Extracorporeal membrane oxygenation (ECMO) and beyond in near fatal asthma: A comprehensive review

Lozano-Espinosa, María; Antolín-Amérigo, Darío; Riera, Jordi; Gordo Vidal, Federico; Quirce, Santiago; Álvarez Rodríguez, Joaquín

doi:10.1016/j.rmed.2023.107246

Cited by 6 publications

(5 citation statements)

References 59 publications

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“…Five studies met inclusion criteria and were selected ( Table 1 ). 1 , 5 – 9 The studies ranged in size from 10 to 272 patients (total, 449 patients). The in-hospital mortality rate estimated from all five studies was 8% (95% CI, 2%–14%).…”

Section: Resultsmentioning

confidence: 99%

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Evidence Synthesis of Outcomes of Extracorporeal Membrane Oxygenation for Life-Threatening Asthma Exacerbations

Shen,

Law,

Wilson

2024

CHEST Critical Care

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Section: Resultsmentioning

confidence: 99%

“…We were reassured that this is unlikely, however, because a recent review article that performed a systematic literature search did not identify any additional studies. 9 …”

Section: Discussionmentioning

confidence: 99%

Evidence Synthesis of Outcomes of Extracorporeal Membrane Oxygenation for Life-Threatening Asthma Exacerbations

Shen,

Law,

Wilson

2024

CHEST Critical Care

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“…Extracorporeal membrane oxygenation (ECMO) has been implemented in clinical practice since 1972 ( 6 ), which has become an indispensable auxiliary support technology in the clinical treatment of critically ill patients ( 7 - 10 ) to provide both blood flow support and in vitro gas exchange. However, ECMO is an invasive procedure that is associated with significant complications.…”

Section: Introductionmentioning

confidence: 99%

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

Zhang,

Li,

Xie

et al. 2024

J Thorac Dis

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Background Extracorporeal membrane oxygenation (ECMO) has been increasingly used as life support for lung transplantation. However, there are no clinical risk models to predict whether ECMO support is required for lung transplantation. This study developed a simple risk score to predict the need for intraoperative ECMO in patients undergoing lung transplantation, identify high-risk patients who need ECMO support, and guide clinical interventions. Methods Patients, who underwent lung transplantation between January 1, 2016 and July 31, 2021, were systematically reviewed. All enrolled patients were divided in a ratio of 7:3 to establish the development and validation datasets. A risk score model was established using stepwise logistic regression and verified using bootstrapping and the split-sample method. Results A total of 248 patients who underwent lung transplants were enrolled. Multivariate analysis showed that the primary disease diagnosis, pulmonary artery systolic pressure, sex, surgical type, creatine kinase isoenzyme-MB, and pro-B-type natriuretic peptide were risk factors for intraoperative ECMO during lung transplantation. The risk score was established and calibrated according to these six factors, ranging from 0 to 41, with the associated prediction of intraoperative use of ECMO ranging from 1.5% to 99.7% (Hosmer-Lemeshow χ 2 =5.624; P=0.689). Good discrimination was verified by developing and validating the datasets (C-statistics =0.850 and 0.842, respectively). Based on the distribution of the scores, the three levels were classified as low-risk (0–10], moderate-risk (10–20], and high-risk (20–41]. Conclusions This simple risk score model effectively predicts the need for intraoperative ECMO and stratifies high-risk patients who require ECMO support.

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“…It is characterized by airway inflammation, bronchoconstriction, and increased mucus secretion, resulting in episodic symptoms such as wheezing, coughing, chest tightness, and dyspnea. Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with severe asthma who are unresponsive to conventional treatments ( 3 ). This extracorporeal life support temporarily sustains cardiopulmonary function by externally removing carbon dioxide and oxygenating blood ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…This extracorporeal life support temporarily sustains cardiopulmonary function by externally removing carbon dioxide and oxygenating blood ( 4 ). In contemporary times, ECMO has gained significant attention as a viable therapeutic alternative for severe respiratory failure arising from diverse etiologies, including acute respiratory distress syndrome, pneumonia, and exacerbated asthma ( 3 , 5 , 6 ). With the widespread adoption of ECMO technology in intensive care units, its application in managing patients with severe asthma has also increased.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation treatment for severe asthma had unexpected adverse effects: a case report

Wang,

Zhang,

Chen

et al. 2023

Front. Med.

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Asthma, a chronic respiratory ailment, affects millions worldwide. Extracorporeal membrane oxygenation (ECMO) has gained traction as a life-saving intervention for patients with severe asthma who are unresponsive to conventional treatments. However, complications associated with ECMO, including electrolyte imbalances and hemorrhage, can have significant clinical implications. This case report highlights a 49 years-old male patient with severe asthma who developed pronounced hypokalemia and hemorrhage following venovenous ECMO (VVECMO) therapy. Despite potassium supplementation, serum potassium levels continued declining before normalizing after 24 h. The patient subsequently experienced gastrointestinal bleeding, cerebral hemorrhage, and extensive cerebral infarction, ultimately resulting in a deep coma. Hypokalemia during ECMO therapy can result from a rapid reduction of carbon dioxide, β-receptor agonist use, corticosteroid use, and diuretic administration. Hemorrhage is another common ECMO complication, often linked to heparin anticoagulation therapy. Clinicians should be aware of potential complications and adopt appropriate prevention and management strategies when using ECMO in patients with severe asthma.

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Extracorporeal membrane oxygenation (ECMO) and beyond in near fatal asthma: A comprehensive review

Cited by 6 publications

References 59 publications

Evidence Synthesis of Outcomes of Extracorporeal Membrane Oxygenation for Life-Threatening Asthma Exacerbations

Evidence Synthesis of Outcomes of Extracorporeal Membrane Oxygenation for Life-Threatening Asthma Exacerbations

A risk score for predicting extracorporeal membrane oxygenation support before lung transplantation

Extracorporeal membrane oxygenation treatment for severe asthma had unexpected adverse effects: a case report

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