 2x2 comparant un débit normal d’ECLS de 3l/min (groupe NF) à un débit réduit de 1,5 l/min (groupe LF) ainsi qu’un delta de température entre la température centrale et le circuit d’ECLS limité à 5°C, ou une température d’ECLS à 38°C. Protocole B (n = 20) : les animaux ont été randomisés en 2 groupes pendant le réchauffement : un groupe NF et un groupe LF avec un delta de température de 5°C. L’impact de l’ECLS sur le débit cardiaque en fin de réchauffement a été évalué par une technique de thermodilution (site d’injection du catheter positionné dans le ventricule droit) et contrôlé par une technique écho-doppler. Le débit cardiaque, l’hémodynamique et des paramètres de fonction pulmonaire étaient évalués. Des marqueurs biologiques de lésions d’ischémie/reperfusion étaient mesurés.Résultats : Protocole A : Le débit cardiaque final était réduit dans les groupes LF comparé aux groupes NF (1.96±1.4 vs. 3.34±1.7 L/min, p=0.05). L’augmentation de RAGE était plus élevée dans les groupes avec une température d’ECLS à 38°C comparée aux groupes avec delta contrôlé. Protocole B : Durant la phase de refroidissement, le débit cardiaque, la fréquence cardiaque et la pression artérielle ont diminué de façon continue. La pression artérielle pulmonaire avait tendance à augmenter à 32°c comparée à la valeur initiale (20.2±1.7 vs. 29.1±5.6 mmHg, p=0.09). Pendant le réchauffement, la pression artérielle moyenne était plus élevée dans le groupe NF vs. groupe LF à 20°C et 25°C (p=0.003 and 0.05, respectivement). Après réchauffement à 35°C, le débit cardiaque était de 3.9±0.5L/min dans le groupe NF vs. 2.7±0.5 L/min dans le groupe LF (p=0.06). Sous ECLS, le débit cardiaque gauche était inversement proportionnel au débit d’ECLS. En fin de réchauffement, le débit ECLS n’avait pas d’impact significatif sur les résistances pulmonaires.Conclusion : Nos résultats suggèrent que le réchauffement par ECLS des arrêts cardiaques en hypothermie profonde, en utilisant un débit d’ECLS normal avec un delta de température n’excédant pas 5°C par rapport à la température centrale, pourrait être la stratégie la moins délétère au niveau cardiaque et pulmonaire. L’ECLS à débit normal diminuait la dysfonction myocardique en fin de réchauffement et ne majorait pas les résistances vasculaires pulmonaires par rapport au groupe avec un débit d’ECLS réduit. Un delta important entre la température centrale et celle de l’ECLS augmentait le taux du biomarqueur associés aux lésions pulmonaires. Ce modèle expérimental apporte des éléments physiopathologiques dans le choix des modalités de réchauffement des patients victimes d’hypothermie accidentelle profonde et pourrait permettre d’évaluer d’autres stratégies thérapeutiques dans ce contexte
Introduction: Accidental hypothermia is associated with significant mortality and morbidity, especially when core temperature is under 28°C with an increased risk of cardiac arrest. Extracorporeal life support (ECLS) is the preferred treatment in case of cardiac arrest or hemodynamic instability not responding to medical treatment. There are no current guidelines concerning the optimal rewarming strategy. The aim of this work was to develop a porcine experimental model of deep hypothermic cardiac arrest (DHCA) in order to assess the cardiac and pulmonary pathophysiological response during cooling and rewarming with ECLS. We also aimed to assess the impact of different ECLS blood flow rates on cardiopulmonary lesions.Method: Two experimental protocols were performed. Pigs were cannulated for ECLS, cooled until DHCA occurred and subjected to 30 min of cardiac arrest. Protocol A (n = 24): during the rewarming phase, pigs were randomized into 4 groups with 2X2 factorial design. We compared a low blood flow rate of 1.5 L/min (group LF) vs. a normal flow rate of 3.0 L/min (group NF) and a temperature during ECLS adjusted to 5°C above the central core temperature vs. 38°C maintained throughout the rewarming phase. Protocol B (n = 20): Animals were also randomized in 2 groups during rewarming, a group NF and a group LF with a controlled temperature delta of 5°C. In order to assess the physiological impact of ECLS on cardiac output at the end of rewarming we measured flow in the pulmonary artery using a modified thermodilution technique using the Swan-Ganz catheter (injection site inserted in the right ventricle) controlled also by an echocardiographic measurement. Cardiac output, hemodynamics and pulmonary function parameters were evaluated. Biological markers of ischemia/reperfusion injuries were analyzed.Results: Protocol A : The final cardiac output was reduced in the low flow rate versus the high flow rate groups (1.96±1.4 versus 3.34±1.7 L/min, p=0.05). The increase in the serum RAGE concentration was higher in the 38°C rewarming temperature groups compared to 5°C above adjusted temperature.Protocol B: During the cooling phase, cardiac output, heart rhythm, and blood pressure decreased continuously. Pulmonary artery pressure tended to increase at 32°C compared to initial value (20.2 ± 1.7 vs. 29.1 ± 5.6 mmHg, p=0.09). During rewarming, arterial blood pressure was higher at 20° and 25°C in group NF vs. Group LF (p=0.003 and 0.05, respectively). After rewarming at 35°C, cardiac output was 3.9 ± 0.5 in the group NF vs. 2.7 ± 0.5 L/min in group LF (p=0.06). Under ECLS cardiac output was inversely proportional to ECLS flow rate. ECLS flow rate did not significantly change pulmonary vascular resistance.Conclusion: Our results suggest that ECLS rewarming for DHCA patients, using a normal inflow rate of ECLS and a controlled temperature with less than 5°C between ECLS and core temperature could be the less deleterious rewarming strategy to limit cardiac and pulmonary dysfunction. A normal inflow rate of ECLS decreased cardiac dysfunction after rewarming and did not increased pulmonary vascular resistance compared to a low flow rate. A non controlled temperature delta between core temperature and ECLS increased biomarkers level of lung injury. This experimental model on pigs bring some pathophysiological finding for the rewarming strategy of patients who suffer deep accidental hypothermia and could allow to assess different therapeutic strategy in this context
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Erfle, Franziska Désirée [Verfasser], Nestoras [Akademischer Betreuer] Papadopoulos, Spiros [Akademischer Betreuer] Marinos, Nestoras [Gutachter] Papadopoulos, and Udo [Gutachter] Rolle. "Extracorporeal Life Support in Kombination mit IABP : Behandlungsmöglichkeiten und Grenzen einer supportiven Therapie bei kardialem Versagen : Retrospektive Analyse von 118 Patienten / Franziska Désirée Erfle ; Gutachter: Nestoras Papadopoulos, Udo Rolle ; Nestoras Papadopoulos, Spiros Marinos." Frankfurt am Main : Universitätsbibliothek Johann Christian Senckenberg, 2021. http://d-nb.info/1241668639/34.

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Lee, Pei Shan, and 李佩珊. "Evaluation of Mental Health and Quality of Life in Patients who Underwent Extracorporeal Life Support." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/8qckeh.

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碩士
長庚大學
護理學系
105
Background. With the continuing development of medical technology and accumulation of clinical experience, extracorporeal life support systems (ECLS), also called extracorporeal membrane oxygenation, have become widely used with patients suffering from heart and lung failure. ECLS provides more time for damaged organs to recovery, thereby increasing survival rates of patients. However, the complications that ECLS leads to affect the patient's daily life and increase their recovery time, in turn creating psychological distress and lowering the quality of life. Studies indicate that psychological status of critically ill patients has a direct impact on ECLS survivors’ prognosis. Thus, such patients’ anxiety, depression and psychological trauma should not be neglected. However, until now Taiwan’s research has mostly focused on the analysis of factors predicting survival rate of patients who have received ECLS-assisted treatment, and have not yet investigated the effect of psychological factors on their quality of life. Therefore, the aim of this study is to investigate the quality of life in patients who underwent ECLS. Methods. A cross-sectional and descriptive was used, and the study was conducted from October 2015 to October 2016. The patients were convenience sample of 144 participants who underwent ECLS post discharge. The questionnaires included the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), the Medical Outcomes Study Short Form 36-Item Version 2 Health Survey (SF-36v2), and the European quality of life 5-dimension 3 level version (EQ-5D). Results. The results showed that the survial-to-discharge rate was 27% after a median follow-up of 1060 days (44-3612 days). The 144 patients had a low to moderate physical and mental quality of life. Multiple regression analysis revealed that depression, work status, days of hospitalization, self-perceived health status, and body mass index explained 42.7% of the total variance of quality of life in the “physical functioning”. Self-perceived health status, work status, days of hospitalization, and anxiety explained 37.4% of the total variance of quality of life in the “role limitation due to emotional problems”. Depression, body mass index, work status, and psychological trauma explained 34.6% of the total variance of quality of life in the“bodily pain”. Self-perceived health status, anxiety, and work status explained 33.7% of the total variance of quality of life in the“general health”. Depression, anxiety, days of hospitalization, and self-perceived health status explained 39.4% of the total variance of quality of life in the“vitality”. Depression and psychological trauma explained 30.5% of the total variance of quality of life in the“social functioning”. Depression, anxiety, and body mass index explained 41.8% of the total variance of quality of life in the“role limitation due to emotional problems”. Anxiety, depression, and gender explained 39.2% of the total variance of quality of life in the“mental health”. Depression, days of hospitalization and age explained 39.6% of the total variance of EQ-5D index. Self-perceived health status, depression and education explained 49.3%of the total variance of EQ-5D VAS. Conclusions. The results of the current study are instructive for clinical healthcare professionals to understand patient’s psychological problems, quality of life and factors influencing quality of life. Therefore, healthcare professionals can develop appropriate care plans which meet patients’ needs, in turn, decreasing negative impacts on quality of life resulting from psychological problems.
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Uen, Shu-Ru, and 溫淑如. "Stressors of Pediatric Intensive Care Unit Nurses Caring for Children with Extracorporeal Life Support." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/38223323588858621212.

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碩士
國立臺灣大學
護理學研究所
102
Background and purposes: In recent years, owing to the medical development and media spreading, patients and families are over expectations to the Extracorporeal Life Support (ECLS). The use of ECLS also becomes prevalent in Pediatric Intensive Care Unit (PICU). The problems which the medical staff faces are as follows: what kinds of patients are suitable for use, who is able make the decision, the influences of the prognoses and the complications of the patients, the future life quality of the patient, who will be in charge of removing the ECLS or keeping it without unknown ending. It is wonder that this is to extend the patient’s life or death. For this, the ethical issue makes the nursing staff has to face not only high tension but also frustration and maladaptation of the medical environment. The purpose of this research was to explore the stressors that nurses of PICU may encounter when tending children using ECLS, and it also discusses the decision making process. Methods: It is a qualitative descriptive study. From January 1st to March 26th 2014, focus groups are being held with 15 nurses from Pediatrics ICU as participants, each meeting lasts 60 - 100 minutes. Semi-structured interviews are adopted to collect data, making the participants subjectively narrating and describing their experiences in taking care of children using ECLS, and their interactions with patients’ families. The interviews are recorded, processed and analyzed in hope to unveil its thorough picture beneath the data and to find nurses’ possible pressure sources when tending children with ECLS. Result: The data was analyzed according to the phenomenology methods suggested by Cloaizzi(1978) and categorized in four domains: the challenges of caring patient and his family, the medical care of ECLS, the self-preparedness of nurse competence, the ethical dilemma of clinical decision making. First, the challenges of caring patient and his family includes two themes: 1. The complexity of patient’s condition, the subthemes is includes the complexity and variety of the disease course, and the sudden loss of patient’s life. 2. The family’s uncertainty in illness among patients, the subthemes includes the struggle before they decide to receive treatment, the reluctance and anxiety when they wait for the operation of setting ECLS, the uncertain of future, the unrealistic expectation and the discrepancy in reality and perseverance during the end of life. Second, the self-preparedness of nursing competence, includes three themes: 1. Medical care of ECLS, the subthemes includes the unfamiliarity with the medical supply and equipment, the rush of preparation, the fear to operate the medical devices and their alarms, the fear to operate the circuit of ECLS. 2. The learning curve of the newbie, the subthemes includes the pressure when they firstly face the patients with ECLS, the upset and helpless feeling of self-learning. 3. The judgment and reaction during emergency, the subthemes includes lack of experience of caring ECLS patients, the inconsistence of the standard of medical care, the emergent management in abnormal situation, the psychological trauma after compilation occurs in patients. Third, the communication and co-operation between medical teams, includes two themes: 1. The adjustment of team work, the subthemes includes the urgent atmosphere during the placement of ECLS, the immediate support of emergent medical management, the capacity of cross-team members. 2. The decision making between different medical management, the subthemes includes multiple perspectives of medical management, the integration of medical management. Fourth, the ethical dilemma of clinical decision making, includes three themes: 1. The decision to place ECLS, the subthemes includes objective explanation, the respect for the choice of the family and the rest period of family for their psychological shock. 2. The consideration of ECLS and medical care of patients, the subthemes includes the struggle between scientific evidence and humanity, the balance between the standardization of the criteria of ECLS placement and the equality of medical care. 3. The decision making of the withdrawal of ECLS, the subthemes includes the consideration of life prolongation and life quality, the nature course of disease complications. Conclusion: This research suggests that the nurses are under several kinds of pressure in treating children with ECLS, among which the most dominant ones come from the families of the patients, the collaboration and communication required in inter-professional practice, the decision-making needed in clinical context, as well as their demand in ameliorating proficiency of nursing. This research hopes to provide a direction and guidance to medical staff who works in similar background to their better adaptation to the pressure, and to assist them in getting proper training in terms of learning new nursing skills with cutting-edge technology, and the ability to collaborate with others in inter-professional practice, as well as to increase hospice care for better nursing quality.
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Books on the topic "Extracorporeal Life Support"

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Schmidt, Gregory A., ed. Extracorporeal Life Support for Adults. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0.

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Sangalli, Fabio, Nicolò Patroniti, and Antonio Pesenti, eds. ECMO-Extracorporeal Life Support in Adults. Milano: Springer Milan, 2014. http://dx.doi.org/10.1007/978-88-470-5427-1.

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M, Arensman Robert, and Cornish J. Devn, eds. Extracorporeal life support. Boston: Blackwell Scientific Publications, 1993.

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Dalton, Heidi J., Mark Davidson, and Peter P. Roeleveld. Extracorporeal Life Support. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0002.

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Extracorporeal membrane oxygenation (ECMO) can provide support as a bridge to recovery or a bridge to more definitive therapy for patients with severe respiratory or cardiorespiratory disease. In this chapter, the criteria for ECMO are discussed and a practical decision tree for mode of ECMO (venovenous or venoarterial) is presented. A stepwise approach to initiation and management of ECMO for the patient is described, including flow rate goals, ventilator management, anticoagulation, blood product replacement, identification of recovery, weaning procedures, and specific issues relating to the two different modes of ECMO.
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Dan M., M.D. Meyer and Michael E., M.D. Jessen. Extracorporeal Life Support (Vademecum). Landes Bioscience, 2001.

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Schmidt, Gregory A. Extracorporeal Life Support for Adults. Humana, 2016.

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Schmidt, Gregory A. Extracorporeal Life Support for Adults. Humana, 2015.

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Sangalli, Fabio, Nicolò Patroniti, and Antonio Pesenti. ECMO-Extracorporeal Life Support in Adults. Springer, 2014.

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Sangalli, Fabio, Nicolò Patroniti, and Antonio Pesenti. ECMO-Extracorporeal Life Support in Adults. Springer, 2016.

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Westrope, Claire, and Giles Peek. Extracorporeal respiratory and cardiac support techniques in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0104.

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Extra corporeal life support (ECLS) is an essential tool for the modern intensivist and surgeon. The addition of extracorporeal therapy should be considered in all cases when pathology is potentially reversible and conventional therapy is clearly failing. ECLS is a general term to describe prolonged, but temporary support of heart and lung function using mechanical devices, which has developed as an extension of cardiopulmonary bypass techniques used in the operating theatre. Use in adult severe respiratory and cardiac failure is increasing following significant advances in ECLS techniques learnt from paediatric and neonatal experiences, and successful use of extra corporeal membrane oxygenation in the 2009 and 2001 H1N1 (swine flu) outbreaks. This chapter describes the techniques required for providing successful ECLS in adult respiratory and cardiac failure.
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Book chapters on the topic "Extracorporeal Life Support"

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Muratore, Christopher S. "Extracorporeal Life Support." In Fundamentals of Pediatric Surgery, 93–102. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-27443-0_13.

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Fiser, Richard T. "Extracorporeal Life Support." In Pediatric Critical Care Medicine, 215–36. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6356-5_12.

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Holecek, William F. "Extracorporeal Membrane Oxygenation and Extracorporeal Life Support." In Interventional Critical Care, 225–33. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-64661-5_21.

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Sangalli, Fabio, Chiara Marzorati, and Nerlep K. Rana. "History of Extracorporeal Life Support." In ECMO-Extracorporeal Life Support in Adults, 3–10. Milano: Springer Milan, 2014. http://dx.doi.org/10.1007/978-88-470-5427-1_1.

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Eytan, Danny, and Gail M. Annich. "Anticoagulation for Extracorporeal Life Support." In Pediatric Critical Care, 231–41. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96499-7_13.

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Brain, Matthew J., Warwick W. Butt, and Graeme MacLaren. "Physiology of Extracorporeal Life Support (ECLS)." In Extracorporeal Life Support for Adults, 1–60. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0_1.

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Schmidt, Gregory A. "Mobilization During ECLS." In Extracorporeal Life Support for Adults, 211–21. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0_12.

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Peek, Giles J. "Daily Care on ECLS." In Extracorporeal Life Support for Adults, 181–91. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0_10.

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Agerstrand, Cara L., Linda B. Mongero, Darryl Abrams, Matthew Bacchetta, and Daniel Brodie. "Crises During ECLS." In Extracorporeal Life Support for Adults, 193–210. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0_11.

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Krishnan, Sundar, and Gregory A. Schmidt. "ECMO Weaning and Decannulation." In Extracorporeal Life Support for Adults, 223–32. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3005-0_13.

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Conference papers on the topic "Extracorporeal Life Support"

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Choi, Gordon YS. "18 Principles of extracorporeal life support (ECLS)." In 1st Asia Pacific Advanced Heart Failure Forum (APAHFF), 15th December 2017, Hong Kong. BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association, 2018. http://dx.doi.org/10.1136/heartasia-2018-apahff.18.

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Gupta, V. S., S. Tripathi, A. Tchakarov, J. Melionas, and M. T. Harting. "Extracorporeal Life Support in Vaping-Associated Pulmonary Injury." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a6041.

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Radakovic, D., E. Prashovikj, L. Kizner, R. Al-Khalil, F. Brünger, R. Schramm, J. Gummert, and S. P. Sommer. "Left Ventricular Unloading by Impella Device during Extracorporeal Life Support." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678930.

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Velloze, S., K. Kotkar, M. Masood, A. Itoh, R. Hachem, and P. Aguilar. "Impact of Deep Vein Thrombosis on Outcomes After Extracorporeal Life Support." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1599.

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Chrysostomou, Constantinos, Victor O. Morell, Bradley Kuch, Timothy Maul, Brittany Tomsic, and Peter Wearden. "Neurologic Outcomes After Extracorporeal Life Support In Children With Cardiac Disease." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a1839.

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Schenkman, Kenneth A., Andrew D. Mesher, D. Michael McMullan, Wayne A. Ciesielski, Faith J. Ross, and Lorilee S. L. Arakaki. "Optical spectroscopy to assess muscle oxygenation in infants undergoing extracorporeal life support." In Diagnostic and Therapeutic Applications of Light in Cardiology 2020, edited by Kenton W. Gregory and Laura Marcu. SPIE, 2020. http://dx.doi.org/10.1117/12.2553230.

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Höhling, I., F. König, F. Born, M. Grab, M. Hanuna, C. Kamla, S. Günther, C. Hagl, and N. Thierfelder. "Out-of-Hospital Extracorporeal Life Support—Emergency and Resident Physicians Point of View." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678928.

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Zhigalov, K., A. Alofesh, J. Easo, H. Eichstaedt, J. Ennker, and A. Weymann. "Clinical Outcomes of Venoarterial Extracorporeal Life Support in 462 Patients: Single-Center Experience." In 49th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705490.

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Provaznik, Z., A. Philipp, M. Foltan, D. Camboni, L. Rupprecht, D. Lunz, C. Unterbuchner, B. Flörchinger, and C. Schmid. "Extracorporeal Life Support in Cardiac Surgery Patients—Does Scenario of Support Affect Outcome? Experience of 235 Cases." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678865.

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Castro, L., S. Zipfel, S. Hakmi, B. Reiter, G. Söffker, E. Lubos, M. Rybczinski, et al. "Impella 5.0 Therapy Decreases Bleeding Complications in Patients after Change from Extracorporeal Life Support." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678931.

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