Physiologic Effect and Safety of the Pumpless Extracorporeal Interventional Lung Assist System in Patients With Acute Respiratory Failure—A Pilot Study

Cho, Woo Hyun; Lee, Kwangha; Huh, Jin Won; Lim, Chae‐Man; Koh, Younsuck; Hong, Sang-Bum

doi:10.1111/j.1525-1594.2011.01359.x

Cited by 13 publications

(14 citation statements)

References 24 publications

(34 reference statements)

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“…Platelet counts significantly dropped and remained low in patients treated with ECMO, but not in those treated with iLA. The latter finding is consistent with a small cohort of iLA-treated adult patients from Korea (30). During vv-ECMO, platelets decreased on average within 4 days to 60% of pre-ECMO values, and remained stable thereafter.…”

Section: Discussionsupporting

confidence: 89%

Comparison of Coagulation Parameters, Anticoagulation, and Need for Transfusion in Patients on Interventional Lung Assist or Veno-Venous Extracorporeal Membrane Oxygenation

et al. 2015

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Clinical data on anticoagulation needs of modern extracorporeal membrane oxygenation (ECMO) and its impact on coagulation are scarce. Therefore, we analyzed coagulation-related parameters, need for transfusion, and management of anticoagulation in adult patients with severe acute respiratory failure during treatment with either pumpless interventional lung assist (iLA) or veno-venous ECMO (vv-ECMO). Sixty-three patients treated with iLA and 192 patients treated with vv-ECMO at Regensburg University Hospital between January 2005 and May 2011 were analyzed. Data related to anticoagulation, transfusion, and coagulation parameters were collected prospectively by the Regensburg ECMO registry. Except for a higher, sequential organ failure assessment (SOFA) score in the ECMO group (12 [9-15] vs. 11 [7-14], P = 0.007), a better oxygenation, and a lower dosage of vasopressors in the iLA patients, both groups had similar baseline characteristics. No difference was noted in terms of outcome and overall transfusion requirements. Factors of the plasmatic coagulation system were only marginally altered over time and did not differ between groups. Platelet counts in ECMO-treated patients, but not in those treated with iLA, dropped significantly during extracorporeal support. A more intense systemic anticoagulation with a mean activated partial thromboplastin time (aPTT) > 53 s led to a higher need for transfusions compared with the group with a mean aPTT < 53 s, whereas the average durability of membrane oxygenators was not affected. Need for red blood cell (RBC) transfusion was highest in patients with extrapulmonary sepsis (257 mL/day), and was significantly lower in primary pulmonary adult respiratory distress syndrome (ARDS) (102 mL/day). Overall, 110 (0-274) mL RBC was transfused in the ECMO group versus 146 (41-227) mL in the iLA group per day on support. The impact of modern iLA and ECMO systems on coagulation allows comparatively safe long-term treatment of adult patients with acute respiratory failure. A moderate systemic anticoagulation seems to be sufficient. Importantly, platelets are more affected by vv-ECMO compared with pumpless iLA.

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Section: Discussionsupporting

confidence: 89%

Comparison of Coagulation Parameters, Anticoagulation, and Need for Transfusion in Patients on Interventional Lung Assist or Veno-Venous Extracorporeal Membrane Oxygenation

et al. 2015

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“…Jayroe et al 6 suggested that a blood flow of 1.0-1.5 L/min is sufficient to remove CO 2 effectively, and a smaller cannula decreases the incidence of cannula-related limb ischemia. Further, other data showed that low blood flow settings decreased distal limb ischemia as well as effectively removed CO 2 level in Asians with petite body figures 7 . However, stasis which originates from low flow may have an impact on venous thrombosis.…”

Section: Discussionmentioning

confidence: 92%

“…The iLA employs a low-gradient device designed to operate without a mechanical pump in an arteriovenous configuration 7 . The natural arteriovenous blood pressure gradient determines the flow through the oxygenator 4 .…”

Section: Discussionmentioning

confidence: 99%

Thrombotic Complications during Interventional Lung Assist: Case Series

et al. 2015

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Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

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“…Additionally, two summary scores can be obtained; the Physical Component Summary (PCS) score and the Mental Component Summary (MCS) score. The Turkish version of the SF-36 was used in the study [16]. …”

Section: Methodsmentioning

confidence: 99%

Reliability, construct validity and measurement potential of the ICF comprehensive core set for osteoarthritis

Kurtaiş

Öztuna

Küçükdeveci

et al. 2011

BMC Musculoskelet Disord

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BackgroundThis study aimed to investigate the reliability and construct validity of the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for osteoarthritis (OA) in order to test its possible use as a measuring tool for functioning.Methods100 patients with OA (84 F, 16 M; mean age 63 yr) completed forms including demographic and clinical information besides the Short Form (36) Health Survey (SF-36®) and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). The ICF Comprehensive Core Set for OA was filled by health professionals. The internal construct validities of "Body Functions-Body structures" (BF-BS), "Activity" (A), "Participation" (P) and "Environmental Factors" (EF) domains were tested by Rasch analysis and reliability by internal consistency and person separation index (PSI). External construct validity was evaluated by correlating the Rasch transformed scores with SF-36 and WOMAC.ResultsIn each scale, some items showing disordered thresholds were rescored, testlets were created to overcome the problem of local dependency and items that did not fit to the Rasch model were deleted. The internal construct validity of the four scales (BF-BS 16 items, A 8 items, P 7 items, EF 13 items) were good [mean item fit (SD) 0.138 (0.921), 0.216 (1.237), 0.759 (0.986) and -0.079 (2.200); person item fit (SD) -0.147 (0.652), -0.241 (0.894), -0.310 (1.187) and -0.491 (1.173) respectively], indicating a single underlying construct for each scale. The scales were free of differential item functioning (DIF) for age, gender, years of education and duration of disease. Reliabilities of the BF-BS, A, P, and EF scales were good with Cronbach's alphas of 0.79, 0.86, 0.88, and 0.83 and PSI's of 0.76, 0.86, 0.87, and 0.71, respectively. Rasch scores of BF-BS, A, and P showed moderate correlations with SF-36 and WOMAC scores where the EF had significant but weak correlations only with SF36-Social Functioning and SF36-Mental Health.ConclusionSince the four different scales derived from BF-BS, A, P, and EF components of the ICF core set for OA were shown to be valid and reliable through a combination of Rasch analysis and classical psychometric methods, these might be used as clinical assessment tools.

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Physiologic Effect and Safety of the Pumpless Extracorporeal Interventional Lung Assist System in Patients With Acute Respiratory Failure—A Pilot Study

Cited by 13 publications

References 24 publications

Comparison of Coagulation Parameters, Anticoagulation, and Need for Transfusion in Patients on Interventional Lung Assist or Veno-Venous Extracorporeal Membrane Oxygenation

Comparison of Coagulation Parameters, Anticoagulation, and Need for Transfusion in Patients on Interventional Lung Assist or Veno-Venous Extracorporeal Membrane Oxygenation

Thrombotic Complications during Interventional Lung Assist: Case Series

Reliability, construct validity and measurement potential of the ICF comprehensive core set for osteoarthritis

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