Skip to main content
Erschienen in: Intensive Care Medicine 5/2015

01.05.2015 | What's New in Intensive Care

How to wean a patient from veno-arterial extracorporeal membrane oxygenation

verfasst von: Nadia Aissaoui, Aly El-Banayosy, Alain Combes

Erschienen in: Intensive Care Medicine | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Excerpt

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can rescue patients with medical, postcardiotomy, or post-cardiac arrest refractory cardiogenic shock (CS) [1, 2]. It can be used as a bridge to cardiac transplantation, to a long-term ventricular assist device (VAD), or until recovery of myocardial function. Weaning success from VA-ECMO is defined as device removal and no further requirement for mechanical support because of recurring CS over the following 30 days [3]. However, to date, only very few studies have reported weaning strategies and outcomes in VA-ECMO patients recovering from severe CS. …
Literatur
1.
Zurück zum Zitat Abrams D, Combes A, Brodie D (2014) What’s new in extracorporeal membrane oxygenation for cardiac failure and cardiac arrest in adults? Intensive Care Med 40:609–612CrossRefPubMed Abrams D, Combes A, Brodie D (2014) What’s new in extracorporeal membrane oxygenation for cardiac failure and cardiac arrest in adults? Intensive Care Med 40:609–612CrossRefPubMed
2.
Zurück zum Zitat Ghodsizad A, Koerner MM, Brehm CE, El-Banayosy A (2014) The role of extracorporeal membrane oxygenation circulatory support in the crash and burn patient: from implantation to weaning. Curr Opin Cardiol 29:275–280CrossRefPubMed Ghodsizad A, Koerner MM, Brehm CE, El-Banayosy A (2014) The role of extracorporeal membrane oxygenation circulatory support in the crash and burn patient: from implantation to weaning. Curr Opin Cardiol 29:275–280CrossRefPubMed
3.
Zurück zum Zitat Aissaoui N, Luyt CE, Leprince P, Trouillet JL, Léger P, Pavie A, Diebold B, Chastre J, Combes A (2011) Predictors of successful extracorporeal membrane oxygenation (ECMO) weaning after assistance for refractory cardiogenic shock. Intensive Care Med 37:1738–1745CrossRefPubMed Aissaoui N, Luyt CE, Leprince P, Trouillet JL, Léger P, Pavie A, Diebold B, Chastre J, Combes A (2011) Predictors of successful extracorporeal membrane oxygenation (ECMO) weaning after assistance for refractory cardiogenic shock. Intensive Care Med 37:1738–1745CrossRefPubMed
4.
Zurück zum Zitat Combes A, Leprince P, Luyt CE, Bonnet N, Trouillet JL, Leger P, Pavie A, Chastre J (2008) Outcomes and longterm quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 36:1404–1411CrossRefPubMed Combes A, Leprince P, Luyt CE, Bonnet N, Trouillet JL, Leger P, Pavie A, Chastre J (2008) Outcomes and longterm quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 36:1404–1411CrossRefPubMed
5.
Zurück zum Zitat Smedira NG, Moazami N, Golding CM, McCarthy PM, Apperson-Hansen C, Blackstone EH, Cosgrove DM 3rd (2001) Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: survival at 5 years. J Thorac Cardiovasc Surg 122:92–102CrossRefPubMed Smedira NG, Moazami N, Golding CM, McCarthy PM, Apperson-Hansen C, Blackstone EH, Cosgrove DM 3rd (2001) Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: survival at 5 years. J Thorac Cardiovasc Surg 122:92–102CrossRefPubMed
6.
Zurück zum Zitat Rastan AJ, Dege A, Mohr M, Doll N, Falk V, Walther T, Mohr FW (2010) Early and late outcomes of 517 consecutive adult patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock. J Thorac Cardiovasc Surg 139:302–311CrossRefPubMed Rastan AJ, Dege A, Mohr M, Doll N, Falk V, Walther T, Mohr FW (2010) Early and late outcomes of 517 consecutive adult patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock. J Thorac Cardiovasc Surg 139:302–311CrossRefPubMed
7.
Zurück zum Zitat Sheu JJ, Tsai TH, Lee FY, Fang HY, Sun CK, Leu S, Yang CH, Chen SM, Hang CL, Hsieh YK, Chen CJ, Wu CJ, Yip HK (2010) Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicated with profound cardiogenic shock. Crit Care Med 38:1810–1817CrossRefPubMed Sheu JJ, Tsai TH, Lee FY, Fang HY, Sun CK, Leu S, Yang CH, Chen SM, Hang CL, Hsieh YK, Chen CJ, Wu CJ, Yip HK (2010) Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicated with profound cardiogenic shock. Crit Care Med 38:1810–1817CrossRefPubMed
8.
Zurück zum Zitat Chen YC, Tsai FC, Chang CH, Lin CY, Jenq CC, Juan KC, Hsu HH, Chang MY, Tian YC, Hung CC, Fang JT, Yang CW (2011) Prognosis of patients on extracorporeal membrane oxygenation: the impact of acute kidney injury on mortality. Ann Thorac Surg 91:137–142CrossRefPubMed Chen YC, Tsai FC, Chang CH, Lin CY, Jenq CC, Juan KC, Hsu HH, Chang MY, Tian YC, Hung CC, Fang JT, Yang CW (2011) Prognosis of patients on extracorporeal membrane oxygenation: the impact of acute kidney injury on mortality. Ann Thorac Surg 91:137–142CrossRefPubMed
9.
Zurück zum Zitat Distelmaier K, Winter MP, Rutzler K, Heinz G, Lang IM, Maurer G, Koinig H, Steinlechner B, Niessner A, Goliasch G (2014) Serum butyrylcholinesterase predicts survival after extracorporeal membrane oxygenation after cardiovascular surgery. Crit Care 18:R24CrossRefPubMedCentralPubMed Distelmaier K, Winter MP, Rutzler K, Heinz G, Lang IM, Maurer G, Koinig H, Steinlechner B, Niessner A, Goliasch G (2014) Serum butyrylcholinesterase predicts survival after extracorporeal membrane oxygenation after cardiovascular surgery. Crit Care 18:R24CrossRefPubMedCentralPubMed
10.
Zurück zum Zitat Li C, Wang H, Jia M, Ma N, Meng X, Hou X (2014) The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support: a retrospective observational study. J Thorac Cardiovasc Surg 24:S0022–S5223 Li C, Wang H, Jia M, Ma N, Meng X, Hou X (2014) The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support: a retrospective observational study. J Thorac Cardiovasc Surg 24:S0022–S5223
11.
Zurück zum Zitat Luyt CE, Landivier A, Leprince P, Bernard M, Pavie A, Chastre J, Combes A (2012) Usefulness of cardiac biomarkers to predict cardiac recovery in patients on extracorporeal membrane oxygenation support for refractory cardiogenic shock. J Crit Care 27:7–14CrossRef Luyt CE, Landivier A, Leprince P, Bernard M, Pavie A, Chastre J, Combes A (2012) Usefulness of cardiac biomarkers to predict cardiac recovery in patients on extracorporeal membrane oxygenation support for refractory cardiogenic shock. J Crit Care 27:7–14CrossRef
12.
Zurück zum Zitat Schmidt M, Zogheib E, Rozé H, Repesse X, Lebreton G, Luyt CE, Trouillet JL, Bréchot N, Nieszkowska A, Dupont H, Ouattara A, Leprince P, Chastre J, Combes A (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 39:1704–1713CrossRefPubMed Schmidt M, Zogheib E, Rozé H, Repesse X, Lebreton G, Luyt CE, Trouillet JL, Bréchot N, Nieszkowska A, Dupont H, Ouattara A, Leprince P, Chastre J, Combes A (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 39:1704–1713CrossRefPubMed
13.
Zurück zum Zitat Aissaoui N, Guerot E, Combes A, Delouche A, Chastre J, Leprince P, Leger P, Diehl JL, Fagon JY, Diebold B (2012) Two-dimensional strain rate and Doppler tissue myocardial velocities: analysis by echocardiography of hemodynamic and functional changes of the failed left ventricle during different degrees of extracorporeal life support. J Am Soc Echocardiogr 25:632–640CrossRefPubMed Aissaoui N, Guerot E, Combes A, Delouche A, Chastre J, Leprince P, Leger P, Diehl JL, Fagon JY, Diebold B (2012) Two-dimensional strain rate and Doppler tissue myocardial velocities: analysis by echocardiography of hemodynamic and functional changes of the failed left ventricle during different degrees of extracorporeal life support. J Am Soc Echocardiogr 25:632–640CrossRefPubMed
14.
Zurück zum Zitat Cavarocchi NC, Pitcher HT, Yang Q, Karbowski P, Miessau J, Hastings HM, Hirose H (2013) Weaning of extracorporeal membrane oxygenation using continuous hemodynamic transesophageal echocardiography. J Thorac Cardiovasc Surg 146:1474–1479CrossRefPubMed Cavarocchi NC, Pitcher HT, Yang Q, Karbowski P, Miessau J, Hastings HM, Hirose H (2013) Weaning of extracorporeal membrane oxygenation using continuous hemodynamic transesophageal echocardiography. J Thorac Cardiovasc Surg 146:1474–1479CrossRefPubMed
15.
Zurück zum Zitat Affronti A, di Bella I, Carino D, Ragni T (2013) Levosimendan may improve weaning outcomes in venoarterial ECMO patients. ASAIO J 59:554–557CrossRefPubMed Affronti A, di Bella I, Carino D, Ragni T (2013) Levosimendan may improve weaning outcomes in venoarterial ECMO patients. ASAIO J 59:554–557CrossRefPubMed
Metadaten
Titel
How to wean a patient from veno-arterial extracorporeal membrane oxygenation
verfasst von
Nadia Aissaoui
Aly El-Banayosy
Alain Combes
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 5/2015
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-3663-y

Weitere Artikel der Ausgabe 5/2015

Intensive Care Medicine 5/2015 Zur Ausgabe

Update AINS

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