Psychiatric Outcome after Severe Cardio-Respiratory Failure Treated with Extracorporeal Membrane Oxygenation: A Case-Series

2013 ◽  
Vol 54 (5) ◽  
pp. 418-427 ◽  
Author(s):  
Ivar Risnes ◽  
Aasta Heldal ◽  
Kari Wagner ◽  
Birgitte Boye ◽  
Ira Haraldsen ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
Membrane Oxygenation ◽  
Psychiatric Outcome

scholarly journals Physical Rehabilitation of Patients in the Intensive Care Unit Requiring Extracorporeal Membrane Oxygenation: A Small Case Series

2013 ◽  
Vol 93 (2) ◽  
pp. 248-255 ◽  
Author(s):  
Rod A. Rahimi ◽  
Julie Skrzat ◽  
Dereddi Raja S. Reddy ◽  
Jennifer M. Zanni ◽  
Eddy Fan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Physical Function ◽  
Case Series ◽  
Physical Rehabilitation ◽  
Care Utilization ◽  
Rehabilitation Therapy ◽  
Membrane Oxygenation

Background and Purpose Neuromuscular weakness and impaired physical function are common and long-lasting complications experienced by intensive care unit (ICU) survivors. There is growing evidence that implementing rehabilitation therapy shortly after ICU admission improves physical function and reduces health care utilization. Recently, there is increasing interest and utilization of extracorporeal membrane oxygenation (ECMO) to support patients with severe respiratory failure. Patients receiving ECMO are at great risk for significant physical impairments and pose unique challenges for delivering rehabilitation therapy. Consequently, there is a need for innovative examples of safely and feasibly delivering active rehabilitation to these patients. Case Description This case report describes 3 patients with respiratory failure requiring ECMO who received physical rehabilitation to illustrate and discuss relevant feasibility and safety issues. Outcomes In case 1, sedation and femoral cannulation limited rehabilitation therapy while on ECMO. In the 2 subsequent cases, minimizing sedation and utilizing a single bicaval dual lumen ECMO cannula placed in the internal jugular vein allowed patients to be alert and participate in active physical therapy while on ECMO, illustrating feasible rehabilitation techniques for these patients. Discussion Although greater experience is needed to more fully evaluate the safety of rehabilitation on ECMO, these initial cases are encouraging. We recommend systematically and prospectively tracking safety events and patient outcomes during rehabilitation on ECMO to provide greater evidence in this area.

The use of extracorporeal membrane oxygenation in HIV-positive patients with severe respiratory failure: a retrospective observational case series

2018 ◽  
Vol 30 (4) ◽  
pp. 316-322 ◽  
Author(s):  
Luke W Collett ◽  
Thomas Simpson ◽  
Luigi Camporota ◽  
Chris IS Meadows ◽  
Nicholas Ioannou ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Hiv Infection ◽  
Case Series ◽  
University Hospital ◽  
Severe Respiratory Failure ◽  
Hiv Status ◽  
Membrane Oxygenation ◽  
The United Kingdom ◽  
Immunodeficiency Virus

The objective is to describe the outcomes of patients with human immunodeficiency virus (HIV) infection who received extracorporeal membrane oxygenation (ECMO) for severe respiratory failure (SRF). The design and setting was a single centre retrospective observational case series, from January 2012 to June 2017, at a tertiary university hospital and regional referral centre for ECMO in the United Kingdom. The participants were all patients referred with SRF and HIV infection. The main outcome measure was patient 90-day survival. Twenty-four patients were referred, of whom nine received ECMO. Six out of nine (67%) of patients were alive at 90 days. Median duration of ECMO was 18 days. There were no identified differences between survivors and non-survivors. ECMO can be used successfully in selected patients with HIV and SRF, including those with poor HIV control and high illness severity. HIV status alone should not exclude patients from treatment with extracorporeal therapy.

scholarly journals Extracorporeal Membrane Oxygenation Use in Thoracic Surgery

Membranes ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 416
Author(s):  
Pavel Suk ◽  
Vladimír Šrámek ◽  
Ivan Čundrle
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Thoracic Surgery ◽  
Lung Transplantation ◽  
Case Series ◽  
Narrative Review ◽  
Conventional Ventilation ◽  
Sleeve Lobectomy ◽  
Membrane Oxygenation ◽  
Postoperative Respiratory Failure

This narrative review is focused on the application of extracorporeal membrane oxygenation (ECMO) in thoracic surgery, exclusive of lung transplantation. Although the use of ECMO in this indication is still rare, it allows surgery to be performed in patients where conventional ventilation is not feasible—especially in single lung patients, sleeve lobectomy or pneumonectomy and tracheal or carinal reconstructions. Comparisons with other techniques, various ECMO configurations, the management of anticoagulation, anesthesia, hypoxemia during surgery and the use of ECMO in case of postoperative respiratory failure are reviewed and supported by two cases of perioperative ECMO use, and an overview of published case series.

Evaluation of Bivalirudin as the Primary Anticoagulant in Patients Receiving Extracorporeal Membrane Oxygenation for SARS-CoV-2–Associated Acute Respiratory Failure

2021 ◽  
pp. 106002802110361
Author(s):  
Brittany D. Bissell ◽  
Taylor Gabbard ◽  
Erica A. Sheridan ◽  
Maher A. Baz ◽  
George A. Davis ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Acute Respiratory Failure ◽  
Retrospective Chart Review ◽  
Venous Thromboembolic Event ◽  
Membrane Oxygenation ◽  
Published Report ◽  
Starting Dose ◽  
Venous Thromboembolic ◽  
Polymerase Chain

Background Extracorporeal membrane oxygenation (ECMO) is a potential option for the management of severe acute respiratory failure secondary to COVID-19. Conflicting the use of this therapy is the known coagulopathy within COVID-19, leading to an incidence of venous thrombotic events of 25% to 49%. To date, limited guidance is available on optimal anticoagulation strategies in this population. Objective The purpose of this study was to evaluate the utilization of a pharmacist-driven bivalirudin dosing protocol for anticoagulation in the setting of ECMO for COVID-19–associated respiratory failure. Methods This was a single-center retrospective chart review over a 9-month period of patients receiving bivalirudin while on ECMO. All patients with acute respiratory failure requiring ECMO with a positive SARS-CoV-2 polymerase chain reaction were included. Bivalirudin was dosed via aPTT monitoring after a starting dose of 0.2 or 0.3 mg/kg/h. Results There were 33 patients included in this study, all receiving mechanical ventilation. The most common starting dose of bivalirudin was 0.2 mg/kg/h, with an average time to therapeutic range of 20 hours. Compared to previous reports, rates of bleeding were low at 15.1%, and 6.1% of patients developed a new venous thromboembolic event while on ECMO. ECMO survival was 51.5%, with an ICU mortality rate of 48.5%. Conclusion and Relevance In the first published report of its use within this population, bivalirudin was found to be a viable choice for anticoagulation in those patients on ECMO for severe respiratory failure secondary to COVID-19.

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