Assistance extracorporelle au cours du syndrome de détresse respiratoire aiguë (chez l’adulte et l’enfant, à l’exclusion du nouveau-né). Conférence de consensus organisée par la Société de réanimation de langue française

Richard, Christian; Argaud, Laurent; Blet, Alice; Boulain, Thierry; Contentin, L.; Dejode, M.; Donetti, L.; Fartoukh, Muriel; Fletcher, Dominique; Kuteifan, Khaldoun; Lasocki, Sigismond; Liet, M.; Lukaszewicz, C.; Mal, Hervé; Maury, Éric; Osman, David; Outin, Hervé; Schneider, Francis; Tamion, Fabienne

doi:10.1007/s13546-014-0858-4

Cited by 11 publications

(2 citation statements)

References 59 publications

(76 reference statements)

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“…Our study describes a collaborative institutional multicenter process for implementation of new ECCO 2 R medical devices in a large metropolis area, with the aim to establish a registry, in accordance with national recommendations [16]. Despite a low rate of utilization, mainly in COPD and ARDS patients, we were able to report a confirmed physiological efficacy and different safety profiles between the devices.…”

Section: Discussionmentioning

confidence: 99%

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A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO2 removal in a large metropolis area

et al. 2019

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Background Extracorporeal carbon dioxide removal (ECCO 2 R) is a promising technique for the management of acute respiratory failure, but with a limited level of evidence to support its use outside clinical trials and/or data collection initiatives. We report a collaborative initiative in a large metropolis. Methods To assess on a structural basis the rate of utilization as well as efficacy and safety parameters of 2 ECCO 2 R devices in 10 intensive care units (ICU) during a 2-year period. Results Seventy patients were recruited in 10 voluntary and specifically trained centers. The median utilization rate was 0.19 patient/month/center (min 0.04; max 1.20). ECCO 2 R was started under invasive mechanical ventilation (IMV) in 59 patients and non-invasive ventilation in 11 patients. The Hemolung Respiratory Assist System (Alung) was used in 53 patients and the iLA Activve iLA kit (Xenios Novalung) in 17 patients. Main indications were ultraprotective ventilation for ARDS patients ( n = 24), shortening the duration of IMV in COPD patients ( n = 21), preventing intubation in COPD patients ( n = 9), and controlling hypercapnia and dynamic hyperinflation in mechanically ventilated patients with severe acute asthma ( n = 6). A reduction in median V T was observed in ARDS patients from 5.9 to 4.1 ml/kg ( p <0.001). A reduction in PaCO 2 values was observed in AE-COPD patients from 67.5 to 51 mmHg ( p < 0.001). Median duration of ECCO 2 R was 5 days (IQR 3–8). Reasons for ECCO 2 R discontinuation were improvement ( n = 33), ECCO 2 R-related complications ( n = 18), limitation of life-sustaining therapies or measures decision ( n = 10), and death ( n = 9). Main adverse events were hemolysis ( n = 21), bleeding ( n = 17), and lung membrane clotting ( n = 11), with different profiles between the devices. Thirty-five deaths occurred during the ICU stay, 3 of which being ECCO 2 R-related. Conclusions Based on a registry, we report a low rate of ECCO 2 R device utilization, mainly in severe COPD and ARDS patients. Physiological efficacy was confirmed in these two populations. We confirmed safety concerns such as hemolysis, bleeding, and thrombosis, with different profiles between the devices. Such results could help to design future studies aiming to enhance safety, to demonstrate a still-lacking strong...

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Section: Discussionmentioning

confidence: 99%

“…Corresponding physiological respiratory benefits have been demonstrated, at the price however of hemolytic, hemorrhagic, and thrombotic complications [1, 2, 15]. Awaiting the results of current or planned RCTs, it has been suggested to use ECCO 2 R within clinical trials and/or to contribute to data registries [1, 2, 15, 16].…”

Section: Introductionmentioning

confidence: 99%

A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO2 removal in a large metropolis area

et al. 2019

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Mobilizing the ECMO Patients: Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation (vvECMO)

Valéra

2017

Nursing Care and ECMO

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Des émulsions de lipides pour sauver les patients gravement intoxiqués par cardiotropes : mythe ou réalité ?

Mégarbane

2014

Réanimation

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Assistance extracorporelle au cours du syndrome de détresse respiratoire aiguë (chez l’adulte et l’enfant, à l’exclusion du nouveau-né). Conférence de consensus organisée par la Société de réanimation de langue française

Cited by 11 publications

References 59 publications

A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO2 removal in a large metropolis area

A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO2 removal in a large metropolis area

Mobilizing the ECMO Patients: Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation (vvECMO)

Des émulsions de lipides pour sauver les patients gravement intoxiqués par cardiotropes : mythe ou réalité ?

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