Persistent hypoxemia on ECMO

Conrad, Steven A.

doi:10.5339/qmj.2017.swacelso.18

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…Coronary Hypoxia - Oxygen saturation on V-A ECMO is usually normal (>90%), as the upper body is provided with blood from LV that has been oxygenated by normally functioning lungs, while the lower body is supported by fully saturated blood from V-A ECMO [74]. However, in the event of patients with concomitant pulmonary dysfunction, blood ejected from the heart is no longer sufficiently oxygenated This deoxygenated blood preferentially supplies the coronary arteries, cerebral circulation and upper limbs, resulting in “dual circuits” and possible hypoxic injury (coronary and cerebral) [75,76].…”

Section: Mechanical Circulatory Support (Mcs)mentioning

confidence: 99%

Hurdles to Cardioprotection in the Critically Ill

Hoe

Bartnikowski

Wells

et al. 2019

IJMS

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Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies.

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Section: Mechanical Circulatory Support (Mcs)mentioning

confidence: 99%