tetano
Editor, Senior Moderator
Curr Opin Crit Care. 2011 Dec 18. [Epub ahead of print]
Extracorporeal membrane oxygenation for respiratory failure in adults.
Combes A, Bacchetta M, Brodie D, M?ller T, Pellegrino V.
Source
aService de R?animation M?dicale, H?pital Piti?-Salp?tri?re, Assistance Publique-H?pitaux de Paris, Universit? Pierre-et-Marie-Curie, Paris, France bColumbia College of Physicians and Surgeons/New York Presbyterian Hospital, New York, New York, USA cDepartment of Medicine, University Medical Center Regensburg, Regensburg, Germany dMonash University and Alfred Hospital, Melbourne, Victoria, Australia.
Abstract
PURPOSE OF REVIEW:
This article reviews case series and trials that evaluated extracorporeal membrane oxygenation (ECMO) for respiratory failure and describes patient and circuit management in the modern era of ECMO support.
RECENT FINDINGS:
In recent years, pivotal progress has been made in the conception and construction of ECMO circuits. They are now simpler, safer, require less anticoagulation and are associated with fewer bleeding complications. The encouraging results of the efficacy and economic assessment of conventional ventilatory support versus ECMO for severe adult respiratory failure (CESAR) trial performed in the United Kingdom and good outcomes of patients who received ECMO as rescue therapy during the recent H1N1 influenza pandemic, in which the latest generation of ECMO technology was used, reignited interest in ECMO for severe acute respiratory distress syndrome (ARDS).
SUMMARY:
The latest generation of ECMO systems is more biocompatible, better performing and longer lasting. Although recent studies suggested that veno-venous ECMO might improve the outcomes of patients with ARDS, indications for ECMO use remain uncertain. Future trials of ECMO for severe ARDS should strictly control for standard-of-care mechanical ventilation strategies in the control group and early transportation on ECMO for patients in the intervention arm.
PMID:
22186218
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22186218
Extracorporeal membrane oxygenation for respiratory failure in adults.
Combes A, Bacchetta M, Brodie D, M?ller T, Pellegrino V.
Source
aService de R?animation M?dicale, H?pital Piti?-Salp?tri?re, Assistance Publique-H?pitaux de Paris, Universit? Pierre-et-Marie-Curie, Paris, France bColumbia College of Physicians and Surgeons/New York Presbyterian Hospital, New York, New York, USA cDepartment of Medicine, University Medical Center Regensburg, Regensburg, Germany dMonash University and Alfred Hospital, Melbourne, Victoria, Australia.
Abstract
PURPOSE OF REVIEW:
This article reviews case series and trials that evaluated extracorporeal membrane oxygenation (ECMO) for respiratory failure and describes patient and circuit management in the modern era of ECMO support.
RECENT FINDINGS:
In recent years, pivotal progress has been made in the conception and construction of ECMO circuits. They are now simpler, safer, require less anticoagulation and are associated with fewer bleeding complications. The encouraging results of the efficacy and economic assessment of conventional ventilatory support versus ECMO for severe adult respiratory failure (CESAR) trial performed in the United Kingdom and good outcomes of patients who received ECMO as rescue therapy during the recent H1N1 influenza pandemic, in which the latest generation of ECMO technology was used, reignited interest in ECMO for severe acute respiratory distress syndrome (ARDS).
SUMMARY:
The latest generation of ECMO systems is more biocompatible, better performing and longer lasting. Although recent studies suggested that veno-venous ECMO might improve the outcomes of patients with ARDS, indications for ECMO use remain uncertain. Future trials of ECMO for severe ARDS should strictly control for standard-of-care mechanical ventilation strategies in the control group and early transportation on ECMO for patients in the intervention arm.
PMID:
22186218
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22186218