DR. JOHN WHITTEMORE STOKES IV, M.D.

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This study looked at how a technique called normothermic regional perfusion (NRP) affects the outcomes of ex vivo lung perfusion (EVLP), which is used to evaluate lungs from donors who have died from circulatory causes. Researchers analyzed 187 donor lungs and found that the decline rates for usable lungs were similar whether they had NRP or were quickly procured without it, with 52% for the NRP group and 50% for the rapid procurement group. This matters because it shows that using NRP does not increase the risk of losing potentially usable donor lungs, which could improve the availability of organs for transplants. Who this helps: This helps doctors and patients in need of lung transplants.

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This study looked at three patients with a severe type of lung disease who were not getting enough oxygen, despite being on a special breathing machine called V-V ECMO. By adding another machine, called V-A ECMO, these patients were able to survive long enough for a lung transplant, with all three successfully receiving transplants within 2 to 8 days and recovering well afterward. This finding is important because it shows that using both types of ECMO can help keep critically ill lung patients stable until they can receive transplants. Who this helps: This helps patients with severe lung disease who are awaiting transplant and their doctors who care for them.

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This study looked at how the introduction of a new scoring system, the lung composite allocation score (CAS), affected the use of extracorporeal membrane oxygenation bridge to transplant (ECMO-BTT) for lung transplant patients. After CAS was implemented, patients using ECMO-BTT were younger and had shorter wait times for transplants; specifically, wait times decreased notably for those with high allocation scores. Overall, patients who received transplants without ECMO-BTT had a better chance of surviving one year after the surgery in the CAS era compared to the previous year, with survival rates of 92% versus 90%. Who this helps: This research benefits lung transplant patients and healthcare providers by highlighting changes in transplant practices and outcomes.

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This study examined a technique called remote, centralized ex vivo lung perfusion (rc-EVLP), which helps increase the number of donor lungs available for transplant, especially from donors with less-than-ideal conditions. Researchers found that 56% of the assessed lungs were successfully transplanted after being evaluated with rc-EVLP, and the one-year survival rate for recipients was an impressive 93%. This method makes it possible to use more donor lungs while maintaining high survival rates, which could help address the ongoing shortage of transplantable organs. Who this helps: Patients in need of lung transplants.

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The study looked at why some people on the lung transplant waitlist are removed due to health declines or death, particularly before and after a new scoring system was put in place in 2022. Researchers found that several factors increased the risk of being removed from the waitlist, including needing a machine for breathing support, having a low weight, and having a specific blood type (type O). Understanding these risk factors is crucial for better monitoring of at-risk patients, which can potentially improve their chances of getting a transplant. Who this helps: This helps patients waiting for a lung transplant and their doctors.

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The ECMO-Free Trial is studying whether a daily check on patients' readiness to stop using a life-support machine (known as venovenous extracorporeal membrane oxygenation or V-V ECMO) can help them stop using it faster compared to standard care. The trial involves 225 adults across seven hospitals in North America and will track how long it takes to safely disconnect patients from ECMO over 60 days. This is important because finding a quicker and safer way to free patients from ECMO could lead to better health outcomes for those who need this support. Who this helps: This benefits patients on ECMO and their healthcare providers.

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This study looked at how different levels of blood thinning medication (anticoagulation) during a treatment called venovenous ECMO affect bleeding and clotting issues in severely ill patients. Out of 26 patients, major bleeding happened in 1 of 12 (8.3%) in the low-intensity group and 4 of 14 (28.6%) in the moderate-intensity group, suggesting that lower intensity may reduce serious bleeding risks. Given that no patients died in the low-intensity group compared to 2 in the moderate group who experienced major bleeding, this matters because it could offer a safer option for patients needing ECMO support. Who this helps: Patients undergoing venovenous ECMO treatment.

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This study looked at using an extra ECMO machine alongside a main one in patients with severe COVID-19-related breathing problems that didn’t improve with standard treatment. Out of 84 patients treated with ECMO, 22 (26.2%) needed this additional support, with 73% of those patients surviving until they were discharged from the hospital. This is important because it shows that having a second ECMO circuit can help more patients recover from serious lung issues associated with COVID-19. Who this helps: Patients with severe COVID-19-related lung problems.

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This study looked at how different levels of blood-thinning medication affect the need for blood transfusions during lung transplants. Researchers analyzed data from 163 patients and found that those who received lower doses of the blood thinner heparin needed fewer blood transfusions: those with very low anticoagulation required an average of about half the units of blood compared to patients in higher intensity groups. This matters because it suggests that using less blood-thinning medication during these procedures may help reduce the risk of needing extra blood during surgery. Who this helps: Patients undergoing lung transplants.

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This study looked at a new type of wearable device designed to help animals with right heart failure caused by high blood pressure in the lungs. Researchers tested this device on 6 sheep and found that, after 7 days of use, three of the sheep survived and the device provided a blood flow of 2.8 liters per minute, which is close to the normal blood flow of 3.5 liters per minute. This is significant because it shows that this mechanical support can help maintain vital body functions and allows animals to move around while receiving support, paving the way for similar technology to help patients with heart failure. Who this helps: This helps patients with right heart failure and their doctors by offering potential new treatment options.

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This study looked at how to choose patients for extracorporeal membrane oxygenation (ECMO) during the COVID-19 pandemic, especially since the number of patients needing ECMO increased. Out of 202 patients evaluated for ECMO, 174 had COVID-19, but only 41 were approved to receive ECMO, while 157 were turned down mainly due to age (over 60), multiple health issues, or limited resources. This research shows that having a team of experts work together to make these decisions can be effective, which is important for managing care in future health crises. Who this helps: This helps doctors and medical teams better navigate ECMO decisions for patients in critical condition.

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This study looked at how community wealth and resources, measured by two scores called the Area Deprivation Index (ADI) and the Distressed Communities Index (DCI), affect patient outcomes after they receive a treatment called extracorporeal life support (ECLS). The researchers found that socioeconomic status did not change the chances of patients surviving either during their hospital stay or afterward; for example, the death rates were similar at about 54% for the highest deprivation scores compared to about 50% for lower scores. This matters because it shows that factors like community wealth might not influence recovery outcomes after this critical medical procedure. Who this helps: This helps patients and healthcare providers by highlighting that ECLS outcomes may be independent of community socioeconomic factors.

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This study looked at how different setups for a heart-support device affect sheep with right ventricular failure caused by pulmonary hypertension. The researchers found that the right atrium-to-left atrium (RA-LA) configuration was the most effective, achieving a blood flow of 3 liters per minute and improving heart function without needing extra medications. These findings are important because they could lead to better treatment options for patients suffering from severe pulmonary hypertension and heart failure. Who this helps: This helps patients with pulmonary hypertension and their doctors.

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This study looked at a new method called xenogeneic cross-circulation to support human livers that couldn't be used for transplantation. Researchers tested this method on 5 human livers, and found that after 24 hours, oxygen usage in the livers increased by 75%, and the livers cleared lactic acid, indicating improved function. The livers showed better overall health, repair of injury, and maintained their structure, which could help make more marginal livers suitable for transplantation in the future. Who this helps: This helps patients needing liver transplants and doctors involved in transplantation.

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This study looked at a system that connects pig blood to donated human lungs to help keep them healthy for transplant. Researchers found that even though pig immune cells entered the human lungs during this process, the lungs were still able to stay viable and function better for up to 24 hours. This matters because it could improve the availability of donor lungs for patients who need transplants. Who this helps: This helps patients waiting for lung transplants.

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This study looked at a new technique called xenogeneic cross-circulation, which uses pigs to support and improve human donor lungs that weren’t initially suitable for transplant. After 24 hours of using this technique on nine lungs, researchers found that lung function improved significantly; oxygen exchange increased by 158% and lung compliance went up by 127%. This method is important because it could help make more donor lungs available for patients in need of transplants by ensuring they remain healthy and functional before surgery. Who this helps: This benefits patients waiting for lung transplants.

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This study looked at how doctors in seven U.S. hospitals understand and manage the complex ethical issues surrounding extracorporeal membrane oxygenation (ECMO), a critical but costly treatment for severely ill patients. It found that, on average, doctors spent between 7.5 minutes and 20 minutes explaining ECMO to patients or their families, but only 29% reported that patients regularly understand what they are agreeing to. Additionally, 92% of responding departments had strict criteria for who could receive ECMO, often excluding older patients or those with certain health conditions. Who this helps: This research provides important insights for patients and their families considering ECMO and helps doctors navigate the ethical landscape of this treatment.

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This study looked at how different training methods impact clinicians' understanding of extracorporeal membrane oxygenation (ECMO), a crucial technique in critical care. Researchers found that clinicians who underwent simulation training scored significantly higher on knowledge tests immediately after training (90%) compared to those who used mobile quizzes (70%) or received no formal training (75%). However, all groups had similar retention of knowledge after four months. Who this helps: This benefits clinicians who need effective training in critical care techniques to improve patient outcomes.

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Researchers studied a technique to collect more blood from pigs while minimizing changes in their health during the process. They found that by using a method called acute normovolemic hemodilution, they could collect about 47 mL of blood for every kilogram of the pig's body weight, which amounts to roughly 73% of the pig's total blood volume. This approach is important because it improves blood collection for organ preservation studies without harming the animals significantly. Who this helps: This benefits researchers studying organ preservation techniques.

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This study looked at a new method of using a special heart-lung machine to help patients with both heart and lung failure before they receive a transplant. The researchers found that this approach allowed patients to receive the necessary support while minimizing invasive surgery. This matters because it can improve the chances for patients awaiting a heart-lung transplant by providing better care with less risk. Who this helps: This helps patients waiting for heart-lung transplants.

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This study looked at using two ECMO machines together (in parallel) to help patients with severe breathing problems from COVID-19 when one machine wasn't enough. The researchers found that adding a second machine can significantly improve oxygen levels and assist with recovery efforts like rehabilitation. This is important because it shows a new way to treat patients who are not responding to traditional ECMO support, potentially saving more lives. Who this helps: This benefits patients with severe COVID-19-related breathing difficulties.

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Researchers studied a sheep model of pulmonary hypertension to understand how right ventricular failure progresses. They found that after 10 weeks, the sheep showed severe signs of heart failure, including swollen fluids in the body and a significant increase in heart pressure, leading to the animal's death. This research is important because it helps create better treatments and devices for patients suffering from heart failure related to pulmonary hypertension. Who this helps: This helps doctors and patients with pulmonary hypertension and related heart conditions.

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This study tested a new method called V-AV cross-circulation to support livers outside the body in pigs. Over 12 hours, the livers showed good function and no major injury, meaning they were able to produce bile and clear waste effectively. These findings are important because they could lead to better ways to preserve and evaluate liver organs for transplantation, addressing the shortage of available organs. Who this helps: This helps patients waiting for liver transplants.

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This study looked at how to choose the right disposable parts for extracorporeal life support (ECLS) machines to save money. Over five years, the costs for different device combinations were analyzed, measuring from around $1.25 million to about $6.64 million, depending on the devices used. This information is important because hospitals can use it to make more cost-effective decisions that save money while providing critical care. Who this helps: Hospitals and medical teams involved in ECLS care.

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This study focused on using a medical treatment called ECMO (extracorporeal membrane oxygenation) to help patients with severe lung disease while they wait for a lung transplant. The findings indicate that advances in technology and better patient care have made ECMO more effective, allowing for safer and better transplant outcomes for these patients. Although there's still a need for more research to improve how ECMO is used, it shows promise in helping critically ill patients receive lung transplants successfully. Who this helps: This helps patients with end-stage lung disease and their doctors.

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This study looked at a new daily assessment method to see if patients on venovenous ECMO (a type of life-support machine) were ready to be taken off the machine safely and quickly. Among 26 patients, 47.5% successfully passed the trial to come off ECMO, and 87.5% of those who did were able to be taken off the machine, often within just two days. This approach could lead to quicker recoveries and lower costs for patients needing this life-saving support. Who this helps: Patients needing venovenous ECMO and their healthcare providers.

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This study looked at the use of a technique called ECMO (extracorporeal membrane oxygenation) during high-risk procedures involving the airway, particularly in patients with serious lung conditions. They found that all 9 procedures performed while on ECMO were successful, with patients needing the support for an average of about 18 hours. Importantly, 88% of patients were able to leave the hospital, and half of them were still alive a year later, showing that using ECMO can help high-risk patients undergo important treatments safely. Who this helps: Patients with severe lung issues who need risky airway procedures.

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This study developed a model using sheep to better understand how pulmonary hypertension leads to right heart failure. The researchers found that over nine weeks, the pressure in the right ventricle of the sheep significantly increased, indicating heart strain, with average pressures rising from 28 to 44 mmHg. This work is important because it helps develop new treatments for pulmonary hypertension and assess how the heart adapts to increased pressure. Who this helps: This benefits patients with pulmonary hypertension and doctors working on new treatment options.

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This study focused on creating a better model for studying pulmonary hypertension and related heart issues in sheep by blocking off the left pulmonary artery and gradually tightening the main pulmonary artery. The researchers found that this method effectively induced pulmonary hypertension and right heart changes in a controlled way, reducing the risk of sudden deaths during the process. This matters because it allows for safer testing of heart support devices that could one day help patients with severe lung and heart conditions. Who this helps: Patients with pulmonary hypertension and right heart failure.

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This study looked at patients undergoing a treatment called venovenous extracorporeal membrane oxygenation (VV-ECMO), which helps people with severe breathing problems. Researchers found that 45.5% of the 55 patients experienced bleeding, while 14.5% had blood clots. Patients who had bleeding required more time on the machine and faced worse survival outcomes, indicating the importance of understanding how to safely manage blood-thinning treatments during this therapy. Who this helps: This helps critically ill patients who need VV-ECMO and their doctors.

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This study looked at how quickly and effectively a training program for extracorporeal membrane oxygenation (ECMO) could be set up for a large group of critical care clinicians. Out of 97 clinicians who completed the training, their knowledge scores significantly increased from an average of 70% before training to 90% afterward, showing a 20% improvement. This is important because it means clinicians can provide better and more consistent care for patients in need of ECMO, a life-saving treatment for severe respiratory failure. Who this helps: This helps patients in intensive care who require ECMO support.

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Most donated lungs are never used because injury makes them too risky for transplant. Researchers connected damaged human lungs to a living pig's circulation as an extended support system and showed the lungs could recover function over multiple days. This xenogeneic cross-circulation approach could dramatically increase the number of usable donor lungs.

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This study looked at how patients respond to a tool called the ACS Surgical Risk Calculator, which helps them understand their specific risks for complications before surgery. Out of 150 patients surveyed, almost 90% wanted to see their risk report before deciding on surgery, and 71% felt less anxious after reviewing their risks. Notably, high-risk patients were three times more likely to underestimate their potential complications than low-risk patients, suggesting they might not fully grasp the risks involved. Who this helps: This helps patients, especially those at high risk for complications, by giving them better information to make informed decisions about their surgeries.

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This study examined how well patients can assess their own functional capacity compared to evaluations made by doctors before surgery. Out of 204 patients, 53.4% were classified by clinicians as having low functional capacity (less than 4 metabolic equivalents), while only 8.8% self-reported the same using a questionnaire. This matters because the differences in assessments could affect how patients are prioritized for preoperative evaluations, potentially altering their care and risk management. Who this helps: This benefits patients by improving the pre-surgery evaluation process.

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This study looked at how posttraumatic stress disorder (PTSD) and similar symptoms can develop in people who have experienced mild traumatic brain injuries (like concussions), especially in military veterans. Researchers found that PTSD often occurs alongside mild TBI, and both conditions can complicate recovery, making proper diagnosis and treatment challenging. Understanding these connections is important for improving care and support for affected individuals. Who this helps: This helps patients, particularly veterans, who suffer from both PTSD and mild traumatic brain injuries.