Assistência circulatória com oxigenação por membrana extracorpórea (ECMO) no adulto: um conceito falido ou esquecido?

Colafranceschi, Alexandre Siciliano; Monteiro, Andrey José de Oliveira; Canale, Leonardo Secchin; Campos, Luiz Antonio de Almeida; Montera, Marcelo Westerlund; Silva, Paulo Roberto Dutra da; Fernandes, Marcelo Ramalho; Pinto, Alexandre de Araújo; Molas, Stelmar Moura; Mesquita, Evandro Tinoco

doi:10.1590/s0066-782x2008001300006

Cited by 6 publications

(5 citation statements)

References 9 publications

(10 reference statements)

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“…Experiences from several centers 7 , 8 suggest improvement in early and late survival with this strategy. In our environment, the use of ECMO for resuscitation of severe hemodynamic disorders has been limited 9 , and its application in the postoperative period of cardiac transplantation lacks description in the national literature.…”

Section: Introductionmentioning

confidence: 99%

Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

Lima¹,

Cunha²,

Barzilai³

et al. 2015

Arquivos Brasileiros De Cardiologia

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BackgroundPrimary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome.ObjectiveDescribe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction.MethodsBetween January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally.ResultsThe average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge.ConclusionMechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients.

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Section: Introductionmentioning

confidence: 99%

Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

Lima¹,

Cunha²,

Barzilai³

et al. 2015

Arquivos Brasileiros De Cardiologia

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“…En la actualidad, el trasplante pulmonar ha sido el único tratamiento efectivo para algunas enfermedades pulmonares terminales. Sin embargo, a pesar de los avances de la última década de este procedimiento, la lesión pulmonar inducida por la PGD en el acto quirúrgico, todavía representa frecuente causa de morbidad y mortalidad en el período postoperatorio, siendo la ECMO una de las opciones utilizadas para el tratamiento de la PGD tras el trasplante de pulmón (4,9,27) .…”

Section: Discussionunclassified

“…La ECMO (Extracoporeal Membrane Oxygenation) ha sido utilizada como opción terapéutica en el tratamiento de la insuficiencia respiratoria grave (8) causada por la PGD y consiste en un circuito cerrado de circulación extracorpórea que recibe, a través de una cánula venosa, sangre rica en gas carbónico, de modo que esta es impulsionada por medio de una bomba centrífuga a través de la membrana de oxígeno artificial, y retorna al paciente oxigenado a partir de un sistema arterial o venoso, con un flujo continuo, de modo a ofrecer asistencia cardíaca, respiratoria o cardiorrespiratoria (9) . La ECMO, tras el trasplante pulmonar, ha sido utilizada en pacientes con insuficiencia respiratoria a fin de mejorar el intercambio gaseoso, posibilitando la realización de una estrategia de ventilación protectora para evitar mayores daños al pulmón trasplantado.…”

Section: Introductionunclassified

Uso da Membrana de Oxigenação Extracorpórea em uma Paciente Pós-Transplante Pulmonar: Cuidados de Enfermagem

Oliveira

Neves

Jardim

et al. 2015

eglobal

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Se trata de un relato de experiencia de un caso sin precedentes en Brasil acerca de la sistematización de los cuidados de enfermería aplicados a una paciente en asistencia circulatoria mecánica con membrana de oxigenación extracorpórea en el postoperatorio de un trasplante de pulmón. Se establecieron 18 diagnósticos de enfermería y las 94 conductas implementados abarcaron: cuidados con el circuito de asistencia, monitorización hemodinámica y control de las pruebas de laboratorio. Los principales resultados fueron que el paciente presentaba: un mejor intercambio de gases, mantenimiento de la estabilidad hemodinámica y ausencia de efectos adversos relacionados con el tratamiento, como el sangrado y reducción de la perfusión de la extremidad de la cánula venosa. La sistematización de la atención establecida mostró agregar conocimiento científico, orientación a la práctica clínica y atención integral.

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“…On the other hand, the Brazilian experience regarding the use of mechanical circulatory assistance devices includes only initial series with extracorporeal membrane oxygenation (ECMO) 41,42 and paracorporeal artificial ventricles in the treatment of cardiogenic shock or as bridge to heart transplant 43 .…”

Section: Introductionmentioning

confidence: 99%

Impacto das publicações científicas brasileiras nos recentes avanços científicos na cardiologia

Bacal¹

2009

Arq. Bras. Cardiol.

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The Brazilian research, in the clinical and surgical areas as well as in the basic areas, has developed greatly in recent years. Cardiology, in turn, has effectively contributed for this development. Currently, the Brazilian Archives of Cardiology (Arquivos Brasileiros de Cardiologia), an ISI-indexed journal, joins other important national and also indexed journals, offering the national and international researchers good options for the publication of their studies. This Editorial will discuss the impact of the recent Brazilian scientific publications from the clinical and surgical areas in Cardiology.

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Assistência circulatória com oxigenação por membrana extracorpórea (ECMO) no adulto: um conceito falido ou esquecido?

Cited by 6 publications

References 9 publications

Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

Uso da Membrana de Oxigenação Extracorpórea em uma Paciente Pós-Transplante Pulmonar: Cuidados de Enfermagem

Impacto das publicações científicas brasileiras nos recentes avanços científicos na cardiologia

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