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https://www.readbyqxmd.com/read/29901798/the-use-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-in-severe-burns-without-inhalation-injury
#1
Juliet J Ray, Richard J Straker, Valerie J Hart, Jonathan P Meizoso, Carl I Schulman, Matthias Loebe, Ali Ghodsizad
Burn injury results in a severe systemic inflammatory response which is associated with the development of acute respiratory distress syndrome (ARDS), even without associated inhalation injury. Venous-venous extracorporeal membrane oxygenation (VV-ECMO) has been implemented in various cases of ARDS to provide support and allow for protective lung ventilation strategies. We report the case of a 27-year-old man presenting with a 60% total body surface area partial thickness burn who developed refractory ARDS with Murray Score of 3...
June 13, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29872632/catheter-directed-thrombolysis-combined-with-ecmo-for-massive-pulmonary-emboli
#2
J Lauren Lindsey, Rajay Jain, Vidula Vachharajani
This case report discusses a previously healthy young male who suffered an in hospital cardiac arrest, found to be secondary to massive pulmonary emboli (PE). This patient was not a candidate for PE dosing of tPA, but continued to have worsening cardiogenic shock and acute hypoxic respiratory failure. The decision was made to initiate venoarterial extracorporeal membrane oxygenation (VA ECMO) in combination with catheter assisted thrombolysis. With time, the sequelae of his disease process changed. Although his cardiogenic shock improved, the hypoxemia worsened, and the patient was transitioned from VA to venovenous (VV) ECMO, while managing further complications due to multiple episodes of cardiac arrest and severe coagulopathy with multiple, acute, life-threatening bleeding events...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29852149/increasing-opportunity-for-lung-transplant-in-interstitial-lung-disease-with-pulmonary-hypertension
#3
Scott Chicotka, Felipe E Pedroso, Cara L Agerstrand, Erika B Rosenzweig, Darryl Abrams, Tom Benson, Aimee Layton, Daniel Burkhoff, Daniel Brodie, Matthew D Bacchetta
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (BTT) for end-stage interstitial lung disease (ILD) and pulmonary hypertension (PH) has varying results based on ECMO configuration. We compare our experience using venovenous (VV) and venoarterial (VA) ECMO BTT for ILD with PH on survival to successful transplantation. METHODS: A single center retrospective review of patients with ILD and secondary PH who were placed on either VV or VA ECMO as BTT from 2010 to 2016...
May 28, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29799136/nitrogen-balance-during-venovenous-extracorporeal-membrane-oxygenation-support-preliminary-results-of-a-prospective-observational-study
#4
Stacy Pelekhaty, Samuel M Galvagno, Eric Hochberg, Daniel L Herr, James H Lantry, Zachary N Kon, Kristopher B Deatrick, Jay Menaker
BACKGROUND: Current literature is insufficient to support specific guidelines for estimating nutrition needs during extracorporeal membrane oxygenation (ECMO). The purpose of this single-center observational study was to investigate protein catabolism during venovenous (VV) ECMO support and assess whether current nutrition recommendations were adequate. METHODS: All patients admitted to the Lung Rescue Unit between November 2016 and June 2017 were screened for eligibility...
May 25, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29788843/effect-of-pump-type-on-outcomes-in-neonates-with-congenital-diaphragmatic-hernia-requiring-ecmo
#5
Patrick T Delaplain, Lishi Zhang, Danh V Nguyen, Amir H Ashrafi, Peter T Yu, Matteo Di Nardo, Yanjun Chen, Joanne Starr, Henri R Ford, Yigit S Guner
PURPOSE: With the exception of neonatal respiratory failure, most centers are now using centrifugal over roller-type pumps for the delivery of extracorporeal membrane oxygenation (ECMO). Evidence supporting the use of centrifugal pumps specifically in infants with congenital diaphragmatic hernia (CDH) remains lacking. We hypothesized that the use of centrifugal pumps in infants with CDH would not affect mortality or rates of severe neurologic injury (SNI). METHODS: Infants with CDH were identified within the ELSO registry (2000-2016)...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788836/intracranial-hemorrhage-in-adults-on-ecmo
#6
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29774445/pregnancy-complicated-by-influenza-a-ards-requiring-consecutive-vv-ecmo-treatment-with-successful-vaginal-delivery
#7
Peter Radsel, Vojka Gorjup, Anja Jazbec, Rihard Knafelj, Miha Lucovnik, Gorazd Kavsek, Lilijana Kornhauser Cerar, Marko Noc
A 29-year-old woman presented with influenza A ARDS at 23+0 weeks of gestation. Mechanical ventilation failed and VV-ECMO was started in a non-ECMO hospital. Transportation was performed on ECMO. Within 5 days ECMO weaning was successful. Fetal condition was stable, and decision to continue pregnancy was taken. However, second VV-ECMO was needed due to ventilator-associated pneumonia. At 25+6 weeks, the patient spontaneously delivered a neonate vaginally. Patient's condition improved, and ECMO could be removed 10 days postpartum...
May 17, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29732190/hybrid-extracorporeal-membrane-oxygenation
#8
REVIEW
Alexandre Brasseur, Sabino Scolletta, Roberto Lorusso, Fabio Silvio Taccone
Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732188/weaning-from-veno-venous-extracorporeal-membrane-oxygenation-how-i-do-it
#9
REVIEW
Lars M Broman, Maximilian V Malfertheiner, Andrea Montisci, Federico Pappalardo
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a rescue treatment for acute respiratory distress syndrome (ARDS) failing protective mechanical ventilation. It temporarily provides proper gas exchange: hypoxia is treated by adjusting the blood flow rate and fraction in spired oxygen over the ventilator (FiO2 ) on the extracorporeal membrane oxygenation (ECMO) circuit while CO2 removal is regulated by the ECMO fresh gas flow. Therefore, ventilator settings can be gradually reduced allowing the lungs to rest and recover...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732187/adjunctive-therapies-during-veno-venous-extracorporeal-membrane-oxygenation
#10
REVIEW
Federico Pappalardo, Andrea Montisci
Veno-venous extracorporeal membrane oxygenation (VV ECMO) restores gas exchanges in severely hypoxemic patients. The need for adjunctive therapies usually originates either from refractory hypoxemia during ECMO (defined as the persistence of low blood oxygen levels despite extracorporeal support) or from the attempt to give a specific therapy for acute respiratory distress syndrome (ARDS). In this review, therapeutic strategies to treat refractory and persistent hypoxemia during ECMO are evaluated. In the second part, therapies that can be added on top of VV ECMO to address inflammation and altered vascular permeability in ARDS are examined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732186/right-ventricular-dysfunction-during-acute-respiratory-distress-syndrome-and-veno-venous-extracorporeal-membrane-oxygenation
#11
REVIEW
Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers, Dinis Reis Miranda
Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732185/ambulatory-veno-venous-extracorporeal-membrane-oxygenation
#12
REVIEW
Jonas Andersson Lindholm
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is used for support in patients with severe respiratory failure. The method allows extracorporeal gas exchange and may replace the patient's lung function for weeks and even years. ECMO is not a contraindication for lung transplant. The most important factor for a good outcome is the physiological status of the patient when accepted for transplantation. Ambulatory ECMO makes it possible for the patient to exercise and walk, and provides the best outcome for high risk patients in severe respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732184/spontaneous-breathing-during-veno-venous-extracorporeal-membrane-oxygenation
#13
REVIEW
Stefania Crotti, Nicola Bottino, Elena Spinelli
Veno-venous extracorporeal membrane oxygenation (VV ECMO) has started to be applied in awake spontaneously breathing patients as an alternative to invasive mechanical ventilation. As the physiologic cardiorespiratory variability is increased in this condition, the dynamic interaction between patient respiratory activity and extracorporeal system function affects the clinical management. The effect of extracorporeal CO2 removal on patient respiratory drive is variable and not always predictable, with some patients responding to CO2 removal with a decrease in respiratory rate and effort and other patients demonstrating a persistently high work of breathing independent on CO2 unload...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732180/bicaval-dual-lumen-cannula-in-adult-veno-venous-extracorporeal-membrane-oxygenation-clinical-pearls-for-safe-cannulation
#14
REVIEW
Chun-Wai Ngai, Pauline Yeung Ng, Wai-Ching Sin
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been traditionally delivered with two independent cannulae at different venous insertion sites. The bicaval dual lumen cannula has gained popularity as a cannula for simultaneous venous drainage and reinfusion of blood via the internal jugular vein (IJV). Its insertion requires special attention to details to prevent the occurrence of serious complications. In this review, we discuss different techniques of cannula insertion and tips for troubleshooting...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732179/cannulation-technique-femoro-femoral
#15
REVIEW
Aidan J C Burrell, Joshua F Ihle, Vincent A Pellegrino, Jayne Sheldrake, Paul T Nixon
The cannulation technique used during veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion can have a major impact on a patients' overall outcome. We have developed a technique that aims to combine speed and effectiveness, with minimal risk. The steps include: (I) percutaneous cannulation using the Seldinger technique; (II) ultrasound guided access and positioning of cannulas; (III) femoro-femoral circuit configuration with a later option of high flow; (IV) a no skin cut serial dilation technique; (V) non-suturing securing of cannulas and (VI) a non-surgical manual pressure technique of explantation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732178/femoro-jugular-cannulation-in-veno-venous-extracorporeal-membrane-oxygenation-pro-con
#16
REVIEW
Martina Crivellari, Federico Pappalardo
Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is the most efficient technique for respiratory support. It is based on a patient adequate circulation and cardiac function and it is indicated for isolated lung failure after optimization of the ventilatory support and the medical treatment. We describe PRO and CONs of the Femoro-jugular (F>J) approach, as an ideal setting for patients which require high flow (>5 L/min), such as those with extreme hypoxemia and/or septic shock. This technique can be accomplished very quickly at the bedside also in an unstable patient...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732177/cannulation-for-veno-venous-extracorporeal-membrane-oxygenation
#17
REVIEW
Jonas Andersson Lindholm
Extracorporeal membrane oxygenation (ECMO) is described as a modified, smaller cardiopulmonary bypass circuit. The veno-venous (VV) ECMO circuit drains venous blood, oxygenate the blood, and pump the blood back into the same venous compartment. Draining and reinfusing in the same compartment means there are a risk of recirculation. The draining position within the venous system, ECMO pump flow, return flow position within the venous system and the patients cardiac output (CO) all have an impact on recirculation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29714432/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-center-experience-in-turkey
#18
Emel Okulu, F. Begüm Atasay, Gaffari Tunç, Hasan Akduman, Ömer Erdeve, Saadet Arsan, Zeynep Eyileten, Tayfun Uçar, H. Ercan Tutar
Background/aim: Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with respiratory failure, cardiac failure, or both. The aim of this study was to evaluate neonates supported with ECMO and report our experience as a Turkish neonatal intensive care unit. Materials and methods: We retrospectively reviewed 11 newborn infants treated with ECMO at Ankara University for respiratory and cardiac failure. We reported the demographic, diagnostic, laboratory, and clinical data of the patients...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29707290/age-is-major-factor-for-predicting-survival-in-patients-with-acute-respiratory-failure-on-extracorporeal-membrane-oxygenation-a-korean-multicenter-study
#19
Moon Seong Baek, Chi Ryang Chung, Hwa Jung Kim, Woo Hyun Cho, Young-Jae Cho, Sunghoon Park, Seung Yong Park, Byung Ju Kang, Jung-Hyun Kim, So Hee Park, Jin Young Oh, Yun Su Sim, Sang-Bum Hong
Background: The proportion of elderly patients in the intensive care unit population is increasing. Although the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score is widely used for survival prediction of extracorporeal membrane oxygenation (ECMO) patients, it is questionable whether the RESP score is applicable to older patients. The aim of this study was to investigate the applicability of the RESP score in Korean cohort. Methods: Data were retrospectively analyzed from 209 acute respiratory failure (ARF) patients treated with ECMO from 2014 to 2015 at 11 hospitals...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#20
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
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