“Beyond waking and walking. Intensive rehabilitation in patients requiring extended durations of advanced mechanical circulatory support: A case series”

Whitlock, Katelyn C; Rzewnicki, Daniel; Krieger, Briana; Miller, Casey; Creel-Bulos, Christina

doi:10.1177/02676591231159570

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…The elevated right atrium pressure may direct the reinfused blood away from the right heart toward the inflow limb, resulting in recirculation and hypoxemia (31). Additionally, for patients with dual-lumen single-cannula strategies, the lack of a femoral access site may facilitate active rehabilitation in some patients (32, 33).…”

Section: Risks and Benefitsmentioning

confidence: 99%

The Roles of Venopulmonary Arterial Extracorporeal Membrane Oxygenation

Hockstein,

Fan

2023

Critical Care Medicine

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Objectives: Concise definitive review of the use of venopulmonary arterial extracorporeal membrane oxygenation (V-PA ECMO) support in patients with cardiopulmonary failure. Data Sources: Original investigations identified through a PubMed search with search terms “percutaneous right ventricular assist device,” “oxy-RVAD,” “V-PA ECMO,” and “veno-pulmonary arterial ECMO” were reviewed and evaluated for relevance. Study Selection: Studies that included more than three patients supported with V-PA ECMO were included. Data Extraction: Clinically relevant data from included studies, including patient-important outcomes, were summarized and discussed. Data Synthesis: We identified four groups of patients where V-PA ECMO has been studied: acute respiratory distress syndrome, right ventricular dysfunction after left ventricular assist device placement, bridge to lung transplantation, and pulmonary embolism. Most identified works are small, single center, and retrospective in nature, precluding definitive conclusions regarding the efficacy of V-PA ECMO. There have been no clinical trials evaluating the efficacy of V-PA ECMO for any indication. Conclusions: V-PA ECMO is a promising form of extracorporeal support for patients with right ventricular dysfunction. Future work should focus on identifying the optimal timing and populations for the use of V-PA ECMO.

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Section: Risks and Benefitsmentioning

confidence: 99%

The Roles of Venopulmonary Arterial Extracorporeal Membrane Oxygenation

Hockstein,

Fan

2023

Critical Care Medicine

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Outcomes in peripheral right ventricular device support: Comparing the dual lumen, single canula and femoral vein cannulation strategies for right ventricular support

Florea,

Kotkar,

Fischer

et al. 2024

Perfusion

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Introduction The Protek Duo (PtD) dual lumen, single cannula was developed as a percutaneous system for temporary mechanical support, inserted through the internal jugular vein (IJ) for both atrial inflow and pulmonary artery outflow. Outcomes of PtD compared to alternative Peripheral Right Ventricular Assist Device (pRVAD) methods are limited. Methods A retrospective analysis was conducted of pRVAD recipients from January 2017 - February 2022 ( n = 111). These were classified into PtD ( n = 52) patients and Non-Protek [(N-PtD) ( n = 59)] recipients undergoing cannulation of the IJ and femoral vein. Results were further stratified by indication for pRVAD support: cardiogenic etiologies of heart failure and progressive ARDS. Results No survival benefit was detected between PtD and N-PtD groups at 1-week (OR: 1.32, 95% CI: 0.49–3.56, p = 0.58) or 6-month (OR: 9.83, 95% CI: 0.37–1.84, p = 0.64) follow-up. There were no statistically significant differences in whether patients’ mobility progressed to out-of-bed activity ( p = 0.26) or ambulation ( p = 0.38). No differences were noted in time to out-of-bed ( p = 0.26) or time to ambulation ( p = 0.36). On subgroup analysis of patients by indication for pRVAD cannulation, these results persisted; no difference was noted in mid-term mortality (Cardiogenic: p = 0.39; ARDS: p = 0.91), progression to out-of-bed ( p = 0.59; p = 1.00), or ambulation ( p = 0.51; p-0.68). Among secondary outcomes, PtD patients had an increased dialysis requirement ( p = 0.02). There were no differences in ability to wean from RVAD ( p = 0.06), tracheostomy ( p = 0.88), major bleeding events ( p = 0.57), stroke ( p = 0.58), or hospital length of stay ( p = 0.39). Conclusions Outcomes with PtD are comparable to those of traditional pRVAD cannulation strategies. Of note, no mobility benefit was observed to the use of PtD across several metrics.

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“Beyond waking and walking. Intensive rehabilitation in patients requiring extended durations of advanced mechanical circulatory support: A case series”

Cited by 2 publications

References 17 publications

The Roles of Venopulmonary Arterial Extracorporeal Membrane Oxygenation

The Roles of Venopulmonary Arterial Extracorporeal Membrane Oxygenation

Outcomes in peripheral right ventricular device support: Comparing the dual lumen, single canula and femoral vein cannulation strategies for right ventricular support

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