Indian Journal of Respiratory Care

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VOLUME 3 , ISSUE 2 ( July-December, 2014 ) > List of Articles

REVIEW ARTICLE

Extracorporeal Membrane Oxygenation Therapy - A review

Sagar S Haval

Keywords : Cardiac failure, extracorporeal membrane oxygenation, respiratory failure

Citation Information : Haval SS. Extracorporeal Membrane Oxygenation Therapy - A review. Indian J Respir Care 2014; 3 (2):479-487.

DOI: 10.5005/ijrc-3-2-479

License: NA

Published Online: 30-11-2022

Copyright Statement:  NA


Abstract

Since the first successful case of Extracorporeal Membrane Oxygenation (ECMO) in early 1970’s till date, there has been quite a change in clinical approach and technology. The recent H1N1 flu pandemic led to a wider use of ECMO therapy worldwide, proving its superiority in supporting respiratory failures with better outcomes. More over centres applied it as a rescue therapy for refractory hypoxaemia and refractory circulatory failures understanding its benefits and limitations. Understanding and execution of the ECMO therapy can be quite challenging and may have a greater learning curve. Initiating the ECMO program in the hospital with an organised and planned approach may shorten the learning curve and improve outcomes. Multiple factors are responsible for successful and smoother functioning of the ECMO program, which should be identified and worked upon. There are many indications where ECMO therapy can be applied and understanding its potential in the hospital is of utmost importance. Along with this, forming an ECMO team with trained members, forming policies and protocols, and taking the right decisions at the right time are important. An in-depth review of every aspect of its successful institution has been discussed in this article.


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  1. Bartlett RH, Fong SW, Burns NE, Gazzaniga AB. Prolonged partial venoarterial bypass: physiologic, biochemical and haematologic responses. Ann Surg 1974; 180: 850-6.
  2. Hill JD, O’Brien TG, Murray JJ et al. Prolonged extracorporeal oxygenation for acute posttraumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 1972; 286: 629-34.
  3. Bartlett RH, Gazzaniga AB, Jeff eries MR, Huxtable RF, Haiduc NJ, Fong SW: Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. Trans Am Soc Artif Intern Organs 1976, 22:80-93.
  4. Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagniewski A, Miller RG Jr: Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. JAMA 1979, 242:2193-6.
  5. Kolobow T, Gattinoni L, Tomlinson T, White D, Pierce J, Iapichino G: The carbon dioxide membrane lung (CDML): a new concept. Trans Am Soc Artif Intern Organs 1977, 23:17-21.
  6. Kolobow T, Gattinoni L, Tomlinson TA, Pierce JE: Control of breathing using an extracorporeal membrane lung. Anesthesiology 1977, 46:138-41.
  7. Drummond M, Braile D, Paula A. Technological evolution of membrane oxygenators. Braz J Cardiovasc Surg 2005; 20: 432-7.
  8. Peek GJ, Mugford M, Tiruvoipati R et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009, 374:1351-63.
  9. Davies A, Jones D, Bailey M et al. Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 2009, 302:1888-95
  10. Delius RE, Otto AM. Extracorporeal membrane oxygenation support (ECMO) for cardiorespiratory failure. In: Mechanical Circulatory Support. Ed. Richenbacher Wayne. LandesBioscience:Texas: 1999.p.53-75
  11. Sivarajan VB, Best D, Brizard CP. Improved outcomes of paediatric extracorporeal support associated with technology change. Interact Cardiovasc Thorac Surg 2010; 10: 400-5.
  12. Park SB, Yang JH, Suh GY et al. Surviving factors of extracorporeal cardiopulmonary resuscitation in adults with in-hospital arrest. Crit Care Med 2013;41:12
  13. PalatianosGM, Foroulis CN, Vassili MI et al. A prospective, double blind study on the efficacy of the bioline surface heparinized extracorporeal perfusion circuit. Ann Thorac Surg 2003; 76: 129-35.
  14. Harig F, Feyrer R, Mahmoud FO et al. Reducing the post-pump syndrome by using heparincoated circuits, steroids, or aprotinin.Thorac Cardiovasc Surg 1999; 47: 111-8.
  15. Wahba A, Philipp A, Behr R, Bimbaum DE. Heparin-coated equipment reduces the risk of oxygenator failure. Ann Thorac Surg 1998; 65: 1310-2.
  16. Feyrer R, Harig F, Cesnjevar R, et al. Bioline or safeline treatment of CPB circuits? Cardiovascular Engineering 2003; 8:79-84.
  17. Freeman L C., Bennett D T, Casper Cet al. Pediatric and neonatal extracorporeal membrane oxygenation: does center volume impact mortality? Crit Care Med 2014; 42:512-9.
  18. Esteban A, Ferguson ND, Meade MO, et al. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med 2008;177:170-7.
  19. Brun-Buisson C, Minelli C, Bertolini G, et al. ALIVE Study Group. Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study. Intensive Care Med 2004;30:51-61.
  20. Ranieri VM, Rubenfeld GD, Thompson BT et al. The ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin definition. JAMA 2012; 307: 2526-33.
  21. Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med 2005;353:1685-93.
  22. Kaul TK, Fields BL. Postoperative acute refractory right ventricular failure: incidence, pathogenesis, management and prognosis. Cardiovasc Surg 2000;8:1-9.
  23. Deng MC, Edwards LB, Hertz MI, Rowe AW, Keck BM, Kormos R, et al. International Society for Heart and Lung Transplantation. Mechanical circulatory support device database of the International Society for Heart and Lung Transplantation: third annual report. J Heart Lung Transplant 2005;24(9):1182-7.
  24. Killip T 3rd, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol 1967; 20(4):457-64.
  25. Menon V, Hochman JS. Management of cardiogenic shock complicating acute myocardial infarction. Heart 2002; 88(5):531-7.
  26. Goldberg RJ, Gore JM, Alpert JS, Osganian V, de Groot J, Bade J, Chen Z, Frid D, Dalen JE. Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988. N Engl J Med; 325:1117-22.
  27. Holmes DR Jr, Bates ER, Kleiman NS, Sadowski Z, Horgan JH, Morris DC, Califf RM, Berger PB, Topol EJ. Contemporary reperfusion therapy for cardiogenic shock: the GUSTO-I trial experience. The GUSTO-I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. J Am Coll Cardiol 1995; 26:668-74.
  28. Jacobs AK, French JK, Col J, et al. Cardiogenic shock with non-ST-segment elevation myocardial infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularizeoccluded coronaries for cardiogenic shocK? J Am Coll Cardiol 2000; 36:1091-6.
  29. Holmes DR Jr, Berger PB, Hochman JS et al. Cardiogenic shock in patients with acute ischemic syndromes with and without STsegment elevation. Circulation 1999; 100:2067-73.
  30. Khalid L, Dhakam SH. A review of cardiogenic shock in acute myocardial infarction. Curr Cardiol Rev 2008; 4: 34-40.
  31. Lee CJ. Intensive cardiopulmonary support for otherwise dying post-heart and lung transplant recipients with extracorporeal membrane oxygenation. Artif Organs 2001; 25:597-8.
  32. OtoT, Rosenfeldt F, Rowland M. Extracorporeal membrane oxygenation after lung transplantation: evolving technique improves outcomes. Ann Thorac Surg 2004; 78:1230-5.
  33. Cypel M, Keshavjee S. Extracorporeal life support as a bridge to lung transplantation. Clin Chest Med 2011; 32:245-51.
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