Extracorporeal carbon dioxide removal may prevent the need for extracorporeal membrane oxygenation in severe respiratory failure

2020 ◽  
Vol 37 (10) ◽  
pp. 950-952
Author(s):  
David Pestaña ◽  
Antonio Gomis ◽  
Raúl de Pablo ◽  
María T. Tenorio
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Carbon Dioxide Removal ◽  
Severe Respiratory Failure ◽  
Extracorporeal Carbon Dioxide Removal ◽  
Membrane Oxygenation

scholarly journals Extracorporeal Membrane Oxygenation for Respiratory Failure

2020 ◽  
Vol 132 (5) ◽  
pp. 1257-1276 ◽  
Author(s):  
Michael Quintel ◽  
Robert H. Bartlett ◽  
Michael P. W. Grocott ◽  
Alain Combes ◽  
Marco V. Ranieri ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Carbon Dioxide Removal ◽  
Chronic Obstructive ◽  
Extracorporeal Carbon Dioxide Removal ◽  
Hypoxemic Respiratory Failure ◽  
Membrane Oxygenation ◽  
Technical Developments ◽  
Extracorporeal Lung Support

Abstract This review focuses on the use of veno-venous extracorporeal membrane oxygenation for respiratory failure across all blood flow ranges. Starting with a short overview of historical development, aspects of the physiology of gas exchange (i.e., oxygenation and decarboxylation) during extracorporeal circulation are discussed. The mechanisms of phenomena such as recirculation and shunt playing an important role in daily clinical practice are explained. Treatment of refractory and symptomatic hypoxemic respiratory failure (e.g., acute respiratory distress syndrome [ARDS]) currently represents the main indication for high-flow veno-venous-extracorporeal membrane oxygenation. On the other hand, lower-flow extracorporeal carbon dioxide removal might potentially help to avoid or attenuate ventilator-induced lung injury by allowing reduction of the energy load (i.e., driving pressure, mechanical power) transmitted to the lungs during mechanical ventilation or spontaneous ventilation. In the latter context, extracorporeal carbon dioxide removal plays an emerging role in the treatment of chronic obstructive pulmonary disease patients during acute exacerbations. Both applications of extracorporeal lung support raise important ethical considerations, such as likelihood of ultimate futility and end-of-life decision-making. The review concludes with a brief overview of potential technical developments and persistent challenges.

Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database

2009 ◽  
Vol 35 (12) ◽  
pp. 2105-2114 ◽  
Author(s):  
Thomas V. Brogan ◽  
Ravi R. Thiagarajan ◽  
Peter T. Rycus ◽  
Robert H. Bartlett ◽  
Susan L. Bratton
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Severe Respiratory Failure ◽  
Membrane Oxygenation

Repair of iatrogenic tracheal injury in acute respiratory failure with veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2020 ◽  
Vol 36 (1) ◽  
pp. 100-102
Author(s):  
Pauline H Go ◽  
Albert Pai ◽  
Sharon B Larson ◽  
Kalpaj Parekh
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Severe Respiratory Failure ◽  
Tracheal Injury ◽  
Lung Isolation ◽  
Membrane Oxygenation

Iatrogenic tracheal injuries are rare but potentially serious complications of endotracheal intubation that frequently require lung isolation to repair. This is not tolerated in patients with severe respiratory failure. We describe a case in a patient with acute respiratory distress syndrome, repaired using veno-venous extracorporeal membrane oxygenation.

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