Oxigenação extracorpórea por membrana na hipoxemia grave: hora de revermos nossos conceitos?

Abstract

In 2009, during the influenza A (H1N1) epidemic, there were many reported cases of pulmonary infection with severe hypoxemia that was refractory to the ventilatory strategies and rescue therapies commonly used to treat patients with severe acute respiratory distress syndrome. Many of those cases were treated with extracorporeal membrane oxygenation (ECMO), which renewed international interest in the technique. The Extracorporeal Support Study Group was created in order to practice ECMO and to employ it in the treatment of patients with severe hypoxemia. In this article, we discuss the indications for using ECMO and report the case of a patient with refractory hypoxemia who was successfully treated with ECMO.

Severe virus influenza A H1N1 related pneumonia and community-acquired pneumonia: differences in the evolution

“…The main cause of death in patients with H1N1 is respiratory failure refractory to the usual mechanical ventilation. (21) Currently, the use of extracorporeal membrane oxygenation in these patients seems to be one of the most effective measures for reducing mortality. (21) The presence of severe hypoxemia in patients who died suggests that the medical centers that receive these patients should be prepared to offer this type of advanced life support to patients with severe hypoxemia.…”

Respiratory failure after lung transplantation: extracorporeal membrane oxygenation as a rescue treatment

“…In conjunction with lung transplantation, ECMO may be useful as a temporary support for respiratory failure while patients are waiting for the organ and after transplantation in cases of refractory hypoxemia (23-25). Most cases of severe hypoxemia after LTx are due to PGD and result in high rates of mortality.…”

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

“…En los últimos años, principalmente en el período de la epidemia de influenza A (H1N1) en el año 2009, el soporte de intercambio gaseoso a través de ECMO fue muy utilizado como terapia de salvamento en casos graves de insuficiencia respiratoria grave refractaria a las estrategias ventilatorias convencionales (13)(14)(15)(16)(17)(18) . Otro uso de la ECMO descrito en la literatura es el de un estudio (19) que mostró mayor tasa de supervivencia tras la cirugía de una serie de casos de pacientes jóvenes con diagnóstico de insuficiencia respiratoria irreversible y refractaria a la ventilación convencional que utilizaron la ECMO como puente para trasplante pulmonar.…”