Continuous Ilioinguinal Nerve Block for Treatment of Femoral Extracorporeal Membrane Oxygenation Cannula Site Pain

Graber, Taylor J.; Meineke, Minhthy N.; Said, Engy T.; Finneran, John J.

doi:10.1053/j.jvca.2020.08.023

Cited by 1 publication

(1 citation statement)

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“…A total of 57 articles including data from 467 awake ECMO patients (923 total ECMO patients) were included in the analysis ( Fig. 1 ) (21–73). Of these, 28 articles (49%) were case reports including a single patient each and 29 articles (51%) were case series with a median sample size of 10 patients (range, 3–65 patients) ( Supplementary Table 1 , http://links.lww.com/CCM/H411).…”

Section: Resultsmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation Without Invasive Ventilation for Respiratory Failure in Adults: A Systematic Review*

Belletti,

Sofia,

Cicero

et al. 2023

Critical Care Medicine

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OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is an advanced treatment for acute severe respiratory failure. Patients on ECMO are frequently maintained sedated and immobilized until weaning from ECMO, first, and then from mechanical ventilation. Avoidance of sedation and invasive ventilation during ECMO may have potential advantages. We performed a systematic literature review to assess efficacy and safety of awake ECMO without invasive ventilation in patients with respiratory failure. DATA SOURCES: PubMed, Web of Science, and Scopus were searched for studies reporting outcome of awake ECMO for adult patients with respiratory failure. STUDY SELECTION: We included all studies reporting outcome of awake ECMO in patients with respiratory failure. Studies on ECMO for cardiovascular failure, cardiac arrest, or perioperative support and studies on pediatric patients were excluded. Two investigators independently screened and selected studies for inclusion. DATA EXTRACTION: Two investigators abstracted data on study characteristics, rate of awake ECMO failure, and mortality. Primary outcome was rate of awake ECMO failure (need for intubation). Pooled estimates with corresponding 95% CIs were calculated. Subgroup analyses by setting were performed. DATA SYNTHESIS: A total of 57 studies (28 case reports) included data from 467 awake ECMO patients. The subgroup of patients with acute respiratory distress syndrome showed a pooled estimate for awake ECMO failure of 39.3% (95% CI, 24.0–54.7%), while in patients bridged to lung transplantation, pooled estimate was 23.4% (95% CI, 13.3–33.5%). Longest follow-up mortality was 121 of 439 (pooled estimate, 28%; 95% CI, 22.3–33.6%). Mortality in patients who failed awake ECMO strategy was 43 of 74 (pooled estimate, 57.2%; 95% CI, 40.2–74.3%). Two cases of cannula self-removal were reported. CONCLUSIONS: Awake ECMO is feasible in selected patients, although the effect on outcome remains to be demonstrated. Mortality is almost 60% in patients who failed awake ECMO strategy.

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Section: Resultsmentioning

confidence: 99%