Improved Results Treating Lung Allograft Failure With Venovenous Extracorporeal Membrane Oxygenation

Institutional experience with extracorporeal membrane oxygenation in lung transplantation☆

“…Conduct of ECMO in this indication is controversly discussed in the literature. One report suggests a lower complication rate with veno-venous approach [16], whereas other groups change their technique from case to case [17]. We prefer the veno-arterial approach in this indication, which also provides relief of the pulmonary circulation, since the impaired graft function almost uniformly is accompanied by a rise in pulmonary arterial pressure.…”

Early Institution of Extracorporeal Membrane Oxygenation for Primary Graft Dysfunction After Lung Transplantation Improves Outcome

“…13 In addition, several centers have documented improved outcomes after recent refinements of both surgical technique as well as ECMO technology and timing. [13][14][15][16] Temporary extracorporeal maintenance of systemic oxygenation allows for advanced ventilatory strategies to influence recovery from alveolar volutrauma and inflammatory parenchymal lung injury.…”

Extracorporeal membrane oxygenation in adults for severe acute respiratory failure

“…It has been used in various other severe conditions apart from ARDS, such as primary graft dysfunction after lung transplantation [9], lung trauma [10], and pulmonary embolism [11]. The decision to initiate ECMO requires several criteria that must be discussed: these include assessment of arterial blood gases, optimization of ARDS treatment, multiorgan failure, comorbidities, a prognosis before acute respiratory failure, duration of mechanical ventilation, treatment of aetiology of ARDS.…”