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  1. Article ; Online: Volume Displacement Pulsatile Veno-Arterial Extracorporeal Membrane Oxygenation: Preliminary Data From In Vitro Tests.

    Heinsar, Silver / Semenzin, Clayton / Farah, Samia M / Fraser, John F

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2024  

    Language English
    Publishing date 2024-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000002207
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  2. Article ; Online: Add-on Therapies in VA-ECMO for Cardiogenic Shock: The Heart Recovers, Yet Other Organs Suffer.

    Heinsar, Silver / Farah, Samia M / Fraser, John F

    Journal of cardiothoracic and vascular anesthesia

    2022  Volume 36, Issue 7, Page(s) 2246

    MeSH term(s) Extracorporeal Membrane Oxygenation ; Heart ; Heart-Assist Devices ; Humans ; Retrospective Studies ; Shock, Cardiogenic/therapy ; Thorax
    Language English
    Publishing date 2022-03-08
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.03.005
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  3. Article ; Online: Highlights from the Asia-Pacific Extracorporeal Life Support Organization 2021 Conference.

    Heinsar, Silver / Chen, Yih-Sharng / Fraser, John F

    Artificial organs

    2021  Volume 46, Issue 1, Page(s) 164–166

    MeSH term(s) Asia ; Extracorporeal Membrane Oxygenation ; Humans ; Societies, Scientific
    Language English
    Publishing date 2021-11-24
    Publishing country United States
    Document type Congress
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.14114
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  4. Article ; Online: To Pulse or Not to Pulse, That Is the Question.

    Haymet, Andrew B / Heinsar, Silver / Fraser, John F

    Critical care medicine

    2020  Volume 48, Issue 4, Page(s) e332

    MeSH term(s) Extracorporeal Membrane Oxygenation ; Heart Rate ; Humans ; Pulse ; Shock, Cardiogenic
    Language English
    Publishing date 2020-03-23
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004170
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  5. Article ; Online: ECMO during the COVID-19 pandemic: When is it justified?

    Heinsar, Silver / Peek, Giles J / Fraser, John F

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 650

    MeSH term(s) COVID-19/epidemiology ; COVID-19/therapy ; Extracorporeal Membrane Oxygenation/methods ; Humans ; Pandemics ; Patient Selection ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-11-19
    Publishing country England
    Document type Letter
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-03386-4
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  6. Article ; Online: Improved Microcirculation with Pulsatile Veno-Arterial ECMO: An Ovine Model of Cardiogenic Shock.

    Heinsar, Silver / Sato, Kei / Obonyo, Nchafatso / Farah, Samia M / Bouquet, Mahe / Passmore, Margaret R / Liu, Keibun / Ijunin, Shinichi / Ainola, Carmen / Li Bassi, Gianluigi / Suen, Jacky Y / Fraser, John F

    American journal of respiratory and critical care medicine

    2024  

    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202402-0419LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Preclinical Studies on Pulsatile Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review.

    Kanagarajan, Dhayananth / Heinsar, Silver / Gandini, Lucia / Suen, Jacky Y / Dau, Van Thanh / Pauls, Jo / Fraser, John F

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2023  Volume 69, Issue 5, Page(s) e167–e180

    Abstract: Refractory cardiogenic shock is increasingly being treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO), without definitive proof of improved clinical outcomes. Recently, pulsatile V-A ECMO has been developed to address some of the ... ...

    Abstract Refractory cardiogenic shock is increasingly being treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO), without definitive proof of improved clinical outcomes. Recently, pulsatile V-A ECMO has been developed to address some of the shortcomings of contemporary continuous-flow devices. To describe current pulsatile V-A ECMO studies, we conducted a systematic review of all preclinical studies in this area. We adhered to PRISMA and Cochrane guidelines for conducting systematic reviews. The literature search was performed using Science Direct, Web of Science, Scopus, and PubMed databases. All preclinical experimental studies investigating pulsatile V-A ECMO and published before July 26, 2022 were included. We extracted data relating to the 1) ECMO circuits, 2) pulsatile blood flow conditions, 3) key study outcomes, and 4) other relevant experimental conditions. Forty-five manuscripts of pulsatile V-A ECMO were included in this review detailing 26 in vitro , two in silico , and 17 in vivo experiments. Hemodynamic energy production was the most investigated outcome (69%). A total of 53% of studies used a diagonal pump to achieve pulsatile flow. Most literature on pulsatile V-A ECMO focuses on hemodynamic energy production, whereas its potential clinical effects such as favorable heart and brain function, end-organ microcirculation, and decreased inflammation remain inconclusive and limited.
    MeSH term(s) Humans ; Extracorporeal Membrane Oxygenation ; Shock, Cardiogenic/therapy ; Hemodynamics/physiology ; Pulsatile Flow/physiology ; Inflammation
    Language English
    Publishing date 2023-03-27
    Publishing country United States
    Document type Systematic Review ; Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000001922
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  8. Article ; Online: A mock circulation loop to evaluate differential hypoxemia during peripheral venoarterial extracorporeal membrane oxygenation.

    Rozencwajg, Sacha / Wu, Eric L / Heinsar, Silver / Stevens, Michael / Chinchilla, Josh / Fraser, John F / Pauls, Jo P

    Perfusion

    2022  Volume 39, Issue 1, Page(s) 66–75

    Abstract: Introduction: Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) creates a retrograde flow along the aorta competing with the left ventricle (LV) in the so-called 'mixing zone' (MZ). Detecting it is essential to understand which of ... ...

    Abstract Introduction: Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) creates a retrograde flow along the aorta competing with the left ventricle (LV) in the so-called 'mixing zone' (MZ). Detecting it is essential to understand which of the LV or the ECMO flow perfuses the upper body - particularly the brain and the coronary arteries - in case of differential hypoxemia (DH).
    Methods: We described a mock circulation loop (MCL) that enabled experimental research on DH. We recreated the three clinical situations relevant to clinicians: where the brain is either totally perfused by the ECMO or the LV or both. In a second step, we used this model to investigate two scenarios to diagnose DH: (i) pulse pressure and (ii) thermodilution via injection of cold saline in the ECMO circuit.
    Results: The presented MCL was able to reproduce the three relevant mixing zones within the aortic arch, thus allowing to study DH. Pulse pressure was unable to detect location of the MZ. However, the thermodilution method was able to detect whether the brain was totally perfused by the ECMO or not.
    Conclusion: We validated an
    MeSH term(s) Animals ; Extracorporeal Membrane Oxygenation/methods ; Shock, Cardiogenic ; Hypoxia/therapy ; Coronary Vessels ; Aorta
    Language English
    Publishing date 2022-01-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591211056567
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  9. Article ; Online: An appraisal of lung computer tomography in very early anti-inflammatory treatment of two different ovine ARDS phenotypes.

    Wildi, Karin / Colombo, Sebastiano Maria / McGuire, Daniel / Ainola, Carmen / Heinsar, Silver / Sato, Noriko / Sato, Kei / Liu, Keibun / Bouquet, Mahé / Wilson, Emily / Passmore, Margaret / Hyslop, Kieran / Livingstone, Samantha / Di Feliciantonio, Marianna / Strugnell, Wendy / Palmieri, Chiara / Suen, Jacky / Li Bassi, Gianluigi / Fraser, John

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 2162

    Abstract: Mortality and morbidity of Acute Respiratory Distress Syndrome (ARDS) are largely unaltered. A possible new approach to treatment of ARDS is offered by the discovery of inflammatory subphenotypes. In an ovine model of ARDS phenotypes, matching key ... ...

    Abstract Mortality and morbidity of Acute Respiratory Distress Syndrome (ARDS) are largely unaltered. A possible new approach to treatment of ARDS is offered by the discovery of inflammatory subphenotypes. In an ovine model of ARDS phenotypes, matching key features of the human subphenotypes, we provide an imaging characterization using computer tomography (CT). Nine animals were randomized into (a) OA (oleic acid, hypoinflammatory; n = 5) and (b) OA-LPS (oleic acid and lipopolysaccharides, hyperinflammatory; n = 4). 48 h after ARDS induction and anti-inflammatory treatment, CT scans were performed at high (H) and then low (L) airway pressure. After CT, the animals were euthanized and lung tissue was collected. OA-LPS showed a higher air fraction and OA a higher tissue fraction, resulting in more normally aerated lungs in OA-LPS in contrast to more non-aerated lung in OA. The change in lung and air volume between H and L was more accentuated in OA-LPS, indicating a higher recruitment potential. Strain was higher in OA, indicating a higher level of lung damage, while the amount of lung edema and histological lung injury were largely comparable. Anti-inflammatory treatment might be beneficial in terms of overall ventilated lung portion and recruitment potential, especially in the OA-LPS group.
    MeSH term(s) Animals ; Anti-Inflammatory Agents/pharmacology ; Anti-Inflammatory Agents/therapeutic use ; Lipopolysaccharides ; Lung/pathology ; Oleic Acid/pharmacology ; Phenotype ; Respiratory Distress Syndrome/pathology ; Sheep ; Sheep, Domestic ; Tomography
    Chemical Substances Anti-Inflammatory Agents ; Lipopolysaccharides ; Oleic Acid (2UMI9U37CP)
    Language English
    Publishing date 2024-01-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-52698-w
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  10. Article ; Online: The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis.

    Heinsar, Silver / Raman, Sainath / Suen, Jacky Y / Cho, Hwa Jin / Fraser, John F

    Clinical and experimental pediatrics

    2020  Volume 64, Issue 5, Page(s) 188–195

    Abstract: Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential ... ...

    Abstract Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.
    Language English
    Publishing date 2020-08-10
    Publishing country Korea (South)
    Document type Journal Article
    ISSN 2713-4148
    ISSN (online) 2713-4148
    DOI 10.3345/cep.2020.00836
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