• Title/Summary/Keyword: oxygenation

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Conversion to Veno-arteriovenous Extracorporeal Membrane Oxygenation for Differential Hypoxia

  • Ho Jeong Cha;Jong Woo Kim;Dong Hoon Kang;Seong Ho Moon;Sung Hwan Kim;Jae Jun Jung;Jun Ho Yang;Joung Hun Byun
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.274-281
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    • 2023
  • Background: Patients who require initial venoarterial extracorporeal membrane oxygenation (VA ECMO) support may need to undergo veno-arteriovenous ECMO (VAV ECMO) conversion. However, there are no definitive criteria for conversion to VAV ECMO. We report 9 cases of VAV ECMO at Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine. Methods: Of 158 patients who received ECMO support between January 2017 and June 2019, 82 were supported by initial VA ECMO. We retrospectively reviewed the medical records of 9 patients (7 men and 2 women; age, 53.1±19.4 years) who had differential hypoxia and required VAV ECMO support. Percutaneous transaortic catheter venting was used to detect the differential hypoxia. Results: Among the 82 patients who received VA ECMO support, 9 (10.9%) had differential hypoxia and required conversion to VAV ECMO support. The mean time from VA ECMO support to VAV ECMO support and the mean duration of the VAV support were 2.1±2.2 days and 1.9±1.5 days, respectively. The average peak inspiratory pressure before and after VAV ECMO application was 23.89±3.95 cmH2O and 20.67±5.72 cmH2O, respectively, decreasing by an average of 3.2±3.5 cmH2O (p=0.040). The PaO2/FiO2 ratio was kept below 100 mm Hg in survivors and non-survivors for 116±65.4 and 250±124.9 minutes, respectively (p=0.016). Six patients underwent extracorporeal cardiopulmonary resuscitation, of whom 4 survived (67%). The overall survival rate of patients who underwent conversion from VA ECMO to VAV ECMO was approximately 56%. Conclusion: Rapid detection of differential hypoxia is required when VA ECMO is applied, and efficient conversion to VAV ECMO may be critical for patient survival.

Comparison of Veno-arterial Extracorporeal Membrane Oxygenation Configurations for Patients Listed for Heart Transplantation

  • Jung Ae Hong;Ah-Ram Kim;Min-Ju Kim;Dayoung Pack;Junho Hyun;Sang Eun Lee;Jae-Joong Kim;Pil Je Kang;Sung-Ho Jung;Min-Seok Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.535-547
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    • 2023
  • Background and Objectives: Veno-arterial extracorporeal membrane oxygenation (VAECMO) as a bridge to eventual heart transplantation (HT) is increasingly used worldwide. However, the effect of different VA-ECMO types on HT outcomes remains unclear. Methods: This was a retrospective observational study of 111 patients receiving VA-ECMO and awaiting HT. We assessed 3 ECMO configuration groups: peripheral (n=76), central (n=12), and peripheral to central ECMO conversion (n=23). Cox proportional hazards regression and landmark analysis were conducted to analyze the effect of the ECMO configuration on HT and in-hospital mortality rates. We also evaluated adverse events during ECMO support. Results: HT was performed in the peripheral (n=48, 63.2%), central (n=10, 83.3%), and conversion (n=11, 47.8%) ECMO groups (p=0.133) with a median interval of 10.5, 16, and 30 days, respectively (p<0.001). The cumulative incidence of HT was significantly lower in the conversion group (hazard ratio, 0.292, 95% confidence interval, 0.145-0.586, p=0.001). However, there was no difference in in-hospital mortality (log-rank p=0.433). In the landmark analysis, in-hospital mortality did not differ significantly among the 3 groups. Although we did note a trend toward lower HT in the conversion group, the difference was not statistically significant. Surgical site bleeding occurred mainly in the central, while limb ischemia occurred mainly in the peripheral groups. Conclusions: We suggest that if patients are being stably supported with their initial ECMO configuration, whether it is central or peripheral, it should be maintained, and ECMO conversion should only be cautiously performed when necessary.

Production of Indigo and Indirubin by Escherichia coli Containing a Phenol Hydroxylase Gene of Bacillus stearothermophilus

  • Kim, In-Cheol;Chang, Hae-Choon;Oriel, Patrick
    • Journal of Microbiology and Biotechnology
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    • v.7 no.3
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    • pp.197-199
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    • 1997
  • Escherichia coli recombinants containing the cloned phenol hydroxylase gene of Bacillus stearothermophilus BR219 were shown to produce both indigo and its structural isomer indirubin during culture on LB broth. The ratio of indirubin/indigo was highest under conditions of prolonged culture and reduced culture oxygenation.

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Surgical Treatment of Blunt Traumatic Cardiac Rupture - Two Case Reports - (둔상성 외상에 의한 심장파열에 대한 수술적 치험)

  • Noh, Tae Ook;Seo, Pil Won
    • Journal of Trauma and Injury
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    • v.27 no.1
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    • pp.5-8
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    • 2014
  • Although blunt traumatic cardiac rupture is an uncommon injury, it can be associated with a high mortality rate. Two cases of cardiac rupture in blunt trauma patients are described herein. In those cases, applications of mechanical support devices such as ECMO (extracorporeal membrane oxygenation) and early surgery for exploration under cardiopulmonary bypass may be helpful for treating blunt chest trauma patients.

Comparison of rosiglitazone metabolite profiles in rat plasma between intraperitoneal and oral administration and identifcation of a novel metabolite by liquid chromatography-triple time of flight mass spectrometry (액체크로마토그라피-삼중비행시간질량분석기를 사용한 rosiglitazone의 복강 및 경구투여 후 대사체 비교 분석)

  • Park, Minho;Na, Sook-Hee;Lee, Hee-Joo;Shin, Byung-Hee;An, Byung-Jun;Shin, Young G.
    • Analytical Science and Technology
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    • v.28 no.2
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    • pp.132-138
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    • 2015
  • Rosiglitazone metabolites in rat plasma were analyzed after intraperitoneal and oral administration to rats. Seven metabolites (M1-M7) were detected in rat plasma (IP and PO), and the structures were confirmed using liquid chromatography-triple time of flight (TOF) mass spectrometry; as a result, the most abundant metabolite was M5, a de-methylated rosiglitazone. Other minor in vivo metabolites were driven from monooxygenation and demethylation (M2), thiazolidinedione ring-opening (M1, M3), mono-oxygenation (M4, M7), and mono-oxygenation followed by sulfation (M6). Among them, M1 was found to be a 3-{p-[2-(N-methyl-N-2-pyridylamino)ethoxy]phenyl}-2-(methylsulfinyl)propionamide, which is a novel metabolite of rosiglitazone. There was no significant difference in the metabolic profiles resulting from the two administrations. The findings of this study provide the first comparison of circulating metabolite profiles of rosiglitazone in rat after IP and PO administration and a novel metabolite of rosiglitazone in rat plasma.