nach oben

Erschienen in:

23.03.2016 | Review

Venovenous extracorporeal membrane oxygenation for acute respiratory failure

A clinical review from an international group of experts

verfasst von: Eddy Fan, Luciano Gattinoni, Alain Combes, Matthieu Schmidt, Giles Peek, Dan Brodie, Thomas Muller, Andrea Morelli, V. Marco Ranieri, Antonio Pesenti, Laurent Brochard, Carol Hodgson, Cecile Van Kiersbilck, Antoine Roch, Michael Quintel, Laurent Papazian

Erschienen in: Intensive Care Medicine | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Despite expensive life-sustaining interventions delivered in the ICU, mortality and morbidity in patients with acute respiratory failure (ARF) remain unacceptably high. Extracorporeal membrane oxygenation (ECMO) has emerged as a promising intervention that may provide more efficacious supportive care to these patients. Improvements in technology have made ECMO safer and easier to use, allowing for the potential of more widespread application in patients with ARF. A greater appreciation of the complications associated with the placement of an artificial airway and mechanical ventilation has led clinicians and researchers to seek viable alternatives to providing supportive care in these patients. Thus, this review will summarize the current knowledge regarding the use of venovenous (VV)-ECMO for ARF and describe some of the recent controversies in the field, such as mechanical ventilation, anticoagulation and transfusion therapy, and ethical concerns in patients supported with VV-ECMO.

Nur mit Berechtigung zugänglich

Hill JD, O’Brien TG, Murray JJ et al (1972) Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 286:629–634. doi:10.1056/NEJM197203232861204 CrossRefPubMed

Gille JP, Bagniewski AM (1976) Ten years of use of extracorporeal membrane oxygenation (ECMO) in the treatment of acute respiratory insufficiency (ARI). Trans Am Soc Artif Intern Organs 22:102–109PubMed

Zapol WM, Snider MT, Hill JD et al (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. JAMA 242:2193–2196CrossRefPubMed

Kolobow T, Gattinoni L, Tomlinson T, Pierce JE (1978) An alternative to breathing. J Thorac Cardiovasc Surg 75:261–266PubMed

Gattinoni L, Iapichino G, Kolobow T (1979) Hemodynamic, mechanical and renal effects during “apneic oxygenation” with extracorporeal carbon dioxide removal, at different levels of intrapulmonary pressure in lambs. Int J Artif Organs 2:249–253PubMed

Gattinoni L, Kolobow T, Tomlinson T et al (1978) Control of intermittent positive pressure breathing (IPPB) by extracorporeal removal of carbon dioxide. Br J Anaesth 50:753–758CrossRefPubMed

Cressoni M, Caironi P, Polli F et al (2008) Anatomical and functional intrapulmonary shunt in acute respiratory distress syndrome. Crit Care Med 36:669–675. doi:10.1097/01.CCM.0000300276.12074.E1 CrossRefPubMed

Lamy M, Eberhart RC, Fallat RJ et al (1975) Effects of extracorporeal membrane oxygenation (ECMO) on pulmonary hemodynamics, gas exchange and prognose. Trans Am Soc Artif Intern Organs 21:188–198PubMed

Guervilly C, Dizier S, Thomas G et al (2014) Comparison of femorofemoral and femorojugular configurations during venovenous extracorporeal membrane oxygenation for severe ARDS. Intensive Care Med 40:1598–1599. doi:10.1007/s00134-014-3427-0 CrossRefPubMed

10.

Combes A, Brodie D, Bartlett R et al (2014) Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med 190:488–496

11.

Brodie D, Bacchetta M (2011) Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med 365:1905–1914. doi:10.1056/NEJMct1103720 CrossRefPubMed

12.

Del Sorbo L, Cypel M, Fan E (2014) Extracorporeal life support for adults with severe acute respiratory failure. Lancet Respir Med 2:154–164. doi:10.1016/S2213-2600(13)70197-8 CrossRefPubMed

13.

Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators, Davies A, Jones D et al (2009) Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 302:1888–1895. doi:10.1001/jama.2009.1535 CrossRef

14.

Noah MA, Peek GJ, Finney SJ et al (2011) Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1). JAMA 306:1659–1668. doi:10.1001/jama.2011.1471 CrossRefPubMed

15.

Pham T, Combes A, Chevret S et al (2013) Extracorporeal membrane oxygenation for pandemic influenza A(H1N1)-induced acute respiratory distress syndrome: a cohort study and propensity-matched analysis. Am J Respir Crit Care Med 187:276–285. doi:10.1164/rccm.201205-0815OC

16.

Mikkelsen ME, Woo YJ, Sager JS et al (2009) Outcomes using extracorporeal life support for adult respiratory failure due to status asthmaticus. ASAIO J 55:47–52. doi:10.1097/MAT.0b013e3181901ea5 CrossRefPubMedPubMedCentral

17.

Frenckner B, Palmér P, Lindén V (2002) Extracorporeal respiratory support and minimally invasive ventilation in severe ARDS. Minerva Anestesiol 68:381–386PubMed

18.

Fuehner T, Kuehn C, Hadem J et al (2012) Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med 185:763–768. doi:10.1164/rccm.201109-1599OC

19.

Barbaro RP, Odetola FO, Kidwell KM et al (2015) Association of hospital-level volume of extracorporeal membrane oxygenation cases and mortality. Analysis of the Extracorporeal Life Support Organization registry. Am J Respir Crit Care Med 191:894–901. doi:10.1164/rccm.201409-1634OC CrossRefPubMed

20.

Rich PB, Awad SS, Crotti S et al (1998) A prospective comparison of atrio-femoral and femoro-atrial flow in adult venovenous extracorporeal life support. J Thorac Cardiovasc Surg 116:628–632CrossRefPubMed

21.

Broman M, Frenckner B, Bjällmark A, Broomé M (2015) Recirculation during veno-venous extra-corporeal membrane oxygenation—a simulation study. Int J Artif Organs 38:23–30. doi:10.5301/ijao.5000373 CrossRefPubMed

22.

Rastan AJ, Lachmann N, Walther T et al (2006) Autopsy findings in patients on postcardiotomy extracorporeal membrane oxygenation (ECMO). Int J Artif Organs 29:1121–1131PubMed

23.

Combes A, Leprince P, Luyt C-E et al (2008) Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 36:1404–1411. doi:10.1097/CCM.0b013e31816f7cf7 CrossRefPubMed

24.

Cooper E, Burns J, Retter A et al (2015) Prevalence of venous thrombosis following venovenous extracorporeal membrane oxygenation in patients with severe respiratory failure. Crit Care Med 43:e581–e584. doi:10.1097/CCM.0000000000001277 CrossRefPubMed

25.

Lubnow M, Philipp A, Foltan M et al (2014) Technical complications during veno-venous extracorporeal membrane oxygenation and their relevance predicting a system-exchange—retrospective analysis of 265 cases. PLoS One 9:e112316. doi:10.1371/journal.pone.0112316 CrossRefPubMedPubMedCentral

26.

Müller T, Lubnow M, Philipp A et al (2011) Risk of circuit infection in septic patients on extracorporeal membrane oxygenation: a preliminary study. Artif Organs 35:E84–E90. doi:10.1111/j.1525-1594.2010.01185.x CrossRefPubMed

27.

Glick D, Dzierba AL, Abrams D et al (2015) Clinically suspected heparin-induced thrombocytopenia during extracorporeal membrane oxygenation. J Crit Care 30:1190–1194. doi:10.1016/j.jcrc.2015.07.030 CrossRefPubMed

28.

Pan KC, McKenzie DP, Pellegrino V et al (2015) The meaning of a high plasma free haemoglobin: retrospective review of the prevalence of haemolysis and circuit thrombosis in an adult ECMO centre over 5 years. Perfusion. doi:10.1177/0267659115595282 PubMed

29.

Weingart C, Lubnow M, Philipp A et al (2015) Comparison of coagulation parameters, anticoagulation, and need for transfusion in patients on interventional lung assist or veno-venous extracorporeal membrane oxygenation. Artif Organs 39:765–773. doi:10.1111/aor.12464 CrossRefPubMed

30.

Peek GJ, Mugford M, Wilson A et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374:1351–1363. doi:10.1016/S0140-6736(09)61069-2 CrossRefPubMed

31.

Patroniti N, Zangrillo A, Pappalardo F et al (2011) The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks. Intensive Care Med 37:1447–1457. doi:10.1007/s00134-011-2301-6 CrossRefPubMed

32.

Combes A (2011) Extracorporeal membrane oxygenation (ECMO) pour les syndromes de détresse respiratoire aiguë (SDRA) sévères. Reanimation 20:49–61. doi:10.1007/s13546-010-0002-8 CrossRef

33.

Luyt C-E, Combes A, Becquemin M-H et al (2012) Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS. Chest 142:583–592. doi:10.1378/chest.11-2196 CrossRefPubMed

34.

Schmidt M, Zogheib E, Rozé H et al (2013) The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med 39:1704–1713. doi:10.1007/s00134-013-3037-2 CrossRefPubMed

35.

Schmidt M, Bailey M, Sheldrake J et al (2014) Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score. Am J Respir Crit Care Med 189:1374–1382. doi:10.1164/rccm.201311-2023OC CrossRefPubMed

36.

Hodgson CL, Hayes K, Everard T et al (2012) Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia. Crit Care 16:R202. doi:10.1186/cc11811 CrossRefPubMedPubMedCentral

37.

Hemmila MR, Rowe SA, Boules TN et al (2004) Extracorporeal life support for severe acute respiratory distress syndrome in adults. Ann Surg 240:595–605. doi:10.1097/01.sla.0000141159.90676.2d (discussion 605–7)PubMedPubMedCentral

38.

Roch A, Hraiech S, Masson E et al (2014) Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center. Intensive Care Med 40:74–83. doi:10.1007/s00134-013-3135-1 CrossRefPubMed

39.

Grasso S, Terragni P, Birocco A et al (2012) ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure. Intensive Care Med 38:395–403. doi:10.1007/s00134-012-2490-7 CrossRefPubMed

40.

Amato MBP, Meade MO, Slutsky AS et al (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372:747–755. doi:10.1056/NEJMsa1410639 CrossRefPubMed

41.

Gattinoni L, Pesenti A, Mascheroni D et al (1986) Low-frequency positive-pressure ventilation with extracorporeal CO₂ removal in severe acute respiratory failure. JAMA 256:881–886CrossRefPubMed

42.

Gattinoni L, Agostoni A, Pesenti A et al (1980) Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO₂. Lancet 2:292–294CrossRefPubMed

43.

Schmidt M, Stewart C, Bailey M et al (2015) Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a retrospective international multicenter study. Crit Care Med 43:654–664. doi:10.1097/CCM.0000000000000753 CrossRefPubMed

44.

Schmidt M, Pellegrino V, Combes A et al (2014) Mechanical ventilation during extracorporeal membrane oxygenation. Crit Care 18:203. doi:10.1186/cc13702 CrossRefPubMedPubMedCentral

45.

Kolobow T, Gattinoni L, Tomlinson TA, Pierce JE (1977) Control of breathing using an extracorporeal membrane lung. Anesthesiology 46:138–141CrossRefPubMed

46.

Karagiannidis C, Lubnow M, Philipp A et al (2010) Autoregulation of ventilation with neurally adjusted ventilatory assist on extracorporeal lung support. Intensive Care Med 36:2038–2044. doi:10.1007/s00134-010-1982-6 CrossRefPubMed

47.

Mauri T, Bellani G, Foti G et al (2011) Successful use of neurally adjusted ventilatory assist in a patient with extremely low respiratory system compliance undergoing ECMO. Intensive Care Med 37:166–167. doi:10.1007/s00134-010-2030-2 CrossRefPubMed

48.

Marhong JD, Telesnicki T, Munshi L et al (2014) Mechanical ventilation during extracorporeal membrane oxygenation. An international survey. Ann Am Thorac Soc 11:956–961. doi:10.1513/AnnalsATS.201403-100BC CrossRefPubMed

49.

Marhong JD, Munshi L, Detsky M et al (2015) Mechanical ventilation during extracorporeal life support (ECLS): a systematic review. Intensive Care Med 41:994–1003. doi:10.1007/s00134-015-3716-2 CrossRefPubMed

50.

Byrnes J, McKamie W, Swearingen C et al (2011) Hemolysis during cardiac extracorporeal membrane oxygenation: a case–control comparison of roller pumps and centrifugal pumps in a pediatric population. ASAIO J 57:456–461. doi:10.1097/MAT.0b013e31822e2475 CrossRefPubMed

51.

Bembea MM, Annich G, Rycus P et al (2013) Variability in anticoagulation management of patients on extracorporeal membrane oxygenation: an international survey. Pediatr Crit Care Med 14:e77–e84. doi:10.1097/PCC.0b013e31827127e4 CrossRefPubMedPubMedCentral

52.

Chu DC, Abu-Samra AG, Baird GL et al (2015) Quantitative measurement of heparin in comparison with conventional anticoagulation monitoring and the risk of thrombotic events in adults on extracorporeal membrane oxygenation. Intensive Care Med 41:369–370. doi:10.1007/s00134-014-3574-3 CrossRefPubMedPubMedCentral

53.

Herbert DG, Buscher H, Nair P (2014) Prolonged venovenous extracorporeal membrane oxygenation without anticoagulation: a case of Goodpasture syndrome-related pulmonary haemorrhage. Crit Care Resusc 16:69–72PubMed

54.

Abrams D, Agerstrand CL, Biscotti M et al (2015) Extracorporeal membrane oxygenation in the management of diffuse alveolar hemorrhage. ASAIO J 61:216–218. doi:10.1097/MAT.0000000000000183 CrossRefPubMed

55.

Biscotti M, Gannon WD, Abrams D et al (2015) Extracorporeal membrane oxygenation use in patients with traumatic brain injury. Perfusion 30:407–409. doi:10.1177/0267659114554327 CrossRefPubMed

56.

Lynch WR, MacLaren G, Wilson JM, Bartlett RH (2012) ECMO: extracorporeal cardiopulmonary support in critical care, 4 edn. Extracorporeal Life Support Organization, Ann Arbor

57.

Combes A, Bacchetta M, Brodie D et al (2012) Extracorporeal membrane oxygenation for respiratory failure in adults. Curr Opin Crit Care 18:99–104. doi:10.1097/MCC.0b013e32834ef412 CrossRefPubMed

58.

Agerstrand CL, Burkart KM, Abrams DC et al (2015) Blood conservation in extracorporeal membrane oxygenation for acute respiratory distress syndrome. Ann Thorac Surg 99:590–595. doi:10.1016/j.athoracsur.2014.08.039 CrossRefPubMed

59.

Voelker MT, Busch T, Bercker S et al (2015) Restrictive transfusion practice during extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome. Artif Organs 39:374–378. doi:10.1111/aor.12385 CrossRefPubMed

60.

Esper SA, Levy JH, Waters JH, Welsby IJ (2014) Extracorporeal membrane oxygenation in the adult: a review of anticoagulation monitoring and transfusion. Anesth Analg 118:731–743. doi:10.1213/ANE.0000000000000115 CrossRefPubMed

61.

Puthucheary ZA, Rawal J, McPhail M et al (2013) Acute skeletal muscle wasting in critical illness. JAMA 310:1591–1600. doi:10.1001/jama.2013.278481 CrossRefPubMed

62.

TEAM Study Investigators, Hodgson C, Bellomo R et al (2015) Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Crit Care 19:81. doi:10.1186/s13054-015-0765-4 CrossRef

63.

Hermans G, Van Mechelen H, Clerckx B et al (2014) Acute outcomes and 1-year mortality of intensive care unit-acquired weakness. A cohort study and propensity-matched analysis. Am J Respir Crit Care Med 190:410–420. doi:10.1164/rccm.201312-2257OC CrossRefPubMed

64.

Hodgson CL, Fan E (2013) A step up for extracorporeal membrane oxygenation: active rehabilitation. Respir Care 58:1388–1390. doi:10.4187/respcare.02606 CrossRefPubMed

65.

Abrams D, Javidfar J, Farrand E et al (2014) Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care 18:R38. doi:10.1186/cc13746 CrossRefPubMedPubMedCentral

66.

AVERT Trial Collaboration group, Bernhardt J, Langhorne P et al (2015) Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet 386:46–55. doi:10.1016/S0140-6736(15)60690-0 CrossRef

67.

Fan E, Pham T (2014) Extracorporeal membrane oxygenation for severe acute respiratory failure: yes we can! (But should we?). Am J Respir Crit Care Med 189:1293–1295. doi:10.1164/rccm.201404-0711ED

68.

Moratti S (2009) The development of “medical futility”: towards a procedural approach based on the role of the medical profession. J Med Ethics 35:369–372. doi:10.1136/jme.2008.027755 CrossRefPubMed

69.

Abrams DC, Prager K, Blinderman CD et al (2014) Ethical dilemmas encountered with the use of extracorporeal membrane oxygenation in adults. Chest 145:876–882. doi:10.1378/chest.13-1138 CrossRefPubMed

70.

Pappalardo F, Pieri M, Greco T et al (2013) Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med 39:275–281. doi:10.1007/s00134-012-2747-1 CrossRefPubMed

71.

Enger T, Philipp A, Videm V et al (2014) Prediction of mortality in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation: a prospective observational study. Crit Care 18:R67. doi:10.1186/cc13824 CrossRefPubMedPubMedCentral

Titel: Venovenous extracorporeal membrane oxygenation for acute respiratory failure
A clinical review from an international group of experts
verfasst von: Eddy Fan
Luciano Gattinoni
Alain Combes
Matthieu Schmidt
Giles Peek
Dan Brodie
Thomas Muller
Andrea Morelli
V. Marco Ranieri
Antonio Pesenti
Laurent Brochard
Carol Hodgson
Cecile Van Kiersbilck
Antoine Roch
Michael Quintel
Laurent Papazian
Publikationsdatum: 23.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 5/2016
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4314-7

Neu im Fachgebiet AINS

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Traumatologische Notfälle Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Venovenous extracorporeal membrane oxygenation for acute respiratory failure

A clinical review from an international group of experts

Abstract

Neu im Fachgebiet AINS

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Update AINS

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2016

The Berlin definition met our needs: not sure

Extracorporeal membrane oxygenation: evolving epidemiology and mortality

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

What’s new in ARDS: can we prevent it?

The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia

Brain injury during venovenous extracorporeal membrane oxygenation

Neu im Fachgebiet AINS

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Update AINS