ABSTRACT Extracorporeal cardiopulmonary resuscitation is a method of cardiopulmonary resuscitation that uses extracorporeal membrane oxygenation with conventional cardiopulmonary resuscitation and has emerged as a promising intervention for patients with refractory cardiac arrest. This report describes the case of a 44-year-old man at significant risk for mortality according to his high RESCUE-IHCA Score who was awaiting heart transplantation and experienced in-hospital cardiac arrest during hemodialysis. Prompt recognition, immediate activation of the extracorporeal membrane oxygenation team, and initiation of support within 60 minutes contributed to a favorable outcome. This case emphasizes important considerations associated with extracorporeal cardiopulmonary resuscitation implementation, including optimal patient selection, intervention timing, and nuances of cannulation procedures. Continuous monitoring, involvement of a specialized extracorporeal membrane oxygenation team, recognition of extracorporeal membrane oxygenation as bridge therapy, and integration of extracorporeal membrane oxygenation with definitive treatment strategies are highlighted. Extracorporeal cardiopulmonary resuscitation is a vital intervention for patients with refractory cardiac arrest, and adequate patient selection and swift implementation are crucial to improving outcomes. A comprehensive review of extracorporeal cardiopulmonary resuscitation is also presented to highlight its efficacy and challenges associated with in-hospital cardiac arrest. 44yearold yearold 44 year old RESCUEIHCA RESCUE IHCA inhospital in hospital hemodialysis team 6 outcome timing procedures monitoring therapy highlighted outcomes 4

RESUMO Objetivo: O mundo vem sofrendo com a pandemia de COVID-19. Alguns pacientes com COVID-19 desenvolvem pneumonia viral grave, necessitando ventilação mecânica e medidas para tratar a hipoxemia refratária, como estratégias de ventilação protetora, posição prona e uso de oxigenação por membrana extracorpórea venovenosa (ECMO-VV). Descrevemos uma série de casos de 30 pacientes com COVID-19 que necessitaram de ECMO-VV no Hospital Alemão Oswaldo Cruz, localizado na cidade de São Paulo, Brasil. Métodos: Foram incluídos todos os pacientes que necessitaram de ECMO-VV devido à pneumonia por COVID-19 entre março de 2020 e junho de 2021. Resultados: Antes da ECMO-VV, os pacientes apresentavam as seguintes medianas: escore SOFA de 11; escore APPS de 7; escore Respiratory ECMO Survival Prediction de 2; e escore de Murray de 3,3. A mortalidade hospitalar em 60 dias foi de 33,3% (n = 10). Conclusões: Apesar de nossos pacientes apresentarem um perfil de alta gravidade, nossos resultados foram semelhantes aos de outros estudos de coorte na literatura. Isso demonstra que a ECMO-VV pode ser uma boa ferramenta mesmo em uma situação de pandemia quando administrada em um centro experiente. Objetivo COVID19. COVID19 COVID 19. 19 COVID-1 grave refratária protetora ECMOVV. ECMOVV VV . (ECMO-VV) 3 Cruz Paulo Brasil Métodos 202 2021 Resultados ECMOVV, VV, medianas 11 7 2 33 3,3 6 333 33,3 n 10. 10 10) Conclusões gravidade literatura experiente COVID1 1 COVID- (ECMO-VV 20 3, 33,

ABSTRACT Objective: The world has been suffering from the COVID-19 pandemic. Some COVID-19 patients develop severe viral pneumonia, requiring mechanical ventilation and measures to treat refractory hypoxemia, such as a protective ventilation strategy, prone positioning, and the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO). We describe a case series of 30 COVID-19 patients who needed VV-ECMO at the Hospital Alemão Oswaldo Cruz, located in the city of São Paulo, Brazil. Methods: We included all patients who required VV-ECMO due to COVID-19 pneumonia between March of 2020 and June of 2021. Results: Prior to VV-ECMO, patients presented with the following median scores: SOFA score, 11; APPS score, 7; Respiratory ECMO Survival Prediction score, 2; and Murray score, 3.3. The 60-day-in-hospital mortality was 33.3% (n = 10). Conclusions: Although our patients had a highly severe profile, our results were similar to those of other cohort studies in the literature. This demonstrates that VV-ECMO can be a good tool even in a pandemic situation when it is managed in an experienced center. Objective COVID19 COVID 19 COVID-1 hypoxemia strategy positioning venovenous veno venous VVECMO. VVECMO VV . (VV-ECMO) 3 Cruz Paulo Brazil Methods 202 2021 Results VVECMO, ECMO, scores score 11 7 2 33 3.3 60dayinhospital dayinhospital 60 day hospital 333 33.3 n 10. 10 10) Conclusions profile literature center COVID1 1 COVID- (VV-ECMO 20 3. 6 33.

ABSTRACT Ischemia-reperfusion injury is a pathophysiological event occuring after abdominal organ transplantation, and has a significant influence on prognosis and survival of the graft. It is involved in delaying the primary function or non-functioning of the graft. The objective of this study was to provide information on heat shock protein mechanisms in ischemia-reperfusion injuries in abdominal organ transplantations, and to indicate the possible factors involved that may influence the graft outcome. Several classes of heat shock proteins are part of the ischemia and reperfusion process, both as inflammatory agonists and in protecting the process. Studies involving heat shock proteins enhance knowledge on ischemia-reperfusion injury mitigation processes and the mechanisms involved in the survival of abdominal grafts, and open space to support therapeutic future clinical studies, minimizing ischemia and reperfusion injuries in abdominal organ transplantations. Expression of heat shock proteins is associated with inflammatory manifestations and ischemia-reperfusion injuries in abdominal organ transplantations and may influence graft outcomes.