Pumpless Extracorporeal Lung Assist: A 10-Year Institutional Experience

Flörchinger, Bernhard; Philipp, Alois; Klose, Alexander D.; Hilker, Michael; Kobuch, Reinhard; Rupprecht, Leopold; Keyser, Andreas; Pühler, Thomas; Hirt, Stephan; Wiebe, Karsten; Müller, Thomas; Langgartner, Julia; Lehle, Karla; Schmid, Çhristof

doi:10.1016/j.athoracsur.2008.04.045

Cited by 78 publications

(72 citation statements)

References 21 publications

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“…13 Flörchinger and coworkers reported 159 patients with acute respiratory distress syndrome and severe pneumonia; the mean support time was 8.5 days, 30-day mortality was 13.6%, and they concluded that the best indication for use of PECLA was severe hypercapnia and moderate hypoxia. 2 Our patient who had PECLA (case 1) satisfied these indications.…”

Section: Discussionmentioning

confidence: 90%

“…Despite these advantages, blood flow is dependent on cardiac output. 2 The PECLA allows lung protective ventilation and improves alveolar gas exchange. Diseased lung sections may have better recovery because mechanical ventilation can be downgraded, and iatrogenic lung injury from barotrauma and volutrauma can be reduced.…”

Section: Discussionmentioning

confidence: 99%

“…1 Pumpless extracorporeal lung assist (PECLA) method is an arteriovenous method that uses the patient's own cardiac output. 2 Different ECMO methods have been used in liver transplant operations. The main indications for ECMO therapy with liver transplant are portopulmonary or hepatopulmonary syndrome and other types of cardiorespiratory failure refractory to conventional therapy.…”

Section: Introductionmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation After Living-Related Liver Transplant

Gedik

Çelik²,

Otan³

et al. 2015

Exp Clin Transplant

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Various types of extracorporeal membrane oxygenation methods have been used in liver transplant operations. The main indications are portopulmonary or hepatopulmonary syndromes and other cardiorespiratory failure syndromes that are refractory to conventional therapy. There is little literature available about extracorporeal membrane oxygenation, especially after liver transplant. We describe our experience with 2 patients who had living-related liver transplant. A 69-year-old woman had refractory aspergillosis pneumonia and underwent pumpless extracorporeal lung assist therapy 4 weeks after liver transplant. An 8-month-old boy with biliary atresia underwent urgent liver transplant; he received venoarterial extracorporeal membrane oxygenation therapy on postoperative day 1. Despite our unsuccessful experience with 2 patients, extracorporeal membrane oxygenation and pumpless extracorporeal lung assist therapy for liver transplant patients may improve prognosis in selected cases.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation After Living-Related Liver Transplant

Gedik

Çelik²,

Otan³

et al. 2015

Exp Clin Transplant

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“…Overall, there is good evidence that ECCO 2 R can effectively reduce PaCO 2 and make a small contribution to oxygenation in patients with ARDS. Likewise, studies 14,[18][19][20]22,23 have demonstrated that ECCO 2 R facilitates a lung-protective ventilation strategy by allowing a reduction in tidal volumes and inspiratory airway pressures. ECCO 2 R may even complement specific forms of protective ventilation such as HFOV 21,24 or APRV (Airway Pressure Release Ventilation) with 2-4 mL/kg tidal volumes.…”

Section: Current Evidencementioning

confidence: 99%

“…Within these 18 citations, there were no randomised controlled trials, a single health technology assessment 15 and only two prospective interventional studies 10,14 both of which have already been summarised. The remainder of the relevant literature was confined to either prospective or retrospective case series [16][17][18][19][20][21][22][23][24] although these do demonstrate that ECCO 2 R has been used on over 500 patients (with no unifying database). Overall, there is good evidence that ECCO 2 R can effectively reduce PaCO 2 and make a small contribution to oxygenation in patients with ARDS.…”

Section: Current Evidencementioning

confidence: 99%

Extracorporeal Carbon Dioxide Removal (ECCO₂R) in Respiratory Failure: An Overview, and where Next?

Baker

Richardson

Craig

2012

Journal of the Intensive Care Society

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Extracorporeal carbon dioxide removal (ECCO2R) is used to facilitate protective ventilation strategies and to treat severe hypercapnic acidosis that is refractory to mechanical ventilation. There is an increasing amount of interest in the use of ECCO2R but there are no recommendations for its use that take the most recent evidence into account. In 2008, the National Institute of Health and Clinical Excellence (NICE) published guidelines on ‘Arteriovenous Extracorporeal Membrane Carbon Dioxide Removal.’1 However, since that time there have been a number of studies in the area and some significant technological advances including the introduction of commercially available VV-ECCO2R systems. The aim of this article is to provide an overview of ECCO2R, review the literature relating to its use and discuss its future role in the intensive care setting.

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