The Feasibility of Extracorporeal Membrane Oxygenation Support for Inter-Hospital Transport and as a Bridge to Lung Transplantation

Lee, Sang Gwon; Son, Bong Soo; Kang, Pil Jae; Cho, Woo Hyun; Kim, Do-Hyung; Lee, Young Seok; Lee, Kwang Ha

doi:10.5761/atcs.oa.12.00203

Cited by 12 publications

(6 citation statements)

References 17 publications

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“…It is relatively straightforward for most cardiothoracic or general surgeons because they are familiar with the percutaneous wire technique. This is particularly useful when placing cannulas emergently at an outside facility (9). Also, the oxygenation tends to be excellent and highly predictable.…”

Section: Vv Ecmo Supportmentioning

confidence: 99%

Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

Loor¹,

Simpson²,

Parulekar³

2017

J. Thorac. Dis.

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Section: Vv Ecmo Supportmentioning

confidence: 99%

Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

Loor¹,

Simpson²,

Parulekar³

2017

J. Thorac. Dis.

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“…The application of extracorporeal membrane oxygenation [ECMO] for patients with refractory respiratory failure failing conventional therapy has increased considerably [ 1 ] with improvement on outcome [ 2 – 5 ]. Despite the development of new miniaturized ECMO-systems, technical-induced hemolysis during ECMO therapy remains of concern with a reported incidence between 5 and 18% [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Technical-Induced Hemolysis in Patients with Respiratory Failure Supported with Veno-Venous ECMO – Prevalence and Risk Factors

Lehle

Philipp

Zeman³

et al. 2015

PLoS ONE

101

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The aim of the study was to explore the prevalence and risk factors for technical-induced hemolysis in adults supported with veno-venous extracorporeal membrane oxygenation (vvECMO) and to analyze the effect of hemolytic episodes on outcome. This was a retrospective, single-center study that included 318 adult patients (Regensburg ECMO Registry, 2009–2014) with acute respiratory failure treated with different modern miniaturized ECMO systems. Free plasma hemoglobin (fHb) was used as indicator for hemolysis. Throughout a cumulative support duration of 4,142 days on ECMO only 1.7% of the fHb levels were above a critical value of 500 mg/l. A grave rise in fHb indicated pumphead thrombosis (n = 8), while acute oxygenator thrombosis (n = 15) did not affect fHb. Replacement of the pumphead normalized fHb within two days. Neither pump or cannula type nor duration on the first system was associated with hemolysis. Multiple trauma, need for kidney replacement therapy, increased daily red blood cell transfusion requirements, and high blood flow (3.0–4.5 L/min) through small-sized cannulas significantly resulted in augmented blood cell trauma. Survivors were characterized by lower peak levels of fHb [90 (60, 142) mg/l] in comparison to non-survivors [148 (91, 256) mg/l, p≤0.001]. In conclusion, marked hemolysis is not common in vvECMO with modern devices. Clinically obvious hemolysis often is caused by pumphead thrombosis. High flow velocity through small cannulas may also cause technical-induced hemolysis. In patients who developed lung failure due to trauma, fHb was elevated independantly of ECMO. In our cohort, the occurance of hemolysis was associated with increased mortality.

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“…With advances in extracorporeal technology leading to more compact circuit components, ECMO is increasingly mobile, allowing patients to be cannulated at their hospital of origin and transported safely to specialized centers. [67][68][69][70][71][72] …”

Section: Interhospital Transport On Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

Novel Uses of Extracorporeal Membrane Oxygenation in Adults

Abrams

Brodie

2015

Clinics in Chest Medicine

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The Feasibility of Extracorporeal Membrane Oxygenation Support for Inter-Hospital Transport and as a Bridge to Lung Transplantation

Cited by 12 publications

References 17 publications

Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

Technical-Induced Hemolysis in Patients with Respiratory Failure Supported with Veno-Venous ECMO – Prevalence and Risk Factors

Novel Uses of Extracorporeal Membrane Oxygenation in Adults

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