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https://www.readbyqxmd.com/read/28074818/cannulation-strategies-in-adult-veno-arterial-and-veno-venous-extracorporeal-membrane-oxygenation-techniques-limitations-and-special-considerations
#1
Arun L Jayaraman, Daniel Cormican, Pranav Shah, Harish Ramakrishna
Extracorporeal membrane oxygenation (ECMO) refers to specific mechanical devices used to temporarily support the failing heart and/or lung. Technological advances as well as growing collective knowledge and experience have resulted in increased ECMO use and improved outcomes. Veno-arterial (VA) ECMO is used in selected patients with various etiologies of cardiogenic shock and entails either central or peripheral cannulation. Central cannulation is frequently used in postcardiotomy cardiogenic shock and is associated with improved venous drainage and reduced concern for upper body hypoxemia as compared to peripheral cannulation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072940/elective-use-of-veno-venous-extracorporeal-membrane-oxygenation-and-high-flow-nasal-oxygen-for-resection-of-subtotal-malignant-distal-airway-obstruction
#2
Rkf Fung, J Stellios, P G Bannon, A Ananda, P Forrest
We describe the use of peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) and high-flow nasal oxygen as procedural support in a patient undergoing debulking of a malignant tumour of the lower airway. Due to the significant risk of complete airway obstruction upon induction of anaesthesia, ECMO was established while the patient was awake, and was maintained without systemic anticoagulation to minimise the risk of intraoperative bleeding. This case illustrates that ECMO support with high-flow nasal oxygen can be considered as part of the algorithm for airway management during surgery for subtotal lower airway obstruction, as it may be the only viable option for maintaining adequate gas exchange...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28054897/thrombosis-of-the-right-internal-jugular-vein-is-not-a-contraindication-to-ambulatory-veno-venous-extracorporeal-membrane-oxygenation-with-a-bicaval-dual-lumen-single-cannula-system
#3
Anthony Kronfli, Chetan Pasrija, Aakash Shah, Mehrdad Ghoreishi, Jose P Garcia, Si M Pham, Pablo G Sanchez, Zachary N Kon
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement. CASE REPORT: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS)...
14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27986695/acute-oxygenator-failure-a-new-presentation-of-heparin-induced-thrombocytopenia-in-a-patient-undergoing-venovenous-extracorporeal-membrane-oxygenation-support
#4
Robert A Ratzlaff, Juan G Ripoll, Lena L Kassab, Jose L Diaz-Gomez
A 58-year-old man with medical history of thrombocytopenia was admitted to an outside hospital for a 6-day history of worsening dyspnoea requiring mechanical ventilator support. He was transferred to our institution for extracorporeal membrane oxygenation (ECMO) given his refractory hypoxaemia. On arrival, H1N1 influenza virus was confirmed and all measures to improve oxygenation were ineffective. Thus, the decision was made to start venovenous (VV)-ECMO. Although a low baseline platelet count was recognised (60-70×10(9)/L), a sudden further decrease occurred (30×10(9)/L) and platelet transfusion was initiated...
December 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27923943/venovenous-ecmo-support-in-an-infant-with-single-ventricle-physiology-and-catastrophic-pulmonary-venous-abnormalities
#5
Richard P Fernandez, Don Hayes, Patrick I McConnell, Darren Berman
Extracorporeal membrane oxygenation (ECMO) is an accepted treatment modality for life support refractory to conventional efforts in neonates with complex congenital heart lesions. Cannulation for ECMO can be accomplished by venovenous (VV) access where patients receive primarily respiratory support or venoarterial (VA) access which provides complete cardiopulmonary support. VV ECMO delivered by a single-vessel cannulation with a dual-chamber venous cannula allows for respiratory support while the patient remains dependent upon intrinsic cardiac function to support hemodynamics...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#6
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...
February 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27850758/1121-to-prone-or-not-to-prone-the-adult-vv-ecmo-patient-is-it-safe-that-is-the-question
#7
Kate Dolly, Maria Madden, Ray Rector, Tina Wright, Amber Pyzik, Ali Tabatabai, Daniel Herr, Jay Menaker
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850696/1058-protein-expression-profile-in-acute-exacerbation-of-interstitial-pneumonia-supported-on-vv-ecmo
#8
Yoshiko Kida, Shinichiro Ohshimo, Michihito Kyo, Amatya J Vishwa, Yukio Takeshima, Nobuaki Shime
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849847/205-comparison-of-vv-ecmo-and-non-ecmo-patient-mortality-among-equivalent-drg-risk-adjusted-patients
#9
Markos Kashiouris, Vishal Yajnik, Varun Bhasin, Michael Czekajlo, Orlando Debesa
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849826/183-comparison-between-echocardiography-and-uncalibrated-pulse-contour-method-co-measurement-in-vv-ecmo
#10
Ottavia Bond, Selene Pozzebon, Sabino Scolletta, Federico Franchi, Federica Zama Cavicchi, Jacques Creteur, Jean-Louis Vincent, Fabio Silvio Taccone
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849820/177-occurence-of-complications-in-percutaneous-va-and-vv-ecmo-cannulation-performed-by-the-intensivist
#11
Abiodun Orija, Aly El Banayosy, Michael Koerner
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27822747/venovenous-extracorporeal-membrane-oxygenation-for-ards-outcome-analysis-of-a-croatian-referral-center-for-respiratory-ecmo
#12
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/27815258/inflammation-and-lung-injury-in-an-ovine-model-of-extracorporeal-membrane-oxygenation-support
#13
Margaret R Passmore, Yoke L Fung, Gabriela Simonova, Samuel R Foley, Kimble R Dunster, Sara D Diab, John-Paul Tung, Robyn M Minchinton, Charles I McDonald, Chris M Anstey, Kiran Shekar, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for patients with severe refractory cardiorespiratory failure. Exposure to the ECMO circuit is thought to trigger/exacerbate inflammation. Determining whether inflammation is the result of the patients' underlying pathologies or the ECMO circuit is difficult. To discern how different insults contribute to the inflammatory response, we developed an ovine model of lung injury and ECMO to investigate the impact of smoke-induced lung injury and ECMO in isolation and cumulatively on pulmonary and circulating inflammatory cells, cytokines, and tissue remodeling...
December 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27787651/body-mass-index-and-echocardiography-in-refractory-ards-treated-with-veno-venous-extracorporeal-membrane-oxygenation
#14
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Paolo Terenzi, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
The aims of the present investigation, performed in 118 consecutive patients with refractory ARDS treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), were as follows: (a) to assess ICU mortality in overweight, obese and morbid obese patients in respect to normal weight; (b) to evaluate echocardiographic findings according to BMI subgroups. Echocardiography was performed before VV-ECMO implantation. Forty-five patients (38.1%) showed normal BMI, 37 patients (31.4%) were overweight and the remaining were obese (21...
October 27, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27779577/extracorporeal-membrane-oxygenation-for-adult-respiratory-distress-syndrome-in-trauma-patients-a-case-series-and-systematic-literature-review
#15
Chiara Robba, Andrea Ortu, Federico Bilotta, Alessandra Lombardo, Mypinder S Sekhon, Fabio Gallo, Basil F Matta
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an established salvage therapy for severe respiratory failure, and may provide an alternative form of treatment for trauma-induced adult respiratory distress syndrome (ARDS) when conventional treatments have failed. The need for systemic anticoagulation is a relative contraindication for patients with bleeding risks, especially in multitraumatic injury. METHODS: We describe a case series of four trauma patients with ARDS who were managed with ECMO admitted to the neuro critical care unit at Addenbrooke's Hospital, Cambridge (UK), from January 2000 to January 2016...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27714705/predictive-factors-of-bleeding-events-in-adults-undergoing-extracorporeal-membrane-oxygenation
#16
Cécile Aubron, Joris DePuydt, François Belon, Michael Bailey, Matthieu Schmidt, Jayne Sheldrake, Deirdre Murphy, Carlos Scheinkestel, D Jamie Cooper, Gilles Capellier, Vincent Pellegrino, David Pilcher, Zoe McQuilten
BACKGROUND: Bleeding is the most frequent complication associated with extracorporeal membrane oxygenation (ECMO) support in critically ill patients. Nonetheless, risk factors for bleeding have been poorly described especially those associated with coagulation anomalies and anticoagulant therapy during ECMO support. The aim of this study is to describe bleeding complications in critically ill patients undergoing ECMO and to identify risk factors for bleeding events. METHODS: We retrospectively analysed ICU charts of adults who received either veno-venous (VV) or veno-arterial (VA) ECMO support in two participating ICUs between 2010 and 2013...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27696630/extracorporeal-membrane-oxygenation-in-61-neonates-single-center-experience
#17
Eiji Hirakawa, Satoshi Ibara, Takuya Tokuhisa, Yoshinobu Maede, Takako Kuwahara, Chie Ishihara, Hiroyuki Noguchi, Yoshiki Naitou, Masakatsu Yamamoto, Masaya Kibe, Tsuyoshi Yamamoto, Tomonori Kurimoto, Masato Kamitomo, Kazutoshi Cho, Hisanori Minakami
BACKGROUND: There have been few reports on the outcome of extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. METHODS: A review was carried out of 61 neonates with ECMO between January 1995 and December 2015 at a single center. ECMO was used in neonates with oxygenation index >20 after conventional treatment. Background factors, such as etiology, vascular access mode (veno-venous [VV] or veno-arterial [VA]), number of days with ECMO, and early ECMO (within 24 h after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD)...
October 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27690525/anticoagulation-practices-during-venovenous-extracorporeal-membrane-oxygenation-for-respiratory-failure-a-systematic-review
#18
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. OBJECTIVES: 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 prespecified outcomes, including major bleeding episodes, thrombotic events, and in-hospital mortality...
December 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27689428/safety-of-intensivist-led-bedside-decannulation-of-internal-jugular-bi-caval-dual-lumen-veno-venous-extracorporeal-membrane-oxygenation-cannulas-and-report-of-technique
#19
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported in the literature. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27670564/venovenous-extracorporeal-membrane-oxygenation-in-pediatric-respiratory-failure
#20
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
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