Hybrid extracorporeal membrane oxygenation.

Abstract:

:Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency. In this review, we described all these "hybrid" approaches, such as the addition of a third or fourth ECMO cannula to improve venous drainage and/or optimize systemic hemodynamics/oxygenation, or the implementation of surgical or percutaneous unloading of the left ventricle (LV), to reduce cardiac dilation and pulmonary edema. Although few data are still available about the effectiveness of such interventions, clinicians should be aware of these advances in ECMO management to improve the management of more complex cases.

journal_name

J Thorac Dis

authors

Brasseur A,Scolletta S,Lorusso R,Taccone FS

doi

10.21037/jtd.2018.03.84

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

S707-S715

issue

Suppl 5

eissn

2072-1439

issn

2077-6624

pii

jtd-10-S5-S707

journal_volume

10

pub_type

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