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Chapter 29 - Extracorporeal Membrane Oxygenation

from Section 5 - Cardiopulmonary Bypass

Published online by Cambridge University Press:  12 May 2020

By
Simon Colah
Edited by
Joseph Arrowsmith ,
Andrew Roscoe  and
Jonathan Mackay
Joseph Arrowsmith
Affiliation:
Royal Papworth Hospital, Cambridge
Andrew Roscoe
Affiliation:
Singapore General Hospital
Jonathan Mackay
Affiliation:
Royal Papworth Hospital, Cambridge
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Summary

ECMO can either provide total cardiopulmonary support (veno-arterial or VA-ECMO) or pulmonary support (veno-venous or VV-ECMO). The technique effectively enables the use of CPB in an ICU setting. In adult practice, ECMO was initially reserved for patients with severe respiratory failure secondary to ARDS. ECMO in adults fell out of favour, largely because of poor outcomes. In paediatric practice, where outcomes are generally better, ECMO has remained in routine use for over three decades. Recent H1N1 (‘swine flu’) epidemics have led to a re-examination of the role of ECMO in adults with respiratory failure and a re-emergence of VV-ECMO.

Type
Chapter
Information
Core Topics in Cardiac Anaesthesia , pp. 218 - 222
Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Charlesworth, M, Venkateswaran, R, Barker, JM, Feddy, L. Postcardiotomy VA-ECMO for refractory cardiogenic shock. J Cardiothorac Surg 2017; 12: 116.CrossRefGoogle ScholarPubMed
Grecu, L. Extracorporeal membrane oxygenation. In Ghosh, S, Falter, F, Perrino, AC (eds), Cardiopulmonary Bypass, 2nd edn. Cambridge: Cambridge University Press; 2015, pp. 121–8.Google Scholar
Khorsandi, M, Dougherty, S, Bouamra, O, et al. Extra-corporeal membrane oxygenation for refractory cardiogenic shock after adult cardiac surgery: a systematic review and meta-analysis. J Cardiothorac Surg 2017; 12: 55.Google Scholar
Kirklin, JK, Pagani, FD, Kormos, RL, et al. Eighth annual INTERMACS report: special focus on framing the impact of adverse events. J Heart Lung Transplant 2017; 36: 1080–6.Google Scholar
Schmidt, M, Burrell, A, Roberts, L, et al. Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J 2015; 36: 2246–56.Google Scholar
Wengenmayer, T, Duerschmied, D, Graf, E, et al. Development and validation of a prognostic model for survival in patients treated with venoarterial extracorporeal membrane oxygenation: the PREDICT VA-ECMO score. Eur Heart J Acute Cardiovasc Care 2018 Jul 1:2048872618789052. doi: 10.1177/2048872618789052.CrossRefGoogle Scholar

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