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Predictors of successful extracorporeal membrane oxygenation (ECMO) weaning after assistance for refractory cardiogenic shock.

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TLDR
Patients who tolerated a full ECMO weaning trial and had aortic VTI ≥10 cm, LVEF >20–25%, and TDSa ≥6 cm/s at minimal ECMO flow were all successfully weaned, and further studies are needed to validate these simple and easy-to-acquire Doppler echocardiography parameters as predictors of subsequent EC MO weaning success in patients recovering from severe cardiogenic shock.
Abstract
Purpose Detailed extracorporeal membrane oxygenation (ECMO) weaning strategies and specific predictors of ECMO weaning success are lacking. This study evaluated a weaning strategy following support for refractory cardiogenic shock to identify clinical, hemodynamic, and Doppler echocardiography parameters associated with successful ECMO removal.

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Journal ArticleDOI

Discontinuation of ECMO—a review with a note on Indian scenario

TL;DR: In this paper , the authors discuss the weaning strategies of veno-venous and venoarterial ECMO including the bridge to recovery and bridge to transplant along with post-ECMO care.
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Monitorage hémodynamique par échocardiographie des patients en état de choc

P. Vignon
TL;DR: Critical care echocardiography is currently recommended as the first-line technique for the hemodynamic assessment of patients presenting with acute circulatory failure and may be completed by the transesophageal approach in the presence of suboptimal imaging quality or if expected diagnostic accuracy is deemed insufficient.
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Hemodynamic monitoring in cardiogenic shock

TL;DR: In this paper , a review of the different parameters relevant to each monitoring approach and the way they can be used to support optimal management of these patients is presented, along with a discussion of the right timing of the indication, weaning from mechanical cardiac support, and guidance on inotropic treatments.
Journal ArticleDOI

Parameters associated with successful weaning of veno-arterial extracorporeal membrane oxygenation: a systematic review

TL;DR: A systematic review of the medical literature to determine the biomarkers, hemodynamic and echocardiographic parameters associated with successful weaning of VA-ECMO in adults with cardiogenic shock and to present an evidence-based weaning algorithm incorporating key findings is presented in this article .
Journal ArticleDOI

The ABCDE approach to difficult weaning from venoarterial extracorporeal membrane oxygenation

TL;DR: In this paper , the authors provide an overview of pivotal factors that potentially prevent successful weaning of Venoarterial extracorporeal membrane oxygenation (VA ECMO) in patients with cardiogenic shock.
References
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Journal ArticleDOI

The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.

TL;DR: The ESICM developed a so-called sepsis-related organ failure assessment (SOFA) score to describe quantitatively and as objectively as possible the degree of organ dysfunction/failure over time in groups of patients or even in individual patients.
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A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study

J R Le Gall, +2 more
- 22 Dec 1993 - 
TL;DR: The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis, and is a starting point for future evaluation of the efficiency of intensive care units.
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Doppler Tissue Imaging: A Noninvasive Technique for Evaluation of Left Ventricular Relaxation and Estimation of Filling Pressures

TL;DR: Mitral E velocity, corrected for the influence of relaxation (i.e., the E/Ea ratio), relates well to mean PCWP and may be used to estimate LV filling pressures.
Journal ArticleDOI

Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock*

TL;DR: ECMO support can rescue 40% of otherwise fatal cardiogenic shock patients but its initiation under cardiac massage or after renal or hepatic failure carried higher risks of intensive care unit death, while fulminant myocarditis had a better prognosis.
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