scholarly journals Transportation of patients on extracorporeal membrane oxygenation: a tertiary medical center experience and systematic review of the literature

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Pedro Vitale Mendes ◽  
Cesar de Albuquerque Gallo ◽  
Bruno Adler Maccagnan Pinheiro Besen ◽  
Adriana Sayuri Hirota ◽  
Raquel de Oliveira Nardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Extracorporeal Membrane Oxygenation ◽  
Medical Center ◽  
Transportation Of Patients ◽  
Review Of The Literature ◽  
Membrane Oxygenation

scholarly journals Review of the Literature on the Occurrence of Delirium after Veno-Venous and Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review

2019 ◽  
Vol 9 (3) ◽  
pp. 374-380
Author(s):  
Sabina Krupa ◽  
Dorota Ozga
Keyword(s):  
Systematic Review ◽  
Extracorporeal Membrane Oxygenation ◽  
Cochrane Collaboration ◽  
Risk Of Bias ◽  
Review Of The Literature ◽  
Exchange Method ◽  
Membrane Oxygenation ◽  
Extracorporeal Gas Exchange ◽  
The Subject ◽  
Ecmo Therapy

Introduction: Extracorporeal membrane oxygenation (ECMO) is an extracorporeal gas exchange method which, despite a number of advantages, carries the risk of many complications. ECMO is a modern intensive care method which in many cases is the last resort for the patient. Care and supervision are provided by a multidisciplinary team of specialists: physicians, perfusionists, and nurses. The aim of this review is to analyze the occurrence of delirium in ECMO patients. Methods: Both authors independently extracted data from all included trials and assessed the risk of bias. A systematic review was performed using the protocol of the Cochrane Collaboration Risk of Bias tool. The search was based on PubMed, Web of Science, and Mendeley. Three articles from recent years have been analyzed in this work. Literature selection was made using the PRISMA checklist. The analyzed literature proves how important the topic of delirium is in ECMO therapy. In the case of pharmacotherapy, there are many combinations of drugs that prevent the occurrence of the delirium phenomenon. Results: This work deals with the subject of delirium after ECMO, which is not a common subject in the popular literature. Many of the elements mentioned in the articles analyzed show how important this topic is. The authors place great emphasis on the elements which are not related to pharmacotherapy and the prevention of delirium. For the prevention of delirium after ECMO, a psychological approach to the patient is important. As far as pharmacotherapy is concerned, it is the last element to be taken into account in the prevention of delirium in ECMO patients. An overview of the literature indicates that the subject of nursing care has been omitted; however, there are tools which allow nurses to assess delirium in patients. Conclusion: Delirium in patients undergoing ECMO therapy is a topic that has not been fully described in the literature. This review of the literature shows how important it is to treat a patient with delirium during this therapy and how important it may be to have an early diagnosis of delirium to prevent complications.

Adenosine Infusion Improves Oxygenation in Term Infants With Respiratory Failure

PEDIATRICS ◽  
1996 ◽  
Vol 97 (3) ◽  
pp. 295-300
Author(s):  
G. Ganesh Konduri ◽  
Daisy C. Garcia ◽  
Nadya J. Kazzi ◽  
Seetha Shankaran
Keyword(s):  
Pulmonary Hypertension ◽  
Placebo Group ◽  
Extracorporeal Membrane Oxygenation ◽  
Normal Saline ◽  
Medical Center ◽  
Blood Gases ◽  
Adenosine Infusion ◽  
Term Infants ◽  
Membrane Oxygenation ◽  
Arterial Blood

Objective. Adenosine infusion causes selective pulmonary vasodilation in fetal and neonatal lambs with pulmonary hypertension. We investigated the effects of a continuous infusion of adenosine on oxygenation in term infants with persistent pulmonary hypertension of newborn (PPHN). Design. A randomized, placebo-controlled, masked trial comparing the efficacy of intravenous infusion of adenosine to normal saline infusion over a 24-hour period. Setting. Inborn and outborn level III neonatal intensive care units at a university medical center. Participants. Eighteen term infants with PPHN and arterial postductal Po2 of 60 to 100 Torr on inspired O2 concentration of 100% and optimal hyperventilation (PaCo2 <30 Torr) were enrolled into the study. Study infants were randomly assigned to receive a placebo infusion of normal saline, or adenosine infusion in doses of 25 to 50 µg/kg/min over a 24-hour period. Results. Nine infants each received adenosine or placebo. The two groups did not differ in birth weight, gestational age, or blood gases and ventilator requirements at the time of entry into the study. Four of nine infants in the adenosine group and none of the placebo group had a significant improvement in oxygenation, defined as an increase in postductal PaO2 of ≥20 Torr from preinfusion baseline. The mean PaO2 in the adenosine group increased from 69 ± 19 at baseline to 94 ± 15 during 50 µg/kg/min infusion rate of adenosine and did not change significantly in the placebo group. Arterial blood pressure and heart rate did not change during the study in either group. The need for extracorporeal membrane oxygenation, incidence of bronchopulmonary dysplasia, and mortality were not different in the two groups. Conclusion. Data from this pilot study indicate that adenosine infusion at a dose of 50 µg/kg/min improves PaO2 in infants with PPHN without causing hypotension or tachycardia. Larger trials are needed to determine its effects on mortality and/or need for extracorporeal membrane oxygenation in infants with PPHN.

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