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  • 1
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 128, No. 10 ( 2013-09-03), p. 1139-1169
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1466401-X
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  • 2
    In: The Journal of ExtraCorporeal Technology, EDP Sciences, Vol. 52, No. 2 ( 2020-6), p. 96-102
    Abstract: The American Society of Extracorporeal Technology Board of Directors, consistent with the American Society of Extracorporeal Technology’s safe patient care improvement mission, charged the International Board of Blood Management to write a knowledge and skill certification examination for healthcare personnel employed as adult extracorporeal membrane oxygenation (ECMO) specialists. Nineteen nationally recognized ECMO subject-matter experts were selected to complete the examination development. A job analysis was performed, yielding a job description and examination plan focused on 16 job categories. Multiple-choice test items were created and validated. Qualified ECMO specialists were identified to complete a pilot examination and both pre- and post-examination surveys. The examination item difficulty and candidate performance were ranked and matched using Rasch methodology. Candidates’ examination scores were compared with their profession, training, and experience as ECMO specialists. The 120-item pilot examination form ranked 76 ECMO specialist candidates consistent with their licensure, ECMO training, and clinical experience. Forty-three registered nurses, 28 registered respiratory therapists, four certified clinical perfusionists, and one physician assistant completed the pilot examination process. Rasch statistics revealed examination reliability coefficients of .83 for candidates and .88 for test items. Candidates ranked the appropriateness for examination items consistent with the item content, difficulty, and their personal examination score. The pilot examination pass rate was 80%. The completed examination product scheduled for enrollment in March 2020 includes 100 verified test items with an expected pass rate of 84% at a cut score of 67%. The online certification examination based on a verified job analysis provides an extramural assessment that ranks minimally prepared ECMO specialists’ knowledge, skills, and abilities (KSA) consistent with safe ECMO patient care and circuit management. It is anticipated that ECMO facilities and ECMO service providers will incorporate the certification examination as part of their process improvement, safety, and quality assurance plans.
    Type of Medium: Online Resource
    ISSN: 0022-1058 , 2969-8960
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2020
    detail.hit.zdb_id: 2465229-5
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  • 3
    In: The Journal of ExtraCorporeal Technology, EDP Sciences, Vol. 36, No. 3 ( 2004-09), p. 235-239
    Abstract: A challenge faced by many university-based perfusion education (PE) programs is the need for student clinical rotations at hospital locations that are geographically disparate from the main educational campus. The problem has been addressed through the employment of distance-learning environments. The purpose of this educational study is to evaluate the effectiveness of this teaching model as it is applied to PE. Web-based virtual classroom (VC) environments and educational management system (EMS) software were implemented independently and as adjuncts to live, interactive Internet-based audio/video transmission from classroom to classroom in multiple university-based PE programs. These Internet environments have been used in a variety of ways including: 1) forum for communication between the university faculty, students, and preceptors at clinical sites, 2) didactic lectures from expert clinicians to students assigned to distant clinical sites, 3) small group problem-based-learning modules designed to enhance students analytical skills, and 4) conversion of traditional face-to-face lectures to asynchronous learning modules. Hypotheses and measures of student and faculty satisfaction, clinical experience, and learning outcomes are proposed, and some early student feedback was collected. For curricula that emphasize both didactic and clinical education, the use of Internet-based VC and EMS software provides significant advancements over traditional models. Recognized advantages include: 1) improved communications between the college faculty and the students and clinical preceptors, 2) enhanced access to a national network of clinical experts in specialized techniques, 3) expanded opportunity for student distant clinical rotations with continued didactic course work, and 4) improved continuity and consistency of clinical experiences between students through implementation of asynchronous learning modules. Students recognize the learning efficiency of on-line information presentation but still prefer the traditional face-to-face classroom environment. Traditional paradigms impose limitations that are rooted in dependence upon the students and instructors being physically located in the same place at the same time. These represents significant impediments for PE programs that use geographically separate clinical sites to provide clinical experience. Historically this has led to a disintegration of the presentation of theory, and a reduction in the quantity or quality of clinical experience opportunities. New PE models help to eliminate limitations and improve the quality of education especially in the face of economic challenges. Perfusion education students and faculty will have to work together to find computer-based offerings that are equivalent to traditional classroom methods.
    Type of Medium: Online Resource
    ISSN: 2969-8960
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2004
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Anesthesia & Analgesia Vol. 110, No. 2 ( 2010-02), p. 288-290
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 110, No. 2 ( 2010-02), p. 288-290
    Type of Medium: Online Resource
    ISSN: 0003-2999
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2010
    detail.hit.zdb_id: 2018275-2
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Anesthesia & Analgesia Vol. 109, No. 6 ( 2009-12), p. 1715-1717
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 109, No. 6 ( 2009-12), p. 1715-1717
    Type of Medium: Online Resource
    ISSN: 0003-2999
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
    detail.hit.zdb_id: 2018275-2
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  • 6
    In: Perfusion, SAGE Publications, Vol. 22, No. 4 ( 2007-07), p. 239-244
    Abstract: Introduction. Some degree of recirculation occurs during venovenous extracorporeal membrane oxygenation (VV ECMO) which, (1) reduces oxygen (O 2 ) delivery, and (2) renders venous line oxygen saturation monitoring unreliable as an index of perfusion adequacy. Ultrasound dilution allows clinicians to rapidly monitor and quantify the percent of recirculation that is occurring during VV ECMO. The purpose of this paper is to test whether accurate patient mixed venous oxygen saturation (S V O 2 ) can be calculated once recirculation is determined. It is hypothesized that it is possible to derive patient mixed venous saturations by integrating recirculation data with the ECMO circuit arterial and venous line oxygen saturation data. Methods. A test system containing sheep blood adjusted to three venous saturations (low-30%, med-60%, high-80%) was interfaced via a mixing chamber with a standard VV ECMO circuit. Recirculation, arterial line and venous line oxygen saturations were measured and entered into a derived equation to calculate the mixed venous saturation. The resulting value was compared to the actual mixed venous saturation. Results. Recirculation was held constant at 30.5 ± 2.0% for all tests. A linear regression comparison of “actual” versus “calculated” mixed venous saturations produced a correlation coefficient of R 2 = 0.88. Direct comparison of actual versus calculated saturations for all three test groups respectively are as follows; Low: 31.8 ± 3.95% vs. 37.0 ± 6.7% (NS), Med: 61.7 ± 1.5% vs. 72.3 ± 1.8% (p 〈 0.05), High: 84.4 ± 0.9% vs. 91.2 ± 1.1% (p 〈 0.05). Discussion. There was a strong correlation between actual and calculated mixed venous saturations; however, significant differences between actual and calculated values where observed at the Med and High groups. While this data suggests that using quantified recirculation data to calculate S V O 2 is promising, it appears that a straightforward derivative of the oxygen saturation-based equation may not be sufficient to produce clinically accurate calculations of actual mixed venous saturations. Perfusion (2007) 22, 239—244.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2029611-3
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  • 7
    Online Resource
    Online Resource
    EDP Sciences ; 2021
    In:  The Journal of ExtraCorporeal Technology Vol. 53, No. 4 ( 2021-12), p. 245-250
    In: The Journal of ExtraCorporeal Technology, EDP Sciences, Vol. 53, No. 4 ( 2021-12), p. 245-250
    Abstract: The dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) over the last decade with the concomitant need for ECMO competent perfusionists has raised questions of how well perfusion education programs are preparing entry-level perfusionists to participate in ECMO. While all perfusion schools teach ECMO principles, there is no standardized or systematic approach to the delivery of didactic knowledge and clinical skills in ECMO. Given this variability of ECMO education across and within perfusion schools, the CES-A exam may provide a metric for comparing curricular approaches. The purpose of this study is to examine three different curricular approaches to prepare new perfusion graduates to master the Adult ECMO Specialist Certification exam (CES-A). We examined three different curricular approaches to prepare new perfusion graduates to master the Adult ECMO Specialist Certification exam (CES-A). We hypothesized that there would be no difference in CES-A pass rate, exam score, Rasch measure, and item category scores between SUNY Cardiovascular Perfusion Program (CVP) graduates who completed SUNY’s ECMO Capstone experience (Group III) and CVP graduates who did not select the ECMO Capstone experience (Group II). Further, we studied the performance of a third group of new graduates from an external program that does not offer formal ECMO courses or an ECMO Capstone experience (Group I). Every perfusion graduate in all groups passed the adult ECMO specialist exam. The graduates who as students completed an ECMO Capstone experience (Group III) scored higher on the exam and significantly higher on four exam categories: coagulation and hemostasis ( p  = .058), lab analysis point of care ( p  = .035), and monitor patient and circuit ( p  = .073), and the safety and failure modes ( p  = .017). Overall the median graduate Rasch measures ranked with Group III demonstrating the highest measure to Group I the lowest measures (not significant at p  = .085). There is a positive educational effect due to CVP graduates completion of the ECMO Capstone experience compared to the program standard ECMO-related curricula in the two perfusion programs participating in this study. From this observation a structured ECMO simulation-based program appears to be equally effective as a traditional, typical lecture-only, clinical perfusion preceptorship, while demonstrating a more satisfactory experience with a higher reported case experience. In this study the standard perfusionist education curriculum prepared the new graduate to be successful on the CES-A exam. The three curricular approaches appear to prepare perfusionist graduates to be successful on the Adult ECMO Specialist exam.
    Type of Medium: Online Resource
    ISSN: 0022-1058 , 2969-8960
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2021
    detail.hit.zdb_id: 2465229-5
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  • 8
    Online Resource
    Online Resource
    EDP Sciences ; 2021
    In:  The Journal of ExtraCorporeal Technology Vol. 53, No. 4 ( 2021-12), p. 263-269
    In: The Journal of ExtraCorporeal Technology, EDP Sciences, Vol. 53, No. 4 ( 2021-12), p. 263-269
    Abstract: The utilization of simulators for training is increasing in the professions associated with cardiac surgery. Before applying these simulators to high-stakes assessment, the simulator’s output data must be validated. The aim of this study is to validate a Cardiopulmonary Bypass (CPB) simulator by comparing the simulated hemodynamic and technical outputs to published clinical norms. Three Orpheus™ CPB simulators were studied and compared to a published reference of physiologic and technical metrics that are managed during clinical CPB procedures. The limits of the simulators user modifiable variables were interrogated across their full range and the results were plotted against the published clinical norms. The data generated with the simulator conforms to validated clinical parameters for patients between 50 and 110 kg. For the pre- and post-CPB periods, the independent variables of central venous pressure (CVP), heart rate (HR), contractility, and systemic vascular resistance (SVR) must be operated between the limits of 7 and 12 mmHg, 65 and 110 beats/min, 28% and 65%, and 6 and 32 units respectively. During full CPB the arterial pump flows should be maintained between 3.5 and 5.5 LPM and SVR between 18 and 38 units. Validated technical parameters during cardioplegia delivery are expected at solution flow rates between 250 and 400 mL/min and 100 and 225 mL/min for antegrade and retrograde delivery routes, respectively. We have identified the limits for user-modifiable settings that produce data conforming to the physiologic and technical parameter limits reported in the peer reviewed literature. These results can inform the development of simulation scenarios used for high stakes assessments of personnel, equipment, and technical protocols.
    Type of Medium: Online Resource
    ISSN: 0022-1058 , 2969-8960
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2021
    detail.hit.zdb_id: 2465229-5
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  • 9
    In: Journal of Thrombosis and Thrombolysis, Springer Science and Business Media LLC
    Abstract: The 2MACE score was specifically developed as a risk-stratification tool in atrial fibrillation (AF) to predict cardiovascular outcomes. We evaluated the predictive ability of the 2MACE score in the GLORIA-AF registry. All eligible patients from phase II/III of the prospective global GLORIA-AF registry were included. Major adverse cardiac events (MACEs) were defined as the composite outcome of stroke, myocardial infarction and cardiovascular death. Cox proportional hazards were used to examine the relationship between the 2MACE score and study outcomes. Predictive capability of the 2MACE score was investigated using receiver-operating characteristic curves. A total of 25,696 patients were included (mean age 71 years, female 44.9%). Over 3 years, 1583 MACEs were recorded. Patients who had MACE were older, with more cardiovascular risk factors and were less likely to be managed using a rhythm-control strategy. The median 2MACE score in the MACE and non-MACE groups were 2 (IQR 1–3) and 1 (IQR 0–2), respectively (p  〈  0.001). The 2MACE score was positively associated with an increase in the risk of MACE, with a score of ≥ 2 providing the best combination of sensitivity (69.6%) and specificity (51.6%), HR 2.47 (95% CI, 2.21–2.77). The 2MACE score had modest predictive performance for MACE in patients with AF (AUC 0.655 (95% CI, 0.641–0.669)). Our analysis in this prospective global registry demonstrates that the 2MACE score can adequately predict the risk of MACE (defined as myocardial infarction, CV death and stroke) in patients with AF. Clinical trial registration: http://www.clinicaltrials.gov . Unique identifiers: NCT01468701, NCT01671007 and NCT01937377
    Type of Medium: Online Resource
    ISSN: 1573-742X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2017305-2
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  • 10
    In: Clinical Research in Cardiology, Springer Science and Business Media LLC, Vol. 111, No. 5 ( 2022-05), p. 593-593
    Abstract: In this article, the name of the GLORIA-AF investigator Anastasios Kollias was given incorrectly as Athanasios Kollias in the Acknowledgements. The original article has been corrected.
    Type of Medium: Online Resource
    ISSN: 1861-0684 , 1861-0692
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2218331-0
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