Extracorporeal membrane oxygenation: a ten-year experience

Mols, Georg; Loop, Torsten; Geiger, K.; Farthmann, Edward; Benzing, A.

doi:10.1016/s0002-9610(00)00432-3

Cited by 149 publications

(87 citation statements)

References 65 publications

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“…With proper patient selection, the mortality among patients who have the most severely impaired gas exchange treated with ECMO can be lowered to approximate the mortality of those patients not requiring ECMO. [24][25][26][27][28] The Australia and New Zealand (ANZ) influenza investigators recently reported their experience with ECMO for respiratory failure secondary to H1N1-2009 infection in ANZ. 29 In this series, ECMO usage for H1N1-2009 infection was frequent (68/201, 33.8%), whereas it was infrequent in Canada (6/168, 3.6%).…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada

Freed

Henzler

White

et al. 2010

Can J Anesth/J Can Anesth

107

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Section: Discussionmentioning

confidence: 99%

Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada

Freed

Henzler

White

et al. 2010

Can J Anesth/J Can Anesth

107

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“…Ten studies fulfilled the inclusion criteria, including four RCTs (19)(20)(21)(22) and six observational studies (14,(23)(24)(25)(26)(27). No SYSTEMATIC REVIEW SYSTEMATIC REVIEW pediatric trials met the inclusion criteria, and, therefore, only adult patients were included in all analyses.…”

Section: Literature Searchmentioning

confidence: 99%

Extracorporeal Life Support for Acute Respiratory Failure. A Systematic Review and Metaanalysis

et al. 2014

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Rationale: Extracorporeal life support (ECLS) for acute respiratory failure has increased as a result of technological advancements and promising results from recent studies as compared with historical trials.Objectives: Systematically review the effect of ECLS compared with mechanical ventilation on mortality, length of stay, and adverse events in respiratory failure.Methods: Data sources included were MEDLINE, EMBASE, and CENTRAL (through to October 2013). Any randomized controlled trial (RCT) or observational study comparing ECLS to mechanical ventilation in adults was used. Two authors independently abstracted the data. Our primary outcome was mortality. Secondary outcomes included intensive care unit length of stay, hospital length of stay, and adverse events. A sensitivity analysis was performed restricted to RCTs and quasi-RCTs, and a number of predefined subgroups were identified to explore heterogeneity. Measurements and Main Results:Ten studies (four RCTs, six observational studies, 1,248 patients) were included. There was no significant difference in hospital mortality with ECLS as compared with mechanical ventilation (risk ratio [RR], 1.02; 95% confidence interval [CI], 0.79-1.33; I 2 = 77%). When restricted to venovenous ECLS studies of randomized trials and quasi-randomized trials (three studies; 504 patients), there was a decrease in mortality with ECLS compared with mechanical ventilation (RR, 0.64; 95% CI, 0.51-0.79; I 2 = 15%). There were insufficient study-level data to evaluate most secondary outcomes. Bleeding was significantly greater in the ECLS group (RR, 11.44; 95% CI, 3.11-42.06; I 2 = 0%). In the H1N1 subgroup (three studies; 364 patients), ECLS was associated with significantly lower hospital mortality (RR, 0.62; 95% CI, 0.45-0.8; I 2 = 25%).Conclusions: ECLS was not associated with a mortality benefit in patients with acute respiratory failure. However, a significant mortality benefit was seen when restricted to higher-quality studies of venovenous ECLS. Patients with H1N1-acute respiratory distress syndrome represent a subgroup that may benefit from ECLS. Future studies are needed to confirm the efficacy of ECLS as well as the optimal configuration, indications, and timing for adult patients with respiratory failure.

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“…Extracorporeal gas exchange devices, i.e., venovenous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO 2 R), were developed more than 40 years ago [4,5] to rescue these dying patients. Whereas venovenous ECMO provides complete extracorporeal blood oxygenation and decarboxylation using high blood flows (4-6 l/min) and large (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) cannulas [6][7][8][9], efficient extracorporeal CO 2 removal (with minimal blood oxygenation) can be achieved with ECCO 2 R devices using limited extracorporeal blood flow (0.4-1 l/min) and thin double lumen venous catheters (14)(15)(16)(17)(18) [10,11], because CO 2 clearance is more effective than oxygenation due to the greater solubility and more rapid diffusion of CO 2 [12]. Extracorporeal gas exchange devices also permit 'ultraprotective' mechanical ventilation with further reduction of volume and pressure, which may ultimately enhance lung protection and improve clinical outcomes for patients with acute respiratory distress syndrome (ARDS).…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Gas Exchange for Acute Respiratory Failure in Adult Patients: A Systematic Review

Schmidt

Hodgson

2015

Annual Update in Intensive Care and Emergency Medicine

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Extracorporeal membrane oxygenation: a ten-year experience

Cited by 149 publications

References 65 publications

Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada

Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada

Extracorporeal Life Support for Acute Respiratory Failure. A Systematic Review and Metaanalysis

Extracorporeal Gas Exchange for Acute Respiratory Failure in Adult Patients: A Systematic Review

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