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vv ecmo

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
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 regarding outcomes after extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. METHODS: A review of 61 neonates with ECMO through January 1995 at a single center was performed. ECMO was used in neonates with oxygenation index > 20 after conventional treatments. 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 hours 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
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
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. 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...
September 30, 2016: Anaesthesiology Intensive Therapy
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
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
Oscar Palmér, Kenneth Palmér, Jan Hultman, Mikael Broman
Extracorporeal membrane oxygenation (ECMO) is used as a lifesaving rescue treatment in refractory respiratory and/or cardiac failure. During veno-venous (VV) ECMO the presence of recirculation is known but quantification and actions to minimize recirculation following measurement are to date not routinely practiced. In the present study we investigated the effect of draining cannula design on recirculation fraction (Rf) during VV ECMO; Conventional mesh cannula was compared to a Multi-stage cannula. The effect of adjusting cannula position was also studied...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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
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
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
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
Alberto Zanella, Domenico Salerno, Vittorio Scaravilli, Marco Giani, Luigi Castagna, Federico Magni, Eleonora Carlesso, Paolo Cadringher, Michela Bombino, Giacomo Grasselli, Nicolò Patroniti, Antonio Pesenti
PURPOSE: To develop a mathematical model of oxygenation during venovenous extracorporeal membrane oxygenation (vv-ECMO). MATERIAL AND METHODS: Total oxygen consumption, cardiac output, blood flow, recirculation, intrapulmonary shunt, hemoglobin, natural lung, and membrane lung oxygen fractions were chosen as inputs. Content, partial pressure, and hemoglobin saturation of oxygen in arterial, venous, pulmonary, and extracorporeal blood were outputs. To assess accuracy and predictive power of the model, we retrospectively analyzed data of 25 vv-ECMO patients...
July 15, 2016: Journal of Critical Care
M Laufenberg, T Schneider
A 58-year male patient was admitted to the intensive care unit of our hospital due to an exacerbated COPD (GOLD IV) complicated by a pneumonia. The clinical course deteriorated despite of evidence based intensive care treatment and lungprotective ventilation, a vv-ECMO and a volatile sedation were established. After a few days vv-ECMO could be discontinued and the patient was discharged from hospital after 20 days.Our case report suggests that early support with vv-ECMO could reduce the cumulative duration of invasive ventilation in case of severe COPD exacerbation...
August 16, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Michihito Kyo, Shinichiro Ohshimo, Yoshiko Kida, Tatsutoshi Shimatani, Yusuke Torikoshi, Kei Suzuki, Satoshi Yamaga, Nobuyuki Hirohashi, Nobuaki Shime
BACKGROUND: Venoarterial-venous extracorporeal membrane oxygenation (VAV ECMO) configuration is a combined procedure of extracorporeal membrane oxygenation (ECMO). The proportion of cardiac and respiratory support can be controlled by adjusting arterial and venous return. Therefore, VAV ECMO can be applicable as a bridging therapy in the transition from venoarterial (VA) to venovenous (VV) ECMO. CASE PRESENTATION: We present an 11-year-old girl with chemotherapy-induced myocarditis requiring extracorporeal cardiorespiratory support...
2016: BMC Pulmonary Medicine
Joo Han Song, Won Ki Woo, Seung Hwan Song, Hyo Hyun Kim, Bong Joon Kim, Ha Eun Kim, Do Jung Kim, Jee Won Suh, Yu Rim Shin, Han Ki Park, Seung Hyun Lee, Hyun Chel Joo, Sak Lee, Byung Chul Chang, Kyung Jong Yoo, Young Sam Kim, Young Nam Youn
BACKGROUND: Cardiac surgery with cardiopulmonary bypass (CPB) is a known risk factor for acute respiratory distress syndrome (ARDS). We aimed to analyze the treatment outcome in patients who required veno-venous extracorporeal membrane oxygenation (VV-ECMO) for postcardiotomy ARDS despite other rescue modalities. METHODS: We retrospectively reviewed the outcomes in 13 patients (mean age, 54.7±5.9 years) who received VV-ECMO support for refractory ARDS after cardiac surgery between March 2013 and February 2016 at Severance Hospital, Yonsei University (Seoul, Korea)...
July 2016: Journal of Thoracic Disease
Yu-Ting Cheng, Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Pyng-Jing Lin
Despite gaining popularity, venovenous extracorporeal membrane oxygenation (VV-ECMO) remains a controversial therapy for acute respiratory failure (ARF) in adult patients due to its equivocal survival benefits. The study was aimed at identifying the preinterventional prognostic predictors of hospital mortality in adult VV-ECMO patients and developing a practical mortality prediction score to facilitate clinical decision-making.This retrospective study included 116 adult patients who received VV-ECMO for severe ARF in a tertiary referral center, from 2007 to 2015...
July 2016: Medicine (Baltimore)
Lei Huang, Tong Li, Lei Xu, Xiao-Min Hu, Da-Wei Duan, Zhi-Bo Li, Xin-Jing Gao, Jun Li, Peng Wu, Ying-Wu Liu, Song Wang, Yu-Heng Lang
BACKGROUND: There has been no external validation of survival prediction models for severe adult respiratory distress syndrome (ARDS) with extracorporeal membrane oxygenation (ECMO) therapy in China. The aim of study was to compare the performance of multiple models recently developed for patients with ARDS undergoing ECMO based on Chinese single-center data. METHODS: A retrospective case study was performed, including twenty-three severe ARDS patients who received ECMO from January 2009 to July 2015...
July 20, 2016: Chinese Medical Journal
Thomas Langer, Alessandro Santini, Nicola Bottino, Stefania Crotti, Andriy I Batchinsky, Antonio Pesenti, Luciano Gattinoni
Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the timing of ECMO initiation has been readdressed and ECMO is often started earlier in the time course of respiratory failure. Furthermore, some centers are starting to use ECMO as a first line of treatment, i.e., as an alternative to invasive mechanical ventilation in awake, non-intubated, spontaneously breathing patients with respiratory failure ("awake" ECMO)...
June 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
Chun-Hsien Hsin, Meng-Yu Wu, Chung-Chi Huang, Kuo-Chin Kao, Pyng-Jing Lin
Despite a potentially effective therapy for adult respiratory failure, a general agreement on venovenous extracorporeal membrane oxygenation (VV-ECMO) has not been reached among institutions due to its invasiveness and high resource usage. To establish consensus on the timing of intervention, large ECMO organizations have published the respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and the ECMOnet score, which allow users to predict hospital mortality for candidates with their pre-ECMO presentations...
June 2016: Medicine (Baltimore)
Sara Redaelli, Alberto Zanella, Manuela Milan, Stefano Isgrò, Alberto Lucchini, Antonio Pesenti, Nicolò Patroniti
Daily nursing in critical care patients may alter vital parameters, especially in the most critically ill patients. The aim of our study was to evaluate feasibility and safety of daily nursing on patients undergoing venous-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure. Daily nursing was performed following defined phases (sponge bath, elevation with scooping stretcher, change position of endotracheal tube, dressing replacement). We recorded physiological and ECMO parameters before and during daily nursing in 5 patients for several days (total: 25 daily nursing) and adverse events: desaturation, hypertension, reduction of mixed venous oxygen saturation, arterial oxygen saturation or ECMO blood flow and elevation in minute ventilation...
June 16, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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