Extracorporeal Membrane Oxygenation in the Treatment of Respiratory Failure—A Review

Newland, P E

doi:10.1177/0310057x7700500202

Cited by 8 publications

(4 citation statements)

References 54 publications

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“…La membrana de oxigenación extracorpórea es estudiada desde los años 70 como un método de soporte para el intercambio gaseoso en pacientes a quienes falla la ventilación convencional. 19 Recientemente, la membrana de oxigenación extracorpórea (ECMO) veno-venosa (V-V) es adoptada como una terapia de segunda línea en pacientes con SDRA e hipoxemia refractaria y está asociada con mejoría en la supervivencia. 20…”

Section: Ventilación Con Volumen Corriente Bajounclassified

El decúbito prono como estrategia terapéutica para la mejora del síndrome de distrés respiratorio agudo

Marimon¹,

huguet²,

Biosca³

2017

metas

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RESUMENEl objetivo del presente escrito es realizar una amplia revisión sobre el tema de SDRA, complementándolo con el reporte de un caso tratado en Admisión Continua del Instituto Mexicano del Seguro Social, Hospital General «Gaudencio González Garza» Centro Médico Nacional «La Raza», enfocándonos en la importancia de esta patología y las opciones terapéuticas que se pueden aplicar en Urgencias. La recopilación de datos se realizó de los artículos más relevantes en el buscador PubMed y en la base de datos de Cochrane. Resultados: El SDRA es un tipo de proceso infl amatorio difuso que lleva a incremento de la permeabilidad vascular, incremento del peso y disminución de las zonas ventiladas del tejido pulmonar generando hipoxemia. Conclusión: La ventilación pulmonar en posición prono y la ventilación protectora disminuyen de manera signifi cativa la mortalidad en pacientes con SDRA grave, siendo factible el uso de estas estrategias en Urgencias.Palabras clave: Ventilación en posición prono, SDRA, Berlín, infl uenza, hipoxemia, ventilación protectora. ABSTRACTThe objective of this paper is to conduct a comprehensive review on the subject of ARDS, complemented by the reporting of a case that was treated in Admission Continuing, Mexican Institute of Social Security, Hospital General «Gaudencio González Garza» National Medical Center «La Raza», focusing on the importance of this disease and the treatment options that can be applied in emergencies. The data collection was carried out in the most relevant articles in the PubMed search engine and database of Cochrane. Results: ARDS is a type of diffuse infl ammatory process leading to increased vascular permeability, increased weight and decreased tissue ventilated lung areas causing hypoxemia. Conclusion: Pulmonary ventilation in the prone position and protective ventilation signifi cantly reduce mortality in patients with severe ARDS, being feasible to use these strategies in emergencies.

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Section: Ventilación Con Volumen Corriente Bajounclassified

El decúbito prono como estrategia terapéutica para la mejora del síndrome de distrés respiratorio agudo

Marimon¹,

huguet²,

Biosca³

2017

metas

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“…Extracorporeal membrane oxygenation (ECMO) has been studied since 1970s as a method for supporting gas exchange in patients failing conventional ventilation [88]. A RCT conducted in 1979 showed that ECMO use had no effect on long-term survival of ARDS patients [89].…”

Section: Treatmentmentioning

confidence: 99%

Acute Respiratory Distress Syndrome: Pathophysiology and Therapeutic Options

et al. 2012

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Acute Respiratory Distress Syndrome (ARDS) is a common entity in critical care. ARDS is associated with many diagnoses, including trauma and sepsis, can lead to multiple organ failure and has high mortality. The present article is a narrative review of the literature on ARDS, including ARDS pathophysiology and therapeutic options currently being evaluated or in use in clinical practice. The literature review covers relevant publications until January 2011. Recent developments in the therapeutic approach to ARDS include refinements of mechanical ventilatory support with emphasis on protective lung ventilation using low tidal volumes, increased PEEP with use of recruitment maneuvers to promote reopening of collapsed lung alveoli, prone position as rescue therapy for severe hypoxemia, and high frequency ventilation. Supportive measures in the management of ARDS include attention to fluid balance, restrictive transfusion strategies, and minimization of sedatives and neuromuscular blocking agents. Inhaled bronchodilators such as inhaled nitric oxide and prostaglandins confer short term improvement without proven effect on survival, but are currently used in many centers. Use of corticosteroids is also important, and appropriate timely use may reduce mortality. Finally, extra corporeal oxygenation methods are very useful as rescue therapy in patients with intractable hypoxemia, even though a survival benefit has not, to this date been demonstrated. Despite intense ongoing research on the pathophysiology and treatment of ARDS, mortality remains high. Many pharmacologic and supportive strategies have shown promising results, but data from large randomized clinical trials are needed to fully evaluate the true effectiveness of these therapies.KeywordsARDS; Pathophysiology; Treatment

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“…Silicone polymers available in thin sheets, which enhanced gas transfer through membranes, began to be characterized quantitatively during this period. It was not until the 1970s-almost two decades after Clowes developed the first membrane lung-that clinical trials of prolonged ECMO began [4][5][6][7].…”

Section: History and Adult Experiencementioning

confidence: 99%

Neonatal Extracorporeal Membrane Oxygenation: A Review

Short

Pearson

1986

J Intensive Care Med

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The history of extracorporeal membrane oxygenation (ECMO) therapy is summarized. The adult and pediatric experiences are described, but emphasis is placed on the development of neonatal ECMO, now an accepted therapy for newborns with severe respiratory failure. The technical aspects of neonatal ECMO are outlined, as are the clinical criteria for its use. Experience at Children's Hospital National Medical Center, Washington, DC, is reported. Promising new technological developments, and their implications for future applications of neonatal ECMO, are presented.

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Extracorporeal Membrane Oxygenation in the Treatment of Respiratory Failure—A Review

Cited by 8 publications

References 54 publications

El decúbito prono como estrategia terapéutica para la mejora del síndrome de distrés respiratorio agudo

El decúbito prono como estrategia terapéutica para la mejora del síndrome de distrés respiratorio agudo

Acute Respiratory Distress Syndrome: Pathophysiology and Therapeutic Options

Neonatal Extracorporeal Membrane Oxygenation: A Review

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