Extracorporeal membrane oxygenation as rescue therapy for severe hypoxemic respiratory failure

Patel, Bhoumesh; Chatterjee, Subhasis; Davignon, Seanna; Herlihy, James

doi:10.21037/jtd.2019.05.73

Cited by 27 publications

(23 citation statements)

References 46 publications

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“…The indications for CRRT/RRT were:1) AKI which was defined according to the KDIGO criteria [19]; 2) Fluid overload which was defined as the fluid overload > 10% [fluid overload = (CRRT initial weight-PICU admission weight)/PICU admission weight× 100%] [20,21]. The indications for ECMO were:1) severe hypoxemia with a PaO2/ FiO2 ratio of < 50 mmHg for > 3 h or < 80 mmHg for > 6 h, or pH < 7.25 and a partial pressure of arterial CO2 of ≥60 mmHg for > 6 h [22]. 2) hypoxemia complicated with cardio dysfunction when cardiac index (CI) less than 2.2 L/min.m2; and 3) hypoxemia complicated with circulatory dysfunction when persistent lactatemia greater than 4 mmol/L and vasoactive inotropic score (VIS) greater than 50.VIS was calculated as ([(epinephrine+ norepinephrine) ug/kg.min] × 100 + [(dobutamine + dopamine) ug/kg.min] + [milrinone ug/kg.min] × 15.…”

Section: Management and Outcomesmentioning

confidence: 99%

A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU

et al. 2020

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Background: Describe the outcome of adenovirus pneumonia in a pediatric intensive care unit (PICU) over a 3-year period, to identify the risk factors that may be associated with worse outcome. Methods: A retrospective observational study was performed in the PICU of children's hospital in Shanghai from July 2016 to June 2019. Sixty-seven children over 29 days to 14 years old with adenovirus pneumonia who were admitted to PICU with acute hypoxemic respiratory failure were included in this study. The primary outcome was hospital mortality, and secondary outcomes were hospital and PICU length of stay (LOS), and risk factors of worse outcome. Results: Of 67 children with severe adenovirus pneumonia, the hospital mortality was 16.42% (11/67) and 28-day mortality was 14.93% (10/67). Median Pediatric Risk of Mortality III (PRISM III) score at admission was 13 (interquartile range [IQR], 10-15). Median PICU LOS stay was 11 days (8-18d) and hospital LOS was 22 days (16-31d). Among children with extracorporeal membrane oxygenation (n = 9), 6 cases survived and 3 cases died. The patients who need renal replacement therapy, neuromuscular blockade, parenteral nutrition, and packed red blood cell perfusion had higher hospital mortality (p < 0.001, p = 0.041, p = < 0.001, p = 0.012, respectively). Multivariate logistic analysis indicated that liver dysfunction and nosocomial infection were associated with high risk of mortality. Conclusions: The hospital mortality of adenovirus pneumonia in our PICU was 16.42%. Patients complicated liver dysfunction and co-infection & nosocomial infection were associated with poor outcome.

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Section: Management and Outcomesmentioning

confidence: 99%

A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU

et al. 2020

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“…Usage of VV ECMO in severe acute respiratory distress syndrome (ARDS) is very well known [ 8 ]. There are several publications providing contemporary guidelines and fundamentals for clinicians for bedside troubleshooting [ 8 , 9 ]. Our case was special as it involved severe pre-existing cardiac dysfunction also.…”

Section: Discussionmentioning

confidence: 99%

Determination of cardiovascular dysfunction before initiation of extracorporeal membrane oxygenation in septic shock

Rijst

Mangukia

Muhammad

et al. 2021

Indian J Thorac Cardiovasc Surg

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Extracorporeal membrane oxygenation (ECMO) is being increasingly used in patients having sepsis-induced cardiovascular dysfunction. We report successful use of venovenous ECMO in septic shock secondary to pneumonia in the presence of severe left ventricular dysfunction. We also discuss the quantitative evaluation of cardiovascular dysfunction, which provides important input in choosing the type of ECMO in septic shock.

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“…The most common complications of VV-ECMO were bleeding (29.3%), neurological complications (7.1%) including intracranial hemorrhage, ischemic stroke, brain death and seizures. 86,89 Given the above evidence, the guidelines endorsed by British Thoracic Society suggest using ECMO in the selected patient group mentioned above and ATS/European Respiratory Society (ERS)/SCCM have no definitive recommendations for or against ECMO in severe ARDS. 88,90 In conclusion, the use of ECMO should be considered in a select number of patients with severe ARDS on lung protective ventilation with Murray Score >3 or pH < 7.2 due to uncompensated hypercapnia.…”

Section: Extracorporeal Membrane Oxygenation (Ecmo)mentioning

confidence: 99%

Management of ARDS – What Works and What Does Not

Banavasi

Nguyen

Osman

et al. 2021

The American Journal of the Medical Sciences

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Acute respiratory distress syndrome (ARDS) is a clinically and biologically heterogeneous disorder associated with a variety of disease processes that lead to acute lung injury with increased non-hydrostatic extravascular lung water, reduced compliance, and severe hypoxemia. Despite significant advances, mortality associated with this syndrome remains high. Mechanical ventilation remains the most important aspect of managing patients with ARDS. An in-depth knowledge of lung protective ventilation, optimal PEEP strategies, modes of ventilation and recruitment maneuvers are essential for ventilatory management of ARDS. Although, the management of ARDS is constantly evolving as new studies are published and guidelines being updated; we present a detailed review of the literature including the most up-to-date studies and guidelines in the management of ARDS. We believe this review is particularly helpful in the current times where more than half of the acute care hospitals lack in-house intensivists and the burden of ARDS is at large.

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Extracorporeal membrane oxygenation as rescue therapy for severe hypoxemic respiratory failure

Cited by 27 publications

References 46 publications

A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU

A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU

Determination of cardiovascular dysfunction before initiation of extracorporeal membrane oxygenation in septic shock

Management of ARDS – What Works and What Does Not

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