Dynamic Extracorporeal Life Support in a Patient With Left Ventricular Assist Device and Electrical Storm: A Case Report
Bibliographic record
Abstract
Left ventricular assist device (LVAD)-supported patients experiencing electrical storm (ES) and cardiac arrest present unique management challenges. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is commonly used for extracorporeal cardiopulmonary resuscitation (ECPR), but its application in LVAD-supported patients presents hemodynamic complexities. Alternative ECMO modes, including venopulmonary (VP) and hybrid venoarteriopulmonary (VAP) ECMO, may provide tailored circulatory and respiratory support in select cases. This case report describes a patient with a newly implanted LVAD who developed ES, refractory right ventricular failure, and cardiac arrest. The patient underwent staged ECMO support, transitioning from VA ECMO for ECPR to hybrid VAP ECMO and ultimately to VP ECMO, based on evolving hemodynamic needs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.007 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".