11 research outputs found

    Heterogeneity in clinical practices for post-cardiotomy extracorporeal life support: A pilot survey from the PELS-1 multicenter study

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    Background: High-quality evidence for post-cardiotomy extracorporeal life support (PC-ECLS) management is lacking. This study investigated real-world PC-ECLS clinical practices. Methods: This cross-sectional, multi-institutional, international pilot survey explored center organization, anticoagulation management, left ventricular unloading, distal limb perfusion, PC-ECLS monitoring, and transfusion practices. Twenty-nine questions were distributed among 34 hospitals participating in the Post-cardiotomy Extra-Corporeal Life Support Study. Results: Of the 32 centers [16 low-volume (50%); 16 high-volume (50%)] that responded, 16 (50%) had dedicated ECLS specialists. Twenty-six centers (81.3%) reported using additional mechanical circulatory supports. Anticoagulation practices were highly heterogeneous: 24 hospitals (75%) reported using patients bleeding status as a guide, without a specific threshold in 54.2% of cases. Transfusion targets ranged from 7 to 10 g/dL. Most centers used cardiac venting on a case-by-case basis (78.1%) and regular distal limb perfusion (84.4%). Nineteen (54.9%) centers reported dedicated monitoring protocols, including daily echocardiography (87.5%), Swan-Ganz catheterization (40.6%), cerebral near-infrared spectroscopy (53.1%), and multimodal assessment of limb ischemia. Inspection of the circuit (71.9%), oxygenator pressure drop (68.8%), plasma free hemoglobin (75%), d-dimer (59.4%), lactate dehydrogenase (56.3%), and fibrinogen (46.9%) are used to diagnose hemolysis and thrombosis. Conclusions: This study shows remarkable heterogeneity in clinical practices for PC-ECLS management. More standardized protocols and better implementation of the available evidence are recommended

    Combining two structured domains for modeling various graph matching problems

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    Graph pattern matching is a central application in many fields. In various areas, the structure of the pattern can only be approximated and exact matching is then too accurate. We focus here on approximations declared by the user within the pattern (optional nodes and forbidden arcs), covering graph/subgraph mono/isomorphism problems. In this paper, we show how the integration of two domains of computation over countable structures, graphs and maps, can be used for modeling and solving various graph matching problems from the simple graph isomorphism to approximate graph matching. To achieve this, we extend map variables allowing the domain and range to be non-fixed and constrained. We describe how such extended maps are designed then realized on top of finite domain and finite set variables with specific propagators. We show how a single monomorphism constraint is sufficient to model and solve those multiples graph matching problems. Furthermore, our experimental results show that our CP approach is competitive with a state of the art algorithm for subgraph isomorphism.Anglai
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