Initial experience with CentriMag extracorporal membrane oxygenation for support of critically ill patients with refractory cardiogenic shock

Aziz, Tariq; Singh, Gurpal; Popjes, Eric; Stephenson, Edward R.; Mulvey, Suzanne; Pae, Walter E.; El‐Banayosy, Aly

doi:10.1016/j.healun.2009.08.025

Cited by 72 publications

(69 citation statements)

References 12 publications

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“…2 The VA ECMO indications include patients who are unable to be weaned from cardiopulmonary bypass postoperatively, post-cardiac transplantation primary graft failure, acute coronary syndrome, cardiogenic shock, cardiomyopathy, myocarditis, and other types of cardiac failure as a bridge to recovery, a bridge to transplant, or a bridge to a ventricular-assist device. 2,[8][9][10] Many criteria must be considered before a patient is selected as a candidate for ECMO. The literature details multiple exclusion criteria for ECMO such as multisystem organ failure, unwillingness to receive blood transfusions, inability to be anticoagulated, poor neurologic function or ability to recover, age greater than 65 years, mechanical ventilation greater than 5 to 10 days, metastatic cancer, immunosuppression, and chronic illness with limited hope for recovery.…”

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

“…11 The typical ECMO circuit is composed of large-bore tubing, a blood pump, a heat exchanger, and a device used to exchange gas referred to as an oxygenator. 2,3,10,11 Currently, there are 2 different types of pumps available for use with the ECMO circuit: the roller pump and the centrifugal pump. 2 Advances in technology have allowed for the use of the centrifugal pump to be used for ECMO.…”

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

“…2 One advantage of the centrifugal pump is reduced hemolysis due to limited shear and friction, whereas disadvantages include the influence of flow through the circuit based on volume, cannula size, pump size, and speed. 2,10 In a 2007 survey of members of the Extracorporeal Life Support Organization (ELSO), findings in adult patients indicated that 50% of responding facilities used roller pumps whereas the other 50% of respondents used centrifugal pumps. 13 Aziz et al 10 found using a centrifugal pump, the CentriMag, for ECMO with cardiogenic shock produced "no major complications directly related to the device and no equipment malfunctions."…”

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

“…2 When determining the ability to wean from VA ECMO, considerations with regard to the amount of inotropic assistance, fluid status, ejection fraction, and stable hemodynamics such as cardiac index, mean arterial pressure, pulmonary artery wedge pressure, or central venous pressure are all essential to determine a plan of care. 10 Multiple complications have been associated with the use of ECMO in critically ill patients. Complications related to the ECMO circuit include problems such as failure of the oxygenator, mechanical pump failure, clot formation in the circuit, and tubing rupture, or disruption.…”

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

See 3 more Smart Citations

Expanded Resources Through Utilization of a Primary Care Giver Extracorporeal Membrane Oxygenation Model

Freeman

Nault

Mowry

et al. 2012

Critical Care Nursing Quarterly

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Extracorporeal membrane oxygenation (ECMO) is a long-term extracorporeal support for critically ill patients with life-threatening compromises in cardiac and/or respiratory function. The unpredictability of ECMO resources for a large pediatric and adult population prompted a need for the ability to respond to significant fluctuations in the volume of patients on ECMO. Through multidisciplinary collaboration, the Primary Care Giver (PCG) ECMO Staffing Model was developed to accommodate unpredictable fluctuations in ECMO activity and to maintain flexibility and fiscal responsibility in turbulent economic times. Advancements in extracorporeal technology supported the opportunity to develop a safe and extended staffing model for ECMO. Combining the use of a centrifugal pump system with specialized and experienced cardiovascular intensive care nurses and the ECMO specialist team provided a milieu for education and training to support the new staffing model. The PCG ECMO model provides a safe, flexible, and fiscally responsible staffing model for variable ECMO activity.

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Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

Section: Extracorporeal Membrane Oxygenation Description Modalitiesmentioning

confidence: 99%

See 2 more Smart Citations

Expanded Resources Through Utilization of a Primary Care Giver Extracorporeal Membrane Oxygenation Model

Freeman

Nault

Mowry

et al. 2012

Critical Care Nursing Quarterly

View full text Add to dashboard Cite

show abstract

“…The device can produce flows of up to 10 L/min. & Aziz et al [11] outlined their single-center experience with the peripheral CentriMag ECMO system in a recent article describing the outcomes of the first 10 patients to receive the device at their institution. Criteria for using the system included refractory CS (defined as a MAPG65 mmHg with evidence of end-organ dysfunction, elevated filling pressures, or a CIG2.2 L/min/m 2 despite maximal inotropic support), with or without respiratory failure.…”

Section: Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

Short-Term Mechanical Management of Cardiogenic Shock

Brown¹,

Bogaev²,

O'Connell³

2011

Curr Treat Options Cardio Med

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Cardiogenic shock (CS), a state of cardiac dysfunction that results in systemic hypoperfusion and end-organ dysfunction, is associated with high in-hospital mortality. Various forms of mechanical circulatory support have been used to treat CS. First employed in the 1960s, the intra-aortic balloon pump (IABP) has been a mainstay in the treatment of acute CS. However, the IABP is unable to provide adequate support in many patients, and newer technologies, including extracorporeal membrane oxygenation and percutaneous ventricular assist devices, appear to be more effective in reversing CS. These devices are also useful for supporting patients during complex percutaneous coronary intervention. Perhaps most importantly, they can be used as a bridge to decision or definitive therapy in CS patients who are potential candidates for surgical ventricular assist devices or cardiac transplantation.

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Predicting Parameters for Successful Weaning from Veno‐Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock

et al. 2020

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Aims Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is utilized for patients with cardiogenic shock or cardiac arrest. However, the procedure protocol for weaning from VA-ECMO has not been well established. The present study aimed to determine the usefulness of echocardiographic and pulmonary artery catheter parameters for predicting successful weaning from VA-ECMO in patients with refractory cardiogenic shock. Methods and results We retrospectively studied 50 patients who were hospitalized and supported by VA-ECMO for >48 h between January 2013 and March 2017. Patients successfully weaned from VA-ECMO without reintroduction of VA-ECMO or left ventricular assist device implantation were defined as 30 day survivors. Echocardiographic and pulmonary artery catheter parameters were evaluated when ECMO flow was limited to a maximum of 1.5-2.0 L/min. Twenty-four patients were successfully weaned from VA-ECMO, whereas 26 were not. Fractional shortening, corrected left ventricular ejection time (LVETc, defined as LVET divided by the square root of heart rate), left ventricular outflow tract velocity time integral, and LVETc divided by pulmonary artery wedge pressure (PAWP) were significantly larger in the 30 day survivor groups. Multivariable analysis revealed LVETc∕PAWP as a significant independent predictor of successful weaning (LVETc∕PAWP, odds ratio 0.82, 95% confidence interval 0.71-0.94, P = 0.005). Receiver operating characteristic curve analysis revealed 15.9 as the optimal LVETc∕PAWP for predicting successful weaning (area under the curve 0.82). Conclusions The present findings indicate that LVETc∕PAWP is a potential predictor of successful weaning from VA-ECMO.

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Initial experience with CentriMag extracorporal membrane oxygenation for support of critically ill patients with refractory cardiogenic shock

Cited by 72 publications

References 12 publications

Expanded Resources Through Utilization of a Primary Care Giver Extracorporeal Membrane Oxygenation Model

Expanded Resources Through Utilization of a Primary Care Giver Extracorporeal Membrane Oxygenation Model

Short-Term Mechanical Management of Cardiogenic Shock

Predicting Parameters for Successful Weaning from Veno‐Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock

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