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RPHICUTeaching2016.1-ECMO

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4 papers 0 to 25 followers Research Papers used in aid of the in-house ICU registrar teaching programme at Royal Perth Hospital in the first half of 2016.
https://www.readbyqxmd.com/read/25046529/extracorporeal-life-support-in-critically-ill-adults
#1
REVIEW
Corey E Ventetuolo, Christopher S Muratore
Extracorporeal life support (ECLS) has become increasingly popular as a salvage strategy for critically ill adults. Major advances in technology and the severe acute respiratory distress syndrome that characterized the 2009 influenza A(H1N1) pandemic have stimulated renewed interest in the use of venovenous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal to support the respiratory system. Theoretical advantages of ECLS for respiratory failure include the ability to rest the lungs by avoiding injurious mechanical ventilator settings and the potential to facilitate early mobilization, which may be advantageous for bridging to recovery or to lung transplantation...
September 1, 2014: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/22087681/extracorporeal-membrane-oxygenation-for-ards-in-adults
#2
REVIEW
Daniel Brodie, Matthew Bacchetta
A 41-year-old woman presents with severe community-acquired pneumococcal pneumonia. Chest radiography reveals diffuse bilateral infiltrates, and hypoxemic respiratory failure develops despite appropriate antibiotic therapy. She is intubated and mechanical ventilation is initiated with a volume- and pressure-limited approach for the acute respiratory distress syndrome (ARDS). Over the ensuing 24 hours, her partial pressure of arterial oxygen (Pao2) decreases to 40 mm Hg, despite ventilatory support with a fraction of inspired oxygen (Fio2) of 1...
November 17, 2011: New England Journal of Medicine
https://www.readbyqxmd.com/read/21262750/a-review-of-the-fundamental-principles-and-evidence-base-in-the-use-of-extracorporeal-membrane-oxygenation-ecmo-in-critically-ill-adult-patients
#3
REVIEW
Steve Allen, Daniel Holena, Maureen McCunn, Benjamin Kohl, Babak Sarani
Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefit, but it is possible that ECMO may be beneficial in certain adult populations beyond postcardiotomy heart failure. As such, all intensivists should be familiar with the evidence-base and principles of ECMO in adult population...
January 2011: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/19762075/efficacy-and-economic-assessment-of-conventional-ventilatory-support-versus-extracorporeal-membrane-oxygenation-for-severe-adult-respiratory-failure-cesar-a-multicentre-randomised-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
Giles J Peek, Miranda Mugford, Ravindranath Tiruvoipati, Andrew Wilson, Elizabeth Allen, Mariamma M Thalanany, Clare L Hibbert, Ann Truesdale, Felicity Clemens, Nicola Cooper, Richard K Firmin, Diana Elbourne
BACKGROUND: Severe acute respiratory failure in adults causes high mortality despite improvements in ventilation techniques and other treatments (eg, steroids, prone positioning, bronchoscopy, and inhaled nitric oxide). We aimed to delineate the safety, clinical efficacy, and cost-effectiveness of extracorporeal membrane oxygenation (ECMO) compared with conventional ventilation support. METHODS: In this UK-based multicentre trial, we used an independent central randomisation service to randomly assign 180 adults in a 1:1 ratio to receive continued conventional management or referral to consideration for treatment by ECMO...
October 17, 2009: Lancet
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