Time controlled adaptive ventilation™ as conservative treatment of destroyed lung

Background: Acute respiratory distress syndrome (ARDS) often requires controlled ventilation, yielding high mechanical power and possibly further injury. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) can be used as a bridge to recovery, however, if this fails the end result is destroyed lung parenchyma. This condition is fatal and the only remaining alternative is lung transplantation. In the case study presented in this paper, lung transplantation was not an option given the critically ill state and the presence of HLA antibodies. Airway pressure release ventilation (APRV) may be valuable in ARDS, but APRV settings recommended in various patient and clinical studies are inconsistent. The Time Controlled Adaptive Ventilation (TCAV™) method is the most studied technique to set and adjust the APRV mode and uses an extended continuous positive airway pressure (CPAP) Phase in combination with a very brief Release Phase. In addition, the TCAV™ method settings are personalized and ad

Higher 1-year mortality in women admitted to intensive care units after cardiac arrest

Purpose: We study sex differences in 1-year mortality of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) patients admitted to the intensive care unit (ICU). Data: A retrospective cohort analysis of OHCA and IHCA patients registered in the NICE registry in the Netherlands. The pr

Higher 1-year mortality in women admitted to intensive care units after cardiac arrest

Purpose: We study sex differences in 1-year mortality of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) patients admitted to the intensive care unit (ICU). Data: A retrospective cohort analysis of OHCA and IHCA patients registered in the NICE registry in the Netherlands. The pr

Do women have a higher mortality risk than men following icu admission after out‐of‐hospital cardiac arrest? A retrospective cohort analysis

purpose: previous studies showed that women have a higher mortality risk than men after out‐of‐hospital cardiac arrest (OHCA). This sex difference may disappear after adjustment for cardiac arrest characteristics. Most s

Survival of patients with acute pulmonary embolism treated with venoarterial extracorporeal membrane oxygenation

Background: To examine whether venoarterial extracorporeal membrane oxygenation (VA-ECMO) improves survival of patients with acute pulmonary embolism (PE). Methods: Following the PRISMA guidelines, a systematic search was conducted up to August 2019 of the databases: PubMed/MEDLINE, EMBASE and Cochrane. All studies reporting the survival of adult patients with acute PE treated with VA-ECMO and including four patients or more were included. Exclusion criteria were: correspondences, reviews and studies in absence of a full text, written in other languages than English or Dutch, or dating before 1980. Short-term (hospital or 30-day) survival data were pooled and presented with relative risks (RR) and 95% confidence intervals (95% CI). Also, the following pre-defined factors were evaluated for their association with survival in VA-ECMO treated patients: age &gt; 60 years, male sex, pre-ECMO cardiac arrest, surgical embolectomy, catheter directed therapy, systemic thrombolysis, and VA-ECMO as single therapy. Results: A total of 29 observational studies were included (N = 1947 patients: VA-ECMO N = 1138 and control N = 809). There was no difference in short-term survival between VA-ECMO treated patients and control patients (RR 0.91, 95% CI 0.71–1.16). In acute PE patients undergoing VA-ECMO, age &gt; 60 years was associated with lower survival (RR 0.72, 95% CI 0.52–0.99), surgical embolectomy was associated with higher survival (RR 1.96, 95% CI 1.39–2.76) and pre-ECMO cardiac arrest showed a trend toward lower survival (RR 0.88, 95% CI 0.77–1.01). The other evaluated factors were not associated with a difference in survival. Conclusions: At present, there is insufficient evidence that VA-ECMO treatment improves short-term survival of acute PE patients. Low quality evidence suggest that VA-ECMO patients aged ≤60 years or who received SE have higher survival rates. Considering the limited evidence derived from the present data, this study emphasizes the need for prospective studies. Protocol registration: PROSPERO CRD42019120370.</p