Use of ECMO in ARDS: does the EOLIA trial really help?

Gattinoni, Luciano; Vasques, Francesco; Quintel, Michael

doi:10.1186/s13054-018-2098-6

Cited by 62 publications

(44 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study failed to show a significantly better 60-day mortality rate (hazard ratio 0.70 compared to conventional treatment, 95% CI 0.47 -1.04, P=0.07). Crossover from the conventional treatment group was high (28% of patients randomised to conventional treatment), and it has been questioned whether the goal to show an absolute mortality reduction of 20% was possible, given the low recruitment rate (32). Therefore, it remains controversial whether ECMO should be used early in ARDS, but its role as a salvage therapy in refractory cases is relatively well mounted (33).…”

Section: Scientific Evidence In Respiratory Failurementioning

confidence: 99%

Long-term pulmonary function and quality of life in adults after extracorporeal membrane oxygenation for respiratory failure

et al. 2019

View full text Add to dashboard Cite

show abstract

Section: Scientific Evidence In Respiratory Failurementioning

confidence: 99%

Long-term pulmonary function and quality of life in adults after extracorporeal membrane oxygenation for respiratory failure

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The role of ECMO in ARDS has been controversial, with conflicting data on its effect on survival compared with conventional ventilator management 17. Nevertheless, four randomised trials have studied the effectiveness of ECMO in respiratory failure 18. Only a few cases of ARDS due to leptospirosis treated successfully with ECMO have been reported.…”

Section: Discussionmentioning

confidence: 99%

A case of leptospirosis with acute respiratory failure and acute kidney injury treated with simultaneous extracorporeal membrane oxygenation and haemoperfusion

et al. 2019

View full text Add to dashboard Cite

A 47-year-old man with a recent history of wading in floodwaters presented with a 1-week history of cough, myalgia, conjunctival suffusion and decreasing urine output. The patient had uraemia, hypotension, leukocytosis, thrombocytopenia, elevated liver enzymes and oliguria. His condition quickly worsened with haemoptysis, and respiratory distress which subsequently required intubation and mechanical ventilation. Continuous renal replacement therapy was started together with haemoperfusion (HP). The patient initially required norepinephrine and this was discontinued after the first session of HP. He was referred for veno-venous extracorporeal membrane oxygenation (ECMO) due to severe hypoxia and pulmonary haemorrhage. Oxygenation and lung compliance improved, and serum creatinine levels continued to normalise with improved urine output. He was placed off ECMO, extubated and eventually discharged. Patient was diagnosed with severe leptospirosis, acute respiratory failure and acute kidney injury successfully treated with simultaneous ECMO and HP. Blood samples were positive for Leptospira spp. DNA via PCR assay.

show abstract

“…Half of the patients in this cohort survived to be weaned off of ECMO, and 40% survived to hospital discharge without significant sequelae and continued to receive further treatment for their underlying diseases, such as malignancies, during follow-up. Thus, when ARDS developed during the early post-operative period after abdominal surgery, the timely utilization of VV-ECMO may avoid prolonged refractory hypoxia and may further reduce the risk of systemic hypotension and multiorgan dysfunction [23,24]. While some clinicians may be concerned about ECMO-related complications in this context and thus hesitate to employ VV-ECMO in this population, especially those with a diagnosed malignancy, such concerns need to be revised on the basis of the data presented in this study.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Surgery Needs Extracorporeal Life Support as a Final Back-up

Lin

Chen

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: There are very limited published data regarding the experience of extracorporeal membrane oxygenation (ECMO) after abdominal surgery. Our objective was to examine the clinical application and outcome of ECMO in patients deteriorating early after abdominal surgery. Methods: Between 1998 and 2018, patients who had ECMO implantation within 30 days after abdominal surgery were enrolled. Clinical outcomes, patient demographics, ECMO types and indications, laboratory findings and other relevant aspects of their medical histories were reviewed. Results: Sixteen patients aged between 20 and 77 years were enrolled, including 11 patients who underwent elective surgery and 5 who underwent emergency laparotomies. Six veno-arterial ECMO (VA-ECMO) and 10 veno-venous ECMO (VV-ECMO) devices were implanted for refractory hypotension or acute respiratory distress syndrome (ARDS) based on the clinical discretion of the attending physician. After timely diagnosis of the aetiology underlying the deterioration, 4 additional salvage interventions were allowed under ECMO support. Three VA-ECMO and 5 VV-ECMO patients were successfully weaned, while 5 patients (31.25%) survived to hospital discharge without significant sequelae. Patients who survived to discharge had a significant inotropic dose taper on day two after ECMO implantation (59.4 versus 1.3 mcg/kg/min, p = 0.0487). ECMO-related complications included 3 implantation wound haematomas, limb ischaemia requiring wound debridement and reperfusion catheter insertion. There was no intra-abdominal bleeding or major thromboembolic event in our series. Conclusions: ECMO gave surgeons additional chances to treat reversible cause of sudden patient collapse after the timely diagnosis of the cause. No patients in our cohort encountered serious ECMO-related complications. Our study demonstrated that ECMO may be used as a final back-up for sudden deterioration after abdominal surgery.

show abstract

Use of ECMO in ARDS: does the EOLIA trial really help?

Cited by 62 publications

References 9 publications

Long-term pulmonary function and quality of life in adults after extracorporeal membrane oxygenation for respiratory failure

Long-term pulmonary function and quality of life in adults after extracorporeal membrane oxygenation for respiratory failure

A case of leptospirosis with acute respiratory failure and acute kidney injury treated with simultaneous extracorporeal membrane oxygenation and haemoperfusion

Abdominal Surgery Needs Extracorporeal Life Support as a Final Back-up

Contact Info

Product

Resources

About