54
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Thoratec CentriMag for Temporary Treatment of Refractory Cardiogenic Shock or Severe Cardiopulmonary Insufficiency: A Systematic Literature Review and Meta-Analysis of Observational Studies

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Supplemental Digital Content is available in the text.

          Abstract

          The aim of the study was to systematically evaluate effect of CentriMag heart pump (Thoratec Corporation) as temporary ventricular assist device (VAD) and part of extracorporeal membrane oxygenation (ECMO) system on outcomes in patients with cardiac or cardiac-respiratory failure. A systematic search was conducted in five databases for the period 2003 to 2012. Fifty-three publications with data for 999 patients, supported with CentriMag, were included. In 72% studies, CentriMag was used as a VAD and in 25% as part of ECMO circuit. Mean duration of VAD support was 25.0 days in precardiotomy group, 10.9 days in postcardiac surgery cardiogenic shock group, 8.8 days in post-transplant graft failure and rejection group, and 16.0 days in post-LVAD placement right ventricular failure group. Survival on support was 82% (95% CI 70–92) for VAD support in precardiotomy cardiogenic shock indication, 63% (95% CI 46–78) in VAD support in postcardiac surgery cardiogenic shock indication, 62% (95% CI 46–76) in VAD support in post-transplant graft rejection or failure indication, and 83% (95% CI 73–92) in VAD support in post-LVAD placement right ventricular failure indication. CentriMag is an effective technology for temporary support of patients with cardiac and cardiorespiratory failure.

          Related collections

          Most cited references77

          • Record: found
          • Abstract: found
          • Article: not found

          Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective.

          Limited information is available about potentially changing and contemporary trends in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction. The objectives of our study were to examine 3-decade-long trends (1975 to 2005) in the incidence rates of cardiogenic shock complicating acute myocardial infarction, patient characteristics and treatment practices associated with this clinical complication, and hospital death rates in residents of a large central New England community hospitalized with acute myocardial infarction at all area medical centers. The study population consisted of 13 663 residents of the Worcester (Mass) metropolitan area hospitalized with acute myocardial infarction at all greater Worcester medical centers during 15 annual periods between 1975 and 2005. Overall, 6.6% of patients developed cardiogenic shock during their index hospitalization. The incidence rates of cardiogenic shock remained stable between 1975 and the late 1990s but declined in an inconsistent manner thereafter. Patients in whom cardiogenic shock developed had a significantly greater risk of dying during hospitalization (65.4%) than those who did not develop cardiogenic shock (10.6%) (P<0.001). Encouraging increases in hospital survival in patients with cardiogenic shock, however, were observed from the mid-1990s to our most recent study years. Several patient demographic and clinical characteristics were associated with an increased risk for developing cardiogenic shock. Our findings indicate improving trends in the hospital prognosis associated with cardiogenic shock. Given the high death rates associated with this clinical complication, monitoring future trends in the incidence and death rates and the factors associated with an increased risk for developing cardiogenic shock remains warranted.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Ambulatory veno-venous extracorporeal membrane oxygenation: innovation and pitfalls.

            End-stage lung disease and severe acute lung injury are complex entities that remain challenges to manage. Therapies include early institution of mechanical ventilation with positive end-expiratory pressure, permissive hypercapnia, pulmonary vasodilators, and complex fluid regimens. Veno-venous extracorporeal membrane oxygenation is an available treatment option for these patients but, in its conventional form, can be associated with significant complications. We present our early experience with an attempt to optimize extracorporeal membrane oxygenation, emphasizing reduced adjunctive mechanical ventilatory support and aggressive rehabilitation, with a goal of ambulation. This strategy has been enabled by the introduction of a dual-lumen draw and return cannula placed via the internal jugular vein. The first 10 patients (mean age of 45.3 years, 8 male) treated with this strategy between January 1, 2009, and October 1, 2009, were retrospectively reviewed. The ambulatory extracorporeal membrane oxygenation strategy was initiated with an aim of minimal mechanical ventilation and aggressive rehabilitation. The patients were intended to be weaned from all respiratory support or bridged to transplantation. The mean duration of extracorporeal membrane oxygenation was 20 (9-59) days, with average mean blood flows of 3.5 (1.6-4.9) L/min, and levels of CO(2) removal and O(2) transfer of 228 (54-570) mL/min and 127 (36-529) mL/min, respectively. Six of 10 patients were weaned from respiratory support (N = 4) or underwent transplantation (N = 2) and survived to discharge from the hospital. The remaining 4 patients died of sepsis (N = 3) and withdrawal of care after renal failure (N = 1). Four of the 6 surviving patients were extubated and ambulatory while still on extracorporeal membrane oxygenation. During that time, 3 of the 4 patients exercised at the bedside, with the remaining patient able to undergo full cardiopulmonary rehabilitation, including treadmill walking. Improvements in the durability of membrane blood oxygenators and pumps have prompted renewed consideration of extracorporeal membrane oxygenation in patients with severe lung disease. This report describes an attempt to augment extracorporeal membrane oxygenation with the goal of ambulation by minimizing mechanical ventilatory support and using aggressive in-and-out-of-bed rehabilitation. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Outcomes of a multicenter trial of the Levitronix CentriMag ventricular assist system for short-term circulatory support.

              The Levitronix CentriMag (Levitronix LLC, Waltham, Mass) ventricular assist system is designed for temporary left, right, or biventricular support. Advantages include ease of use, excellent reliability, and low thrombosis risk,. which may allow wider application of short-term support and improved outcomes in patients with cardiogenic shock. This multi-institutional study evaluated safety, effectiveness, and outcomes of the CentriMag in patients with cardiogenic shock.
                Bookmark

                Author and article information

                Journal
                ASAIO J
                ASAIO J
                MAT
                Asaio Journal
                Lippincott Williams & Wilkins
                1058-2916
                1538-943X
                September 2014
                28 August 2014
                : 60
                : 5
                : 487-497
                Affiliations
                From the [* ]Synergus AB, Danderyd, Sweden; []Scottish Extracorporeal Life Support Service, Royal Hospital for Sick Children, Glasgow, United Kingdom; []Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, United Kingdom; [§ ]Medical Management Centre, Department of Learning Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; []Paediatric and Neonatal ECMO Service, Freeman Hospital, Newcastle upon Tyne, United Kingdom; []Department of Cardiothoracic Transplant, Wythenshawe Hospital, Manchester, United Kingdom; and [# ]Emeritus Cardiothoracic Surgeon, Glenfield General Hospital, Leicester, United Kingdom.
                Author notes
                Correspondence: Oleg Borisenko, MD, PhD, Synergus AB, Svardvagen 19, 18233, Danderyd, Stockholm, Sweden. Email: oleg.borisenko@ 123456synergus.com
                Article
                00001
                10.1097/MAT.0000000000000117
                4154791
                25010916
                7c18d1e4-00bd-4133-8141-803b81069df3
                Copyright © 2014 by the American Society for Artificial Internal Organs

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

                History
                Categories
                Review Article
                Custom metadata
                TRUE
                T

                ventricular assist device,extracorporeal membrane oxygenation,mechanical circulatory support,cardiorespiratory failure,systematic literature review

                Comments

                Comment on this article