Extracorporeal membrane oxygenation in curing a young man after modified Fontan operation:A case report

BACKGROUND The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ hemodynamics.After successful operation,patients typically recover the ability to engage in general physical activity.As a better ventilatory strategy,extracorporeal membrane oxygenation(ECMO) provides gas exchange via an extracorporeal circuit,and is increasingly being used to improve respiratory and circulatory function.After the modified Fontan operation,circulation is different from that of patients who are not subjected to the procedure.This paper describe a successful case using ECMO in curing influenza A infection in a young man,who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago.The special cardiac structure and circulatory characteristics are explored in this case.CASE SUMMARY We report a successful case using ECMO in curing influenza A infection in a 23-year-old man,who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago.The man was admitted to the intensive care unit with severe acute respiratory distress syndrome as a result of influenza A infection.He was initially treated by veno-venous(VV) ECMO,which was switched to veno-venous-arterial ECMO(VVA ECMO) 5 d later.As circulation and respiratory function gradually improved,the VVA ECMO equipment was removed on May 1,2018.The patient was successfully withdrawn from artificial ventilation on May 28,2018 and then discharged from hospital on May 30,2018.CONCLUSION After the modified Fontan operation,circulation is different compared with that of patients who are not subjected to the procedure.There are certainly many differences between them when they receive the treatment of ECMO.Due to the special cardiac structure and circulatory characteristics,an individualized liquid management strategy is necessary and it might be better for them to choose an active circulation support earlier.

Enzyme-assisted Photoinitiated Polymerization-induced Self-assembly in Continuous Flow Reactors with Oxygen Tolerance

Polymerization-induced self-assembly(PISA)is an emerging method for the preparation of block copolymer nano-objects at high concentrations.However,most PISA formulations have oxygen inhibition problems and inert atmospheres(e.g.argon,nitrogen)are usually required.Moreover,the large-scale preparation of block copolymer nano-objects at room temperature is challenging.Herein,we report an enzyme-assisted photoinitiated polymerization-induced self-assembly(photo-PISA)in continuous flow reactors with oxygen toleranee.The addition of glucose oxidase(GOx)and glucose into the reaction mixture can consume oxygen efficiently and constantly,allow the flow photo-PISA to be performed under open-air conditions.Polymerization kinetics indicated that only a small amount of GOx(0.5 μmol/L)was needed to achieve the oxygen tolerance.Block copolymer nano-objects with different morphologies can be prepared by varying reaction conditions including the degree of polymerization(DP)of core-forming block,monomer concentration,reaction temperature,and solvent composition.We expect this study will provide a facile platform for the large-scale production of block copolymer nano-objects with different morphologies at room temperature.