Veno-venous ECMO: a synopsis of nine key potential challenges, considerations, and controversies.

Title

Veno-venous ECMO: a synopsis of nine key potential challenges, considerations, and controversies.

Creator

Tulman David B; Stawicki Stanislaw P; Whitson Bryan A; Gupta Saarik C; Tripathi Ravi S; Firstenberg Michael S; Hayes Don Jr; Xu Xuzhong; Papadimos Thomas J

Publisher

BMC anesthesiology

Date

2014
2014

Description

BACKGROUND: Following the 2009 H1N1 Influenza pandemic, extracorporeal membrane oxygenation (ECMO) emerged as a viable alternative in selected, severe cases of ARDS. Acute Respiratory Distress Syndrome (ARDS) is a major public health problem. Average medical costs for ARDS survivors on an annual basis are multiple times those dedicated to a healthy individual. Advances in medical and ventilatory management of severe lung injury and ARDS have improved outcomes in some patients, but these advances fail to consistently "rescue" a significant proportion of those affected. DISCUSSION: Here we present a synopsis of the challenges, considerations, and potential controversies regarding veno-venous ECMO that will be of benefit to anesthesiologists, surgeons, and intensivists, especially those newly confronted with care of the ECMO patient. We outline a number of points related to ECMO, particularly regarding cannulation, pump/oxygenator design, anticoagulation, and intravascular fluid management of patients. We then address these challenges/considerations/controversies in the context of their potential future implications on clinical approaches to ECMO patients, focusing on the development and advancement of standardized ECMO clinical practices. SUMMARY: Since the 2009 H1N1 pandemic ECMO has gained a wider acceptance. There are challenges that still must be overcome. Further investigations of the benefits and effects of ECMO need to be undertaken in order to facilitate the implementation of this technology on a larger scale.

Subject

Adult; Adult/*therapy; Cannulation; ECMO; Equipment Design; Extracorporeal Membrane Oxygenation/*adverse effects/instrumentation/*methods; Humans; Respiratory distress syndrome; Respiratory Distress Syndrome; Veno-venous

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

65–65

Volume

14

Citation

Tulman David B; Stawicki Stanislaw P; Whitson Bryan A; Gupta Saarik C; Tripathi Ravi S; Firstenberg Michael S; Hayes Don Jr; Xu Xuzhong; Papadimos Thomas J, “Veno-venous ECMO: a synopsis of nine key potential challenges, considerations, and controversies.,” NEOMED Bibliography Database, accessed May 12, 2021, https://neomed.omeka.net/items/show/4839.

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