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Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome: How do we Expand Capacity in the COVID-19 Era?
Despite advances in medical technology, the mortality rate for severe acute respiratory distress syndrome (ARDS) remains high at around 40%. In recent years, multiple studies, systematic reviews, and meta-analyses, including the study in this issue of Heart, Lung and Circulation published by Wang and colleagues, have indicated that treatment with veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be associated with better outcomes in severe ARDS than conventional mechanical ventilation.
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A Multicenter Pilot Study Assessing Regional Cerebral Oxygen Desaturation Frequency During Cardiopulmonary Bypass and Responsiveness to an Intervention Algorithm
The purpose of this multicenter pilot study was to: (1) determine the frequency of regional cerebral oxygen saturation (rScO2) desaturations during cardiac surgery involving cardiopulmonary bypass (CPB); (2) evaluate the accuracy of clinician-identified rScO2 desaturations compared with those recorded continuously during surgery by the near-infrared spectroscopy (NIRS) monitor; and (3) assess the effectiveness of an intervention algorithm for reversing rScO2 desaturations.
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Left Heart Decompression on Veno-Arterial Extracorporeal Membrane Oxygenation in Children With Dilated Cardiomyopathy and Myocarditis: An Extracorporeal Life Support Organization Registry Review
Retrospective review of the Extracorporeal Life Support Organization registry revealed an association between left heart decompression and greater odds of survival in children with myocarditis and dilated cardiomyopathy on extracorporeal membrane oxygenation. When comparing patients with dilated cardiomyopathy against those with myocarditis, we could not exclude a three-fold greater odds of survival associated with the use of left heart decompression. This finding warrants further prospective evaluation.
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