Outcomes of extracorporeal membrane oxygenation in adult patients with hypoxemic respiratory failure refractory to mechanical ventilation

Hantavirus cardiopulmonary syndrome (HCPS) is associated with rapid cardiopulmonary collapse from endothelial injury, resulting in massive capillary leak, shock and severe hypoxemic respiratory failure. To date, treatment remains supportive and includes mechanical ventilation, vasopressors and extracorporeal membrane oxygenation, with mortality approaching 50%. Two HCPS survivors initially given drotrecogin alpha (activated) (DAA) for presumed bacterial septic shock are described. Vasoactive medications were required for a maximum of 52 h, whereas creatinine levels and platelet counts normalized within seven to nine days. Given the similar presentations of HCPS and bacterial septic shock, empirical DAA therapy will likely be initiated before a definitive diagnosis of HCPS is made. Further observations of DAA in HCPS seem warranted.

Download Full-text

Extracorporeal membrane oxygenation as rescue therapy for severe hypoxemic respiratory failure

Journal of Thoracic Disease ◽

10.21037/jtd.2019.05.73 ◽

2019 ◽

Vol 11 (S14) ◽

pp. S1688-S1697 ◽

Cited By ~ 4

Author(s):

Bhoumesh Patel ◽

Subhasis Chatterjee ◽

Seanna Davignon ◽

J. Patrick Herlihy

Keyword(s):

Respiratory Failure ◽

Extracorporeal Membrane Oxygenation ◽

Rescue Therapy ◽

Hypoxemic Respiratory Failure ◽

Membrane Oxygenation

Download Full-text

Computational Analysis of a Wearable Artificial Pump Lung Device in Terms of Rotor/Stator Interactions

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-204441 ◽

2009 ◽

Author(s):

M. Ertan Taskin ◽

Tao Zhang ◽

Bartley P. Griffith ◽

Zhongjun J. Wu

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Gas Exchange ◽

Extracorporeal Membrane Oxygenation ◽

Lung Disease ◽

Computational Analysis ◽

Respiratory Support ◽

Membrane Oxygenation ◽

Current Therapies

Lung disease is America’s third largest killer, and responsible for one in seven deaths [1]. Most lung disease is chronic, and respiratory support is essential. Current therapies for the respiratory failure include mechanical ventilation and bed-side extracorporeal membrane oxygenation (ECMO) devices which closely simulate the physiological gas exchange of the natural lung.

Download Full-text

Does Earlier Cannulation With Veno-Venous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Distress Syndrome Decrease Duration of Artificial Mechanical Ventilation?

Journal of Doctoral Nursing Practice ◽

10.1891/jdnp-d-19-00059 ◽

2020 ◽

Vol 13 (2) ◽

pp. 148-155

Author(s):

Christine Hartner ◽

Jacqueline Ochsenreither ◽

Kenneth Miller ◽

Michael Weiss

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Lung Injury ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Adult Patients ◽

Membrane Oxygenation ◽

Vv Ecmo

BackgroundAcute respiratory distress syndrome (ARDS) is characterized by an acute, diffuse, inflammatory lung injury, leading to increased alveolar capillary permeability, increased lung weight, and loss of aerated lung tissue (Fan, Brodie, & Slutsky, 2018). Primary treatment for ARDS is artificial mechanical ventilation (AMV) (Wu, Huang, Wu, Wang, & Lin, 2016). Given recent advances in technology, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) to treat severe ARDS is growing rapidly (Combes et al., 2014).ObjectiveThis 49-month quantitative, retrospective inpatient EMR chart review compared if cannulation with VV-ECMO up to and including 48 hours of admission and diagnosis in adult patients 30 to 65 years of age diagnosed with ARDS, decreased duration on AMV, as compared to participants who were cannulated after 48 hours of admission and diagnosis with ARDS.MethodsA total of 110 participants were identified as receiving VV-ECMO during the study timeframe. Of the 58 participants who met all inclusion criteria, 39 participants were cannulated for VV-ECMO within 48 hours of admission and diagnosis with ARDS, and 19 participants were cannulated with VV-ECMO after 48 hours of admission and diagnosis with ARDS.ResultsData collected identified no statistically significant (p < 0.579) difference in length of days on AMV between participant groups.ConclusionsFurther studies are needed to determine if earlier initiation of VV-ECMO in adult patients with ARDS decrease time on AMV.Implications for NursingAlthough the results related to length of time on AMV did not produce statistical significance, the decreased duration of AMV in the participants who were cannulated within 48 hours (21 days vs. 27 days) may support several benefits associated with this participant population including increased knowledge of healthcare providers, decreased lung injury, earlier discharge which decreases hospital and patient cost, ability for patients to communicate sooner, decreased risk of pulmonary infection, decreased length of stay, decreased cost, and improved patient and family satisfaction.

Download Full-text