Successful percutaneous coronary intervention with extracorporeal membrane oxygenation for patient with acute coronary syndrome and cardiac arrest: a case report.

BACKGROUND: The incidence rate of acute coronary syndrome (ACS) in China is on the rise and is considered a leading cause of death. Emergency percutaneous coronary intervention (PCI) is the preferred treatment method for ACS. However, severe complications may hinder emergency PCI and lead to increased mortality. Extracorporeal membrane oxygenation (ECMO) redirects blood flow and oxygenates it before returning. Therefore, ECMO support during PCI may improve functional recovery and outcomes. This case report presents a successful case of extracorporeal membrane oxygenation (ECMO)-assisted emergency PCI treatment of an outpatient with ACS. CASE REPORT: Male, 43 years old, experienced sudden, severe, and persistent squeezing-like chest pains accompanied by profuse sweating. After half an hour, the patient suddenly lost consciousness and was unable to exhale. After ECMO-assisted PCI, the patient's blood pressure and blood oxygen status improved, and the autonomous rhythm was restored. Imaging results showed 100% occlusion of the middle to distal anterior descending branch. After undergoing distal thrombus aspiration, a stent was implanted in the proximal end of the anterior descending branch. Repeated angiography showed good stent adhesion and restored blood flow in the anterior descending branch. The postoperative patient was transferred to the coronary care unit (CCU) ward with ECMO and ventilator for monitoring. CONCLUSIONS: ECMO-assisted emergency PCI effectively improved the blood pressure and oxygen status of the ACS patient with cardiac arrest, and restored the autonomous rhythm, with a good rehabilitation effect.

Cluster randomized controlled trial of the plastic BioSand Water filter in Cambodia.

About half of the rural population of Cambodia lacks access to improved water; an even higher percentage lacks access to latrines. More than 35,000 concrete BioSand Water filters (BSF) have been installed in the country. However, the concrete BSF takes time to produce and weighs hundreds of pounds. A plastic BSF has been developed but may not perform to the same benchmarks established by its predecessor. To evaluate plastic BSF performance and health impact, we performed a cluster randomized controlled trial in 13 communities including 189 households and 1147 participants in the Angk Snoul district of Kandal Province from May to December 2008. The results suggest that villages with plastic BSFs had significantly lower concentrations of E. coli in drinking water and lower diarrheal disease (incidence rate ratio 0.41, 95% confidence interval: 0.24-0.69) compared to control villages. As one of the first studies on the plastic BSF in Cambodia, these are important findings, especially in a setting where the concrete BSF has seen high rates of continued use years after installation. The study suggests the plastic BSF may play an important role in scaling up the distribution/implementation of the BSF, potentially improving water quality and health in the region.