International Perfusion Association’s Post

This study explores the efficacy of a novel ECMELLA setup combining veno-arterial extracorporeal membrane oxygenation (va-ECMO) with a micro-axial flow pump in treating cardiogenic shock (CS). Analyzing data from 67 patients treated between December 2020 and December 2022, the study found the technique feasible and effective, with a 27% myocardial recovery rate and a 24% transition rate to #CardiogenicShock #ECLS #ECMELLA #Impella #VAECMO

ECMELLA or ECMO+Impella is a very effective technique to achieve systemic perfusion AND LV offloading for myocardial recovery. This is increasingly used in post-cardiotomy patients, ECPR/STEMI patients with excellent outcomes. #ECMO #IMPELLA #ECPR #Shock #cardiacarrest #criticalcare

Elevated plasma fibrinogen levels in multiple sclerosis patients during relapse Miranda Acuña J, Hidalgo de la Cruz M, Ros AL, Tapia SP, Martínez Ginés ML, de Andrés Frutos CD. Elevated plasma fibrinogen levels in multiple sclerosis patients during relapse. Mult Scler Relat Disord. 2017 Nov;18:157-160. doi: 10.1016/j.msard.2017.09.033. Epub 2017 Sep 30. PMID: 29141800. https://lnkd.in/ek8MhES2 If measurements of 25(OH)D3 and/or calcitriol reveal deficiency, supplement to bring fibrinogen to 2.5 grams/liter. Otherwise, consider Ivermectin to reduce fibrinogen from elevated levels down to 2.5 grams/liter. Feedback from those I dealt with during COVID-19 with MS reveal a stark improvement with supplementation to correct D3 deficiency. #MS #hyperfibrinogenemia #supplement D3 #lab tests when feasible

💡Potential Impact of Direct Versus Indirect Central Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) Cannulation in Refractory Postcardiotomy Cardiogenic Shock. "The study included 60 patients, 25 received icECMO and 35 treated with dcECMO due to RPCS. The icECMO group demonstrated significantly better 30-day survival rates (icECMO; 10 [40%] vs. dcECMO; 5 [14.3%], log-rank test; p=0.042)..." 📝: Al Ghareeb W, Aldabbas M, Sheikh Ali A, et al. (September 14, 2024) Potential Impact of Direct Versus Indirect Central Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) Cannulation in Refractory Postcardiotomy Cardiogenic Shock. Cureus 16(9): e69415. doi:10.7759/cureus.69415 https://lnkd.in/eKW8nr22

#PEERLESSII RCT’s Design and Rationale manuscript was published in #JSCAI! This randomized controlled trial compares large-bore #thrombectomy using #FlowTriever with #anticoagulation to anticoagulation alone. This groundbreaking RCT is looking to settle an important debate:  In intermediate-risk #PE patients, does mechanical thrombectomy provide benefit over AC alone? Learn more: https://lnkd.in/gfjchDEC Society for Cardiovascular Angiography & Interventions

Don't miss our webinar from the “Haemostasis and beyond” series on the topic of "D-dimer for accurate exclusion of Venous thromboembolism". Join renowned expert Dr. Andreas R. Rechner for a comprehensive webinar on the role of D-dimer in excluding deep vein thrombosis (DVT) and pulmonary embolism (PE). Key takeaways: ✅ Understand what venous thromboembolism (VTE) is, when it occurs, and which risk factors are to be considered. ✅ Know the diagnostic means and algorithms used to exclude VTE. ✅ Describe the advantages and disadvantages of diagnostic tests used for the exclusion of VTE. Ideal for: Laboratory professionals, coagulation specialists, haematologists, cardiologists, neurologists, and oncologists. Enrol now here: https://lnkd.in/eWcZbBdG #Sysmex

When it comes to acute MI courage genic shock treatment. Now we have a randomized clinical trial, showing the survival benefit of early use of MCS with impella CP Which supports the notion of early identification and early initiation of MCS has value in improving human dynamics and organ perfusion, despite the potential for adversity in this very sick patient population The DanGer study just presented today at the ACC.24 meeting and Summit published at the NEJM showed that routine use of a microaxial flow pump with standard care in the treatment of patients with STEMI-related cardiogenic shock led to a lower risk of death from any cause at 180 days than standard care alone. The incidence of a composite of adverse events was higher with the use of the microaxial flow pump.

Ahead of print Plasma N-terminal pro-brain natriuretic peptide concentrations may help to identify patients with very low-risk acute pulmonary embolism: A preliminary study Background. Patients with an acute pulmonary embolism (APE) are a heterogeneous group, and some of them may benefit from early discharge and an ambulatory care referral. We aimed to evaluate the use of N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma level assessment in patients with low-risk APE based on clinical findings (0 points on the simplified Pulmonary Embolism Severity Index (sPESI)). Materials and methods. Preliminary analysis of an ongoing prospective study including 1,151 normotensive patients with at least a segmental APE. In the final analysis, 348 patients with a 0-point sPESI were included. Blood samples were collected within the first 24 h of admission. The clinical endpoint (CE) included APE-related mortality and/or rescue thrombolysis in patients with clinical deterioration. https://lnkd.in/dfbzWVhd

❓ What’s the best vascular access for haemodialysis patients? Thus far, arteriovenous fistulas (AVF) have been the primary choice among experts. (1,2) Central-venous catheters (CVC) come next in line as a secondary option, due to the risk of complications. ❗ Recent findings, however, have challenged this approach: In 2023, Navarro et al. published a study comparing the inflammatory profiles of patients with native AVFs and CVCs. (3) Patients with CVCs used either heparin or TauroLock™-HEP500 as a lock solution.  The results after a period of 3 months: ➡️ No significant changes of inflammatory markers with AVF   ➡️ Significant increase of inflammatory markers with CVC + heparin  ➡️ Significant decrease of inflammatory markers with CVC + TauroLock™-HEP500 Eventually, the inflammatory profile of patients with CVCs using TauroLock™-HEP500 did not differ from that of patients with native AVFs. (3) This discovery is of particular importance considering the correlation between inflammation and biofilm. (4,5) 💡 If TauroLock™-HEP500 can reliably prevent both – might CVCs locked with this product work just as well as AVFs? #taurolock #tauropharm #dialysis #infectionprevention #antimicrobial 1) Schmidli et al. Eur J Vasc Endovasc Surg 2018. DOI: 10.1016/j.ejvs.2018.02.001  2) Lok et al. Am J Kidney Dis 2020. DOI: 10.1053/j.ajkd.2019.12.001   3) Navarro et al. Nephrol Dial Transplant 2023. DOI: 10.1093/ndt/gfad063b_3195  4) Cappelli et al. Nephrol Dial Transplant 2005. DOI: 10.1093/ndt/gfh571  5) Fontseré et al. Antimicrob Agents Chemother 2014. DOI: 10.1128/AAC.02421-14 

1. Meta-Analysis Highlighting SGLT2i Benefits on RV Function: This study is the first meta-analysis to show that SGLT2 inhibitors (SGLT2i) improve right ventricular (RV) functions in heart failure (HF) patients, as evidenced by TAPSE, sPAP, and FAC values. Enhanced RV function is crucial for improving HF prognosis, and SGLT2i significantly contribute to this goal. 2. Mechanisms Behind SGLT2i Benefits in HF SGLT2i benefits extend beyond glycemic control through pleiotropic mechanisms, including natriuresis, plasma volume reduction, enhanced oxygen delivery, and endothelial function improvement via increased nitric oxide availability. These inhibitors also reduce glomerular pressure, modulate Na+/H+ exchange, and shift myocardial metabolism to enhance energy efficiency. 3. Improvement in Pulmonary Artery Pressures and RV Function SGLT2i improve pulmonary artery stiffness (PAS) and RV systolic function, as demonstrated by reductions in pulmonary artery (PA) pressures and tricuspid regurgitation. These effects, independent of diuretics, are linked to vasodilation and reduced lung pressure. Improved PAS enhances pulmonary vascular compliance, reduces RV afterload, and supports RV systolic function. 4. Positive Outcomes in HF Patients Clinical studies confirm that SGLT2i reduce all-cause mortality, hospital admissions, and HF symptoms while improving RV function, PAS, and overall patient well-being. Reducing left ventricular (LV) filling pressures and enhancing diastolic function further contribute to RV improvements, highlighting their comprehensive role in HF management. #healthcare #icu