Extracorporeal Life Support in Critically Ill Adults

Ventetuolo, Corey E.; Muratore, Christopher S.

doi:10.1164/rccm.201404-0736ci

Cited by 117 publications

(82 citation statements)

References 142 publications

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“…Treatment of severe IAV with ARDS includes the use of higher dose, intravenous NA inhibitors and aggressive supportive care. Several groups have reported favourable clinical outcomes using extracorporeal membrane oxygenation to support patients with severe hypoxaemic respiratory failure secondary to IAV [165].…”

Section: Therapymentioning

confidence: 99%

Influenza virus-induced lung injury: pathogenesis and implications for treatment

et al. 2015

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The influenza viruses are some of the most important human pathogens, causing substantial seasonal and pandemic morbidity and mortality. In humans, infection of the lower respiratory tract of can result in flooding of the alveolar compartment, development of acute respiratory distress syndrome and death from respiratory failure. Influenza-mediated damage of the airway, alveolar epithelium and alveolar endothelium results from a combination of: 1) intrinsic viral pathogenicity, attributable to its tropism for host airway and alveolar epithelial cells; and 2) a robust host innate immune response, which, while contributing to viral clearance, can worsen the severity of lung injury. In this review, we summarise the molecular events at the virus-host interface during influenza virus infection, highlighting some of the important cellular responses. We discuss immune-mediated viral clearance, the mechanisms promoting or perpetuating lung injury, lung regeneration after influenza-induced injury, and recent advances in influenza prevention and therapy. @ERSpublications We discuss novel aspects of virus-and immune-mediated lung injury and repair after influenza infection

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Section: Therapymentioning

confidence: 99%

Influenza virus-induced lung injury: pathogenesis and implications for treatment

et al. 2015

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“…This work led to technologic innovations and use of extracorporeal life support (ECLS) in management of patients with severe acute respiratory distress syndrome (ARDS). 2009 to 2010 influenza (H1N1) pandemics resulted in an increasing use of ECLS for cardiopulmonary failure after traditional treatment options have failed [41].…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

“…Venoarterial systems support heart and lung, venovenous systems support lung during ECMO. ECCOR (venovenous, lower blood flow rates system with or without pump) supports only lung 41 [36][37][38][39][40][41][42][43][44][45][46][47][48] ECCOR is provided to remove CO 2 and, unlike ECMO, does not provide significant oxygenation. In contrast to ECMO, where the need for oxygenation requires high blood flow rates, ECCOR allows much lower blood flow rates (500-1000mL/min) and needs smaller access cannulas.…”

Section: Extra Corporeal Membrane Oxygenation (Ecmo) and Extra Corpormentioning

confidence: 99%

“…In conclusion, experience with ECMO has been 43 Karakurt et [36][37][38][39][40][41][42][43][44][45][46][47][48] improving with better survival rates and decreasing morbidity. Considering ECMO for patients with respiratory failure or heart failure when conventional therapies failed, if the underlying pathology is reversible or as a bridge to heart and/or lung transplantation is important.…”

Section: Prognosismentioning

confidence: 99%

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Improvements in intensive care units

Karakurt¹,

Yalçin²,

Arıkan³

2016

MMJ

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We have had some important improvements in the intensive care units (ICU) like high flow oxygen system (HFOS), therapeutic hypothermia, extra corporeal membrane oxygenation (ECMO), extra corporeal carbon dioxide removal (ECCOR), echocardiography (ECHO) and ultrasonography (US).HFOS gives oxygen to the patients at rates of flow higher (up to 60 L/min) than that delivered traditionally in LFOS (up to 16L/ min). It is obtained 1 cmH2O PEEP for every 10L/min of flow delivered by HFOS. HFOS serves as an important alternative to noninvasive mechanical ventilation especially in the management of the patients with hypoxemic respiratory failure.Post-resuscitation care consists of optimization of oxygenation and ventilation, avoiding hypotension, treating immediate precipitants of cardiac arrest such as acute coronary ischemia and initiating therapeutic (induced) hypothermia. Therapeutic hypothermia decreases cerebral metabolic rate, blood volume, and intracranial pressure, prevents reperfusion injury. So hypotermia protects cerebral functions.ECMO, the type of cardiopulmonary support, has become an essential tool in critical care patients with severe respiratory and cardiac failure, refractory to conventional therapy methods.Critical care ultrasonography (CCUS) and echocardiography have utility for intensivist-performed, immediate diagnoses of life threatening diseases, with no need to transport patients to radiology or cardiology departments or wait for radiologist or cardiologist on a consultative basis. CCUS and echocardiography should be an essential part of training of every ICU physician.

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“…Therefore, all hope is pinned on percutaneous life-supporting devices like intra-aortic balloon pump (IABP), venoarterial extracorporeal membrane oxygenation (VA-ECMO) and others (1)(2)(3)(4). The Extracorporeal Life Support (ECLS) Organization Registry International Report 2016 (5) contains information on 78,397 ECLS patients.…”

mentioning

confidence: 99%