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ECMO ARDS

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https://www.readbyqxmd.com/read/30053961/salvage-therapies-for-refractory-hypoxemia-in-ards
#1
REVIEW
Sujith V Cherian, Anupam Kumar, Karunakar Akasapu, Rendell W Ashton, Malaygiri Aparnath, Atul Malhotra
Acute Respiratory Distress Syndrome (ARDS) is a condition of varied etiology characterized by the acute onset (within 1 week of the inciting event) of hypoxemia, reduced lung compliance, diffuse lung inflammation and bilateral opacities on chest imaging attributable to noncardiogenic (increased permeability) pulmonary edema. Although multi-organ failure is the most common cause of death in ARDS, an estimated 10-15% of the deaths in ARDS are caused due to refractory hypoxemia, i.e.- hypoxemia despite lung protective conventional ventilator modes...
August 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/30023118/what-about-prognostic-outcome-parameters-in-patients-with-acute-respiratory-distress-syndrome-ards-treated-with-veno-venous-extracorporeal-membrane-oxygenation-vv-ecmo
#2
EDITORIAL
Thomas Datzmann, Karl Träger
No abstract text is available yet for this article.
June 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29996349/-analysis-of-15-cases-of-avian-influenza-virus-h7n9-infection
#3
W Q Yu, M D Ding, G H Dai, C J Gu, L Xue, Y Chen, D M Zhou, J C Xian, H T Xu
Objective: To describe the clinical, chest imaging, pathological manifestations and therapeutic experience of human infection with A/H7N9 virus. Methods: The features of 15 laboratory-confirmed cases of human infection with A/H7N9 virus in Taizhou, Jiangsu Province were retrospectively analyzed. Results: The 15 patients with confirmed viral pneumonia included 12 males and 3 females, with a median age of 61 years(ranging from 33 to 81 years). Twelve patients had a history of exposure to the poultry trading places, or direct contact with ill/dead avian, while 3 patients denied exposure or contact...
July 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29984201/acute-respiratory-distress-syndrome-an-update-and-review
#4
Gautam Rawal, Sankalp Yadav, Raj Kumar
Acute respiratory distress syndrome (ARDS) is a life threatening condition characterized by severe hypoxemia due to pulmonary gas exchange failure and was first recognized in 1960s.Since its first description, it has undergone intensive research in the past few decades to understand its pathogenesis and therapies. Despite this, the recommended therapies to decrease mortality in ARDS remain limited and include low-tidal volume mechanical ventilation, prone ventilation and recently, the ECMO rescue therapy in extreme cases...
June 2018: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29983197/prone-positioning-before-extracorporeal-membrane-oxygenation-for-severe-acute-respiratory-distress-syndrome-a-retrospective-multicenter-study
#5
W-Y Kim, B J Kang, C R Chung, S H Park, J Y Oh, S Y Park, W H Cho, Y S Sim, Y-J Cho, S Park, J-H Kim, S-B Hong
OBJECTIVE: To evaluate the clinical outcomes of patients with severe acute respiratory distress syndrome (ARDS) subjected to prone positioning before extracorporeal membrane oxygenation (ECMO). DESIGN: A retrospective analysis of a multicenter cohort was carried out. SETTING: Patients admitted to the Intensive Care Units of 11 hospitals in Korea. PATIENTS: Patients were divided into those who underwent prone positioning before ECMO (n=28) and those who did not (n=34)...
July 5, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29976250/use-of-ecmo-in-ards-does-the-eolia-trial-really-help
#6
EDITORIAL
Luciano Gattinoni, Francesco Vasques, Michael Quintel
No abstract text is available yet for this article.
July 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29903600/revisiting-extracorporeal-membrane-oxygenation-for-ards-in-burns-a-case-series-and-review-of-the-literature
#7
Craig R Ainsworth, Jeffrey Dellavolpe, Kevin K Chung, Leopoldo C Cancio, Phillip Mason
INTRODUCTION: Recent reports on the use of extracorporeal membrane oxygenation (ECMO) in critically ill burn patients with Acute Respiratory Distress Syndrome (ARDS) recommended against the use of ECMO. The authors cited the high mortality rates associated with the use of ECMO in these patients with no appreciable benefit. Accumulating evidence from referral centers suggests improved survival in patients with ARDS receiving ECMO. We report our recent experience treating patients with severe ARDS with ECMO in a burn intensive care unit...
June 11, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29901798/the-use-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-in-severe-burns-without-inhalation-injury
#8
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/29791822/extracorporeal-membrane-oxygenation-for-severe-acute-respiratory-distress-syndrome
#9
RANDOMIZED CONTROLLED TRIAL
Alain Combes, David Hajage, Gilles Capellier, Alexandre Demoule, Sylvain Lavoué, Christophe Guervilly, Daniel Da Silva, Lara Zafrani, Patrice Tirot, Benoit Veber, Eric Maury, Bruno Levy, Yves Cohen, Christian Richard, Pierre Kalfon, Lila Bouadma, Hossein Mehdaoui, Gaëtan Beduneau, Guillaume Lebreton, Laurent Brochard, Niall D Ferguson, Eddy Fan, Arthur S Slutsky, Daniel Brodie, Alain Mercat
BACKGROUND: The efficacy of venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) remains controversial. METHODS: In an international clinical trial, we randomly assigned patients with very severe ARDS, as indicated by one of three criteria - a ratio of partial pressure of arterial oxygen (Pao2 ) to the fraction of inspired oxygen (Fio2 ) of less than 50 mm Hg for more than 3 hours; a Pao2 :Fio2 of less than 80 mm Hg for more than 6 hours; or an arterial blood pH of less than 7...
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791819/ecmo-for-severe-ards
#10
EDITORIAL
C Corey Hardin, Kathryn Hibbert
New England Journal of Medicine, Volume 378, Issue 21, Page 2032-2034, May 2018.
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#11
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774445/pregnancy-complicated-by-influenza-a-ards-requiring-consecutive-vv-ecmo-treatment-with-successful-vaginal-delivery
#12
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/29734646/evaluation-of-meropenem-pharmacokinetics-in-an-experimental-acute-respiratory-distress-syndrome-ards-model-during-extracorporeal-membrane-oxygenation-ecmo-by-using-a-penp-%C3%AE-lactamase-biosensor
#13
Max Andresen, Joaquin Araos, Kwok-Yin Wong, Yun-Chung Leung, Lok-Yan So, Wai-Ting Wong, Salvador Cabrera, Camila Silva, Leyla Alegria, Alejandro Bruhn, Dagoberto Soto
INTRODUCTION: The use of antibiotics is mandatory in patients during extracorporeal membrane oxygenation (ECMO) support. Clinical studies have shown high variability in the antibiotic concentrations, as well as sequestration of them by the ECMO circuit, suggesting that the doses and/or interval administration used during ECMO may not be adequate. Thus, a fast response sensor to estimate antibiotic concentrations in this setting would contribute to improve dose adjustments. The biosensor PenP has been shown to have a dynamic range, sensitivity and specificity useful for pharmacokinetic (PK) tests in healthy subjects...
May 4, 2018: Sensors
https://www.readbyqxmd.com/read/29732188/weaning-from-veno-venous-extracorporeal-membrane-oxygenation-how-i-do-it
#14
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
#15
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
#16
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/29715710/timing-of-ecmo-initiation-impacts-survival-in-influenza-associated-ards
#17
Desiree A Steimer, Omar Hernandez, David P Mason, Gary S Schwartz
In the past decade, extracorporeal membrane oxygenation (ECMO) has emerged as an innovative therapy for influenza-associated acute respiratory distress syndrome (ARDS). Despite its promising results, the ideal timing of ECMO initiation for these patients remains unclear. Retrospective analysis of a single institution experience with venovenous ECMO for influenza-induced ARDS was performed. Twenty-one patients were identified and categorized into early (0-2 days), standard (3-6 days), or late (more than 7 days) cannulation cohorts...
May 1, 2018: Thoracic and Cardiovascular Surgeon
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
#18
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
#19
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
https://www.readbyqxmd.com/read/29681395/chugging-in-patients-on-veno-venous-extracorporeal-membrane-oxygenation-an-under-recognized-driver-of-intravenous-fluid-administration-in-patients-with-acute-respiratory-distress-syndrome
#20
James M Walter, Chitaru Kurihara, Thomas C Corbridge, Ankit Bharat
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. OBJECTIVES: To provide an example of a common complication, circuit "chugging," and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. METHODS: We use a clinical case to illustrate chugging and discuss potential management strategies...
July 2018: Heart & Lung: the Journal of Critical Care
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