Outcomes of Intraoperative ECMO Versus Cardiopulmonary Bypass for Lung Transplantation

Machuca, Tiago; Collaud, Stéphane; Mercier, Olaf; Linacre, V.; Krueger, Thorsten; Azad, S.; Singer, L.G.; Yasufuku, Kazuhiro; Perrot, Marc de; Pierre, Andrew; Waddell, Thomas K.; Keshavjee, S.; Cypel, Marcelo

doi:10.1016/j.healun.2014.01.109

Cited by 6 publications

(6 citation statements)

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“…The subsequent evolution in extracorporeal support brings us to the issue of arteriovenous ECMO (Figure 1), addressed here by Machuca and colleagues 3 and others. 13 The current study was undertaken to evaluate the lesscomplex technique of ECMO in LTx.…”

mentioning

confidence: 96%

“…Machuca and colleagues 3 of the University of Toronto compare outcomes of intraoperative extracorporeal membrane oxygenation (ECMO) versus cardiopulmonary bypass (CPB) support in patients undergoing lung transplantation (LTx). This study is the first to address which method of extracorporeal intraoperative support may be superior in LTx, a topic of intense current interest.…”

mentioning

confidence: 99%

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The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation

McFadden

Greene

2015

The Journal of Thoracic and Cardiovascular Surgery

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mentioning

confidence: 96%

mentioning

confidence: 99%

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation

McFadden

Greene

2015

The Journal of Thoracic and Cardiovascular Surgery

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“…In our experience, a matched analysis of semielective cases (exclusion of emergent cases of massive bleeding and those bridged with ECMO) including 33 VA-ECMOs and 66 CPBs, the former resulted in lesser intraoperative blood product transfusion requirement (mean 3 vs 6 U of packed red blood cells; 0 vs 4 U of fresh-frozen plasma; 0 vs 1 U of adult pooled platelets), lesser mechanical ventilation requirement (3 vs 7.5 days), shorter ICU stay (5 vs 9.5 days), and ultimately shorter hospital stay (19 vs 27 days). 25 In the experience of Bermudez and colleagues 26 comparing 49 VA-ECMOs with 222 CPBs at the University of Pittsburgh, there was a higher requirement for reintubation, tracheostomy, and dialysis in the CPB group. The lack of significant differences in perioperative blood transfusion requirement and hospital length of stay may have been caused by the ECMO group including a sicker population, as reflected by the higher lung allocation scores (73.3 vs 52.9) and higher pretransplantation ECLS requirement (42.8% vs 7.2%).…”

Section: Lung Transplantation: Cardiopulmonary Bypass or Extracorporementioning

confidence: 99%

Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations

Machuca

Cypel

Keshavjee

2015

Thoracic Surgery Clinics

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“…Comparing the CPB, VA ECMO would allow to decrease the requirement for dialysis, the risk of bleeding, the need of blood products transfusions, the rates of PGD, and the ICU and hospital lengths of stay (24)(25)(26).…”

Section: Ecls As An Intraoperative Supportmentioning

confidence: 99%

Vascular access for extracorporeal life support: tips and tricks

et al. 2016

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In thoracic surgery, extracorporeal life support (ECLS) techniques are performed to (I) provide a short to mid term extracorporeal mechanical support; (II) realize the gas exchanges; and (III)-depending the configuration of the circuit-substitute the failed heart function. The objective of this review is to describe the rational of the different ECLS techniques used in thoracic surgery and lung transplantation (LTx) with a specific attention to the vascular access. Venovenous extracorporeal membrane oxygenation (VV ECMO)is the most common ECLS technique used in thoracic surgery and represents the best strategy to support the lung function. VV ECMO needs peripheral vascular access. The selection between his double-site or single-site configuration should be decided according the level of O 2 requirements, the nosological context, and the interest to perform an ECLS ambulatory strategy. Venoarterial (VA) ECMO uses peripheral and/or central cannulation sites. Central VA ECMO is mainly used in LTx instead a conventional cardiopulmonary bypass (CPB) to decrease the risk of hemorrhagic issues and the rate of primary graft dysfunction (PGD).Peripheral VA ECMO is traditionally realized in a femoro-femoral configuration. Femoro-femoral VA ECMO allows a cardiocirculatory support but does not provide an appropriate oxygenation of the brain and the heart. The isolated hypercapnic failure is currently supported by extracorporeal CO 2 removal (ECCO 2 R) devices inserted in jugular or subclavian veins. The interest of the Novalung (Novalung GmbH, Hechingen, Germany) persists due to his central configuration indicated to bridge to LTx patients suffering from pulmonary hypertension. The increasing panel of ECLS technologies available in thoracic surgery is the results of a century of clinical practices, engineering progress, and improvements of physiological knowledges. The selection of the ECLS technique-and therefore the vascular access to implant the device-for a given nosological context trends to be defined according an evidence-based medicine.

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Outcomes of Intraoperative ECMO Versus Cardiopulmonary Bypass for Lung Transplantation

Cited by 6 publications

References 0 publications

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation

Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations

Vascular access for extracorporeal life support: tips and tricks

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