scholarly journals Commentary: Extracorporeal membrane oxygenation: Is it life-saving and cost effective for all patients?

JTCVS Open ◽  
2020 ◽  
Vol 1 ◽  
pp. 73-75
Author(s):  
Harold L. Lazar
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cost Effective ◽  
Membrane Oxygenation ◽  
Life Saving

Extracorporeal membrane oxygenation in pheochromocytoma-induced cardiogenic shock

2017 ◽  
Vol 26 (4) ◽  
pp. 314-316 ◽  
Author(s):  
Nadia Bouabdallaoui ◽  
Denis Bouchard ◽  
E. Marc Jolicoeur ◽  
Alexandra Chronopoulos ◽  
Pierre Y Garneau ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Clinical Value ◽  
Membrane Oxygenation ◽  
Cardiopulmonary Support ◽  
Life Saving ◽  
Adrenal Pheochromocytoma ◽  
Life Threatening

Extracorporeal membrane oxygenation has been extensively used for cardiopulmonary support in cardiogenic shock. However, its clinical value in the management of pheochromocytoma crisis remains unclear. We report a rare case of life-threatening cardiogenic shock managed with peripheral venoarterial extracorporeal membrane oxygenation combined with endovascular left ventricular venting, in a 40-year-old female patient, in the setting of unknown adrenal pheochromocytoma. We highlight the life-saving role of extracorporeal membrane oxygenation in undiagnosed endocrine emergencies, allowing cardiac and end-organ recovery, and giving time for accurate diagnosis and specific treatment in such unusual situations.

A case of recurrent systemic capillary leak syndrome triggered by influenza A infection associated with cardiogenic shock supported by veno-arterial extracorporeal membrane oxygenation

Perfusion ◽  
2021 ◽  
pp. 026765912110575
Author(s):  
Steven Kin-ho Ling ◽  
Natalie Man-chi Fong ◽  
Mandy Sze-man Chan
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Influenza A ◽  
Clinical Suspicion ◽  
Capillary Leak Syndrome ◽  
Capillary Leak ◽  
Systemic Capillary Leak Syndrome ◽  
Membrane Oxygenation ◽  
Life Saving ◽  
Va Ecmo

Systemic capillary leak syndrome (SCLS) is a rare and under-recognized disease which is potentially fatal. We report a case of SCLS triggered by influenza A infection associated with fulminant cardiogenic shock, successfully supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Strong clinical suspicion with appropriate supportive treatment can be life-saving for patients with SCLS.

Extended Indications for Extracorporeal Membrane Oxygenation in the Operating Room

2019 ◽  
Vol 35 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Barry Kelly ◽  
Edmund Carton
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Operating Room ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Ventricular Tachycardia Ablation ◽  
Membrane Oxygenation ◽  
Support Organization ◽  
Life Saving ◽  
Risk Patients ◽  
Almost All

Background:The use of extracorporeal life support (ECLS) for cardiorespiratory support is increasing. Traditional absolute contraindications are currently deemed relative contraindications. Extracorporeal life support is now considered for a wider cohort of patients on a case-by-case basis.Method:We performed a review of the literature and examined current Extracorporeal Life Support Organization guidelines that support the use of ECLS in the operating room, based on the underlying pathology and surgical procedure proposed. We discuss specific surgical populations and different modes of ECLS and cannulation strategies.Results:Based on the available literature, veno-venous extracorporeal membrane oxygenation (ECMO) can be used for the management of complex tracheobronchial and lung surgery, both in the elective and in the emergent setting. Elective veno-arterial (V-A) ECMO for cardiocirculatory support should be considered in high-risk patients undergoing ventricular tachycardia ablation. Extracorporeal life support should be considered as a potential life-saving intervention in almost all parturients with severe respiratory failure or refractory cardiogenic shock. V-A ECMO should be considered in unanticipated intraoperative cardiac arrest in patients without preexisting end-organ failure.Conclusion:As the number of indications for ECLS in the operating room is growing, anesthesiology and surgical staff should become familiar with the perioperative management of patients on ECLS.

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.

scholarly journals Suspected Heparin-Induced Thrombocytopenia in a COVID-19 Patient on Extracorporeal Membrane Oxygenation Support: A Case Report.

2020 ◽  
Author(s):  
Xuan T. Phan ◽  
Tuan Huu Nguyen ◽  
Tung T. Tran ◽  
Thu-Hien T. Huynh ◽  
Thuy-Ha T. Hoang ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Extracorporeal Membrane Oxygenation ◽  
Ecmo Support ◽  
Specific Situation ◽  
Heparin Induced Thrombocytopenia ◽  
Case Presentation ◽  
Membrane Oxygenation ◽  
Life Saving ◽  
Number Of Patients

Abstract Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating consequences and is difficult to manage. Case presentation: In this report, we present a case of a COVID-19 patient on ECMO support who was diagnosed with HIT and required intensive treatment. Initially, HIT was only suspected due to newly-developed thrombocytopenia and oxygenator dysfunction, with thrombi observed later. Regarding his treatment, since there was no recommended replacement to heparin available to us at the time of diagnosis, we decided to use rivaroxaban temporarily. No adverse events were recorded during that period. The patient was able to make a full recovery.Conclusion: HIT may jeopardize patient’s care during ECMO. As COVID-19 may bring about a surge in the number of patients requiring ECMO support, we need consented guidance to optimize treatment in this specific situation.

scholarly journals The Efficiency and Safety of Bivalirudin versus Heparin in The Anticoagulation Therapy in Extracorporeal Membrane Oxygenation: A Meta-Analysis

2021 ◽  
Author(s):  
Min Ma ◽  
Shichu Liang ◽  
Jingbo Zhu ◽  
Yong He
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Cost Effective ◽  
Cochrane Library ◽  
Thrombin Inhibitor ◽  
Membrane Oxygenation ◽  
Meta Analyses ◽  
The Cochrane Library

Abstract Background: Bivalirudin is a direct thrombin inhibitor (DTI), which can be the alternative of unfractionated heparin (UFH). The efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in Extracorporeal membrane oxygenation(ECMO) remains unclear. The purpose of the meta-analysis is to evaluate the efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in ECMO.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. A systematic literature search for original studies was performed in PubMed, EMBASE and The Cochrane Library to identify all relevant studies published prior to January 13,2021. Studies were reviewed according to eligibility and exclusion criteria. The meta-analysis was used to estimate the efficiency and safety of bivalirudin versus UFH in the anticoagulation therapy in extracorporeal membrane oxygenation. Results: 6 retrospective studies with 254 patients were eventually included for the quantitative analysis. The results showed that the incidence of major bleeding(I2=66%, P=0.16, OR=0.43, 95%CI:0.13-1.40), thrombosis(I2=0%, P=0.09<0.1, OR=0.56, 95%CI:0.29-1.09) and 30-day mortality(I2=0%, P=0.50, OR=0.90, 95%CI:0.42-1.53) was not statistically significant between the bivalirudin group and the UFH group.Conclusions:This study suggests that bivalirudin and UFH are associated with similar rates of major bleeding, thrombosis and 30-day mortality in adult and pediatric ECMO support, which is safe, practicable, dependable, and cost-effective in comparison with UFH. Bivalirudin is non-inferior to UFH in the anticoagulation therapy in ECMO.

scholarly journals Suspected Heparin-Induced Thrombocytopenia in a COVID-19 Patient on Extracorporeal Membrane Oxygenation Support: A Case Report.

2020 ◽  
Author(s):  
Xuan T. Phan ◽  
Tuan Huu Nguyen ◽  
Tung T. Tran ◽  
Thu-Hien T. Huynh ◽  
Thuy-Ha T. Hoang ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Extracorporeal Membrane Oxygenation ◽  
Ecmo Support ◽  
Specific Situation ◽  
Heparin Induced Thrombocytopenia ◽  
Case Presentation ◽  
Membrane Oxygenation ◽  
Life Saving ◽  
Number Of Patients

Abstract Background: Extracorporeal membrane oxygenation (ECMO) support can be life-saving in critically ill COVID-19 patients. However, there are many complications associated with this procedure, including Heparin-induced thrombocytopenia (HIT.) Despite its rarity in ECMO cases, HIT can lead to devastating consequences and is difficult to manage. Case presentation: In this report, we present a case of a COVID-19 patient on ECMO support who was diagnosed with HIT and required intensive treatment. Initially, HIT was only suspected due to newly-developed thrombocytopenia and oxygenator dysfunction, with thrombi observed later. Regarding his treatment, since there was no recommended replacement to heparin available to us at the time of diagnosis, we decided to use rivaroxaban temporarily. No adverse events were recorded during that period. The patient was able to make a full recovery. Conclusion: HIT may jeopardize patient’s care during ECMO. As COVID-19 may bring about a surge in the number of patients requiring ECMO support, we need consented guidance to optimize treatment in this specific situation.

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