Extubation of patients undergoing extracorporeal life support. A retrospective study

Ellouze, Omar; Lamirel, Julie; Perrot, Justine; Missaoui, Anis; Daily, Theresa; Aho, Serge; Petrosyan, Andranik; Guinot, Pierre-Grégoire; Bouchot, O.; Bouhemad, Bélaïd

doi:10.1177/0267659118791072

Cited by 34 publications

(52 citation statements)

References 35 publications

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“…Similar findings have been obtained in other studies. 37 – 39 The reason for ventilator support duration affecting the occurrence of VAP may be owing to deep sedation and analgesia and the use of invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study

et al. 2020

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Objective We aimed to examine the risk factors and prognosis of nosocomial pneumonia (NP) during extracorporeal membrane oxygenation (ECMO). Methods We retrospectively analyzed data of patients who received ECMO at the Affiliated Hangzhou Hospital of Nanjing Medical University between January 2013 and August 2019. The primary outcome was the survival-to-discharge rate. Results Sixty-nine patients who received ECMO were enrolled, median age 42 years and 26 (37.7%) women; 14 (20.3%) patients developed NP. The NP incidence was 24.7/1000 ECMO days. Patients with NP had a higher proportion receiving veno-venous (VV) ECMO (50% vs. 7.3%); longer ECMO support duration (276 vs. 140 hours), longer ventilator support duration before ECMO weaning (14.5 vs. 6 days), lower ECMO weaning success rate (50.0% vs. 81.8%), and lower survival-to-discharge rate (28.6% vs. 72.7%) than patients without NP. Multivariable analysis showed independent risk factors that predicted NP during ECMO were ventilator support duration before ECMO weaning (odds ratio [OR] = 1.288; 95% confidence interval [CI]: 1.111–1.494) and VV ECMO mode (OR = 10.970; 95% CI: 1.758–68.467). Conclusion NP during ECMO was associated with ventilator support duration before ECMO weaning and VV ECMO mode. Clinicians should shorten the respiratory support duration for patients undergoing ECMO to prevent NP.

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Section: Discussionmentioning

confidence: 99%

“…These results suggest that we should evaluate the role of mechanical ventilation in patients receiving ECMO support. Ventilator weaning during ECMO may be one method to reduce ECMO-associated NP and mortality; 37 , 40 , 41 however, under permissible situations, ECMO support should be used alone.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study

et al. 2020

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“…Although some patients need sedation, many VA-ECMO patients remain sedated for the sole reason that they are under VA-ECMO, mainly for safety reasons. Fortunately, the recent literature goes against this dogma,12 13 and patients are lightly sedated or extubated when possible, providing the opportunity for proper neurological evaluation.…”

Section: Discussionmentioning

confidence: 99%

Mechanical thrombectomy in acute ischemic stroke patients under venoarterial extracorporeal membrane oxygenation

Guennec

Schmidt

Clarençon

et al. 2019

J NeuroIntervent Surg

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BackgroundUse of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients to treat refractory cardiogenic shock has increased in recent years, and ischemic stroke is the most frequent VA-ECMO-induced cerebrovascular complication. No adult case of mechanical thrombectomy (MT) has been reported.MethodsRetrospective observational study of hospital medical records of patients who received circulatory support with VA-ECMO with acute ischemic stroke treated with MT, from 2006 to 2018.ResultsTwo adult patients on VA-ECMO with acute ischemic stroke treated with MT were found. Both cases were successfully treated.ConclusionThese cases illustrate the feasibility of performing MT in adult patients on ECMO.

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“…We did not find any literature on extubation before decannulation in patients with asthma, though this has been described in other patient populations where ECMO is used as a bridge to cardiac or lung transplant. 10…”

Section: Ecmo For Refractory Asthmamentioning

confidence: 99%

A winter to remember! Extracorporeal membrane oxygenation for life‐threatening asthma in children: A case series and review of literature

Medar

Derespina

Jakobleff

et al. 2019

Pediatric Pulmonology

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Progressive refractory near‐fatal asthma requiring intubation and mechanical ventilation can lead to death. Data on outcomes in children requiring extracorporeal membrane oxygenation (ECMO) support for status asthmaticus is sparse. We describe our experience of three patients in the winter of 2018 to 2019 successfully rescued with ECMO. We also report our novel use of extubation while still being on ECMO support. Awareness and use of ECMO in refractory asthma can help lower the mortality for this very common disease in children. We also review the current literature on the use of ECMO and other extracorporeal therapies in asthma.

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Extubation of patients undergoing extracorporeal life support. A retrospective study

Abstract: Extubation of patients under ECLS is safe and feasible. Furthermore, in extubated patients, we observed fewer cases of ventilator-associated pneumonia and better 30-day survival rates.

Cited by 34 publications

References 35 publications

Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study

Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study

Mechanical thrombectomy in acute ischemic stroke patients under venoarterial extracorporeal membrane oxygenation

A winter to remember! Extracorporeal membrane oxygenation for life‐threatening asthma in children: A case series and review of literature

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