Veno-venous extracorporeal membrane oxygenation in a patient with severe acute respiratory failure –

Kubisa, Bartosz; Dec, Paweł; Lesińska, Anna; Bocheńska, Anna; Wasilewski, Piotr; Feldyk, Grzegorz; Kubisa, Anna; Pieróg, Jarosław; Bielewicz, Michał; Grodzki, Tomasz

doi:10.5114/kitp.2015.50573

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…The intention of LuTx is to improve the quality of life and to extend the survival of the patients with end-stage respiratory insufficiency. The adequate moment to decide for the lung transplantation is crucial to achieve the success during the procedure [ 6 ]. During the lung transplantation, cardiopulmonary reserve of each lung has to be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Central, peripheral ECMO or CPB? Comparsion between circulatory support methods used during lung transplantation

Ruszel

Kiełbowski

Piotrowska

et al. 2021

J Cardiothorac Surg

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Background Chronic obstructive pulmonary disease, cystic fibrosis and usual interstitial pneumonia are three most common indications for lung transplantation (LuTx) in Poland. As a result of irreversible destruction of pulmonary parenchyma and extended respiratory insufficiency that appear afterwards, it is crucial to estimate the reserve of gas exchange in each lung before and during surgery. Altering conditions of gas exchange require adaptation in circulatory system as well. In some of the cases the use of extracorporeal life support appears to be necessary to undergo the transplantation successfully. Cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) used during operation allow to replace the function of heart and lung, but they are also related to complications in the form of acute kidney failure, bleeding, heart arrhythmias or thromboembolic complications. Methods We reviewed 77 LuTx from 2009 to 2020 performed at the Department of Thoracic Surgery and Transplantation. 40/77 (51%) patients required intraoperative extracorporeal assistance: 8 required CBP and 32 required ECMO. In the ECMO group 14/32 (44%) patients had peripheral cannulation and 18/32 (56%) had central one. We have calculated the survival rates and reviewed postoperative complications after lung transplantations. Cumulative Kaplan–Meier survival curves were calculated. Differences between the groups were evaluated by the Chi- square analysis for discontinuous variables and t-test for continuous variables. Results The use of intraoperative central extracorporeal membrane oxygenator was associated with increased survival rates comparing to patients without external support (30-days, 1-year, 3-years, 5-years rates: 78%, 66%, 66%, 66% vs 83%, 65%, 59%, 44% respectively). Furthermore, survival was enhanced comparing to peripheral ECMO or cardiopulmonary bypass as well (50%, 41%, 41%, 33%; 75%, 50%, 50%, 38% respectively). Acute kidney injury and thromboembolic complications occurred statistically more often in case of patients that underwent lung transplantation with support devices (p = 0.005, p = 0.02 respectively). Frequency of other complications was comparable among groups. Conclusions The use of central extracorporeal membrane oxygenation should be favorized over peripheral cannulation or cardiopulmonary bypass. CPB should be no longer used during LuTx. Trial registration Not applicable.

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Section: Discussionmentioning

confidence: 99%

Central, peripheral ECMO or CPB? Comparsion between circulatory support methods used during lung transplantation

Ruszel

Kiełbowski

Piotrowska

et al. 2021

J Cardiothorac Surg

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“…Depending on the planned duration of circulatory support, the following can be distinguished: – short-term circulatory support (up to 7 days) provided by rotary pumps supporting the functioning of the right or left ventricle and extracorporeal membrane oxygenation (ECMO) systems [ 10 ]; – medium-term circulatory support (from 7 days to 3 months) provided by pulsatile pumps (POLCAS, ABIOMED) and some centrifugal pumps [ 4 ]; – long-term circulatory support (several months or years) provided by left ventricular or biventricular assist devices (LVAD, BiVAD) using continuous flow (HeartMate II, Thoratec, and HeartWare) or pulsatile flow (Novacor LVAD). …”

Section: Types Of Circulatory Supportmentioning

confidence: 99%

“…– short-term circulatory support (up to 7 days) provided by rotary pumps supporting the functioning of the right or left ventricle and extracorporeal membrane oxygenation (ECMO) systems [ 10 ];…”

Section: Types Of Circulatory Supportmentioning

confidence: 99%

Mechanical circulatory support in heart failure

Szyguła‐Jurkiewicz

Szczurek

Suliga

et al. 2016

kitp

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The increasing number of end-stage heart failure patients eligible for heart transplant and the disproportionately low number of donor hearts have led to increased interest in ventricular assist devices (VAD). These devices can be used as a bridge to decision, bridge to recovery, or bridge to candidacy. The main advantage of mechanical circulatory support (MCS) is the improvement of organ perfusion and function, which leads to better quality of life and survival. The MCS can also be used as a destination therapy in end-stage heart failure patients who are not eligible for heart transplant. It should be remembered that, despite the tangible benefits, VAD implantation may also be associated with the risk of serious complications, such as bleeding, infection, arrhythmias, blood clots, right ventricular failure, and cardiovascular events. This study presents an up-to-date overview of the current knowledge on the role of MCS in modern medicine.

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“…ECMO supports cardiac or lung function, depending on the cannulation strategy, and may be applied in veno-venous or veno-arterial modes. Despite the difficulties of conducting ECMO support and its costs, the use of this support device is associated with several complications, such as bleeding, clotting or air bubbles in the cannulas, or acute kidney injury [3].…”

Section: Introductionmentioning

confidence: 99%

Complications associated with bridging to lung transplantation – systematic review and meta-analysis

Kiełbowski¹,

Bakinowska²,

Kubisa³

2022

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Introduction: Lung transplantation (LuTx) is a treatment method of end-stage pulmonary diseases when conventional therapy does not provide further improvement. Preoperative use of extracorporeal life support is known as bridging to LuTx and is associated with several complications. Aim of the research:To investigate the frequencies of complications that may develop during bridging to lung transplantation with extracorporeal life support. Material and methods: A thorough, systematic review in the Medline and Google Scholar databases was performed. Inclusion criteria consisted of studies with or without a control group reporting experience with bridging to lung transplantation. Preferred reporting items for systematic reviews and meta-analysis protocols were used. Forest plots were generated with Open Meta Analyst software. Heterogeneity was assessed using I2 statistics. Results: Thirteen studies met the inclusion criteria. The articles were published between 2011 and 2020. A total of 461 patients bridged to transplantation were included. Bleeding and thrombotic complications occurred in 24.6% of patients; cerebrovascular events were observed in 4.5%; while renal replacement therapy was implemented in 13.2% of the included patients. Conclusions: Frequencies of possible complications occurring during a bridging procedure cannot be overlooked and may lead to death instead of lifesaving surgery. StreszczenieWprowadzenie: Przeszczepienie płuc (LuTx) to metoda leczenia schyłkowych chorób płuc, gdy konwencjonalna terapia nie zapewnia dalszej poprawy. Przedoperacyjne zastosowanie pozaustrojowego wspomagania funkcji życiowych jest znane jako pomostowanie do LuTx i wiąże się z wystąpieniem różnych powikłań. Cel pracy: Zbadanie częstości występowania powikłań, jakie mogą pojawić się podczas pomostowania do przeszczepienia płuc z pozaustrojowym podtrzymywaniem życia. Materiał i metody: Przeprowadzono dokładny przegląd systematyczny w bazach danych Medline i Google Scholar. Kryteria włączenia obejmowały badania z grupą kontrolną lub bez niej, w których autorzy przedstawiali swoje doświadczenie z pomostowaniem do transplantacji płuc. Wykorzystano protokół: Preferred reporting items for systematic reviews and meta--analyses. Wykresy wygenerowano za pomocą oprogramowania Open Meta Analyst. Niejednorodność oceniano za pomocą statystyki I 2 . Wyniki: Kryteria włączenia spełniło 13 badań. Artykuły zostały opublikowane w latach 2011-2020. Uwzględniono łącznie 461 pacjentów pomostowanych do przeszczepienia. Krwawienia i powikłania zakrzepowe wystąpiły u 24,6% chorych, incydenty mózgowo-naczyniowe u 4,5%, a terapię nerkozastępczą wdrożono u 13,2% pacjentów. Wnioski: Częstość możliwych powikłań występujących podczas zabiegu pomostowego nie może zostać pominięta; mogą one prowadzić do śmierci zamiast operacji ratującej życie.

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Veno-venous extracorporeal membrane oxygenation in a patient with severe acute respiratory failure –

Cited by 3 publications

References 5 publications

Central, peripheral ECMO or CPB? Comparsion between circulatory support methods used during lung transplantation

Central, peripheral ECMO or CPB? Comparsion between circulatory support methods used during lung transplantation

Mechanical circulatory support in heart failure

Complications associated with bridging to lung transplantation – systematic review and meta-analysis

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