Ambulatory veno-venous extracorporeal membrane oxygenation

Abstract

Veno-venous extracorporeal membrane oxygenation (VV ECMO) is used for support in patients with severe respiratory failure. The method allows extracorporeal gas exchange and may replace the patient's lung function for weeks and even years. ECMO is not a contraindication for lung transplant. The most important factor for a good outcome is the physiological status of the patient when accepted for transplantation. Ambulatory ECMO makes it possible for the patient to exercise and walk, and provides the best outcome for high risk patients in severe respiratory failure. Ambulatory ECMO is safe in the hands of skilled personnel and prevents critical illness neuropathy and myopathy during prolonged treatments in the intensive care unit.

Extubation of patients undergoing extracorporeal life support. A retrospective study

“…Indeed, ambulatory ECMO, especially for lung transplantation candidates in adult or pediatric populations, is an increasingly frequent practice. 23–25 Early mobilization and physical therapy improve outcomes in critically ill patients. 26…”

Current trends in candidate selection, contraindications, and indications for lung transplantation

“…Extensive prior cardiothoracic surgical procedures and those requiring lung resection may increase both the technical difficulty of explanting the native lung and the operative risk In the current era, prior cardiothoracic procedures are no longer considered contraindications to lung transplant (43). (53,54).…”

Commentary: Finding a solution to the problem: Innovation at its finest

“…2 Further, more prolonged support durations are frequently being used, particularly for respiratory support, where consideration for a cannulation strategy that permits ambulation during ECMO support is paramount. 3 In this issue of the Journal, Orozco-Hernandez and colleagues 4 describe the use of ECMO support in a patient following a bilateral lung transplant complicated initially by right-sided circulatory and respiratory failure with a previous history of right internal jugular vein and superior vena cava thrombosis. Initial cardiopulmonary support was provided with venoarterial ECMO using a 15-French arterial cannula and 21-French multistage venous catheter placed in the right common femoral artery and vein, respectively.…”

“… 2 Further, more prolonged support durations are frequently being used, particularly for respiratory support, where consideration for a cannulation strategy that permits ambulation during ECMO support is paramount. 3 …”