scholarly journals Recommendations for extracorporeal membrane oxygenation (ECMO) in COVID-19 patients

2020 ◽  
Vol 132 (21-22) ◽  
pp. 671-676 ◽  
Author(s):  
Dominik Wiedemann ◽  
◽  
Martin H. Bernardi ◽  
Klaus Distelmaier ◽  
Georg Goliasch ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
Working Environment ◽  
Healthcare Personnel ◽  
Healthcare Facilities ◽  
Safe Patient Care ◽  
Membrane Oxygenation ◽  
Lung Failure ◽  
Medical University ◽  
Safe Working

SummaryThe pandemic from the SARS-CoV‑2 virus is currently challenging healthcare systems all over the world. Maintaining appropriate staffing and resources in healthcare facilities is essential to guarantee a safe working environment for healthcare personnel and safe patient care. Extracorporeal membrane oxygenation (ECMO) represents a valuable therapeutic option in patients with severe heart or lung failure. Although only a limited proportion of COVID-19 patients develop respiratory or circulatory failure that is refractory to conventional treatment, it is of utmost importance to clearly define criteria for the use of ECMO in this steadily growing patient population. The ECMO working group of the Medical University of Vienna has established the following recommendations for ECMO support in COVID-19 patients.

The physiology of extracorporeal membrane oxygenation: The Fick principle

Perfusion ◽  
2021 ◽  
pp. 026765912110559
Author(s):  
Hoong Lim
Keyword(s):  
Blood Flow ◽  
Extracorporeal Membrane Oxygenation ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Fick Principle ◽  
Membrane Oxygenation ◽  
Lung Failure ◽  
Va Ecmo ◽  
The Relationship ◽  
Vv Ecmo

Extracorporeal membrane oxygenation (ECMO) can be delivered in veno-arterial (VA) and veno-venous (VV) configurations based on the cannulation strategy. VA and VV ECMO are delivered primarily for haemodynamic and respiratory support in patients with severe heart and lung failure, respectively. The Fick principle describes the relationship between blood flow and oxygen consumption – key parameters in the physiological management of extracorporeal support. This review will discuss the application of the Fick principle in: (i) recirculation in VV ECMO; (ii) the quantification of oxygen delivery (DO2) in VV ECMO and (iii) the quantification of transpulmonary blood flow and systemic arterial oxygen saturation in VA ECMO.

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

scholarly journals Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096470
Author(s):  
Jianrong Wang ◽  
Jinyu Huang ◽  
Wei Hu ◽  
Xueying Cai ◽  
Weihang Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Extracorporeal Membrane Oxygenation ◽  
Nosocomial Pneumonia ◽  
Discharge Rate ◽  
Multivariable Analysis ◽  
Ventilator Support ◽  
Membrane Oxygenation ◽  
Independent Risk Factors ◽  
Medical University ◽  
Vv Ecmo

Objective We aimed to examine the risk factors and prognosis of nosocomial pneumonia (NP) during extracorporeal membrane oxygenation (ECMO). Methods We retrospectively analyzed data of patients who received ECMO at the Affiliated Hangzhou Hospital of Nanjing Medical University between January 2013 and August 2019. The primary outcome was the survival-to-discharge rate. Results Sixty-nine patients who received ECMO were enrolled, median age 42 years and 26 (37.7%) women; 14 (20.3%) patients developed NP. The NP incidence was 24.7/1000 ECMO days. Patients with NP had a higher proportion receiving veno-venous (VV) ECMO (50% vs. 7.3%); longer ECMO support duration (276 vs. 140 hours), longer ventilator support duration before ECMO weaning (14.5 vs. 6 days), lower ECMO weaning success rate (50.0% vs. 81.8%), and lower survival-to-discharge rate (28.6% vs. 72.7%) than patients without NP. Multivariable analysis showed independent risk factors that predicted NP during ECMO were ventilator support duration before ECMO weaning (odds ratio [OR] = 1.288; 95% confidence interval [CI]: 1.111–1.494) and VV ECMO mode (OR = 10.970; 95% CI: 1.758–68.467). Conclusion NP during ECMO was associated with ventilator support duration before ECMO weaning and VV ECMO mode. Clinicians should shorten the respiratory support duration for patients undergoing ECMO to prevent NP.

Veno-venous extracorporeal membrane oxygenation in obese surgical patients with hypercapnic lung failure

2014 ◽  
Vol 58 (5) ◽  
pp. 534-538 ◽  
Author(s):  
J. SWOL ◽  
D. BUCHWALD ◽  
M. DUDDA ◽  
J. STRAUCH ◽  
T. A. SCHILDHAUER
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Surgical Patients ◽  
Membrane Oxygenation ◽  
Lung Failure

Ambulatory Extracorporeal Membrane Oxygenation: Times Are Changing

2021 ◽  
Vol 32 (4) ◽  
pp. 434-442
Author(s):  
Cristina A. Wojack ◽  
Ashleigh G. VanBlarcom ◽  
Jesus Casida
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Registered Nurses ◽  
Patient Treatment ◽  
Past Century ◽  
Advanced Practice ◽  
Membrane Oxygenation ◽  
Life Saving ◽  
Advanced Practice Registered Nurses ◽  
Lung Failure ◽  
Improve Patient

During the past century, medical technology has evolved to enhance quality and quantity of life. Medications, surgeries, and implantable devices have been developed and enhanced to reduce complications and improve patient outcomes. The use of extracorporeal membrane oxygenation is one of the most substantial advances in life-saving modalities. Extracorporeal membrane oxygenation has been widely used for patients with heart or lung failure across the lifespan. Expansion and simplifications of extracorporeal membrane oxygenation circuit designs have informed changes in patient treatment (from bed confinement to ambulatory) and shifted many clinical staffing structures (from cardiovascular perfusionist to nurse-managed care). Highly skilled registered nurses and advanced practice registered nurses are increasingly involved in managing extracorporeal membrane oxygenation in the critical care setting. The purpose of this article is to highlight the technological evolution of extracorporeal membrane oxygenation and the corresponding patient care that bedside registered nurses and advanced practice registered nurses provide.

Long-Term Survival in Adult Patients With Severe Acute Lung Failure Receiving Veno-Venous Extracorporeal Membrane Oxygenation

2017 ◽  
Vol 45 (10) ◽  
pp. 1718-1725 ◽  
Author(s):  
Tone Bull Enger ◽  
Alois Philipp ◽  
Matthias Lubnow ◽  
Marcus Fischer ◽  
Daniele Camboni ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Adult Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Membrane Oxygenation ◽  
Acute Lung Failure ◽  
Lung Failure

scholarly journals Successful Treatment of Airway Rupture with Femoro-Femoral Venovenous Extracorporeal Membrane Oxygenation in Traumatic Tracheal Injury: A Case Report

2021 ◽  
Author(s):  
Haein Ko ◽  
In-seok Jeong ◽  
Sang Gi Oh ◽  
Kyo Seon Lee ◽  
Sang Yun Song ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Rescue Therapy ◽  
Therapeutic Option ◽  
Thyroid Cartilage ◽  
Vital Signs ◽  
Tracheal Injury ◽  
Rare Type ◽  
Tracheal Rupture ◽  
Membrane Oxygenation ◽  
Type Of Injury

Abstract BackgroundTraumatic tracheal injury is a rare type of trauma. In this type of injury, catastrophes may occur owing to a failure to secure the patient's airway. Extracorporeal membrane oxygenation (ECMO) is rescue therapy available for the treatment of urgent cardiorespiratory distress until the patient's vital signs have stabilized. The various applications of ECMO configurations have expanded the scope for this therapy.Case presentationWe describe the case of a 66-year-old man with tracheal rupture with thyroid cartilage fracture due to cultivator handle who was treated with veno-venous ECMO. This case reflects the role and limitations of veno-venous ECMO, in which patient survival was possible with a bi-femoral configuration while also ensuring a clear airway. ConclusionWe shared our experience with bi-femoral veno-venous ECMO as a therapeutic option to contribute to choosing an appropriate approach. Based on our review of the literature, the present case was an uncommon report of survival after tracheal rupture due to trauma without other complications.

Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation

2016 ◽  
Vol 32 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Minhyeok Lee ◽  
Seulgi Kim ◽  
Oh Jung Kwon ◽  
Ji Hye Kim ◽  
Inbeom Jeong ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Gastrointestinal Disease ◽  
Therapeutic Option ◽  
Antiviral Treatment ◽  
Upper Respiratory Infection ◽  
Membrane Oxygenation

Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir. However, few reports discussed the efficacy of cidofovir in acute respiratory distress syndrome (ARDS). We experienced 3 cases of adenoviral pneumonia associated with ARDS and treated with cidofovir and respiratory support, including extracorporeal membrane oxygenation (ECMO). All 3 patients showed a positive clinical response to cidofovir and survival at 28 days. Cidofovir with early ECMO therapy may be a therapeutic option in adenoviral ARDS. A literature review identified 15 cases of adenovirus pneumonia associated with ARDS.

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