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Original Article
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
  • 743 View
  • 58 Download
  • 1 Crossref
AbstractAbstract PDF
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
Review Article
Pulmonary
Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages
Vorakamol Phoophiboon, Monvasi Pachinburavan, Nicha Ruamsap, Natthawan Sanguanwong, Nattapong Jaimchariyatam
Acute Crit Care. 2021;36(4):286-293.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.00458
  • 6,776 View
  • 442 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDF
The mortality rate of pulmonary hypertension in pregnancy is 25%–56%. Pulmonary arterial hypertension is the highest incidence among this group, especially in young women. Despite clear recommendation of pregnancy avoidance, certain groups of patients are initially diagnosed during the gestational age step into the third trimester. While the presence of right ventricular failure in early gestation is usually trivial, it can be more severe in the late trimester. Current evidence shows no consensus in the management and serious precautions for each stage of the pre-, peri- and post-partum periods of this specific group. Pulmonary hypertension-targeted drugs, mode of delivery, type of anesthesia, and some avoidances should be planned among a multidisciplinary team to enhance maternal and fetal survival opportunities. Sudden circulatory collapse from cardiac decompensation during the peri- and post-partum phases is detrimental, and mechanical support such as extracorporeal membrane oxygenation should be considered for mitigating hemodynamics and extending cardiac recovery time. Our review aims to explain the pathophysiology of pulmonary arterial hypertension and summarize the current evidence for critical management and precautions in each stage of pregnancy.

Citations

Citations to this article as recorded by  
  • Maternal Outcomes Among Pregnant Women With Congenital Heart Disease–Associated Pulmonary Hypertension
    Qian Zhang, Fang Zhu, Guocheng Shi, Chen Hu, Weituo Zhang, Puzhen Huang, Chunfeng Zhu, Hong Gu, Dong Yang, Qiangqiang Li, Yonghua Niu, Hao Chen, Ruixiang Ma, Ziyi Pan, Huixian Miao, Xin Zhang, Genxia Li, Yabing Tang, Guyuan Qiao, Yichen Yan, Zhongqun Zhu,
    Circulation.2023; 147(7): 549.     CrossRef
  • Pregnancy in Patients with Pulmonary Arterial Hypertension in Light of New ESC Guidelines on Pulmonary Hypertension
    Karolina Barańska-Pawełczak, Celina Wojciechowska, Wojciech Jacheć
    International Journal of Environmental Research and Public Health.2023; 20(5): 4625.     CrossRef
  • Pregnancy in Severe Pulmonary Hypertension: A Case Report and Literature Analysis
    一人 王
    Advances in Clinical Medicine.2023; 13(10): 16433.     CrossRef
  • Effects of maternal pulmonary arterial hypertension on fetal hemodynamics and maternal‐fetal outcome in late pregnancy
    Yuan Yuan Xing, Yanping Ruan, Huai Qin, Lei Zhao, Qing Zhao, Yun Wei, Jie Chen, Xiaohai Ma
    Echocardiography.2023; 40(12): 1339.     CrossRef
  • Clinical Analysis in 82 Pregnant Women with the Severity of Pulmonary Hypertension
    安芬 李
    Advances in Clinical Medicine.2023; 13(11): 18492.     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
  • 9,690 View
  • 280 Download
  • 16 Web of Science
  • 20 Crossref
AbstractAbstract 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  
  • 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;[Epub]     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;[Epub]     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;[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; 27: 107424842110690.     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
Original Article
Relationship of Temperature and Humidity with the Number of Daily Emergency Department Visits for Acute Heart Failure: Results from a Single Institute from 2008-2010
Sang Hyun Ha, Bong Gun Song, Na Kyoung Lee, Chang Shin Choi, Chong Kun Hong, Jun Ho Lee, Seong Youn Hwang
Korean J Crit Care Med. 2012;27(3):165-172.
DOI: https://doi.org/10.4266/kjccm.2012.27.3.165
  • 2,824 View
  • 16 Download
AbstractAbstract PDF
BACKGROUND
The incidence of acute heart failure (AHF) increases in cold weather. Whether or not AHF has seasonal variation in Korea is unclear, and the influence of humidity on AHF incidence is also unclear. The aim of this study was to examine the correlation between the number of daily emergency department (ED) visits for AHF and the temperature and humidity in Korea.
METHODS
On a retrospective basis, we investigated the medical records of patients who visited the ED with dyspnea from Jan. 1, 2008 to Dec. 31, 2010. Inclusion criteria comprised both evidence of clinical symptoms and the presence of signs of pulmonary congestion on chest X-rays. Exclusion criteria included a medical history showing end-stage renal disease with dialysis or showing an acute ST elevation myocardial infarction. The number of daily ED visits for AHF was compared with meteorological data after stratifying temperature or humidity into 3 parts.
RESULTS
After stratification by humidity, the results revealed that the number of daily ED visits was significantly associated with minimum temperatures occurring one to 2 days prior to ED admission, although only in the lowest tertile of humidity (p = 0.012, p = 0.021, respectively). The relationship between humidity and daily ED visits for AHF was the same as that mentioned above (p = 0.016, p = 0.039, respectively).
CONCLUSIONS
The number of patients with AHF in Korea increases in cold weather, as is the case in other countries. Specifically, AHF incidence was related to temperature minimums occurring one to 2 days prior to ED admission, as well as with humidity.
Review
Hemodynamic Monitoring and Treatment Strategy of Acute Heart Failure
Chul Soo Park
Korean J Crit Care Med. 2011;26(1):1-5.
DOI: https://doi.org/10.4266/kjccm.2011.26.1.1
  • 2,703 View
  • 85 Download
  • 2 Crossref
AbstractAbstract PDF
Acute heart failure (AHF) has emerged as a major public health problem over the past 2 decades and AHF represents a period of high risk for patients, during which time the patients are more susceptible to have fatal outcomes or be re-hospitalized, compared to periods of chronic stable heart failure. The goals of AHF treatment are symptomatic relief and hemodynamic stabilization, which need accurate assessment of volume status and cardiac function of patients. Until now, there is a paucity of controlled clinical data to define optimal treatment for patients with AHF and most guidelines published by the American Heart Association or European Society of Cardiology have been generated by the consensus opinions of experts. In these guidelines, routine invasive hemodynamic monitoring of AHF patients is not recommended because there have not been any reports showing survival benefit in patients monitored with pulmonary artery catheters. At present, treatment strategies based on clinical characteristics such as pulmonary congestion and tissue hypoperfusion rather than invasive hemodynamic monitoring is widely accepted. In this article, we discuss an optimal management plan including appropriate assessment of the hemodynamic status of patients and treatment of AHF.

Citations

Citations to this article as recorded by  
  • Thoracic aortic aneurysms exerting high extrinsic pressure on the airway
    Hanna Jung, Young Woo Do, Sang Yub Lee, Youngok Lee, Tak Hyuk Oh, Gun Jik Kim
    Journal of Cardiothoracic Surgery.2019;[Epub]     CrossRef
  • Relationship of Temperature and Humidity with the Number of Daily Emergency Department Visits for Acute Heart Failure: Results from a Single Institute from 2008-2010
    Sang Hyun Ha, Bong Gun Song, Na Kyoung Lee, Chang Shin Choi, Chong Kun Hong, Jun Ho Lee, Seong Youn Hwang
    Korean Journal of Critical Care Medicine.2012; 27(3): 165.     CrossRef

ACC : Acute and Critical Care