Publications by authors named "Sarah Aissi James"
Rationale: The significance of the Recruitment to Inflation (R/I) ratio in identifying PEEP recruiters in patients undergoing ultra-protective lung ventilation during venovenous ECMO is not well established.
Objectives: To compare the concordance of the R/I ratio and Electrical Impedance Tomography (EIT) in determining optimum PEEP settings in severe ARDS patients on ECMO and ventilated with very low tidal volumes.
Methods: Initially, a low-flow insufflation was performed to detect and measure the airway opening pressure (AOP).
Article Synopsis
- The study investigates the outcomes of critically ill pregnant women with severe ARDS who underwent ECMO, focusing on whether the timing of delivery (before or after ECMO) affects maternal and fetal health.
- Out of 563 women, those whose delivery was performed after ECMO faced higher rates of major bleeding, while fetal survival rates were significantly better when ECMO was started post-delivery.
- Despite risks, overall maternal survival rates were high, and newborns showed no severe complications or long-term health issues, indicating the need for careful decision-making regarding delivery timing in these critical cases.
Background: Amniotic fluid embolism (AFE) is a rare but often catastrophic complication of pregnancy that leads to cardiopulmonary dysfunction and severe disseminated intravascular coagulopathy (DIC). Although few case reports have reported successful use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) with AFE, concerns can be raised about the increased bleeding risks with that device.
Methods: This study included patients with AFE rescued by VA-ECMO hospitalized in two high ECMO volume centers between August 2008 and February 2021.
Article Synopsis
- ECMO was widely used for severe COVID-19 ARDS treatment during the initial outbreak, with significant changes in patient management observed after July 1, 2020.
- A study compared 88 patients treated before July and 71 patients treated after, revealing that those post-July were older and had higher usage rates of dexamethasone and non-invasive ventilation methods.
- The 90-day mortality rate significantly increased from 36% to 48% after July 1, and factors like failed early oxygenation strategies and greater lung damage may have contributed to the poorer outcomes.