Perspective of clinical application of pumpless extracorporeal lung assist (ECMO) in newborn

Abstract

Extracorporeal lung assist (ECLA) has been proposed as an invasive alternative to conventional treatment when oxygenation is not possible by rigorous mechanical ventilation alone. Usually, ECLA is carried out by establishing a venovenous or venoarterial shunt consisting of a roller or centrifugal pump, a membrane oxygenator, and a heat exchanger. However, the extracorporeal membrane oxygenation (ECMO) with circulatory support lead hemolysis, coagulation disorders, inflammatory response, and specific technical complications inherent to a procedure of high risk and cost. To reduce the drawbacks of mechanical blood trauma during prolonged ECLA, the patient´s arteriovenous pressure gradient as the driving force for the blood flow through for the extracorporeal circuit can be used. In this article are analysed the main contributions of pumpless ECMO, used experimentally and in children and adults with respiratory failure, with perspective of clinical application in newborn. Descriptors: Extracorporeal membrane oxygenation. Membrane oxygenators. Oxygenators. Infant, newborn. Resumo A assistência pulmonar extracorpórea tem sido proposta como uma alternativa invasiva ao tratamento convencional, quando a oxigenação adequada torna-se impossível pelo uso de ventilação mecânica. Usualmente, a ventilação extracorpórea é realizada por meio de shunt veno-venoso ou

Avaliação de oxigenador de membrana infantil em ovinos

“…In Brazil, a new generation of membrane oxygenators manufactured especially for pediatric perfusion, allowed a dramatic perfusate volume reduction and, consequently, better surgical outcomes [3][4][5].…”