Extracorporeal Lung Assist Devices

Kavita, Murughan; Ramanathan, Kollengode

doi:10.1007/978-3-030-40679-0_88

Cited by 1 publication

(5 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ECMO is a relatively young modality that evolved from cardiopulmonary bypass [23]. In essence, ECMO can be considered as a protracted bypass and therapeutic takeover of pulmonary or cardiac function by mechanical devices.…”

Section: The Ecmo Ins and Outsmentioning

confidence: 99%

“…Driven by therapeutic goals, cannula configuration is applied to support the heart, lungs, or both. Venovenous VV-ECMO places both inflow and outflow cannulas in the venous system, allowing for gas exchange support in the absence of severe cardiac function impairment [23,26,27]. The ECMO circuit is integrated serially into the patient's circulation in this configuration.…”

Section: The Ecmo Ins and Outsmentioning

confidence: 99%

“…Conversely, venoarterial ECMO (VA-ECMO) places the intake cannula in the venous system while the outflow is placed into an arterial vessel. This configuration supports lung and cardiac functions [14,23,27]. The circuit is placed in parallel to the heart, allowing for differential support of the cardiac function.…”

Section: The Ecmo Ins and Outsmentioning

confidence: 99%

“…Infection is the main driver for ECMO initiation, with meta-analysis of the CESAR and EOLIA trials finding ARDS to be the main indication for initiation of said therapy, with >60% being precipitated by pneumonia [1,[6][7][8]13,23]. The risks factors for developing infection include more severally sick patients, ongoing immunosuppressive treatment targeting autoimmune diseases, prolonged cannulation, and VA ECMO [8,14].…”

Section: Infection and Ecmomentioning

confidence: 99%

“…The need for understanding how to optimize antibiotics effectiveness in ECMOrelated situations is critical as the implementation and indications of the ECMO continues to progress, while the emergence of ECMO-derivative techniques such as a CO 2 -removal device, Impella, intra-aortic balloon counterpulsation, and cytokine scavengers add other variables to understanding distribution, activity and metabolism of antibiotics in these situations [6,7,[22][23][24][25]. Given the increasing utilization of ECMO in the setting of systemic infection, an understanding of the interactions between said therapies and antibiotics is paramount to successful patient care.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Antibiotics and ECMO in the Adult Population—Persistent Challenges and Practical Guides

2022

View full text Add to dashboard Cite

Extracorporeal membrane oxygenation (ECMO) is an emerging treatment modality associated with a high frequency of antibiotic use. However, several covariables emerge during ECMO implementation, potentially jeopardizing the success of antimicrobial therapy. These variables include but are not limited to: the increased volume of distribution, altered clearance, and adsorption into circuit components, in addition to complex interactions of antibiotics in critical care illness. Furthermore, ECMO complicates the assessment of antibiotic effectiveness as fever, or other signs may not be easily detected, the immunogenicity of the circuit affects procalcitonin levels and other inflammatory markers while disrupting the immune system. We provided a review of pharmacokinetics and pharmacodynamics during ECMO, emphasizing practical application and review of patient-, illness-, and ECMO hardware-related factors.

show abstract

Section: The Ecmo Ins and Outsmentioning

confidence: 99%

Section: The Ecmo Ins and Outsmentioning

confidence: 99%