Blade and balloon atrial septostomy for left heart decompression in patients with severe ventricular dysfunction on extracorporeal membrane oxygenation

Seib, Paul M.; Faulkner, Sherry C.; Erickson, Christopher C.; Devanter, Stephen H. Van; Harrell, James E.; Fasules, James W.; Frazier, Elizabeth A.; Morrow, W. Robert

doi:10.1002/(sici)1522-726x(199902)46:2<179::aid-ccd13>3.3.co;2-n

Cited by 28 publications

(41 citation statements)

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“…Cannulation sites utilized included thoracic (for cardiac patients with recent sternotomy) or cervical/ groin cannulation. In patients with left ventricular dysfunction, consideration was given after ECLS cannulation to early decompression of the left atrium and ventricle which, if necessary, was accomplished by atrial septostomy or a transthoracic left atrial cannula placement (15). …”

Section: Methodsmentioning

confidence: 99%

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

et al. 2009

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SummaryAim-To describe our experience using extracorporeal cardiopulmonary resuscitation (ECPR) in resuscitating children with refractory cardiac arrest in the intensive care unit (ICU) and to describe hospital survival and neurologic outcomes after ECPR.Methods-A retrospective chart review of a consecutive case series of patients requiring ECPR from 2001-2006 at Arkansas Children's Hospital. Data from medical records was abstracted and reviewed. Primary study outcomes were survival to hospital discharge and neurological outcome at hospital discharge.Results-During the 6-year study period, ECPR was deployed 34 times in 32 patients. 24 deployments (73%) resulted in survival to hospital discharge. Twenty eight deployments (82%) were for underlying cardiac disease, 3 for neonatal non cardiac (NICU) patients and 3 for pediatric noncardiac (PICU) patients. On multivariate logistic regression analysis, only serum ALT (p value = 0.043; OR-1.6; 95% confidence interval-1.014-2.527) was significantly associated with risk of death prior to hospital discharge. Blood Lactate at 24 hours post ECPR showed a trend towards significance (p value-0.059; OR-1.27; 95% confidence interval-0.991-1.627). The Hosmer-Lemeshow tests (p value = 0.178) suggested a good fit for the model. Neurological evaluation of the survivors revealed that there was no change in PCPC scores from a baseline of 1-2 in 18/24 (75%) survivors. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflict of interest statementNone of the authors have any conflict of interest that could inappropriately influence (bias) this work. NIH Public Access Author ManuscriptResuscitation. Author manuscript; available in PMC 2010 November 2. Conclusions-ECPR can be used successfully to resuscitate children following refractory cardiac arrest in the ICU, and grossly intact neurologic outcomes can be achieved in a majority of cases.

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Section: Methodsmentioning

confidence: 99%

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

et al. 2009

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“…unmöglich werden. In mehreren Fallberichten wurden unterschiedliche Techniken (atriale Septostomie, trans-aortal eingeführte Pigtaildrainage oder Impella LP2.5 Pumpe) zur Entlastung einer linksventrikulären Dilatation während ECMO Therapie beschrieben [39][40][41][42][43].…”

Section: Komplikationen Und Komplikationsmanagementunclassified

Positionspapier der Österreichischen Kardiologischen Gesellschaft zum Einsatz der extrakorporalen Membranoxygenation (ECMO) bei Erwachsenen kardiologischen Patienten

Pichler

Antretter

Dünser

et al. 2015

Med Klin Intensivmed Notfmed

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The use of ECMO to stabilize critically ill patients with severely depressed cardiac function and hemodynamics increased in the last years due to broader availability, better performance and easier implantation of the devices. The present guidelines of the Austrian Society of Cardiology focus on the use of ECMO in adult non-operated patients with cardiac diseases. Not only indications and contraindications are highlighted, but also the equally important issues of monitoring, complication management, measures during implantation and operation, and weaning of the devices are treated in detail. Thereby the present guidelines aim to optimize the use of ECMO in the individual centers, and aim to help current non-ECMO centers in developing a local ECMO-program or to contact ECMO-centers for discussion of individual patients.

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“…One patient required a repeat BBAS due to residual restriction at the atrial level. As shown previously at our institution [5], BBAS is an important part of the optimal management of patients with left ventricular failure who are supported with ECMO and facilitates adequate reduction of left atrial hypertension and associated pulmonary edema.…”

Section: Discussionmentioning

confidence: 80%

Intrahospital transport of children on extracorporeal membrane oxygenation: Indications, process, interventions, and effectiveness

Prodhan

Fiser

Cenac

et al. 2010

Pediatric Critical Care Medicine

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Objective-Critically ill patients supported with extracorporeal membrane oxygenation (ECMO) are transported within the hospital to the radiology suite, cardiac catheterization suite, operating room, and from one ICU to another. No studies to date have systematically evaluated intrahospital transport (IHT) while on ECMO. This study aims to evaluate indications, process, interventions, and effectiveness of patients undergoing IHT. Design-Retrospective cohort analysis.Setting-Cardiac intensive care unit in a tertiary care children's hospital.Patients-All patients requiring IHT while on ECMO between January 1996 and March 2007 were included and analyzed in detail. Measurement and MainResults-A total of 57 IHTs for cardiac catheterization (CC) and head CT scans were analyzed. In 14/20 (70%) of CC patients, a management change occurred as a result of the diagnostic CC. In 10/17 (59%) bedside echo was of limited value in defining the critical problem. In the interventional group the majority of transports were for atrial septostomy. In the head CT group significant pathology was identified, which led to management change. No major complications occurred during these IHTs. NIH Public AccessConclusions-IHT while on ECMO is labor intensive and requiring extensive logistic support, it can be carried out safely in experienced hands and results in important therapeutic and diagnostic yields. To our knowledge this is the first study designed to evaluate safety and efficacy of IHT for patients receiving ECMO support.

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Blade and balloon atrial septostomy for left heart decompression in patients with severe ventricular dysfunction on extracorporeal membrane oxygenation

Cited by 28 publications

References 0 publications

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

Positionspapier der Österreichischen Kardiologischen Gesellschaft zum Einsatz der extrakorporalen Membranoxygenation (ECMO) bei Erwachsenen kardiologischen Patienten

Intrahospital transport of children on extracorporeal membrane oxygenation: Indications, process, interventions, and effectiveness

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