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Biomedical subjects

A Sosnowski

Publications and source records attributed to A Sosnowski.

At least 19 recordsLinked to original sources
PubMed2006

Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes.

Extrathoracic cannulation to establish cardiopulmonary bypass has been widely applied in recent years and includes: (a) repeat surgery, (b) minimally invasive surgery, and (c) cases with diseased vessels such as porcelain, aneurysmal, and dissecting aorta. In addition, the success and relative ease of peripheral cannulation, among other technological advances, has permitted the development of closed chest extracorporeal life support, in the form of cardiopulmonary support and extracorporeal membrane oxygenation. With this development have come applications for cardiopulmonary bypass based support outside the traditional cardiac theatre setting, including emergency circulatory support for patients in cardiogenic shock and respiratory support for patients with severely impaired gas exchange. This review summarises the approach to extrathoracic cannulation for the generalist.

Cardiopulmonary Bypass↗
PubMed2005

Leptospirosis: a case report of a patient with pulmonary haemorrhage successfully managed with extra corporeal membrane oxygenation.

Leptospirosis is a zoonosis of worldwide significance. Pulmonary involvement is common but often mild and of little clinical significance. However, over the last two decades an increasing number of cases have been reported with pulmonary haemorrhage as a prominent feature [Carvalho CR, Bethlem EP. Pulmonary complications of leptospirosis. Clin Chest Med, 2002;23(2):469-78]. These cases are particularly challenging to treat as they often have resistant hypoxaemia despite maximal invasive mechanical ventilation. Consequently, there is a high mortality rate. Here, we present a case of severe leptospirosis complicated by massive pulmonary haemorrhage which was successfully managed by extra corporeal membrane oxygenation (ECMO).

Adult↗
PubMed1995

Role of ECMO in the treatment of respiratory syncytial virus bronchiolitis: a collaborative report.

AIM: To report the collaborative experience of extracorporeal membrane oxygenation (ECMO) in the treatment of respiratory syncytial virus (RSV) bronchiolitis between April 1989 and January 1995. METHODS: The medical records of patients with confirmed RSV bronchiolitis referred to three centres (Leicester, Glasgow, and Great Ormond Street) were reviewed. RESULTS: Twenty four infants were identified. Seventeen had been born prematurely (gestational range 23-40 weeks, median 30 weeks). Thirteen infants had been mechanically ventilated after birth and seven of these had evidence of bronchopulmonary dysplasia (BPD). The age of onset of RSV infection varied from three to 64 weeks (mean 17.4 weeks, median 12 weeks). Ventilation before ECMO ranged from one to 16 days and oxygenation indices at the time of referral ranged from 21-73 (mean 39). Ribavirin was used in eight of the 24 patients. Sixteen patients received venoarterial and eight veno-venous ECMO. ECMO hours ranged from 32-647 (median 196 hours). One infant died (survival rate 96%). Cranial ultrasound abnormalities were detected in three patients. However, at follow up only one of the 23 survivors had evidence of developmental delay. CONCLUSION: A group of paediatric patients in whom ECMO can be of benefit has been identified. The use of ECMO should be considered when other means of support prove unsuccessful.

Age of Onset↗
PubMed1993

Salvage of postoperative pulmonary hypertensive crisis using ECMO via cervical cannulation in a case of truncus arteriosus.

The survival of patients with truncus arteriosus beyond one year of age is rare without surgical treatment [3 . Early surgery may be associated with a mortality but is still preferable, as the risks of established pulmonary hypertensive disease complicate delayed surgery [2]. We report the successful salvage of a pulmonary hypertensive crisis 24 h after corrective surgery in a late presenting patient using extracorporeal membrane oxygenation (ECMO) via cervical cannulation. Post-operative pulmonary hypertensive crises may present a difficult management problem. Extracorporeal membrane oxygenation is therapeutic in these circumstances in addition to providing life support. Cervical cannulation remains the method of choice in the postoperative cardiac patient.

Catheterization↗
PubMed1993

Extracorporeal life support in paediatrics.

Extracorporeal membrane oxygenation (ECMO) is a life support technique based on modifications of heart-lung bypass technology. It is used to support severe but potentially reversible pulmonary or cardiopulmonary failure. There is increasing use of the technique for neonates and a return of interest in its use for adults. The number of non-neonatal paediatric patients receiving pulmonary support with ECMO worldwide is, however, small, and survival rates average less than 50%. Initial experience in 15 patients aged 3 months to 5 years with a high survival and low morbidity is reported.

Child, Preschool↗
PubMed1990

Effect of selenium supplementation on glutathione peroxidase synthesis and element accumulation in sheep erythrocytes.

For three months four groups of sheep were fed either a basal diet (group A) containing 0.082 ppm selenium (Se), or this diet plus mineral mixture with Se (as selenite) so that the total diet contained 0.25, 0.41 and 0.58 ppm Se (groups B, C, and D, respectively). The Se concentration and GSH-Px activity in red cells were determined at the commencement of the study and at monthly intervals. While in the control group the Se level and GSH-Px activity did not differ throughout the study, in the experimental groups both Se accumulation and GSH-Px activity were elevated. In group B the increase in Se concentration was linear throughout, while in groups C and D great accumulation was observed in the first month and lower in the subsequent period. In all Se-supplemented groups, the red cell GSH-Px increased linearly throughout the study, but no significant differences were found between groups B, C and D. The mean elevations of the enzyme activities were: 58 +/- 8%, 142 +/- 5% and 192 +/- 7% of the initial values after 1, 2 and 3 months of the study, respectively. These data show that the amount of 0.25 ppm Se in the sheep diet satisfy the requirement of the erythropoietic systems to synthesize the enzyme.

Animal Feed↗
PubMed1976

Turban tumor.

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Carcinoma, Adenoid Cystic↗