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Hemodynamic monitoring in patients with venoarterial extracorporeal membrane oxygenation

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TLDR
An overview of VA- ECMO pathophysiology, and the current state of the art in hemodynamic monitoring in patients with VA-ECMO is provided.
Abstract
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective mechanical circulatory support modality that rapidly restores systemic perfusion for circulatory failure in patients. Given the huge increase in VA-ECMO use, its optimal management depends on continuous and discrete hemodynamic monitoring. This article provides an overview of VA-ECMO pathophysiology, and the current state of the art in hemodynamic monitoring in patients with VA-ECMO.

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Citations
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Journal ArticleDOI

Initiation of Invasive Arterial Pressure Monitoring by Critical Care Transport Crews

TL;DR: In this paper , Radial artery cannulation for arterial blood pressure monitoring is a safe and effective procedure that can reasonably be performed in the prehospital setting by both physicians and nonphysicians.
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Monitoring during extracorporeal membrane oxygenation

TL;DR: In this paper , the authors present a review of the cardiorespiratory monitoring tools that can be used to assess and titrate adequacy of ECMO therapy; as well as methods to assess readiness to wean and/or discontinue ECMO support.
Journal ArticleDOI

Radiographic assessment of lung edema (RALE) score is associated with clinical outcomes in patients with refractory cardiogenic shock and refractory cardiac arrest after percutaneous implantation of extracorporeal life support

TL;DR: Implementation of the RALE score could support prediction of outcome parameters during VA-ECMO therapy and help to assess pulmonary edema after ECLS weaning and mortality.
References
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Journal ArticleDOI

Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure.

TL;DR: It was concluded that in mechanically ventilated patients with acute circulatory failure related to sepsis, analysis of DeltaPp is a simple method for predicting and assessing the hemodynamic effects of VE, and that DeltaP p is a more reliable indicator of fluid responsiveness than DeltaPs.
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Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature.

TL;DR: Dynamic changes of arterial waveform-derived variables during mechanical ventilation are highly accurate in predicting volume responsiveness in critically ill patients with an accuracy greater than that of traditional static indices of volume responsiveness.
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The respiratory variation in inferior vena cava diameter as a guide to fluid therapy

TL;DR: Analysis of ΔDIVC is a simple and non-invasive method to detect fluid responsiveness in mechanically ventilated patients with septic shock and identified responders with positive and negative predictive values of 93% and 92%, respectively.
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A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients.

TL;DR: Testing whether increasing oxygen delivery immediately after cardiac surgery would shorten hospital and intensive care unit (ICU) stay found it to be shorter in the protocol group, which can shorten the length of hospital stay.
Journal ArticleDOI

Venous function and central venous pressure: a physiologic story.

TL;DR: The veins contain approximately 70% of total blood volume and are 30 times more compliant than arteries; therefore, changes in blood volume within the veins are associated with relatively small changes in venous pressure.
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