Outcomes of Multiple Runs of Extracorporeal Membrane Oxygenation: An analysis of the Extracorporeal Life Support Registry
Though the use of multiple runs of ECMO is growing, outcomes remain poor for most cohorts. Survival decreases with each additional run. Patients requiring additional runs for a pulmonary indication should be considered prime candidates. Renal complications on the first run significantly increases the risk of mortality on subsequent runs, and as such, careful consideration should be applied in these cases.
Evaluation of Recirculation During Venovenous Extracorporeal Membrane Oxygenation Using Computational Fluid Dynamics Incorporating Fluid-Structure Interaction
We have developed a finite element computational fluid dynamics model incorporating fluid-structure interaction (FSI) that incorporates atrial deformation during atrial filling and emptying, with fluid flow solved using large eddy simulation. With this model, we have evaluated an extensive number of factors that could influence recirculation during two-site VV ECMO, and characterized their impact on recirculation, including cannula construction, insertion depth and orientation, VV ECMO configuration, circuit blood flow, and changes in volume, venous return, heart rate, and blood viscosity.
Central Versus Peripheral Arterial Cannulation for Veno-Arterial Extracorporeal Membrane Oxygenation in Post-Cardiotomy Patients
Central cannulation for VA-ECMO provides antegrade flow without Harlequin’s syndrome, changes of arterial cannula site, and better 30 day survival. Complication rates regarding need for reexploration and transfusion requirements were similar.
Clinical Characteristics and Outcomes of Adults with Peripheral Extracorporeal Membrane Oxygenation in A Developing Country: A Single Center 8-Year Retrospective Study
The mortality rate in our ECMO center was considerably higher than that in the international registry report. Improved team education, rigid patient selection criteria, and a reimbursement protocol should lead to ameliorated outcomes.
International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.
Pediatric Intensive Care Preparedness and ECMO Availability in Children With COVID-19: An International Survey
In conclusion, both the experience in managing patients and the availability of neonatal/pediatric ECMO in the centers the responders are working seemed to increase physicians’ preparedness.
Successful Use of An Automated Proning System to Achieve Prone Positioning in A Patient with Severe ARDS Requiring Veno-Venous ECMO
To our knowledge, this is the first description in the literature of using an automated proning system with an ECMO circuit in place. This report describes the technique we used to safely perform axial rotations for two days with fewer providers required than manual proning.
A Review on Extracorporeal Membrane Oxygenation and Kidney Injury
The pathophysiology of AKI in ECMO is multifactorial, and includes ischaemia, RBCs breakdown, comorbidity, conversion of zymogen form of pro‐inflammatory mediators, structural alteration of the kidney, coadministration of nephrotoxic drugs, coagulation abnormality, and oxidative stress.
Anticoagulation Management in Severe Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation
Hypercoagulability and secondary hyperfibrinolysis during ECMO support in COVID-19 patients are common and possibly increase the propensity for thrombotic events and failure of the oxygenator. Currently, there is not enough evidence to support a more aggressive anticoagulation strategy.
Renal Replacement Therapy in Patients on Extracorporeal Membrane Oxygenation Support: Who and How.
New renal failure requiring RRT occurs in nearly one-half of patients on ECMO support, with poor outcomes. RRT may be performed via the ECMO circuit with similar efficacy as via a dialysis catheter.
2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients
in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training.
Use of Extracorporeal Membrane Oxygenation After Congenital Heart Disease Repair: A Systematic Review and Meta-Analysis
There is an overall high in-hospital mortality of 56.8% in postoperative CHD patients on ECMO. Bleeding is the most common complication during ECMO running with an incidence of 47.1%.