scholarly journals Early usage of extracorporeal membrane oxygenation in the absence of invasive mechanical ventilation to treat COVID-19-related hypoxemic respiratory failure

ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pranav Loyalka ◽  
Faisal H. Cheema ◽  
Harshit Rao ◽  
J. Eduardo Rame ◽  
Keshava Rajagopal
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Invasive Mechanical Ventilation ◽  
Hypoxemic Respiratory Failure ◽  
Membrane Oxygenation

Traumatic respiratory failure and veno-venous extracorporeal membrane oxygenation support

Perfusion ◽  
2021 ◽  
pp. 026765912110128
Author(s):  
Ismael A Salas De Armas ◽  
Bindu Akkanti ◽  
Pratik B Doshi ◽  
Manish Patel ◽  
Sachin Kumar ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Injury Severity ◽  
Invasive Mechanical Ventilation ◽  
Ecmo Support ◽  
Trauma Patients ◽  
Membrane Oxygenation ◽  
Trauma Service ◽  
Proper Patient Selection ◽  
Vv Ecmo

Background: Respiratory failure (RF) is a common cause of death and morbid complication in trauma patients. Extracorporeal membrane oxygenation (ECMO) is increasingly used in adults with RF refractory to invasive mechanical ventilation. However, use of ECMO remains limited for this patient population as they often have contraindications for anticoagulation. Study design: Medical records were retroactively searched for all adult patients who were admitted to the trauma service and received veno-venous ECMO (VV ECMO) support between June 2015 and August 2018. Survival to discharge and ECMO-related complications were collected and analyzed. Results: Fifteen patients from a large Level I trauma center met the criteria. The median PaO2/FiO2 ratio was 53.0 (IQR, 27.0–76.0), median injury severity score was 34.0 (IQR, 27.0–43.0), and the median duration of ECMO support was 11 days (IQR, 7.5–20.0). For this cohort, the survival-to-discharge rate was 87% (13/15). The incidence of neurologic complications was 13%, and deep vein thrombosis was reported in two cases (13%). Conclusions: Survival rates of trauma patients in this study are equivalent to, or may exceed, those of non-trauma patients who receive ECMO support for other types of RF. With the employment of a multidisciplinary team assessment and proper patient selection, early cannulation, traumatic RF may be safely supported with VV ECMO in experienced centers.

scholarly journals Drotrecogin Alpha (Activated) in Two Patients with the Hantavirus Cardiopulmonary Syndrome

2006 ◽  
Vol 13 (5) ◽  
pp. 272-274 ◽  
Author(s):  
Robert C McDermid ◽  
RT Noel Gibney ◽  
Ronald J Brisebois ◽  
Neil M Skjodt
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Definitive Diagnosis ◽  
Endothelial Injury ◽  
Capillary Leak ◽  
Hypoxemic Respiratory Failure ◽  
Vasoactive Medications ◽  
Drotrecogin Alpha

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.

scholarly journals Extracorporeal membrane oxygenation as rescue therapy for severe hypoxemic respiratory failure

2019 ◽  
Vol 11 (S14) ◽  
pp. S1688-S1697 ◽  
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

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

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.

Outcome and Management of Refractory Respiratory Failure With Timely Extracorporeal Membrane Oxygenation: Single-Center Experience With Legionella Pneumonia

2017 ◽  
Vol 34 (4) ◽  
pp. 344-350 ◽  
Author(s):  
Roberto Roncon-Albuquerque ◽  
Rodrigo Vilares-Morgado ◽  
Gert-Jan van der Heijden ◽  
João Ferreira-Coimbra ◽  
Paulo Mergulhão ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Ecmo Support ◽  
Lung Protective Ventilation ◽  
Survival Prediction ◽  
High Survival ◽  
Membrane Oxygenation ◽  
Legionella Pneumonia

Objective: To analyze the management and outcome of patients with refractory respiratory failure complicating severe Legionella pneumonia rescued with extracorporeal membrane oxygenation (ECMO) in our Center. Design and Setting: Observational study of patients with refractory respiratory failure treated with ECMO in Hospital S.João (Porto, Portugal), between November 2009 and September 2016. Participants: A total of 112 patients rescued with ECMO, of which 14 had Legionella pneumonia. Results: Patients with Legionella pneumonia were slightly older than patients with acute respiratory failure of other etiologies (51 [48-56] vs 45 [35-54]), but with no significant differences in acute respiratory failure severity between groups: Pao2/Fio2 ratio 67 (60-75) versus 69 (55-85) and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction score 4 (1-5) versus 2 (-1-4), respectively. Legionella pneumonia was associated with earlier ECMO initiation (days of invasive mechanical ventilation [IMV] before ECMO: 2.0 [1.0-4.0] vs 5.0 [2.0-9.5]). After IMV adjustment to “lung rest” settings, this group presented higher respiratory system (RS) static compliance (28.7 [18.8-37.4] vs 16.0 [10.0-20.8] mL/cmH2O) but required higher ECMO support (blood flow 5.0 [4.3-5.4] vs 4.2 [3.6-4.8]). Patients with Legionella pneumonia had shorter IMV (16 [14-23] vs 27 [20-42] days) and lower incidence of intensive care unit nosocomial infections (35.7% vs 64.3%), with a trend to higher hospital survival (85.7% vs 62.2%; P = .13). Conclusion: In Legionella pneumonia complicated by refractory respiratory failure, ECMO support allowed patient stabilization under lung protective ventilation and high survival rates. Timely ECMO referral should be considered for Legionella pneumonia failing conventional treatment.

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