The Experts below are selected from a list of 150 Experts worldwide ranked by ideXlab platform

Akira Sato - One of the best experts on this subject based on the ideXlab platform.

  • The effects of veno-venous extracorporeal membrane oxygenation on hypoxic fetal lambs.
    Journal of Maternal-fetal & Neonatal Medicine, 2020
    Co-Authors: Keiya Fujimori, Yasuhisa Nomura, Katsuhiko Kato, T Shiroto, Tomohiko Ishida, Akira Sato
    Abstract:

    Objective: The purpose of this study was to determine the applicability of veno-venous extracorporeal membrane oxygenation (V-V ECMO) to support fetal oxygenation in utero. Methods: An ECMO system with a centrifugal pump was applied to ten chronically instrumented fetal lambs, at 126 or 127 days of gestation. Blood was obtained through a double-Lumen Catheter inserted into the right atrium. After oxygenation, the blood was returned through a Single-Lumen Catheter into either the carotid artery (veno-arterial; V-A ECMO) or the right atrium (V-V ECMO). After fetal hypoxia had been experimentally produced, V-A ECMO or V-V ECMO was instituted to maintain fetal oxygenation. We compared fetal blood gases with both routes of ECMO. Results: Oxygen partial pressure (pO2) in the fetal cranial carotid artery decreased to 12.9 ± 0.6 mmHg after reducing the fraction inspiratory oxygen of the mother. After instituting V-A ECMO, pO2 was found to be 23.5 ± 2.6 mmHg; after instituting V-V ECMO, pO2 was found to be 20.3 ± ...

  • THE ENDOCRINOLOGICAL RESPONSES OF VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION ON HYPOXIC FETAL LAMBS
    Fukushima journal of medical science, 2020
    Co-Authors: Yasuhisa Nomura, Keiya Fujimori, Katsuhiko Kato, T Shiroto, Tomohiko Ishida, Akira Sato
    Abstract:

    OBJECTIVE: The purpose of this study was to observe endocrinological responses of veno-arterial and veno-venous extracorporeal membrane oxygenation (V-A and V-V ECMO) to support fetal oxygenation in utero. METHODS: An ECMO system with a centrifugal pump was applied to six chronically instrumented fetal lambs, at 126-134 days of gestation. Blood was obtained through a double-Lumen Catheter inserted into the right atrium. After oxygenation, the blood was returned through a Single-Lumen Catheter into either the carotid artery (veno-arterial; V-A ECMO) or the right atrium (V-V ECMO). After fetal hypoxia had been experimentally produced, V-A ECMO or V-V ECMO was instituted to maintain fetal oxygenation. We compared fetal blood gases and concentrations of atrial natriuretic peptide (ANP), epinephrine and norepinephrine with both routes of ECMO. RESULTS: Fetal carotid artery pH did not change during hypoxemia, but decreased after instituting V-A ECMO and V-V ECMO. After instituting V-A ECMO or V-V ECMO for 30 min, oxygen partial pressure (pO2) in the fetal cranial carotid artery recovered from the hypoxic level. The ANP concentration in V-V ECMO was significantly lower than that in V-A ECMO. Fetal serum epinephrine and norepinephrine concentrations significantly increased in association with hypoxic stimulation. There was a further increase in fetal serum epinephrine concentration after instituting V-A ECMO. No significant difference in concentration was found after instituting V-V ECMO from that of after the institution of V-A ECMO. CONCLUSIONS: This study suggested that V-V ECMO may possibly be less invasive than V-A ECMO for fetal heart, because ANP, a cardiac distress index, was lower in V-V ECMO than in V-A ECMO.

Robert J Norman - One of the best experts on this subject based on the ideXlab platform.

  • a randomized controlled trial of a soft double Lumen embryo transfer Catheter versus a firm Single Lumen Catheter significant improvements in pregnancy rates
    Human Reproduction, 2002
    Co-Authors: Janelle Mcdonald, Robert J Norman
    Abstract:

    BACKGROUND: Embryo transfer has changed little since originally described in 1978. Clinicians rate the type of Catheter used as the third most important variable in embryo transfer, but there are no adequately powered randomized trials. We compared the clinical pregnancy rates with the Single Lumen Catheter (TCC) and the double Lumen Catheter (CC) in a randomized Single blind trial. METHODS: A total of 650 cycles of women from the Adelaide University reproductive medicine units in Australia were included in this trial. Patients were 10 IU/l, previous difficult embryo transfer and pre-implantation genetic diagnosis. Cycles were randomized from numbered sealed envelopes immediately prior to embryo transfer with stratification for fresh or frozen cycles. RESULTS: There was a significantly higher pregnancy rate in the group treated with the CC compared with the TCC Catheter [29.6 versus 20.5% per embryo transfer, odds ratio (OR) = 1.63 (95% confidence interval: 1.14-2.30), P = 0.0076]. The point estimate for the OR was similar for fresh and frozen cycles. CONCLUSIONS: The pregnancy rate was increased by 50% and this justifies the increased cost of the soft double Lumen Catheter and the training of clinical staff required.

S Ringoir - One of the best experts on this subject based on the ideXlab platform.

  • factors and complications affecting Catheter and technique survival with permanent Single Lumen dialysis Catheters
    Nephrology Dialysis Transplantation, 1994
    Co-Authors: J De Meester, R Vanholder, J De Roose, S Ringoir
    Abstract:

    This long-term study on the outcome of permanent silicone Single-Lumen dialysis Catheters consisted of 43 surgically inserted Catheters in 33 patients. All Catheters were attached to a pressure-pressure Single-cannula dialysis system. Technique and Catheter survival were 80 and 59% at 1 year, and 63 and 50% at the 3rd year respectively. These parameters were not different in older patients (greater-than-or-equal-to 70 years, n = 12). Factors corresponding to a less successful outcome were placement in the left jugular vein (3-month actuarial survival of 44%) and absence of distal side holes (1-year actuarial survival of 44%). Insertion in both subclavian veins was not different to the classical right jugular vein. Infectious complications (incidence of 0.72 per 1000 Catheter,days) often caused simultaneous Catheter and technique failure (14 versus 15%), whereas inadequate flow (incidence of 2 per 1000 Catheter days) caused Catheter rather than technique failure (30 versus 12%). The incidence of both complications declined significantly with time after insertion during the follow-up period. The first 3 months after insertion were more predisposed to the occurrence of inadequate flow than Catheter-related infections. The general performance of these permanent Single-Lumen Catheter devices justifies their long-term application in haemodialysis, even as a first choice of vascular access, especially in the elderly. Insertion in the left jugular vein and use of Catheters without side holes should be avoided, providing a better Catheter survival.

Nena Clark-christoff - One of the best experts on this subject based on the ideXlab platform.

  • Use of triple-Lumen subclavian Catheters for administration of total parenteral nutrition.
    Journal of Parenteral and Enteral Nutrition, 1993
    Co-Authors: Nena Clark-christoff, Virginia A. Watters, Wanet Sparks, Phyllis J. Snyder, John Grant
    Abstract:

    This study evaluated the safety of triple vs Single-Lumen Catheters in intravenous nutrition. Patients who were judged likely to benefit from a triple-Lumen Catheter were randomized to receive either a Single-Lumen Catheter, with additional peripheral or central venous access as needed, or a triple-Lumen Catheter. All patients were at increased risk of Catheter-related infection because of one or more of the following conditions: >60 years of age, breakdown of skin integrity, severe underlying illness, diagnosis of acute pancreatitis, recent head or neck surgery, or presence of a preexisting infection. Patients were excluded who had neutropenia, were immuno-suppressed, had body burns >40%, or had contaminated wounds in the subclavicular area. Of 204 patients entered between June 1989 and November 1991, 177 completed the required ≥7 days of therapy. Seventy-eight of these patients were randomized to a Single-Lumen Catheter and 99 to a triple-Lumen Catheter. Catheters were inserted and maintained by the Nut...

  • Use of triple-Lumen subclavian Catheters for administration of total parenteral nutrition.
    JPEN. Journal of parenteral and enteral nutrition, 1992
    Co-Authors: Nena Clark-christoff, Virginia A. Watters, Wanet Sparks, P Snyder, J P Grant
    Abstract:

    This study evaluated the safety of triple vs Single-Lumen Catheters in intravenous nutrition. Patients who were judged likely to benefit from a triple-Lumen Catheter were randomized to receive either a Single-Lumen Catheter, with additional peripheral or central venous access as needed, or a triple-Lumen Catheter. All patients were at increased risk of Catheter-related infection because of one or more of the following conditions: > 60 years of age, breakdown of skin integrity, severe underlying illness, diagnosis of acute pancreatitis, recent head or neck surgery, or presence of a preexisting infection. Patients were excluded who had neutropenia, were immunosuppressed, had body burns > 40%, or had contaminated wounds in the subclavicular area. Of 204 patients entered between June 1989 and November 1991, 177 completed the required > or = 7 days of therapy. Seventy-eight of these patients were randomized to a Single-Lumen Catheter and 99 to a triple-Lumen Catheter. Catheters were inserted and maintained by the Nutrition Support Team. Dressings were monitored daily and changed weekly using a bio-occlusive dressing. When parameters were met for a possible septic episode, simultaneous peripheral and central Catheter blood cultures were obtained using the Isolator method. Catheter-related sepsis was considered present if the colony count from a central Catheter Lumen was > or = 5 times that of the peripheral blood. The incidence of Catheter-related sepsis for Single-Lumen Catheters was 2.6% (2 of 78) compared with 13.1% for triple-Lumen Catheters (13 of 99) (p < .01). No correlation was found with the number of insertion attempts, Catheter days, or patient's age.(ABSTRACT TRUNCATED AT 250 WORDS)

Janelle Mcdonald - One of the best experts on this subject based on the ideXlab platform.

  • a randomized controlled trial of a soft double Lumen embryo transfer Catheter versus a firm Single Lumen Catheter significant improvements in pregnancy rates
    Human Reproduction, 2002
    Co-Authors: Janelle Mcdonald, Robert J Norman
    Abstract:

    BACKGROUND: Embryo transfer has changed little since originally described in 1978. Clinicians rate the type of Catheter used as the third most important variable in embryo transfer, but there are no adequately powered randomized trials. We compared the clinical pregnancy rates with the Single Lumen Catheter (TCC) and the double Lumen Catheter (CC) in a randomized Single blind trial. METHODS: A total of 650 cycles of women from the Adelaide University reproductive medicine units in Australia were included in this trial. Patients were 10 IU/l, previous difficult embryo transfer and pre-implantation genetic diagnosis. Cycles were randomized from numbered sealed envelopes immediately prior to embryo transfer with stratification for fresh or frozen cycles. RESULTS: There was a significantly higher pregnancy rate in the group treated with the CC compared with the TCC Catheter [29.6 versus 20.5% per embryo transfer, odds ratio (OR) = 1.63 (95% confidence interval: 1.14-2.30), P = 0.0076]. The point estimate for the OR was similar for fresh and frozen cycles. CONCLUSIONS: The pregnancy rate was increased by 50% and this justifies the increased cost of the soft double Lumen Catheter and the training of clinical staff required.