Platelets Count During Circulatory Assistance: Involvement in the Changes of Oxygenation Membrane
Alaa Azhari,
Ehab Kasem,
Mohammed Miny,
Adama Sawadogo,
Nicolas D’ostrevy,
Celine Lambert,
Bruno Pereira,
Kazra Azarnoush,
Lionel Camilleri
Issue:
Volume 8, Issue 1, January 2022
Pages:
1-7
Received:
10 November 2021
Accepted:
29 November 2021
Published:
12 January 2022
Abstract: Background To study the evolution of platelet count during patient treatment with Extra-Corporeal Membrane Oxygenation (ECMO) and the causes of Membrane Oxygenation (MO) exchange. Assessment of the morbidity and mortality rate was our secondary objective. Methods A single center retrospective study was conducted from January 2014 to December 2015. One-hundred and thirty-nine MO exchanges were studied over 73 patients who received 66 MO exchange. Alterations in biological parameters were compared before and after each MO exchange, to study the device-related platelet count evolution. Results Mean patient age was 56.8±13.4 years. The mean duration of the MO was 5.9±3.1 days, exchanged 26 times (68%) after clot formation. The median Survival After Veno-arterial ECMO score (SAVE score) was -3.5 [-4; -1] interquartile range [IQR]. The median Respiratory Extra-corporeal membrane Oxygenation Survival Prediction score (RESP score) was -1 [-3; 0] [IQR]. A significant decrease (p<0.001) in platelet count between the first and second MO exchange was observed in comparison with the baseline. Yet a steady decline was noted after the third MO exchange, afterwards, normalization was observed after ECMO weaning. During ECMO, a decrease in platelet count from the baseline was found after the first MO on day 2 (p<0.001), the delta was 58.000±19.000 //µL, followed by an additional significant decrease on day 3 (p=0.001). The average platelet transfusion was 0.6±1.4 units. Interestingly, the more MO was exchanged, the lesser blood products transfusion was done. The overall mortality rate was 39%; in Veno- Arterial ECMO (VA-ECMO) it was 34.48% and 41.38% in Veno-Venous ECMO (VV-ECMO). Conclusion Clot formation is the leading cause of MO exchange during ECMO. Therefore, there is a significant decrease in platelets count starting from day 2 that indicates platelets transfusions in order to prevent complications of hemostasis.
Abstract: Background To study the evolution of platelet count during patient treatment with Extra-Corporeal Membrane Oxygenation (ECMO) and the causes of Membrane Oxygenation (MO) exchange. Assessment of the morbidity and mortality rate was our secondary objective. Methods A single center retrospective study was conducted from January 2014 to December 2015. ...
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Atypical Symptom and Clinical Features of Right Atrial Myxoma: A Case Report
Nakisa Khansari,
Masumeh Abdolhosseini,
Keihan Karimian,
Farnaz Fariba
Issue:
Volume 8, Issue 1, January 2022
Pages:
8-11
Received:
24 October 2021
Accepted:
15 January 2022
Published:
26 January 2022
Abstract: Cardiac tumors are rare in medicine. Myxomas are the most common benign cardiac tumors. Most myxomas (>80%) are found in the left atrium. The site of 15-20% of cases of myxoma is the right atrium. The incidence of cardiac myxoma peaks at 40 to 60 years of age. Most atrial myxomas occur sporadically and are more common in middle-aged women. Patients with atrial myxoma usually have one of the symptoms in the following tetrad: embolic phenomena, intracardiac flow obstruction, arrhythmias and constitutional symptoms. The modality of choice for diagnosis of cardiac myxoma is an Echocardiography. Surgery should be considered promptly, because embolic complications or sudden death can be occured. This surgery is usually safe with low morbidity and mortality. Operative mortality is reported to be within 5%, and will be increased with myxoma occurring in the ventricle. Our case was a 47-year-old Iranian male with right atrial myxoma and a history of heart burn, he does not mention fever and chill, cough, chest pain or dyspnea. In CT Angiography of pulmonary artery showing pulmonary thromboembolism. After echocardiography and pulmonary CT angiography he underwent cardiac surgery and mass with adhesion to the right atrial wall near the IVC was excised. The patient was discharged after surgery with good general condition and stable vital signs.
Abstract: Cardiac tumors are rare in medicine. Myxomas are the most common benign cardiac tumors. Most myxomas (>80%) are found in the left atrium. The site of 15-20% of cases of myxoma is the right atrium. The incidence of cardiac myxoma peaks at 40 to 60 years of age. Most atrial myxomas occur sporadically and are more common in middle-aged women. Patients...
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