scholarly journals Cerebrovascular accidents in patients supported with veno-arterial extra-corporeal membrane oxygenation- is duration of support important?

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Hussain ◽  
N Zero ◽  
T Al-Saadi ◽  
M Asghar ◽  
N Glowacki ◽  
...  
Keyword(s):  
Ecmo Support ◽  
P Value ◽  
Extra Corporeal Membrane Oxygenation ◽  
Cerebrovascular Accidents ◽  
Membrane Oxygenation ◽  
Funding Sources ◽  
Signed Rank ◽  
Increased Risk ◽  
Va Ecmo ◽  
Control Study

Abstract Purpose of study Veno-Arterial Extra-corporeal Membrane Oxygenation (VA-ECMO) is indicated for refractory cardiac and/or respiratory failure. Adverse events remain considerable despite best practices. We specifically aimed to understand risk factors associated with cerebrovascular accidents (CVA) in patients who underwent VA-ECMO support. Methods We retrospectively assessed all VA-ECMO patients from 2007 to 2019 at our institution. We identified those who experienced a CVA while supported by VA-ECMO. Patients with the primary event (CVA) were matched to controls (no CVA) based on age and sex. Comparisons were made between groups using McNemar's, Mantel-Haenszel, and Wilcoxon Signed-Rank tests where appropriate. Results Of the 278 VA-ECMO patients in the registry, 32 patients who experienced a CVA were identified; 24 (8.6%) ischemic and 8 (2.9%) hemorrhagic. Median age was 59.5 years (inter-quartile range: 49–65 years) and 75% of patients were males. Hypertension, diabetes, CAD and CHF were common co-morbidities (Table 1). Cardiogenic shock was the most common indication for VA-ECMO support in both cohorts, 75% in cases and 71.9% in controls. Cannulation strategies were identified as central or peripheral. There was a significant association of duration of VA-ECMO support with incidence of CVA, with a p-value of 0.03. Regression analysis showed a trend of increased risk of CVA by 4% for each additional day on VA-ECMO, however, this was not statistically significant (Odds ratio: 1.04; confidence interval 1.00–1.08). Most common outcome was death followed by decannulation to recovery and bridge to LVAD. Conclusion Ischemic and hemorrhagic CVAs are not uncommon during VA-ECMO support. Our case control study shows an association of duration of VA-ECMO support with incidence of CVA. This underscores the importance of timely assessment and weaning or bridging of VA-ECMO patients to their next management step. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Anticoagulation after VA-ECMO decannulation, providing new insights

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
A Maestro-Benedicto ◽  
A Duran-Cambra ◽  
M Vila-Perales ◽  
J Sans-Rosello ◽  
J Carreras-Mora ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Anticoagulation Therapy ◽  
Thromboembolic Events ◽  
Bleeding Events ◽  
Membrane Oxygenation ◽  
Funding Sources ◽  
Va Ecmo ◽  
A Prospective Study

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential tool for the management of refractory cardiogenic shock. Little is known about the incidence of thromboembolic events after V-A ECMO decannulation, although some studies report a high incidence of cannula-related venous thrombosis after venovenous extracorporeal membrane oxygenation (VV-ECMO). Due to this fact, in our institution anticoagulation therapy is systematically prescribed for at least 3 months after VA-ECMO per protocol.  AIM The main objective of this study was to explore the feasibility of 3-month anticoagulation therapy after VA-ECMO decannulation. METHODS We performed a prospective study that included 27 consecutive patients who were successfully treated with VA-ECMO in a medical ICU between 2016 and 2019 and were prescribed 3-month anticoagulation therapy per protocol after decannulation. Exclusion criteria was dying on ECMO or while on the ICU. Data analysis included demographics, mean days on ECMO, 3-month survival, and thromboembolic and bleeding events (excluding immediate post-decannulation bleeding, since anticoagulation was prescribed 24h after). RESULTS Our cohort consisted mainly of men (N = 21, 78%), with a mean age of 60 ± 11 years and a mean time on VA-ECMO of 8 ± 3 days, who primarily suffered from post-cardiotomy cardiogenic shock (N = 9, 34%) or acute myocardial infarction (N = 6, 23%). 5 patients (18%) received a heart transplant. Regarding anticoagulation, 15 patients (60%) had other indications apart from the protocol, like incidental thrombus diagnosis (N = 7, 26%) or valve surgery (N = 5, 18%). Anticoagulation therapy was not feasible in 1 patient (4%) with severe thrombopenia. No patients had severe or life-threatening bleeding events in the follow-up, although 8 patients (30%) had bleeding events, mainly gastrointestinal bleeding (N = 4, 15%), requiring withdrawal of anticoagulation in 1 patient. The incidence of thromboembolic events was 7%; two patients with low-risk pulmonary embolisms. During the 3-month follow-up survival rate was 95%. CONCLUSIONS This is the only study to date addressing the strategy of 3-month anticoagulation therapy after VAECMO, showing it is feasible and safe and may be helpful in reducing or ameliorate thromboembolic complications in the follow-up, although it is not exempt of complications. Abstract Figure. Kaplan-Meier survival analysis

Abstract P131: Is Older Age (≥ 65 years old) Associated with Increased Mortality Following Extra-Corporeal Membrane Oxygenation?

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
David L Narotsky ◽  
Matthew Mosca ◽  
Ming Liao ◽  
Linda Mongero ◽  
James Beck ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Academic Medical Center ◽  
Bypass Graft ◽  
Older Age ◽  
Extra Corporeal Membrane Oxygenation ◽  
Comorbid Conditions ◽  
Membrane Oxygenation ◽  
Increased Risk ◽  
Social Security Death Index ◽  
Race Ethnicity

Background: Extra-corporeal membrane oxygenation (ECMO) is increasingly being used as a life-saving bypass technique for patients whose acute cardiopulmonary failure is potentially reversible and refractory to conventional care. Prognostic data for ECMO among diverse patients are limited. The purpose of this study was to evaluate the association between age (≥ 65 vs. <65 years) and 1-year mortality after ECMO, adjusted for confounders. Methods: This was a retrospective cohort analysis of 131 consecutive adult patients (28% ≥65 years old, 26% racial/ethnic minority, 38% female) enrolled in an ECMO database who received veno-arterial ECMO at an academic medical center between 2004-2013. Demographics, comorbid conditions, admission characteristics, and mortality status at 1 year were obtained from the hospital clinical information system, updated monthly with Social Security Death Index data. Univariate and multivariate adjusted Cox proportional hazard analyses were conducted to evaluate the associations between age strata and post-ECMO mortality. Results: The 1-year mortality rate post-ECMO was 56% (n=73). Age ≥ 65 vs. <65 was significantly associated with increased mortality (HR=1.8; 95% CI=1.1-2.9); the association was attenuated and did not retain statistical significance after adjustment for comorbid conditions (HR=1.4; 95% CI=0.8-2.5). Figure 1 illustrates mortality risk by age strata adjusted for: a) demographics (race/ethnicity and sex) and b) demographics and comorbid conditions. Race/ethnicity and sex were not significantly associated with 1-year mortality. Significant predictors of mortality included: Medicaid vs. other health insurance status, history of coronary artery bypass graft surgery, peripheral vascular disease, renal failure, dialysis, and shock (p<0.05). Conclusion: Older age (≥65) was not independently associated with 1-year mortality among ECMO patients, but may indicate higher comorbidity, which was associated with increased risk of mortality in the year following ECMO.

Abstract 16543: Severe Thrombocytopenia is Common in Adults Undergoing Venoarterial Extracorporeal Membrane Oxygenation and is Predictive of Hemorrhage

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tia C Kohs ◽  
Vikram Raghunathan ◽  
Patricia Liu ◽  
Ramin Amirsoltani ◽  
Michael Oakes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Logistic Regression ◽  
Platelet Count ◽  
Extracorporeal Membrane Oxygenation ◽  
Clinical Implications ◽  
Severe Thrombocytopenia ◽  
Multivariate Logistic Regression ◽  
Membrane Oxygenation ◽  
Increased Risk ◽  
Va Ecmo

Introduction: Extracorporeal membrane oxygenation (ECMO) is used to provide circulatory support and facilitate gas exchange via cardiopulmonary bypass. The relationship between ECMO and the incidence of severe thrombocytopenia (platelet count <50 x 10 9 /L) and subsequent clinical consequences are ill defined. We aimed to identify the risk factors for the development of thrombocytopenia and its clinical implications. Methods: This is a single-center retrospective cohort study of adults who received venoarterial (VA) ECMO. We examined consecutive platelet counts while on ECMO. Univariate logistic regression was used to determine if mean platelet count, platelet count range, or severe thrombocytopenia were predictors of overall survival, hemorrhage and thrombosis. A multivariate logistic regression model was used to identify factors that contribute to the development of the aforementioned patient outcomes. Results: In our cohort, 33 patients were included with a mean age of 55 years and duration of ECMO of 5.9 days. All patients received heparin, 33.3% received antiplatelet therapy and 45.5% developed severe thrombocytopenia. In univariate, analysis the development of severe thrombocytopenia increased the odds of major bleeding by 450% (OR 5.500, 95% CI 1.219 - 24.813, P -value 0.027), and the odds of surviving hospitalization decreased 84.1% (OR 0.159, 95% CI 0.033 - 0.773, P -value 0.023). Multivariate logistic regression controlling for additional clinical variables found no significant association between the development of severe thrombocytopenia and rates of thrombosis, hemorrhage, or overall survival. Platelet count decreased over time while on ECMO. Conclusions: Nearly half of the patients requiring VA-ECMO developed severe thrombocytopenia, which was associated with an increased risk of hemorrhage and in-hospital mortality. Additional studies are required to clarify the clinical implications of severe thrombocytopenia in ECMO patients.

Impact of extracorporeal membrane oxygenation (ECMO) support on piperacillin exposure in septic patients: a case–control study

2021 ◽  
Author(s):  
P Fillâtre ◽  
F Lemaitre ◽  
N Nesseler ◽  
M Schmidt ◽  
S Besset ◽  
...  
Keyword(s):  
Steady State ◽  
Extracorporeal Membrane Oxygenation ◽  
Creatinine Clearance ◽  
Sofa Score ◽  
Case Control Study ◽  
Case Control ◽  
Ecmo Support ◽  
Icu Patients ◽  
Membrane Oxygenation ◽  
Control Study

Abstract Objectives To describe the impact of extracorporeal membrane oxygenation (ECMO) devices on piperacillin exposure in ICU patients. Methods This observational, prospective, multicentre, case–control study was performed in the ICUs of two tertiary care hospitals in France. ECMO patients with sepsis treated with piperacillin/tazobactam were enrolled. Control patients were matched according to SOFA score and creatinine clearance. The pharmacokinetics of piperacillin were described based on a population pharmacokinetic model, calculating the proportion of time the piperacillin plasma concentration was above 64 mg/L (i.e. 4× MIC breakpoint for Pseudomonas aeruginosa). Results Forty-two patients were included. Median (IQR) age was 60 years (49–66), SOFA score was 11 (9–14) and creatinine clearance was 47 mL/min (5–95). There was no significant difference in the proportion of time piperacillin concentrations were ≥64 mg/L in patients treated with ECMO and controls during the first administration (P = 0.184) or at steady state (P = 0.309). Following the first administration, 36/42 (86%) patients had trough piperacillin concentrations &lt;64 mg/L. Trough concentrations at steady state were similar in patients with ECMO and controls (P = 0.535). Creatinine clearance ≥40 mL/min was independently associated with piperacillin trough concentration &lt;64 mg/L at steady state [OR = 4.3 (95% CI 1.1–17.7), P = 0.043], while ECMO support was not [OR = 0.5 (95% CI 0.1–2.1), P = 0.378]. Conclusions ECMO support has no impact on piperacillin exposure. ICU patients with sepsis are frequently underexposed to piperacillin, which suggests that therapeutic drug monitoring should be strongly recommended for severe infections.

Cost-effectiveness of Argatroban Versus Heparin Anticoagulation in Adult Extracorporeal Membrane Oxygenation Patients

2019 ◽  
pp. 001857871989009
Author(s):  
Angelina E. Cho ◽  
Kathleen Jerguson ◽  
Joy Peterson ◽  
Deepa V. Patel ◽  
Asif A. Saberi
Keyword(s):  
Cost Effectiveness ◽  
Extracorporeal Membrane Oxygenation ◽  
Average Cost ◽  
P Value ◽  
Bleeding Events ◽  
Membrane Oxygenation ◽  
Increased Risk ◽  
Heparin Anticoagulation ◽  
Ischemic Events ◽  
Ecmo Therapy

Purpose: The purpose of this study was to evaluate the cost effectiveness of argatroban compared to heparin during extracorporeal membrane oxygenation (ECMO) therapy. Methods: This was a retrospective study of patients who received argatroban or heparin infusions with ECMO therapy at a community hospital between January 1, 2017 and June 30, 2018. Adult patients who received heparin or argatroban for at least 48 hours while on venovenous (VV) or venoarterial (VA) ECMO were included. Patients with temporary mechanical circulatory assist devices were excluded. Each continuous course of anticoagulant exposure that met the inclusion criteria was evaluated. The primary endpoint was the total cost of anticoagulant therapy for heparin versus argatroban, including all administered study drugs, blood or factor products, and associated laboratory tests. Secondary endpoints included safety and efficacy of anticoagulation with each agent during ECMO. Documentation of bleeding events, circuit clotting, and ischemic events were noted. Partial thromboplastin time (PTT) values were evaluated for time to therapeutic range and percentage of therapeutic PTTs. Results: A total of 11 courses of argatroban and 24 courses of heparin anticoagulation were included in the study. The average cost per course of argatroban was less than the average cost per course of heparin ($7,091.98 vs $15,323.49, respectively; P value = 0.15). Furthermore, argatroban was not associated with an increased incidence of bleeding, thrombotic, or ischemic events. Conclusion: Argatroban may be more cost-effective during ECMO therapy in patients with low antithrombin III levels without increased risk of adverse events.

A retrospective cohort analysis of percutaneous versus side-graft perfusion techniques for veno-arterial extracorporeal membrane oxygenation in patients with refractory cardiogenic shock

Perfusion ◽  
2016 ◽  
Vol 32 (5) ◽  
pp. 363-371 ◽  
Author(s):  
Mehmet Cakici ◽  
Evren Ozcinar ◽  
Cagdas Baran ◽  
Ahmet Onat Bermede ◽  
Mehmet Cahit Sarıcaoglu ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Femoral Artery ◽  
Vascular Complications ◽  
Ecmo Support ◽  
Acute Limb Ischemia ◽  
Membrane Oxygenation ◽  
Refractory Cardiogenic Shock ◽  
Cannulation Site ◽  
Va Ecmo

Objectives: This study was designed to compare vascular complications and the outcomes of ultrasound (US)-guided percutaneous cannulation with distal perfusion catheter (PC-DP) and arterial side-graft perfusion (SGP) techniques in patients who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock (RCS). Methods: We conducted a retrospective, observational cohort study of consequtive patients with RCS treated with VA-ECMO at a single transplant center from March 2010 until August 2015. Overall, 148 patients underwent VA-ECMO for RCS (99 men, aged 56.6 ± 12.0 years; BSA, 1.85 ± 0.19). Patients were categorized based on VA-ECMO perfusion technique into PC-DP via femoral artery and SGP via axillary/femoral artery groups. Results: The median duration of VA-ECMO support was 5 days (range, 8 hours–80 days). Hospital mortality (PC-DP group, 54.7%; SGP group, 64.4%; p=0.23) and overall ECMO survival (PC-DP group, 36.9%; SGP group, 32.2%; p=0.47) was similar between the groups. There were no significant between-group differences in the rate of acute limb ischemia (PC-DP group, 4/75, 5.3%; SGP group, 2/73, 2.7%; p=0.68). However, the rate of surgical/cannulation site bleeding (PC-DP, 9/75 (12%) vs SGP, 18/73 (24.7%), p=0.05) and hyperperfusion syndrome (PC-DP, 2/75 (2.7%) vs SGP, 22/73 (30.1%),p=0.001) were higher in the SGP group than in the PC-DP group. Conclusions: We observed no significant difference in major vascular complications or survival between patients who underwent the PC-DP technique and those who underwent arterial SGP.

scholarly journals Upper Gastrointestinal Bleeding in Adults Under Veno-Arterial Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
jules stern ◽  
Claire Dupuis ◽  
Jean Reuter ◽  
Camille Vinclair ◽  
Marylou Para ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Extracorporeal Membrane Oxygenation ◽  
Upper Gastrointestinal Bleeding ◽  
Univariate Analysis ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Claude Bernard ◽  
Increased Risk ◽  
Va Ecmo ◽  
Upper Gastrointestinal

Abstract Objective. Upper gastrointestinal bleeding is a common complication in adults treated with veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for refractory cardiogenic shock or cardiac arrest. We aimed to determine risk factors, prevalence and outcomes associated with upper gastrointestinal bleeding (UGIB) in adult patients under VA-ECMO.Design. We conducted a retrospective cohort study (2014-2017) on consecutive VA-ECMO patients.Setting. Medical and Infectious Disease intensive care unit of university hospital Bichat-Claude Bernard in Paris, France.Patients. UGIB was defined as 1) an overt bleeding (hematemesis, melena, hematochezia), or 2) acute anemia associated with a lesion diagnosed on upper gastrointestinal endoscopy. Cause-specific models were used to identify factors associated with UGIB and death, respectively.Measurements and Main Results. 257 patients were included, of whom 48 (19%) were diagnosed with UGIB after a median of 18 [7; 43] days following cannulation; median SAPS II was 59 [43; 76]. 100 (39%) patients were implanted after cardiac surgery. Mortality occurred in 31 (65%) patients with UGIB and 121 (58%) patients without. UGIB patients had longer ICU stays (41 [19; 82] vs. 15 [6; 26]; p<.01), longer ECMO (10.5 [7; 15] vs 6 [3; 10]; p <.01) and mechanical ventilation durations (31 [18; 45] vs. 9 [5; 18]; p <.01) in days, as compared to non-UGIB patients. Ninety-nine upper gastrointestinal endoscopies (UGE) were performed and the most frequent lesions detected were gastro-duodenal ulcers (n=28, 28%), leading to 12/99 therapeutic procedures. Neither antiplatelet therapy prior to ICU admission nor a history of peptic ulcer were associated with UGIB in univariate analysis. By multivariate analysis (table), a BMI (body mass index) > 30 kg/m2 (Cause-specific hazard ratio (CSHR) [95% CI]): 3.06 [1.56; 5.98]), and extracorporeal cardiopulmonary resuscitation (ECPR) (CSHR 2.34 [1.03; 5.35]) were independently associated with an increased risk of UGIB. Conclusions. In adult patients under VA-ECMO, obesity and ECPR were independently associated with UGIB. This study highlights the potential role of obesity and acute ischemia reperfusion injury in the pathophysiology of VA-ECMO-associated UGIB.

scholarly journals Use of mechanical pulmonary reperfusion and fibrinolysis in acute massive pulmonary embolism requiring extracorporeal membrane oxygenation support: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Chopard ◽  
P Nielsen ◽  
F Ius ◽  
H Pilichowski ◽  
N Meneveau
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Meta Analysis ◽  
Reperfusion Therapy ◽  
Massive Pulmonary Embolism ◽  
Membrane Oxygenation ◽  
Funding Sources ◽  
Surgical Embolectomy ◽  
Meta Regression ◽  
Va Ecmo

Abstract Background and objectives The optimal pulmonary revascularization strategy in acute massive pulmonary embolism (PE) requiring the implantation extra corporeal membrane oxygenation remains controversial, and data are sparse. Methods We conducted a systematic review and meta-analysis of available evidence regarding the use of mechanical reperfusion (i.e. surgical or catheter-based embolectomy) and fibrinolytic strategies (i.e. systemic fibrinolysis, catheter-directed fibrinolysis, or as stand-alone therapy) in terms of mortality and bleeding outcomes. Results The literature search identified 835 studies, 17 of which were included or a total of 321 PE patients with ECMO. In total, 31.1% were treated with mechanical pulmonary reperfusion, while 78.9% received fibrinolytic strategies. The mortality rate was 23.0% in the mechanical reperfusion group and 43.1% in the fibrinolysis group (Figure). The pooled OR for mortality with mechanical reperfusion was 0.46 (95% CI, 0.213–0.997; I2=28.3%) versus fibrinolysis. The rate of bleeding in PE patients under ECMO was 29.1% in the mechanical reperfusion group and 26.0% in the fibrinolytic reperfusion (OR, 1.09; 95% CI, 0.46–2.54; I2=0.0%) among 10 eligible studies with available bleeding data. The meta-regression model did not identify any relationship between the covariates “more than one pulmonary reperfusion therapy” and “ECMO implantation before pulmonary reperfusion therapy”, and outcomes. Conclusions The results of the present meta-analysis and meta-regression suggest that surgical embolectomy yields the best results, regardless of the timing of VA-ECMO implantation in the reperfusion timeline, and regardless of whether fibrinolysis has been administered or not. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals An Ovine Model of Awake Veno-Arterial Extracorporeal Membrane Oxygenation

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiachen Qi ◽  
Sizhe Gao ◽  
Gang Liu ◽  
Shujie Yan ◽  
Min Zhang ◽  
...  
Keyword(s):  
Animal Models ◽  
Extracorporeal Membrane Oxygenation ◽  
Management Strategies ◽  
Ecmo Support ◽  
Large Animal ◽  
Ovine Model ◽  
Membrane Oxygenation ◽  
Large Animal Models ◽  
Cannulation Site ◽  
Va Ecmo

Background: Large animal models are developed to help understand physiology and explore clinical translational significance in the continuous development of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) technology. The purpose of this study was to investigate the establishment methods and management strategies in an ovine model of VA-ECMO.Methods: Seven sheep underwent VA-ECMO support for 7 days by cannulation via the right jugular vein and artery. The animals were transferred into the monitoring cages after surgery and were kept awake after anesthesia recovery. The hydraulic parameters of ECMO, basic hemodynamics, mental state, and fed state of sheep were observed in real time. Blood gas analysis and activated clotting time (ACT) were tested every 6 h, while the complete blood count, blood chemistry, and coagulation tests were monitored every day. Sheep were euthanized after 7 days. Necropsy was performed and the main organs were removed for histopathological evaluation.Results: Five sheep survived and successfully weaned from ECMO. Two sheep died within 24–48 h of ECMO support. One animal died of fungal pneumonia caused by reflux aspiration, and the other died of hemorrhagic shock caused by bleeding at the left jugular artery cannulation site used for hemodynamic monitoring. During the experiment, the hemodynamics of the five sheep were stable. The animals stayed awake and freely ate hay and feed pellets and drank water. With no need for additional nutrition support or transfusion, the hemoglobin concentration and platelet count were in the normal reference range. The ECMO flow remained stable and the oxygenation performance of the oxygenator was satisfactory. No major adverse pathological injury occurred.Conclusions: The perioperative management strategies and animal care are the key points of the VA-ECMO model in conscious sheep. This model could be a platform for further research of disease animal models, pathophysiology exploration, and new equipment verification.

scholarly journals The Expanding Role of Extracorporeal Membrane Oxygenation Retrieval Services in Australia

2017 ◽  
Vol 45 (1) ◽  
pp. 92-93 ◽  
Author(s):  
J. J. B. Edelman ◽  
M. K. Wilson ◽  
M. P. Vallely ◽  
P. G. Bannon ◽  
G. McKay ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Ecmo Support ◽  
Referral Hospital ◽  
Model Of Care ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Membrane Oxygenation ◽  
Va Ecmo ◽  
Ecmo Centre

Herein we detail the cases of three patients transferred on veno-arterial extracorporeal membrane oxygenation (VA ECMO) from a tertiary referral hospital to an ECMO centre. We highlight the benefits of such a transfer and offer this as a model of care for unwell patients likely to require a prolonged period of ECMO support.

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