Pumpless extracorporeal lung assist

Jc, Möller; Schaible, T; Ahrens, Wiebke; Kohl, M.

doi:10.1016/s0140-6736(05)74555-4

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…Results of metanalyses of randomized control trials for outcomes of surfactant use in pediatric acute respiratory distress syndrome.Forest plots comparing inhaled surfactant and placebo for the outcomes of all-cause mortality (A) and ventilator-free days (VFDs) (B). Five studies were included(25,(29)(30)(31)(32). REML = restricted maximum likelihood.…”

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confidence: 99%

Pulmonary Specific Ancillary Treatment for Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Rowan

Randolph

Iyer

et al. 2023

Pediatric Critical Care Medicine

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We conducted an updated review of the literature on pulmonaryspecific ancillary therapies for pediatric acute respiratory distress syndrome (PARDS) to provide an update to the Pediatric Acute Lung Injury Consensus Conference recommendations and statements about clinical practice and research.DATA SOURCES: MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost). STUDY SELECTION:Searches were limited to children, PARDS or hypoxic respiratory failure and overlap with pulmonary-specific ancillary therapies DATA EXTRACTION: Title/abstract review, full-text review, and data extraction using a standardized data collection form. DATA SYNTHESIS:The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. Twenty-six studies were identified for fulltext extraction. Four clinical recommendations were generated, related to use of inhaled nitric oxide, surfactant, prone positioning, and corticosteroids. Two good practice statements were generated on the use of routine endotracheal suctioning and installation of isotonic saline prior to endotracheal suctioning. Three research statements were generated related to: the use of open versus closed suctioning, specific methods of airway clearance, and various other ancillary therapies. CONCLUSIONS:The evidence to support or refute any of the specific ancillary therapies in children with PARDS remains low. Further investigation, including a focus on specific subpopulations, is needed to better understand the role, if any, of these various ancillary therapies in PARDS.

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confidence: 99%

Pulmonary Specific Ancillary Treatment for Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Rowan

Randolph

Iyer

et al. 2023

Pediatric Critical Care Medicine

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Extracorporeal Membrane Oxygenation

Conrad

Scott

2006

Wiley Encyclopedia of Biomedical Engineering

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Extracorporeal membrane oxygenation (ECMO) is the provision of long‐term support for severe, potentially reversible cardiopulmonary failure through the use of extrathoracic cannulation and an extracorporeal circuit. The extracorporeal circuit is a modification of the heart‐lung machine used in cardiac bypass surgery and consists of a drainage reservoir, blood pump, artificial lung for oxygen and carbon dioxide exchange, a heat exchanger for maintenance of body temperature, cannulae for vascular access, and connecting tubing. ECMO is used in the management of severe, acute, potentially reversible cardiopulmonary failure in neonates, children, and adults. The modes of support include venoarterial (VA), venovenous (VV), arteriovenous (AV), and hybrid VA and VV (VVA). Venoarterial support bypasses the heart and lungs and provides cardiac and pulmonary support. Venovenous provides gas exchange in the central venous circulation, and it provides pulmonary support only. Arteriovenous is performed using an artificial lung without a pump, but provides carbon dioxide removal only. VVA mode combines partial cardiac support in addition to pulmonary support. The performance of the ECMO circuit depends on several factors. Blood flow is dependent on geometry of the vascular cannulae, tubing, and artificial lung, and it includes laminar and turbulent flow. Pressure‐flow relationships for ECMO circuit components have been published. Gas exchange efficiency in venovenous ECMO is affected by recirculation. The determinants of artificial lung gas transfer are complex but based on principles of passive diffusion. Modern cross‐flow hollow fiber devices that have blood flow exterior to the fibers demonstrate the best blood flow and gas transfer performance.

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Pumpless extracorporeal lung assist

Cited by 2 publications

References 2 publications

Pulmonary Specific Ancillary Treatment for Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Pulmonary Specific Ancillary Treatment for Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference

Extracorporeal Membrane Oxygenation

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