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Venovenous extracorporeal membrane oxygenation

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https://www.readbyqxmd.com/read/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#1
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#2
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#3
Alain Combes, Nicolas Bréchot, Charles-Edouard Luyt, Matthieu Schmidt
PURPOSE OF REVIEW: This article summarizes the results of past and more recent series on venovenous extracorporeal membrane oxygenation (VV-ECMO) and discusses its potential indications beyond the rescue of patients with lung failure refractory to conventional mechanical ventilation. RECENT FINDINGS: Successful VV-ECMO treatment in patients with extremely severe influenza A(H1N1)-associated acute respiratory distress syndrome (ARDS) and positive results of the CESAR trial have led to an exponential use of the technology in recent years...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27851528/1893-venovenous-extracorporeal-membrane-oxygenation-for-refractory-status-asthmaticus-a-case-series
#4
Brian Rissmiller, Brian Young, Matthew Musick, Lara Shekerdemian, Maria Gazzaneo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850610/972-ventilation-practices-in-children-on-venovenous-extracorporeal-membrane-oxygenation
#5
Matthew Friedman, Michael Hobson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849788/144-obesity-paradox-in-patients-undergoing-venovenous-extracorporeal-membrane-oxygenation-support
#6
Kha Dinh, Bindu Akkanti, Rahat Hussain
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849705/25-a-comparison-of-anticoagulation-strategies-in-venovenous-extracorporeal-membrane-oxygenation
#7
Aakash Shah, Chetan Pasrija, Anthony Kronfli, Eno-Obong Essien, Gregory Bittle, Jay Menaker, Daniel Herr, Zachary Kon
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27842949/the-hat-score-a-simple-risk-stratification-score-for-coagulopathic-bleeding-during-adult-extracorporeal-membrane-oxygenation
#8
Terence Lonergan, Daniel Herr, Zachary Kon, Jay Menaker, Raymond Rector, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: The study objective was to create an adult extracorporeal membrane oxygenation (ECMO) coagulopathic bleeding risk score. DESIGN: Secondary analysis was performed on an existing retrospective cohort. Pre-ECMO variables were tested for association with coagulopathic bleeding, and those with the strongest association were included in a multivariable model. Using this model, a risk stratification score was created. The score's utility was validated by comparing bleeding and transfusion rates between score levels...
September 1, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#9
Marko Kutleša, Anđa Novokmet, Renata Josipović Mraović, Bruno Baršić
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy in severe acute respiratory distress syndrome (ARDS) has become well established; however, the affirmation of evidence on VV-ECMO application and the analysis of patient outcomes after VV-ECMO treatment for ARDS continues. The aim of the study is to identify variables that affected the outcome of patients treated with VV-ECMO for severe ARDS outside a major ECMO center. METHODS: The study included adult patients with severe ARDS treated with ECMO at a tertiary care hospital in Zagreb, Croatia between October 2009 and July 2014...
November 7, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27743640/the-simplified-acute-physiology-score-ii-as-a-predictor-of-mortality-in-patients-who-underwent-extracorporeal-membrane-oxygenation-for-septic-shock
#10
Myung Jin Choi, Sang Ook Ha, Hyoung Soo Kim, Sunghoon Park, Sang Jin Han, Sun Hee Lee
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) for patients with septic shock is controversial. The outcomes are favorable in children but heterogeneous in adults. The present study aimed to analyze the outcomes of adult patients who underwent ECMO for septic shock, and to determine the factors associated with prognosis. METHODS: We respectively reviewed the medical records of patients who underwent ECMO for septic shock between January 2007 and December 2013...
October 12, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27690525/anticoagulation-practices-during-venovenous-extracorporeal-membrane-oxygenation-vvecmo-for-respiratory-failure-a-systematic-review
#11
Michael C Sklar, Eric Sy, Laurance Lequier, Eddy Fan, Hussein D Kanji
BACKGROUND: The optimal anticoagulation strategy for venovenous extracorporeal membrane oxygenation (VV-ECMO) is not known. OBJECTIVE: To evaluate the safety of anticoagulation strategies and monitoring during VV-ECMO for respiratory failure. DATA SOURCES: We conducted a systematic review to evaluate the association between anticoagulation strategies during VV-ECMO and pre-specified outcomes including major bleeding episodes, thrombotic events, and in-hospital mortality...
October 3, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27670564/venovenous-extracorporeal-membrane-oxygenation-in-pediatric-respiratory-failure
#12
P Benson Ham, Brice Hwang, Linda J Wise, K Christian Walters, Walter L Pipkin, Charles G Howell, Jatinder Bhatia, Robyn Hatley
Conventional treatment of respiratory failure involves positive pressure ventilation that can worsen lung damage. Extracorporeal membrane oxygenation (ECMO) is typically used when conventional therapy fails. In this study, we evaluated the use of venovenous (VV)-ECMO for the treatment of severe pediatric respiratory failure at our institution. A retrospective analysis of pediatric patients (age 1-18) placed on ECMO in the last 15 years (1999-2014) by the pediatric surgery team for respiratory failure was performed...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27666781/serial-lactate-measurements-as-a-prognostic-tool-in-venovenous-extracorporeal-membrane-oxygenation-support
#13
Manuela Bonizzoli, Chiara Lazzeri, Giovanni Cianchi, Maria Boddi, Morena Cozzolino, Simona Di Valvasone, Paolo Terenzi, Stefano Batacchi, Marco Chiostri, Adriano Peris
BACKGROUND: Serial lactate measurements over time or lactate clearance has been reported to be clinically reliable for risk stratification in different pathologic conditions ranging from sepsis to trauma, but no data are so far available on the behavior of lactate during venovenous extracorporeal membrane oxygenation (VV-ECMO) support in refractory adult acute respiratory distress syndrome (ARDS). METHODS: We assessed lactate values during VV-ECMO support and the prognostic role of lactate clearance at 6, 24, and 72 hours after ECMO start in 126 consecutive patients with refractory ARDS treated with VV-ECMO...
September 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27649636/an-international-survey-the-role-of-specialist-nurses-in-adult-respiratory-extracorporeal-membrane-oxygenation
#14
Kathleen Jr Daly, Luigi Camporota, Nicholas A Barrett
BACKGROUND: The last decade has seen an increase in the number of centres able to provide venovenous extracorporeal membrane oxygenation (VV-ECMO) internationally across different health care systems. To support this growth, a variety of staffing arrangements have been adopted depending on local need and availability of resources, both in terms of manpower and finances to safely meet the complex needs of the patient and circuit management. AIM: The aim of the survey was to describe current staffing arrangements of care provision for adult patients on VV-ECMO, with a focus on understanding the professional roles and responsibilities of staff managing the circuit in order to inform further discussion around different approaches to staffing...
September 21, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27632800/injection-of-agitated-saline-to-detect-recirculation-with-transthoracic-echocardiography-during-venovenous-extracorporeal-oxygenation-a-pilot-study
#15
Charalampos Pierrakos, Vincent Collot, Hemlata Van Lieshout, Monique De Doncker, Stephanie Delcourt, Philippe Gottignies, Jacques Devriendt, David De Bels
PURPOSE: We assessed the security and efficiency of intravenously injected agitated saline in conjunction with transthoracic echocardiography to identify recirculation in patients supported with a venovenous extracorporeal membrane oxygenation (VV ECMO) device. MATERIALS AND METHODS: We injected agitated saline 4 consecutive times separated by an interval of 5 minutes in 2 patients supported by VV ECMO. In both patients, the drainage cannula was placed in the left femoral vein, and the return cannula was placed in the right internal jugular vein...
August 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27631452/-respiratory-and-extracorporeal-lung-support
#16
Christopher Lotz, Norbert Roewer, Ralf M Muellenbach
Mechanical ventilation is the most commonly used form of respiratory support to restore or maintain adequate gas exchange. However, mechanical ventilation does not provide a physiological form of breathing. Neither does it provide an optimal ventilation / perfusion ratio due to passive movement of the diagphragm favoring the non-dependent parts of the lung. Furthermore, patients are in danger of ventilator-associated/induced lung injury (VALI/VILI). Hence, lung protective ventilation is mandatory in patients with an acute respiratory distress syndrome (ARDS) and should likewise be used in the operating room...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27610584/evaluation-of-sedatives-analgesics-and-neuromuscular-blocking-agents-in-adults-receiving-extracorporeal-membrane-oxygenation
#17
Jeremy R DeGrado, Benjamin Hohlfelder, Brianne M Ritchie, Kevin E Anger, David P Reardon, Gerald L Weinhouse
PURPOSE: The objective of this study was to evaluate the use of sedative, analgesic, and neuromuscular blocking agents (NMBAs) in patients undergoing extracorporeal membrane oxygenation (ECMO) support. MATERIALS AND METHODS: This was a 2-year, prospective, observational study of adult intensive care unit patients on ECMO support for more than 48hours. RESULTS: We analyzed 32 patients, including 15 receiving VA (venoarterial) ECMO and 17 VV (venovenous) ECMO...
August 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27600419/-predictive-values-of-different-critical-scoring-systems-for-mortality-in-patients-with-severe-acute-respiratory-failure-supported-by-extracorporeal-membrane-oxygenation
#18
R Wang, B Sun, X Y Li, H Y He, X Tang, Q Y Zhan, Z H Tong
OBJECTIVE: To investigate the predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO). METHODS: Forty-two patients with severe ARF supported by VV-ECMO were enrolled from November 2009 to July 2015.There were 25 males and 17 females. The mean age was (44±18) years (rang 18-69 years). Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ⅲ, Ⅳ, Simplified Acute Physiology Score Ⅱ (SAPS) Ⅱ, Sequential Organ Failure Assessment (SOFA), ECMO net, PRedicting dEath for SEvere ARDS on VVECMO (PRESERVE), and Respiratory ECMO Survival Prediction (RESP) scores were collected within 6 hours before VV-ECMO support...
September 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27596367/-complex-control-of-the-source-of-infection-in-sepsis-extracorporeal-membrane-oxygenation-ecmo-as-a%C3%A2-bridging-concept-for-tracheal-fistula-repair-in-sepsis-associated-ards
#19
S Weiterer, K Schmidt, M Deininger, A Ulrich, U Tochtermann, R Eberhardt, S Hofer, M A Weigand, T Brenner
Here, we present a case of a tracheal fistula due to an anastomotic insufficiency following abdominothoracic esophageal resection. Despite immediate discontinuity resection, the tracheal fistula could not be surgically closed, resulting in incomplete control of the source of infection and an alternative treatment concept in the form of interventional fistula closure using a Y-tracheal stent. However, owing to existing severe acute respiratory distress syndrome (ARDS), which is associated with a considerable risk of peri-interventional hypoxia, a temporary bridging concept using venovenous extracorporeal membrane oxygenation (ECMO) was implemented successfully...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27569948/four-year-experience-with-extracorporeal-membrane-oxygenation-for-kidney-transplant-patients-with-severe-refractory-cardiopulmonary-insufficiency
#20
J-K Baek, J S Lee, T H Kim, Y H Kim, D J Han, S K Hong
BACKGROUND: Kidney transplant (KT) recipients are vulnerable to infections because of their immunosuppressive treatments, and they occasionally exhibit serious acute cardiopulmonary dysfunction. The purpose of this study was to report the clinical outcomes of using extracorporeal membrane oxygenation (ECMO) in KT recipients and to identify risk factors for ECMO weaning failure. METHODS: We retrospectively reviewed the electronic medical records of KT patients who experienced severe cardiopulmonary dysfunction refractory to conventional therapy and received ECMO at the Asan Medical Center Surgical Intensive Care Unit between December 2010 and December 2014...
July 2016: Transplantation Proceedings
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