Timing and Mode of Death Following ECPR: A Single Centre, Retrospective Analysis.

Background: Currently little is known about the timing and modality in which people die following extracorporeal cardiopulmonary resuscitation (ECPR). This is important as it may define potential therapeutic targets, pathways for improvement in ECPR outcomes, and resource implications. Therefore, we undertook a study to analyse the mechanisms and timeframes of death within the first 28 days in a high-volume Australian ECPR centre.

Early fluid balance and mortality following extracorporeal cardiopulmonary resuscitation: a high volume, single center study.

Background: For patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO), a positive cumulative fluid balance at day three has been associated with increased mortality. However, there is limited evidence examining this association in patients requiring extracorporeal cardiopulmonary resuscitation (ECPR). The aims of this study were to (1) to describe contemporary fluid practice in patients requiring ECPR and (2) assess the relationship between early cumulative fluid balance and 28-day mortality.

Organ donation from extracorporeal membrane oxygenation and ventricular assist devices in Victoria, Australia: Characteristics and trends.

Objective: To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).

Design: Retrospective, observational, cohort study from June 2014 to June 2021.

Setting: A multicentre study in Victoria, Australia, using DonateLife Victoria databases.

Population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation-an ASAP ECMO study.

This study aimed to describe the population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) and to identify dosing regimens with a high likelihood of achieving effective exposures. Serial blood samples were collected over a single-dosing interval during ECMO. Total plasma concentrations were measured by a validated chromatographic assay.

A Guide to Contrast-Enhanced Computed Tomography in Adult Patients Supported With Extracorporeal Membrane Oxygenation.

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) fundamentally alters patient physiology and blood flow relevant to contrast delivery for computed tomography (CT) imaging. Here, we present a comprehensive guide to contrast-enhanced CT scanning in adult ECMO patients, addressing common questions related to contrast delivery via the ECMO circuit, and modifications to ECMO settings and scanning techniques, to avoid non-diagnostic CT scans. The approach is described in detail for patients supported on VA ECMO, with the return cannula sited in the femoral artery.

Population pharmacokinetics of fluconazole in critically ill patients receiving extracorporeal membrane oxygenation and continuous renal replacement therapy: an ASAP ECMO study.

This multicenter study describes the population pharmacokinetics (PK) of fluconazole in critically ill patients receiving concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) and includes an evaluation of different fluconazole dosing regimens for achievement of target exposure associated with maximal efficacy. Serial blood samples were obtained from critically ill patients on ECMO and CRRT receiving fluconazole. Total fluconazole concentrations were measured in plasma using a validated chromatographic assay.

The effect of restrictive versus liberal selection criteria on survival in ECPR: a retrospective analysis of a multi-regional dataset.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is an established rescue therapy for both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). However, there remains significant heterogeneity in populations and outcomes across different studies. The primary aim of this study was to compare commonly used selection criteria and their effect on survival and utilisation in an Australian ECPR cohort.

ECMO PAL: using deep neural networks for survival prediction in venoarterial extracorporeal membrane oxygenation.

Purpose: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a complex and high-risk life support modality used in severe cardiorespiratory failure. ECMO survival scores are used clinically for patient prognostication and outcomes risk adjustment. This study aims to create the first artificial intelligence (AI)-driven ECMO survival score to predict in-hospital mortality based on a large international patient cohort.

Modified indirect calorimetry for patients on venoarterial extracorporeal membrane oxygenation: a pilot feasibility study.

Background/objectives: Traditional indirect calorimetry is unable to capture complete gas exchange in patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO). We aimed to determine the feasibility of using a modified indirect calorimetry protocol in patients receiving VA ECMO, report measured energy expenditure (EE) and compare EE to control critically ill patients.

Subjects/methods: Mechanically ventilated adult patients receiving VA ECMO were included.

The Hematological Effects of Extracorporeal Membrane Oxygenator Exchange.

Membrane oxygenator failure during venovenous (V-V) extracorporeal membrane oxygenation (ECMO) can lead to life-threatening hypoxia, high replacement costs, and may be associated with a hyperfibrinolytic state and bleeding. The current understanding of the underlying mechanisms that drive this is limited. The primary aim of this study therefore is to investigate the hematological changes that occur before and after membrane oxygenator and circuit exchanges (ECMO circuit exchange) in patients with severe respiratory failure managed on V-V ECMO.

Antimicrobial Exposures in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation.

Data suggest that altered antimicrobial concentrations are likely during extracorporeal membrane oxygenation (ECMO). The primary aim of this analysis was to describe the pharmacokinetics (PKs) of antimicrobials in critically ill adult patients receiving ECMO. Our secondary aim was to determine whether current antimicrobial dosing regimens achieve effective and safe exposure.

Survival and left ventricular dysfunction post lung transplantation for pulmonary arterial hypertension.

Purpose: Bilateral lung transplantation for end-stage pulmonary arterial hypertension (PAH) is traditionally associated with higher early post-transplant mortality when compared with other indications. Changes in perioperative management, including the growing use of perioperative extracorporeal membrane oxygenation (ECMO) and an increased awareness of postoperative left ventricular dysfunction (LVD), have resulted in outcomes that are uncertain.

Materials And Methods: We conducted a single-center, retrospective observational study at a lung transplantation center in Melbourne, Australia, from 2006 to 2019.

Population pharmacokinetics of ciprofloxacin in critically ill patients receiving extracorporeal membrane oxygenation (an ASAP ECMO study).

Introduction: This study aimed to describe the pharmacokinetics (PK) of ciprofloxacin in critically ill patients receiving ECMO and recommend a dosing regimen that provides adequate drug exposure.

Methods: Serial blood samples were taken from ECMO patients receiving ciprofloxacin. Total ciprofloxacin concentrations were measured by chromatographic assay and analysed using a population PK approach with Pmetrics®.

Population pharmacokinetics of cefepime in critically ill patients receiving extracorporeal membrane oxygenation (an ASAP ECMO study).

Objectives: This study aimed to describe the population pharmacokinetics (PK) of cefepime during extracorporeal membrane oxygenation (ECMO) and through dosing simulations, identify a maximally effective and safe dosing strategy.

Methods: Serial cefepime plasma concentrations were measured in patients on ECMO, and data were analysed using a population PK approach with Pmetrics®. Dosing simulations were used to identify the optimal dosing strategy that achieved target trough concentrations (C) of 8-20 mg/L.

Population Pharmacokinetics of Vancomycin in Critically Ill Adult Patients Receiving Extracorporeal Membrane Oxygenation (an ASAP ECMO Study).

Our study aimed to describe the population pharmacokinetics (PK) of vancomycin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO), including those receiving concomitant renal replacement therapy (RRT). Dosing simulations were used to recommend maximally effective and safe dosing regimens. Serial vancomycin plasma concentrations were measured and analyzed using a population PK approach on .

The impact of selection criteria and study design on reported survival outcomes in extracorporeal oxygenation cardiopulmonary resuscitation (ECPR): a systematic review and meta-analysis.

Background: The use of extracorporeal membrane oxygenation (ECMO) during cardiac arrest (ECPR) has increased exponentially. However, reported outcomes vary considerably due to differing study designs and selection criteria. This review assessed the impact of pre-defined selection criteria on ECPR survival.

Population Pharmacokinetics of Piperacillin and Tazobactam in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation: an ASAP ECMO Study.

Our study aimed to describe the population pharmacokinetics (PK) of piperacillin and tazobactam in patients on extracorporeal membrane oxygenation (ECMO), with and without renal replacement therapy (RRT). We also aimed to use dosing simulations to identify the optimal dosing strategy for these patient groups. Serial piperacillin and tazobactam plasma concentrations were measured with data analyzed using a population PK approach that included staged testing of patient and treatment covariates.

Association Between Arterial Carbon Dioxide Tension and Clinical Outcomes in Venoarterial Extracorporeal Membrane Oxygenation.

Objectives: The manipulation of arterial carbon dioxide tension is associated with differential mortality and neurologic injury in intensive care and cardiac arrest patients; however, few studies have investigated this relationship in patients on venoarterial extracorporeal membrane oxygenation. We investigated the association between the initial arterial carbon dioxide tension and change over 24 hours on mortality and neurologic injury in patients undergoing venoarterial extracorporeal membrane oxygenation for cardiac arrest and refractory cardiogenic shock.

Design: Retrospective cohort analysis of adult patients recorded in the international Extracorporeal Life Support Organization Registry.