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22 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#1
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#2
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#3
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...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27842755/extracorporeal-gas-exchange-the-expanding-role-of-extracorporeal-support-in-respiratory-failure
#4
REVIEW
Nikunj Bhatt, Erik Osborn
The use of extracorporeal support is expanding quickly in adult respiratory failure. Extracorporeal gas exchange is an accepted rescue therapy for severe acute respiratory distress syndrome (ARDS) in select patients. Extracorporeal carbon dioxide removal is also being investigated as a preventative, preemptive, and management platform in patients with respiratory failure other than severe ARDS. The non-ARDS patient population is much larger, so the potential for rapid growth is high. This article hopes to inform decisions about the use of extracorporeal support by increasing understanding concerning the past and present practice of extracorporeal gas exchange...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27747024/veno-arterial-extracorporeal-membrane-oxygenation-an-overview-of-different-cannulation-techniques
#5
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/27546757/recirculation-in-venovenous-extracorporeal-membrane-oxygenation
#6
REVIEW
Ashleigh Xie, Tristan D Yan, Paul Forrest
Despite the increasing use of venovenous extracorporeal membrane oxygenation (ECMO) to treat severe respiratory failure, recirculation remains a common complication that may result in severe hypoxemia and end-organ damage. The present review, therefore, examines updated evidence for the causes, measurement, and management of recirculation. Six electronic databases were searched from their dates of inception to January 2016, and 38 relevant studies were selected for analysis. This review revealed that, currently, recirculation is typically calculated from measurement of blood oxygen saturations, although limited evidence suggests that oxygen content may provide a more accurate measure...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27509917/extracorporeal-support-for-chronic-obstructive-pulmonary-disease-a-bright-future
#7
John M Trahanas, William R Lynch, Robert H Bartlett
In the past the only option for the treatment of respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (aeCOPD) was invasive mechanical ventilation. In recent decades, the potential for extracorporeal carbon dioxide (CO2) removal has been realized. We review the various types of extracorporeal CO2 removal, outline the optimal use of these therapies for aeCOPD, and make suggestions for future controlled trials. We also describe the advantages and requirements for an ideal long-term ambulatory CO2 removal system for palliation of COPD...
August 10, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27432039/use-of-extracorporeal-membrane-oxygenation-for-the-treatment-of-influenza-induced-acute-respiratory-distress-syndrome-in-immunocompromised-adults
#8
REVIEW
M Veronica Dioverti, Kelly A Cawcutt, Gregory J Schears, Larry M Baddour
Influenza infection in the adult immunocompromised hosts can have severe presentations and rapid progression to lower respiratory tract infection requiring mechanical ventilation, and it even can progress to acute respiratory distress syndrome. Little is known about the role of extracorporeal membrane oxygenation for management in this setting. We present a review of the current literature on the subject.
July 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27195133/vascular-access-for-extracorporeal-life-support-tips-and-tricks
#9
REVIEW
Jeremie Reeb, Anne Olland, Stephane Renaud, Anne Lejay, Nicola Santelmo, Gilbert Massard, Pierre-Emmanuel Falcoz
In thoracic surgery, extracorporeal life support (ECLS) techniques are performed to (I) provide a short to mid term extracorporeal mechanical support; (II) realize the gas exchanges; and (III)-depending the configuration of the circuit-substitute the failed heart function. The objective of this review is to describe the rational of the different ECLS techniques used in thoracic surgery and lung transplantation (LTx) with a specific attention to the vascular access. Venovenous extracorporeal membrane oxygenation (VV ECMO) is the most common ECLS technique used in thoracic surgery and represents the best strategy to support the lung function...
April 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27381702/year-in-review-2015-extracorporeal-membrane-oxygenation
#10
REVIEW
Lakshmi Raman, Heidi J Dalton
Extracorporeal membrane oxygenation (ECMO) is a modified form of cardiopulmonary bypass. Although early trials were plagued by severe bleeding and high rates of death, subsequent experience with neonates found good survival, and ECMO became an important tool in the care of critically ill infants with respiratory failure. Since the 1980s, expansion to other groups (children, patients with cardiac disease, etc) followed as experience was obtained. Today, there is a rapid growth of ECMO, especially in the adult population...
July 2016: Respiratory Care
https://www.readbyqxmd.com/read/27193131/extracorporeal-carbon-dioxide-removal-ecco2r-in-respiratory-deficiency-and-current-investigations-on-its-improvement-a-review
#11
Hany Hazfiza Manap, Ahmad Khairi Abdul Wahab
The implementation of extracorporeal carbon dioxide removal (ECCO2R) as one of the extracorporeal life support system is getting more attention today. Thus, the objectives of this paper are to study the clinical practice of commercial ECCO2R system, current trend of its development and also the perspective on future improvement that can be done to the existing ECCO2R system. The strength of this article lies in its review scope, which focuses on the commercial ECCO2R therapy in the market based on membrane lung and current investigation to improve the efficiency of the ECCO2R system, in terms of surface modification by carbonic anhydrase (CA) immobilization technique and respiratory electrodialysis (R-ED)...
May 18, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27357690/-awake-extracorporeal-membrane-oxygenation-ecmo-pathophysiology-technical-considerations-and-clinical-pioneering
#12
REVIEW
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
https://www.readbyqxmd.com/read/27064333/monitoring-during-extracorporeal-membrane-oxygenation
#13
Ghislaine Douflé, Niall D Ferguson
PURPOSE OF REVIEW: An increasing number of patients are placed on extracorporeal membrane oxygenation (ECMO) for respiratory or cardiac failure. Sound understanding of physiology and configuration of ECMO is essential for proper management. This review covers different monitoring parameters and tools for patients supported with different types of ECMO. RECENT FINDINGS: Emphasis is placed on monitoring saturations at different sites depending on type of ECMO support...
June 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27040797/physiology-of-gas-exchange-during-ecmo-for-respiratory-failure
#14
Robert H Bartlett
Management of gas exchange using extracorporeal membrane oxygenation (ECMO) in respiratory failure is very different than management when the patient is dependent on mechanical ventilation. All the gas exchange occurs in the membrane lung, and the arterial oxygenation is the result of mixing the ECMO blood with the native venous blood. To manage patients on ECMO, it is essential to understand the physiology described in this essay.
April 3, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27007108/venovenous-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure-a-clinical-review-from-an-international-group-of-experts
#15
REVIEW
Eddy Fan, Luciano Gattinoni, Alain Combes, Matthieu Schmidt, Giles Peek, Dan Brodie, Thomas Muller, Andrea Morelli, V Marco Ranieri, Antonio Pesenti, Laurent Brochard, Carol Hodgson, Cecile Van Kiersbilck, Antoine Roch, Michael Quintel, Laurent Papazian
Despite expensive life-sustaining interventions delivered in the ICU, mortality and morbidity in patients with acute respiratory failure (ARF) remain unacceptably high. Extracorporeal membrane oxygenation (ECMO) has emerged as a promising intervention that may provide more efficacious supportive care to these patients. Improvements in technology have made ECMO safer and easier to use, allowing for the potential of more widespread application in patients with ARF. A greater appreciation of the complications associated with the placement of an artificial airway and mechanical ventilation has led clinicians and researchers to seek viable alternatives to providing supportive care in these patients...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26984504/mechanical-circulatory-support-in-the-new-era-an-overview
#16
REVIEW
Kiran Shekar, Shaun D Gregory, John F Fraser
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
March 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26966691/current-applications-for-the-use-of-extracorporeal-carbon-dioxide-removal-in-critically-ill-patients
#17
REVIEW
Luigi Camporota, Nicholas Barrett
Mechanical ventilation in patients with respiratory failure has been associated with secondary lung injury, termed ventilator-induced lung injury. Extracorporeal venovenous carbon dioxide removal (ECCO2R) appears to be a feasible means to facilitate more protective mechanical ventilation or potentially avoid mechanical ventilation in select patient groups. With this expanding role of ECCO2R, we aim to describe the technology and the main indications of ECCO2R.
2016: BioMed Research International
https://www.readbyqxmd.com/read/26971033/early-veno-venous-extracorporeal-membrane-oxygenation-is-associated-with-lower-mortality-in-patients-who-have-severe-hypoxemic-respiratory-failure-a-retrospective-multicenter-cohort-study
#18
Hussein D Kanji, Jessica McCallum, Monica Norena, Hubert Wong, Donald E Griesdale, Steven Reynolds, George Isac, Demetrios Sirounis, Derek Gunning, Gordon Finlayson, Peter Dodek
PURPOSE: The purpose of the study is to compare outcomes in patients who had severe hypoxemic respiratory failure (Pao2/fraction of inspired oxygen <100) who received early veno-venous extracorporeal membrane oxygenation (ECMO) as an adjunct to mechanical ventilation, to those in patients who received conventional mechanical ventilation alone. MATERIALS AND METHODS: This is a multicenter, retrospective unmatched and matched cohort study of patients admitted between April 2006 and December 2013...
June 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26942446/extracorporeal-membrane-oxygenation-evolving-epidemiology-and-mortality
#19
Christian Karagiannidis, Daniel Brodie, Stephan Strassmann, Erich Stoelben, Alois Philipp, Thomas Bein, Thomas Müller, Wolfram Windisch
PURPOSE: The evolution of the epidemiology and mortality of extracorporeal membrane oxygenation (ECMO) remains unclear. The present study investigates the evolving epidemiology and mortality of various ECMO techniques in Germany over time, used for both severe respiratory and cardiac failure. METHODS: Data on all patients receiving venovenous (vv-ECMO) and venoarterial (va-ECMO) ECMO as well as pumpless extracorporeal lung assist/interventional lung assist (PECLA/ILA) outside the operating room in Germany from 1 January 2007 through 31 December 2014 were obtained from the Federal Statistical Office of Germany and analyzed...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26923646/early-prediction-of-extracorporeal-membrane-oxygenation-eligibility-for-severe-acute-respiratory-distress-syndrome-in-adults
#20
J Kyle Bohman, Joseph A Hyder, Vivek Iyer, Sonal R Pannu, Pablo Moreno Franco, Troy G Seelhammer, Louis A Schenck, Gregory J Schears
PURPOSE: Appropriately identifying and triaging patients with newly diagnosed acute respiratory distress syndrome (ARDS) who may progress to severe ARDS is a common clinical challenge without any existing tools for assistance. MATERIALS AND METHODS: Using a retrospective cohort, a simple prediction score was developed to improve early identification of ARDS patients who were likely to progress to severe ARDS within 7 days. A broad array of comorbidities and physiologic variables were collected for the 12-hour period starting from intubation for ARDS...
June 2016: Journal of Critical Care
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