Acute and Critical Care

Original Articles

Cardiology
Clinical implications of pleural effusion following left ventricular assist device implantation: So-Min Lim, Ah-Ram Kim, Junho Hyun, Sang-Eun Lee, Pil-Je Kang, Sung-Ho Jung, Min-Seok Kim; Acute Crit Care. 2024;39(1):169-178. Published online January 17, 2024; DOI: https://doi.org/10.4266/acc.2023.01102

2,226 View
85 Download
2 Web of Science
1 Crossref

Background
Studies on the association between pleural effusion (PE) and left ventricular assist devices (LVADs) are limited. This study aimed to examine the characteristics and the clinical impact of PE following LVAD implantation.
Methods
This study is a prospective analysis of patients who underwent LVAD implantation from June 2015 to December 2022. We investigated the prognostic impact of therapeutic drainage (TD) on clinical outcomes. We also compared the characteristics and clinical outcomes between early and late PE and examined the factors related to the development of late PE.
Results
A total of 71 patients was analyzed. The TD group (n=45) had a longer ward stay (days; median [interquartile range]: 31.0 [23.0–46.0] vs. 21.0 [16.0–34.0], P=0.006) and total hospital stay (47.0 [36.0–82.0] vs. 31.0 [22.0–48.0], P=0.002) compared to the no TD group (n=26). Early PE was mostly exudate, left-sided, and neutrophil-dominant even though predominance of lymphocytes was the most common finding in late PE. Patients with late PE had a higher rate of reintubation within 14 days (31.8% vs. 4.1%, P=0.004) and longer hospital stays than those without late PE (67.0 [43.0–104.0] vs. 36.0 [28.0–48.0], P<0.001). Subgroup analysis indicated that female sex, low body mass index, cardiac resynchronization therapy, and hypoalbuminemia were associated with late PE.
Conclusions
Compared to patients not undergoing TD, those undergoing TD had a longer hospital stay but not a higher 90-day mortality. Patients with late PE had poor clinical outcomes. Therefore, the correction of risk factors, like hypoalbuminemia, may be required.

Citations

Citations to this article as recorded by

Nuances of pleural effusion after left ventricular assist devices implantation: insights from therapeutic drainage and preoperative predictors
Huijin Lee, Jeehoon Kang
Acute and Critical Care.2024; 39(1): 192. CrossRef

Pulmonary
Use of extracorporeal membrane oxygenation in patients with acute high-risk pulmonary embolism: a case series with literature review: You Na Oh, Dong Kyu Oh, Younsuck Koh, Chae-Man Lim, Jin-Won Huh, Jae Seung Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong; Acute Crit Care. 2019;34(2):148-154. Published online May 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00500

8,675 View
231 Download
24 Web of Science
27 Crossref

Abstract PDF

Background
Although extracorporeal membrane oxygenation (ECMO) has been used for the treatment of acute high-risk pulmonary embolism (PE), there are limited reports which focus on this approach. Herein, we described our experience with ECMO in patients with acute high-risk PE.
Methods
We retrospectively reviewed medical records of patients diagnosed with acute highrisk PE and treated with ECMO between January 2014 and December 2018.
Results
Among 16 patients included, median age was 51 years (interquartile range [IQR], 38 to 71 years) and six (37.5%) were male. Cardiac arrest was occurred in 12 (75.0%) including two cases of out-of-hospital arrest. All patients underwent veno-arterial ECMO and median ECMO duration was 1.5 days (IQR, 0.0 to 4.5 days). Systemic thrombolysis and surgical embolectomy were performed in seven (43.8%) and nine (56.3%) patients, respectively including three patients (18.8%) received both treatments. Overall 30-day mortality rate was 43.8% (95% confidence interval, 23.1% to 66.8%) and 30-day mortality rates according to the treatment groups were ECMO alone (33.3%, n=3), ECMO with thrombolysis (50.0%, n=4) and ECMO with embolectomy (44.4%, n=9).
Conclusions
Despite the vigorous treatment efforts, patients with acute high-risk PE were related to substantial morbidity and mortality. We report our experience of ECMO as rescue therapy for refractory shock or cardiac arrest in patients with PE.

Citations

Citations to this article as recorded by

Management of Pulmonary Embolism: A Single-Center Experience
R. Holt Hammons, Sibu P. Saha
Southern Medical Journal.2025; 118(1): 14. CrossRef
Surgical Embolectomy for tPA Refractory Pulmonary Embolism Requiring VA-ECMO: A Case Report and Literature Review
Olga Gomez Rojas, Moustafa Younis, Mindaugas Rackauskas, Philip Hess, William Ricks, Mohammad Aladaileh, Biplab K. Saha
SN Comprehensive Clinical Medicine.2025;[Epub] CrossRef
Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: an overview of current practice and evidence
Samir Ali, Christiaan L. Meuwese, Xavier J. R. Moors, Dirk W. Donker, Anina F. van de Koolwijk, Marcel C. G. van de Poll, Diederik Gommers, Dinis Dos Reis Miranda
Netherlands Heart Journal.2024; 32(4): 148. CrossRef
Integration of Extracorporeal Membrane Oxygenation into the Management of High-Risk Pulmonary Embolism: An Overview of Current Evidence
Romain Chopard, Raquel Morillo, Nicolas Meneveau, David Jiménez
Hämostaseologie.2024; 44(03): 182. CrossRef
Evidence-Based Management of Massive and Submassive Pulmonary Embolism
Sara Al-Juboori, Tareq Alzaher, Hashem Al Omari, Sufyan Al Gammaz, Mazen Al-Qadi
JAP Academy Journal.2024;[Epub] CrossRef
Mechanical Support in High-Risk Pulmonary Embolism: Review Article
Amer N. Kadri, Razan Alrawashdeh, Mohamad K. Soufi, Adam J. Elder, Zachary Elder, Tamam Mohamad, Eric Gnall, Mahir Elder
Journal of Clinical Medicine.2024; 13(9): 2468. CrossRef
Acute Pulmonary Embolism: Evidence, Innovation, and Horizons
Stanislav Henkin, Francisco Ujueta, Alyssa Sato, Gregory Piazza
Current Cardiology Reports.2024; 26(11): 1249. CrossRef
Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2
Kensuke Takabayashi, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamo
Journal of Intensive Care.2024;[Epub] CrossRef
Extracorporeal membrane oxygenation for large pulmonary emboli
Timothy J. George, Jenelle Sheasby, Rahul Sawhney, J. Michael DiMaio, Aasim Afzal, Dennis Gable, Sameh Sayfo
Baylor University Medical Center Proceedings.2023; 36(3): 314. CrossRef
Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Association
Joshua B. Goldberg, Jay Giri, Taisei Kobayashi, Marc Ruel, Alexander J.C. Mittnacht, Belinda Rivera-Lebron, Abe DeAnda, John M. Moriarty, Thomas E. MacGillivray
Circulation.2023;[Epub] CrossRef
Life-threatening pulmonary embolism: overview and management
Nizar Osmani, Jonathan Marinaro, Sundeep Guliani
International Anesthesiology Clinics.2023;[Epub] CrossRef
Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis
Jonathan Jia En Boey, Ujwal Dhundi, Ryan Ruiyang Ling, John Keong Chiew, Nicole Chui-Jiet Fong, Ying Chen, Lukas Hobohm, Priya Nair, Roberto Lorusso, Graeme MacLaren, Kollengode Ramanathan
Journal of Clinical Medicine.2023; 13(1): 64. CrossRef
Pulmonary ECMO-ism: Let’s add PEA to ECPR indications
Zachary Shinar, Alice Hutin
Resuscitation.2022; 170: 293. CrossRef
Combined use of extracorporeal membrane oxygenation with interventional surgery for acute pancreatitis with pulmonary embolism: A case report
Ling-Ling Yan, Xiu-Xiu Jin, Xiao-Dan Yan, Jin-Bang Peng, Zhuo-Ya Li, Bi-Li He
World Journal of Clinical Cases.2022; 10(12): 3899. CrossRef
Pulmonary Embolism Complicated With Cardiopulmonary Arrest Treated With Combination of Thrombolytics and Aspiration Thrombectomy
Taylor C. Remillard, Zain Kassam, Maks Coven, Aditya Mangla, Zoran Lasic
JACC: Case Reports.2022; 4(10): 576. CrossRef
Anesthetic management for intraoperative acute pulmonary embolism during inferior vena cava tumor thrombus surgery: A case report
Pei-Yu Hsu, En-Bo Wu
World Journal of Clinical Cases.2022; 10(15): 5111. CrossRef
Percutaneous mechanical thrombectomy and extracorporeal membranous oxygenation: A case series
Haytham Mously, Jamal Hajjari, Tarek Chami, Tarek Hammad, Robert Schilz, Teresa Carman, Yakov Elgudin, Yasir Abu‐Omar, Marc P. Pelletier, Mehdi H. Shishehbor, Jun Li
Catheterization and Cardiovascular Interventions.2022; 100(2): 274. CrossRef
Clinical Experiences of High-Risk Pulmonary Thromboembolism Receiving Extracorporeal Membrane Oxygenation in Single Institution
Joonyong Jang, So-My Koo, Ki-Up Kim, Yang-Ki Kim, Soo-taek Uh, Gae-Eil Jang, Wonho Chang, Bo Young Lee
Tuberculosis and Respiratory Diseases.2022; 85(3): 249. CrossRef
Management of High-Risk Pulmonary Embolism: What Is the Place of Extracorporeal Membrane Oxygenation?
Benjamin Assouline, Marie Assouline-Reinmann, Raphaël Giraud, David Levy, Ouriel Saura, Karim Bendjelid, Alain Combes, Matthieu Schmidt
Journal of Clinical Medicine.2022; 11(16): 4734. CrossRef
Optimal reperfusion strategy in acute high-risk pulmonary embolism requiring extracorporeal membrane oxygenation support: a systematic review and meta-analysis
Romain Chopard, Peter Nielsen, Fabio Ius, Serghei Cebotari, Fiona Ecarnot, Hugo Pilichowski, Matthieu Schmidt, Benedict Kjaergaard, Iago Sousa-Casasnovas, Mehrdad Ghoreishi, Rajeev L. Narayan, Su Nam Lee, Gregory Piazza, Nicolas Meneveau
European Respiratory Journal.2022; 60(5): 2102977. CrossRef
Venoarterial Extracorporeal Membrane Oxygenation in High-Risk Pulmonary Embolism: A Case Series and Literature Review
Zied Ltaief, Ermes Lupieri, Jean Bonnemain, Nawfel Ben-Hamouda, Valentina Rancati, Sabine Schmidt Kobbe, Matthias Kirsch, Jean-Daniel Chiche, Lucas Liaudet
Reviews in Cardiovascular Medicine.2022;[Epub] CrossRef
Use of extracorporeal membrane oxygenation in high‐risk acute pulmonary embolism: A systematic review and meta‐analysis
Luca Baldetti, Alessandro Beneduce, Lorenzo Cianfanelli, Giulio Falasconi, Luigi Pannone, Francesco Moroni, Angela Venuti, Stefania Sacchi, Mario Gramegna, Vittorio Pazzanese, Francesco Calvo, Guglielmo Gallone, Matteo Pagnesi, Alberto Maria Cappelletti
Artificial Organs.2021; 45(6): 569. CrossRef
Institutional Experience With Venoarterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism: A Retrospective Case Series
Maxwell A. Hockstein, Christina Creel-Bulos, Joshua Appelstein, Craig S. Jabaley, Michael J. Stentz
Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(9): 2681. CrossRef
Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*
John Harwood Scott, Matthew Gordon, Robert Vender, Samantha Pettigrew, Parag Desai, Nathaniel Marchetti, Albert James Mamary, Joseph Panaro, Gary Cohen, Riyaz Bashir, Vladimir Lakhter, Stephanie Roth, Huaqing Zhao, Yoshiya Toyoda, Gerard Criner, Lisa Moor
Critical Care Medicine.2021; 49(5): 760. CrossRef
Adult Langerhans histiocytosis with rare BRAF mutation complicated by massive pulmonary embolism
Salma Hassan, Christina Fanola, Amy Beckman, Faqian Li, Andrew C. Nelson, Michael Linden, Joan D. Beckman
Thrombosis Research.2020; 193: 207. CrossRef
Efficacy and safety of extracorporeal membrane oxygenation for high-risk pulmonary embolism: A systematic review and meta-analysis
Matteo Pozzi, Augustin Metge, Anthony Martelin, Caroline Giroudon, Justine Lanier Demma, Catherine Koffel, William Fornier, Pascal Chiari, Jean Luc Fellahi, Jean Francois Obadia, Xavier Armoiry
Vascular Medicine.2020; 25(5): 460. CrossRef
Evidence-Based Minireview: Advanced therapies and extracorporeal membrane oxygenation for the management of high-risk pulmonary embolism
Radhika Gangaraju, Frederikus A. Klok
Hematology.2020; 2020(1): 195. CrossRef

Case Report

Pulmonary
Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation: Dong Kyu Oh, Tae Sun Shim, Kyung-Wook Jo, Seung-Il Park, Dong Kwan Kim, Sehoon Choi, Geun Dong Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong; Acute Crit Care. 2020;35(2):117-121. Published online April 8, 2019; DOI: https://doi.org/10.4266/acc.2018.00416

11,332 View
292 Download
23 Web of Science
23 Crossref

Abstract PDF

Right heart decompensation is a fatal complication in patients with respiratory failure, particularly in those transitioned to lung transplantation using veno-venous extracorporeal membrane oxygenation (V-V ECMO). In these patients, veno-arterial (V-A ECMO) or veno-arterialvenous extracorporeal membrane oxygenation (V-AV ECMO) is used to support both cardiac and respiratory function. However, these processes may increase the risk of device-related complications such as bleeding, thromboembolism, and limb ischemia. In the present case, a 64-year-old male patient with idiopathic pulmonary fibrosis developed respiratory failure and commenced treatment with V-V ECMO as a bridge to lung transplantation. Unfortunately, the patient developed right heart decompensation and required both cardiac and respiratory support during treatment with V-V ECMO. Instead of adding arterial cannulation, he was switched to a novel configuration, a right ventricular assist device with an oxygenator (Oxy- RVAD) using ECMO, with drainage cannulation from the femoral vein and return cannulation to the main pulmonary artery. The patient was successfully bridged to lung transplantation without serious complications after 10 days of Oxy-RVAD support. To the best of our knowledge, this is an extreme rare and challenging case of Oxy-RVAD using ECMO in a patient successfully bridged to lung transplantation.

Citations

Citations to this article as recorded by

Improved Results Over Time With Bridge-to-Lung Transplantation: A 10-Year Experience of a Single High-Volume Center
Gyungah Kim, Jee Hwan Ahn, Tae Sun Shim, Pil-Je Kang, Geun Dong Lee, Sehoon Choi, Won Kim, Sung-Ho Jung, Dong Kwan Kim, Seung-Il Park, Sang-Bum Hong
Transplant International.2025;[Epub] CrossRef
The Role of Palliative Care in Cardiovascular Disease
John Arthur McClung, William H. Frishman, Wilbert S. Aronow
Cardiology in Review.2024;[Epub] CrossRef
Percutaneous Venopulmonary Extracorporeal Membrane Oxygenation as Bridge to Lung Transplantation
Asad Ali Usman, Audrey Elizabeth Spelde, Wasim Lutfi, Jacob T. Gutsche, William J. Vernick, Omar Toubat, Salim E. Olia, Edward Cantu, Andrew Courtright, Maria M. Crespo, Joshua Diamond, Mauer Biscotti, Christian A. Bermudez
ASAIO Journal.2024; 70(9): 758. CrossRef
Right Ventricular Assist Device With an Oxygenator for the Management of Combined Right Ventricular and Respiratory Failure: A Systematic Review
Juliette Beaulieu, Christine Vu, Sanjog Kalra, Hamza Ouazani Chahdi, Julie Cousineau, Alexis Matteau, Samer Mansour, E. Marc Jolicoeur, Sabrina Jacques, Bénédicte Nauche, Renata Podbielski, Pasquale Ferraro, Charles Poirier, Brian J. Potter
Canadian Journal of Cardiology.2024; 40(9): 1732. CrossRef
Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report
Ga Young Yoo, June Lee, Seok Beom Hong, Do Yeon Kim
Journal of Chest Surgery.2024; 57(3): 319. CrossRef
Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature
J. Michael Brewer, Roberto Lorusso, L. Mikael Broman, Steven A. Conrad, Justyna Swol, Marc O. Maybauer
ASAIO Journal.2024; 70(9): e123. CrossRef
Outcomes of Lung Transplantation in Patients With Right Ventricular Dysfunction: A Single-Center Retrospective Analysis Comparing ECMO Configurations in a Bridge-to-Transplant Setting
Su Yeon Lee, Jee Hwan Ahn, Ho Cheol Kim, Tae Sun Shim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Seung-Il Park, Sang-Bum Hong
Transplant International.2024;[Epub] CrossRef
Venopulmonary extracorporeal membrane oxygenation for right ventricular support as a bridge to lung transplantation: A narrative review
Phan Quang Thuan, Nguyen Hoai Nam, Nguyen Hoang Dinh
SAGE Open Medicine.2024;[Epub] CrossRef
Early Mobilization for a Patient With a Right Ventricular Assist Device With an Oxygenator
Sheena MacFarlane, Vanessa Lee, Adrienne H. Simonds, Samantha Alvarez, Samantha Carty, Kevin H. Ewers, Victoria R. Kelly, Parker Linden, Amanda L. Moskal
Journal of Acute Care Physical Therapy.2023; 14(1): 45. CrossRef
A 35-month-old boy who ingested laundry detergent pods and underwent veno-pulmonary extracorporeal membrane oxygenation support
Hye-ji Han, Bongjin Lee, Won Jin Jang, Ji Won Lee, Jin Hee Kim, Sungkyu Cho, June Dong Park
Pediatric Emergency Medicine Journal.2023; 10(4): 175. CrossRef
Right Ventricular Assist Device With Extracorporeal Membrane Oxygenation for Bridging Right Ventricular Heart Failure to Lung Transplantation: A Single-Center Case Series and Literature Review
Jae Guk Lee, Chuiyong Pak, Dong Kyu Oh, Ho Cheol Kim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Sang-Bum Hong
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(6): 1686. CrossRef
Advanced Circulatory Support and Lung Transplantation in Pulmonary Hypertension
Marie M. Budev, James J. Yun
Cardiology Clinics.2022; 40(1): 129. CrossRef
A Review of Pulmonary Arterial Hypertension Treatment in Extracorporeal Membrane Oxygenation: A Case Series of Adult Patients
Heather Torbic, Benjamin Hohlfelder, Sudhir Krishnan, Adriano R. Tonelli
Journal of Cardiovascular Pharmacology and Therapeutics.2022;[Epub] CrossRef
A Comprehensive Review of Mechanical Circulatory Support Devices
Varunsiri Atti, Mahesh Anantha Narayanan, Brijesh Patel, Sudarshan Balla, Aleem Siddique, Scott Lundgren, Poonam Velagapudi
Heart International.2022; 16(1): 37. CrossRef
Comprehensive Monitoring in Patients With Dual Lumen Right Atrium to Pulmonary Artery Right Ventricular Assist Device
Asad A. Usman, Audrey E. Spelde, Michael Ibrahim, Marisa Cevasco, Christian Bermudez, Emily MacKay, Sameer Khandhar, Wilson Szeto, William Vernick, Jacob Gutsche
ASAIO Journal.2022; 68(12): 1461. CrossRef
Percutaneous Pulmonary Artery Cannulation to Treat Acute Secondary Right Heart Failure While on Veno-venous Extracorporeal Membrane Oxygenation
Kelly M. Ivins-O’Keefe, Michael S. Cahill, Arthur R. Mielke, Michal J. Sobieszczyk, Valerie G. Sams, Phillip E. Mason, Matthew D. Read
ASAIO Journal.2022; 68(12): 1483. CrossRef
The ProtekDuo for percutaneous V-P and V-VP ECMO in patients with COVID-19 ARDS
Ahmed M El Banayosy, Aly El Banayosy, Joseph M Brewer, Mircea R Mihu, Jaclyn M Chidester, Laura V Swant, Robert S Schoaps, Ammar Sharif, Marc O Maybauer
The International Journal of Artificial Organs.2022; 45(12): 1006. CrossRef
Critical Care Management of the Patient with Pulmonary Hypertension
Christopher J. Mullin, Corey E. Ventetuolo
Clinics in Chest Medicine.2021; 42(1): 155. CrossRef
Successful Lung Transplantation After 213 Days of Extracorporeal Life Support: Role of Oxygenator-Right Ventricular Assist Device
Jae Kyeom Sim, Kyeongman Jeon, Gee Young Suh, Suryeun Chung, Yang Hyun Cho
ASAIO Journal.2021; 67(7): e127. CrossRef
Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation
Sung Kwang Lee, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo
Transplantation.2021; 105(7): 1610. CrossRef
Interventional and Surgical Treatments for Pulmonary Arterial Hypertension
Tomasz Stącel, Magdalena Latos, Maciej Urlik, Mirosław Nęcki, Remigiusz Antończyk, Tomasz Hrapkowicz, Marcin Kurzyna, Marek Ochman
Journal of Clinical Medicine.2021; 10(15): 3326. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(12): 3496. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Anesthesia & Analgesia.2021; 133(6): 1459. CrossRef

First
Prev
Page of 1
Next
Last

Search