Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review

Magon, Federica; Longhitano, Yaroslava; Savioli, Gabriele; Piccioni, Andrea; Tesauro, Manfredi; Del Duca, Fabio; Napoletano, Gabriele; Volonnino, Gianpietro; Maiese, Aniello; La Russa, Raffaele; Di Paolo, Marco; Zanza, Christian

doi:10.3390/diagnostics14040434

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…Throughout the use of ECMO, systemic anticoagulation must be administered to prevent thrombosis of the circuit, but this exposes the patient to an increased risk of bleeding [ 30 ] and may be a leading contributor to maternal mortality and morbidity [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Extra-Corporeal Membrane Oxygenation in Pregnancy

Romenskaya,

Longhitano,

Mahajan

et al. 2024

JCM

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Extracorporeal membrane oxygenation (ECMO) is a cardiac or pulmonary function support system that is used in cases of refractory organ failure in addition to conventional treatment. Currently, Level I evidence is not yet available, which reflects improved outcomes with ECMO in pregnant women, the use in pregnancy should be indicated in selected cases and only in specialized centers. We searched articles in the most important scientific databases from 2009 until 31 December 2023 consulting also the site ClinicalTrials.com to find out about studies that have been recently conducted or are currently ongoing. We matched the combination of the following keywords: “ECMO and pregnancy”, “H1N1 and pregnancy”, “COVID-19 and pregnancy”, “ARDS and pregnancy”, “ECMO and pregnancy AND (cardiac arrest)”. We selected the following number of articles for each keyword combination: “ECMO and pregnancy” (665 articles); “ECMO and influenza H1N1” (384 articles); “pregnancy and influenza H1N1” (1006 articles); “pregnancy and ARDS” (2930 articles); “ECMO and pregnancy and ARDS and influenza H1N1” (24 articles); and “[ECMO and pregnancy AND (cardiac arrest)]” (74 articles). After careful inspection, only 43 papers fitted our scope. There are two types of ECMO: venous-venous (VV-ECMO) and venous-arterial (VA-ECMO). The first-one is necessary to cope with severe hypoxia: oxygen-depleted blood is taken from the venous circulation, oxygenated, and carbon dioxide removed from the extracorporeal circuit and returned to the same venous system. The VA-ECMO is a type of mechanical assistance to the circulatory system that allows to put the failing organ at rest by ensuring adequate oxygenation and systemic de-oxygenation, avoiding multi-organ failure. The main indications for ECMO support in pregnant women are cardiogenic shock, acute respiratory distress syndrome (ARDS), pulmonary embolism, and eclampsia. There are also fetal indications for ECMO, and they are fetal distress, hypoxic-ischemic encephalopathy (HIE), and twin-to-twin transfusion syndrome (TTTS). Until now, based on the outcomes of the numerous clinical studies conducted, ECMO has been shown to be a successful therapeutic strategy in cases where medical treatment has been unsuccessful. In well-selected pregnant patients, it appears to be safe and associated with a low risk of maternal and fetal complications. The aim of this review is to report the main properties of ECMO (VV and VA) and the indications for its use in pregnant women.

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Section: Discussionmentioning

confidence: 99%

Extra-Corporeal Membrane Oxygenation in Pregnancy

Romenskaya,

Longhitano,

Mahajan

et al. 2024

JCM

Self Cite

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Successful pharmaco-invasive approach using a lower alteplase dose and VA-ECMO support in high-risk pulmonary embolism: case report

Gutierrez-Gallegos,

Jimenez-Franco,

Jerjes-Sanchez

et al. 2024

Front. Cardiovasc. Med.

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Despite the elevated mortality rates associated with high-risk pulmonary embolism (PE), this condition remains understudied. Data regarding the effectiveness and safety of invasive therapies such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) in this patient population remains controversial. Here, we present the case of a 61-year-old male with high-risk PE associated with refractory cardiac arrest and cardiogenic shock who underwent a combination of extracorporeal cardiopulmonary resuscitation with VA-ECMO and pharmaco-invasive therapy (mechanical thrombi fragmentation plus lower alteplase dose), resulting in successful pulmonary reperfusion. After a prolonged in-hospital stay, the patient was discharged in stable condition.

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Optimizing Ultrasound Probe Disinfection for Healthcare-Associated Infection Control: A Comparative Analysis of Disinfectant Efficacy

Ferrara,

Cangelosi,

Morales Palomares

et al. 2024

Microorganisms

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Background/Aims: Ultrasound is a key diagnostic tool in modern medicine due to its ability to provide real-time, high-resolution images of the internal structures of the human body. Despite its undeniable advantages, there are challenges related to the contamination of ultrasound probes, with the risk of healthcare-associated infections. The aim of this review was to identify the most effective disinfectants for disinfecting ultrasound probes to prevent the transmission of pathogens between patients. Methods: A narrative review was conducted using the PubMed, CINAHL, Embase, and Cochrane Library databases, resulting in the inclusion of 16 studies from an initial 1202 records. Results: Hydrogen peroxide (H2O2) was the most effective disinfectant, especially in automated systems, achieving a >5-log10 reduction in viral load, including that of resistant pathogens like Human Papillomavirus. Chlorhexidine gluconate (4%) demonstrated strong antibacterial efficacy, eliminating 84.62% of bacterial contamination, but was less effective against viral pathogens. Glutaraldehyde was effective in some cases, though its use carried a higher risk of probe damage. The use of sodium hypochlorite varied across guidelines; some endorsed it for COVID-19 prevention, while others cautioned against its application due to potential probe damage. Conclusions: This study highlights the importance of advanced disinfection technologies and strict adherence to protocols in improving infection control. Automated systems utilizing H2O2 strike an ideal balance between antimicrobial efficacy and equipment preservation. Future research should focus on developing disinfection methods that prioritize safety, cost-effectiveness, and environmental sustainability in various clinical environments.

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Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review

Cited by 3 publications

References 56 publications

Extra-Corporeal Membrane Oxygenation in Pregnancy

Extra-Corporeal Membrane Oxygenation in Pregnancy

Successful pharmaco-invasive approach using a lower alteplase dose and VA-ECMO support in high-risk pulmonary embolism: case report

Optimizing Ultrasound Probe Disinfection for Healthcare-Associated Infection Control: A Comparative Analysis of Disinfectant Efficacy

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