Comparison of Circulatory Unloading Techniques for Venoarterial Extracorporeal Membrane Oxygenation
This study identified clinically significant hemodynamic variability between the different circulatory unloading techniques evaluated. However, the applicability of these techniques will vary with different patient disease etiology. Further studies on ECMO unloading will help to quantify hemodynamic benefits and establish treatment guidelines.
Utility of Gas Inlet Pressure Monitoring in Extracorporeal Membrane Oxygenation
This study confirmed that monitoring the gas inlet pressure changes of an oxygenator during ECMO is clinically useful.
Extracorporeal Membrane Oxygenation-Induced Hemolysis: An In Vitro Study to Appraise Causative Factors
Our preliminary results suggested that the choice of anticoagulant and blood donor gender could be critical factors in hemolysis studies, and should be taken into account to improve testing reliability during ECMO.
Platelets and Extra-Corporeal Membrane Oxygenation in Adult Patients: A Systematic Review and Meta-Analysis
Thrombocytopenia and platelet dysfunction are common in ECMO patients, regardless the type of ECMO mode. The underlying mechanisms are multifactorial, and understanding and management are still limited. Further research to design appropriate strategies and protocols for its monitoring, management, or prevention should be matter of thorough investigations.
Multi-institutional Analysis of 100 Consecutive Patients with COVID-19 and Severe Pulmonary Compromise Treated with Extracorporeal Membrane Oxygenation: Outcomes and Trends Over Time
Extracorporeal membrane oxygenation may facilitate salvage and survival of selected critically ill patients with COVID-19. Survivors tend to be younger. Substantial variation exists in the drug treatment of COVID-19, but ECMO offers a reasonable rescue strategy.
SARS-CoV-2 Leakage From the Gas Outlet Port During Extracorporeal Membrane Oxygenation for COVID-19
In conclusion, SARS-CoV-2 could leak to the gas outlet port of the ECMO circuit through silicone-coated polypropylene membranes during ECMO support of critically ill COVID-19 patients.
Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model
These data demonstrate that diabetes enhances proinflammatory cytokine release, renal damage, and pulmonary edema during ECMO in an animal model.
Effect of Cytokine Adsorption on Survival and Circulatory Stabilization in Patients Receiving Extracorporeal Cardiopulmonary Resuscitation
Due to small case numbers and the retrospective design of the study, our results neither disprove nor confirm a clinically relevant treatment effect of cytokine adsorption. Results from larger trials, preferably randomized-controlled trials are required to better understand the clinical benefit of cytokine adsorption after ECPR.
Improved Drainage Cannula Design to Reduce Thrombosis in Veno-Arterial Extracorporeal Membrane Oxygenation
This study suggests that simple geometrical changes can significantly alter the risk of thrombosis in ECMO drainage cannulas.
Extracorporeal Membrane Oxygenation Network Organisation and Clinical Outcomes During the COVID-19 Pandemic in Greater Paris, France: A Multicentre Cohort Study
Beyond associations with similar factors to those reported on ECMO for non-COVID-19 ARDS, 90-day survival among ECMO-assisted patients with COVID-19 was strongly associated with a centre’s experience in venovenous ECMO during the previous year. Early ECMO management in centres with a high venovenous ECMO case volume should be advocated, by applying centralisation and regulation of ECMO indications, which should also help to prevent a shortage of resources.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
Transport and Retrieval on Extracorporeal Membrane Oxygenation (ECMO): Setup and Activities of an Immersive Transport and Retrieval on ECMO Workshop
This article describes the authors’ experience of developing and running a simulation-based ECMO Transport and Retrieval workshop, with multiple immersive scenarios and opportunities for participants to familiarize themselves with the process and the ambulance equipment and environment.
Brain Injury in Extracorporeal Membrane Oxygenation: A Multidisciplinary Approach
Extracorporeal membrane oxygenation (ECMO) represents an established technique to provide temporary cardiac and/or pulmonary support. ECMO, in veno-venous, veno-arterial or in extracorporeal carbon dioxide removal modality, is associated with a high rate of brain injuries.
Anticoagulation in Critically Ill Adults during Extracorporeal Circulation
This review gives a practical view on current concepts of anticoagulation strategies in patients with extracorporeal assist devices.
Thromboembolic and Bleeding Events in COVID-19 Patients receiving Extracorporeal Membrane Oxygenation
This study describes the incidences of TEE and BE in critically ill COVID-19 patients treated with ECMO. The most common adverse event during ECMO support was bleeding, which occurred at a comparable rate to non-COVID-19 patients treated with ECMO.
Is Extracorporeal Membrane Oxygenation the Standard Care for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Compared with CMV, ECMO contributed to lower 60-day and 1-year mortality, and increased ICU mortality in patients with ARDS. However, H1N1 ARDS was independently associated with higher ICU mortality and nosocomial pneumonia. The results were not affected by removing retrospective control studies or articles published >20 years ago from the sensitivity analysis. This meta-analysis demonstrates the effectiveness of ECMO and its importance in standard treatment of patients with ARDS.
ECMO Assistance during Mechanical Ventilation: Effects Induced on Energetic and Haemodynamic Variables
The new modules of the systemic circulation and ECMO support allowed the study of the effects induced by concomitant mechanical ventilation and circulatory support. Based on our clinical experience during the COVID-19 pandemic, numerical simulations may help clinicians with data analysis and treatment optimisation of patients requiring both mechanical ventilation and circulatory support.
Pump Flow Setting and Assessment of Unloading in Clinical Practice
If a left-sided Impella device is used, it should be run at the highest possible performance level during treatment while avoiding suction events. When combined with VA-ECMO, the Impella device should be run at a lower performance level, ensuring sufficient left ventricular emptying but avoiding suction.
Long-Term Cognitive Outcomes and Sleep in Adults After Extracorporeal Life Support
In this small retrospective case series, no significant differences were found in sleep or cognitive outcomes between extracorporeal life support and non–extracorporeal life support survivors.
Physiological Basis of Extracorporeal Membrane Oxygenation and Extracorporeal Carbon Dioxide Removal in Respiratory Failure
In this review, we will present the physiological basis of gas exchange in ECMO and ECCO2R, and the implications of their interaction with native lung function. We will also discuss the rationale for their use in clinical practice, their current advances, and future directions.
Low vs Standardized Dose Anticoagulation Regimens for Extracorporeal Membrane Oxygenation: A Meta-Analysis
This meta-analysis confirms that LA is a feasible and safe anticoagulation strategy in patients supported by ECMO. Future studies should focus on the long-term benefits of LA compared with SA.
Successful Heart Transplantation Recovered From a Brain-Dead Donor on Veno-Arterial Extracorporeal Membrane Oxygenation Support
The present case reports the successful transplantation of a brain-dead donor heart recently recovered from pulmonary embolism induced acute right ventricular failure supported by VA-ECMO and represents a potential source of increased donor organs that would otherwise not be utilized.
Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome: How Do We Expand Capacity in the COVID-19 Era?
As cases soar, more people require ECMO support, and triaged resource allocation becomes a reality: strategies to expand capacity are even more necessary.
Extracorporeal Life Support for Cardiogenic Shock During Pregnancy and Postpartum: A Single Center Experience
VA ECMO can be employed successfully in obstetric patients with cardiogenic shock with appropriate patient selection. Further research is needed to determine if VA ECMO provides a survival advantage over traditional management strategies in this vulnerable population.