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ECMO

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75 papers 25 to 100 followers
By Anil Gopinath Pulmonary Critical Care. Medical Director, Adult ECMO. Interests - Cardiopulmonary physiology, Muscle physiology, Mechanical ventilation, ECMO
https://www.readbyqxmd.com/read/27747024/veno-arterial-extracorporeal-membrane-oxygenation-an-overview-of-different-cannulation-techniques
#1
Carlo Banfi, Matteo Pozzi, Marie-Eve Brunner, Fabio Rigamonti, Nicolas Murith, Damiano Mugnai, Jean-Francois Obadia, Karim Bendjelid, Raphaël Giraud
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has known a widespread application over the last decade and is now an effective and valuable therapeutic option in refractory cardiogenic shock of various etiologies. In this subgroup of critically ill and unstable patients in cardiogenic shock, VA-ECMO allows, on the one hand, temporary hemodynamic stabilization with improvement of end-organ function and, on the other hand, gives the time to perform complementary diagnostic exams and to decide the therapeutic strategy in these high-risk candidates for immediate long-term mechanical circulatory support (MCS) implantation...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27787651/body-mass-index-and-echocardiography-in-refractory-ards-treated-with-veno-venous-extracorporeal-membrane-oxygenation
#2
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/27666781/serial-lactate-measurements-as-a-prognostic-tool-in-venovenous-extracorporeal-membrane-oxygenation-support
#3
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/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#4
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/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#5
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 patients with ARDS supported with ECMO, as well as to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult patients with ARDS supported with ECMO at our institution between 2010 and 2015...
February 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27919283/outcomes-and-survival-prediction-models-for-severe-adult-acute-respiratory-distress-syndrome-treated-with-extracorporeal-membrane-oxygenation
#6
REVIEW
Sacha Rozencwajg, David Pilcher, Alain Combes, Matthieu Schmidt
Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) has known a growing interest over the last decades with promising results during the 2009 A(H1N1) influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance.Survival has steadily improved for a decade, reaching up to 65% at hospital discharge in the most recent cohorts. However, ECMO is still marred by frequent and significant complications such as bleeding and nosocomial infections...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27922880/investigation-of-key-circuit-constituents-affecting-drug-sequestration-during-extracorporeal-membrane-oxygenation-treatment
#7
Jiheum Park, Dong Ah Shin, Saram Lee, Young-Jae Cho, Sanghoon Jheon, Jung Chan Lee, Hee Chan Kim
We quantified the influence of the elements of the extracorporeal oxygenation (ECMO) circuit on drug sequestration by focusing on the interactions between materials and drugs. Tubing of three different brands (Tygon/Maquet/Terumo) and oxygenators of two different brands (Maquet/Terumo) were used. Drugs included dexmedetomidine, meropenem, and heparin which were dissolved in deionized water. Tubing was cut into ~7 cm sections and allowed drug solutions enclosed inside by clamping both ends. The oxygenator housing, gas membrane, and heat exchanger were dissected into ~1 g pieces and submerged into drug solutions...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28001135/a-survey-of-physicians-attitudes-toward-decision-making-authority-for-initiating-and-withdrawing-va-ecmo-results-and-ethical-implications-for-shared-decision-making
#8
Ellen C Meltzer, Natalia S Ivascu, Meredith Stark, Alexander V Orfanos, Cathleen A Acres, Paul J Christos, Thomas Mangione, Joseph J Fins
OBJECTIVE: Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28030441/does-permissive-hypoxaemia-during-extracorporeal-membrane-oxygenation-cause-long-term-neurological-impairment-a-study-in-patients-with-h1n1-induced-severe-respiratory-failure
#9
Bernhard Holzgraefe, Christin Andersson, Håkan Kalzén, Viktor von Bahr, Mikael Mosskin, Elna-Marie Larsson, Kenneth Palmér, Björn Frenckner, Anders Larsson
BACKGROUND: The Extracorporeal Life Support Organisation accepts permissive hypoxaemia in adult patients during extracorporeal membrane oxygenation (ECMO). The neurological long-term outcome of this approach has not yet been studied. OBJECTIVES: We investigated the prevalence of brain lesions and cognitive dysfunction in survivors from the Influenza A/H1N1 2009 pandemic treated with permissive hypoxaemia during ECMO for severe acute respiratory distress syndrome (ARDS)...
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28030497/extra-corporeal-membrane-oxygenation-ecmo-following-traumatic-injury
#10
Sarwat Ahmad, Jay Menaker, Joseph Kufera, James O'Connor, Thomas M Scalea, Deborah M Stein
BACKGROUND: The use of ECMO for acute respiratory failure following injury is controversial and poorly described. METHODS: We reviewed our single-center experience with use of ECMO from January 2006 to November 2015 at a Level 1 primary adult resource center for trauma to determine the association of in-hospital mortality with patient demographics and clinical variables. RESULTS: 46 patients were treated with ECMO. Patients requiring venoarterial ECMO (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28033162/an-ex-vivo-model-to-decipher-the-impact-of-extracorporeal-membrane-oxygenation-on-beta-lactam-degradation-kinetics
#11
Cyril Leven, Pierre Fillâtre, Antoine Petitcollin, Marie-Clémence Verdier, Jérôme Laurent, Nicolas Nesseler, Yoann Launey, Pierre Tattevin, Eric Bellissant, Erwan Flécher, Florian Lemaitre
BACKGROUND: As a consequence of drug sequestration, increase in volume of distribution or alteration of elimination, extracorporeal membrane oxygenation (ECMO) might lead to inadequate plasma concentrations of vital drugs. The aim of this experimental study was to develop an ex vivo model to better characterize the impact of ECMO procedure on beta-lactam antibiotics pharmacokinetics. METHODS: Plasma concentrations of cefotaxime, ceftazidime, cefepime, piperacillin, oxacillin, amoxicillin, and ceftriaxone were measured in an ex vivo ECMO circuit primed with whole human blood and compared to controls stored in glass tubes and polyvinyl chloride (PVC) tubing...
December 23, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28040370/benefit-of-extracorporeal-membrane-oxygenation-in-major-burns-after-stun-grenade-explosion-experience-from-a-single-military-medical-center
#12
Po-Shun Hsu, Yi-Ting Tsai, Chih-Yuan Lin, Shyi-Gen Chen, Niann-Tzyy Dai, Cheng-Jung Chen, Jia-Lin Chen, Chien-Sung Tsai
INTRODUCTION: Explosion injury is very common on the battlefield and is associated with major burn and inhalation injuries and subsequent high mortality and morbidity rates. Here we report six victims who suffered from explosion injuries caused by stun grenade; all were treated with extracorporeal membrane oxygenation (ECMO) as salvage therapy. This study was aimed to evaluate the indications and efficacy of ECMO in acute and critically ill major burn patients. METHODS: This was a retrospective analysis of six patients from Tri-Service General Hospital, National Defense Medical Center in Taiwan...
December 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28043990/low-dose-bivalirudin-anticoagulation-for-lung-transplantation-with-extracorporeal-membrane-oxygenation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#13
Andreas Koster, Jost Niedermeyer, Jan Gummert, Andre Renner
A patient scheduled for lung transplantation needed veno-venous extracorporeal membrane oxygenation (ECMO) and developed acute heparin-induced thrombocytopenia (HIT). After 21 days on ECMO support, lung transplantation was successfully performed using veno-arterial ECMO with bivalirudin anticoagulation. The target activating clotting time values of 160-180 s resulted in low bivalirudin infusion rates of 0.1 mg/kg/h. Diffuse bleeding stopped quickly after ending the continuous bivalirudin infusion.
January 2, 2017: European Journal of Cardio-thoracic Surgery
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
#14
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/27174922/predicting-ventilator-induced-lung-injury-using-a-lung-injury-cost-function
#15
Katharine L Hamlington, Bradford J Smith, Gilman B Allen, Jason H T Bates
Managing patients with acute respiratory distress syndrome (ARDS) requires mechanical ventilation that balances the competing goals of sustaining life while avoiding ventilator-induced lung injury (VILI). In particular, it is reasonable to suppose that for any given ARDS patient, there must exist an optimum pair of values for tidal volume (VT) and positive end-expiratory pressure (PEEP) that together minimize the risk for VILI. To find these optimum values, and thus develop a personalized approach to mechanical ventilation in ARDS, we need to be able to predict how injurious a given ventilation regimen will be in any given patient so that the minimally injurious regimen for that patient can be determined...
July 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/26208379/lack-of-survival-benefit-found-with-use-of-intraaortic-balloon-pump-in-extracorporeal-membrane-oxygenation-a-pooled-experience-of-1517-patients
#16
REVIEW
Richard Cheng, Rory Hachamovitch, Raj Makkar, Danny Ramzy, Jaime D Moriguchi, Francisco A Arabia, Fardad Esmailian, Babak Azarbal
OBJECTIVE: Intraaortic balloon pumps (IABPs) are frequently used as an adjunctive device to extracorporeal membrane oxygenation (ECMO) and are routinely placed at the initiation of ECMO at many institutions. Evidence for the additive benefit of IABP therapy is limited and conflicting in part due to small sample sizes. In the absence of large randomized trials, a meta-analysis would best elucidate potential benefit. METHODS: A systematic PubMed/Medline search was performed...
October 2015: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/26263439/low-dose-heparin-anticoagulation-during-extracorporeal-life-support-for-acute-respiratory-distress-syndrome-in-conscious-sheep
#17
Nicolas J Prat, Andrew D Meyer, Thomas Langer, Robbie K Montgomery, Bijaya K Parida, Andriy I Batchinsky, Andrew P Cap
BACKGROUND: Over 32% of burned battlefield causalities develop trauma-induced hypoxic respiratory failure, also known as acute respiratory distress syndrome (ARDS). Recently, 9 out of 10 US combat soldiers' survived life-threatening trauma-induced ARDS supported with extracorporeal membrane oxygenation (ECMO), a portable form of cardiopulmonary bypass. Unfortunately, the size, incidence of coagulation complications, and the need for systematic anticoagulation for traditional ECMO devices have prevented widespread use of this lifesaving technology...
December 2015: Shock
https://www.readbyqxmd.com/read/25693014/driving-pressure-and-survival-in-the-acute-respiratory-distress-syndrome
#18
Marcelo B P Amato, Maureen O Meade, Arthur S Slutsky, Laurent Brochard, Eduardo L V Costa, David A Schoenfeld, Thomas E Stewart, Matthias Briel, Daniel Talmor, Alain Mercat, Jean-Christophe M Richard, Carlos R R Carvalho, Roy G Brower
BACKGROUND: Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but the relative importance of each of these components is uncertain. Because respiratory-system compliance (CRS) is strongly related to the volume of aerated remaining functional lung during disease (termed functional lung size), we hypothesized that driving pressure (ΔP=VT/CRS), in which VT is intrinsically normalized to functional lung size (instead of predicted lung size in healthy persons), would be an index more strongly associated with survival than VT or PEEP in patients who are not actively breathing...
February 19, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25374669/mechanical-circulatory-support-in-acute-cardiogenic-shock
#19
REVIEW
Mubashar H Khan, Brian J Corbett, Steven M Hollenberg
Cardiogenic shock complicates about 5% to 8% of all admissions for acute myocardial infarction, and despite advancement in treatment over the past 50 years, mortality remains unacceptably high. Management with vasoactive agents after revascularization can have its limitations and thus mechanical circulatory support is often initiated. Intra-aortic balloon pumps (IABPs) are the devices most commonly used worldwide. IABPs appeared to improve mortality when used along with fibrinolytic therapy but may not when used along with percutaneous coronary interventions...
2014: F1000Prime Reports
https://www.readbyqxmd.com/read/25416535/vancomycin-population-pharmacokinetics-during-extracorporeal-membrane-oxygenation-therapy-a-matched-cohort-study
#20
Katia Donadello, Jason A Roberts, Stefano Cristallini, Marjorie Beumier, Kiran Shekar, Frédérique Jacobs, Asmae Belhaj, Jean-Louis Vincent, Daniel de Backer, Fabio Silvio Taccone
INTRODUCTION: The aim of this study was to describe the population pharmacokinetics of vancomycin in critically ill patients treated with and without extracorporeal membrane oxygenation (ECMO). METHODS: We retrospectively reviewed data from critically ill patients treated with ECMO and matched controls who received a continuous infusion of vancomycin (35 mg/kg loading dose over 4 hours followed by a daily infusion adapted to creatinine clearance, CrCl)). The pharmacokinetics of vancomycin were described using non-linear mixed effects modeling...
2014: Critical Care: the Official Journal of the Critical Care Forum
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