Extracorporeal Membrane Oxygenation
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Extracorporeal Membrane Oxygenation. / Bernhardt, Alexander M; Schrage, Benedikt; Schroeder, Ines; Trummer, Georg; Westermann, Dirk; Reichenspurner, Hermann.
In: DTSCH ARZTEBL INT, Vol. 119, No. 13, 01.04.2022, p. 235-244.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Extracorporeal Membrane Oxygenation
AU - Bernhardt, Alexander M
AU - Schrage, Benedikt
AU - Schroeder, Ines
AU - Trummer, Georg
AU - Westermann, Dirk
AU - Reichenspurner, Hermann
PY - 2022/4/1
Y1 - 2022/4/1
N2 - BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), also known as extracorporeal life support (ECLS), can both be used to treat patients with acute pulmonary or cardiovascular failure.METHODS: This review is based on publications retrieved by a selective search in PubMed on the topics of cardiogenic shock and acute pulmonary failure, also known as the acute respiratory distress syndrome (ARDS), as well as on ECMO. Attention was given chiefly to randomized, controlled trials and guidelines.RESULTS: Initial findings from prospective, randomized trials of VV-ECMO are now available. Trials of ECLS therapy are now in progress or planned. A meta-analysis of two randomized, controlled trials of VV-ECMO for ARDS revealed more frequent survival 90 days after randomization among patients treated with VV-ECMO, compared to the control groups (36% vs. 48%; RR = 0.75 [95% confidence interval 0.6; 0.94]). For selected patients, after evaluation of the benefit-risk profile, VV-ECMO is a good treatment method for severe pulmonary failure, and ECLS for cardiogenic shock and resuscitation. The goal is to secure the circulation so that native heart function can be stabilized in the patient's further course or a permanent left-heart support system can be implanted, or else to support lung function until recovery.CONCLUSION: ECMO is a valid option in selected patients when conservative treatment has failed.
AB - BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), also known as extracorporeal life support (ECLS), can both be used to treat patients with acute pulmonary or cardiovascular failure.METHODS: This review is based on publications retrieved by a selective search in PubMed on the topics of cardiogenic shock and acute pulmonary failure, also known as the acute respiratory distress syndrome (ARDS), as well as on ECMO. Attention was given chiefly to randomized, controlled trials and guidelines.RESULTS: Initial findings from prospective, randomized trials of VV-ECMO are now available. Trials of ECLS therapy are now in progress or planned. A meta-analysis of two randomized, controlled trials of VV-ECMO for ARDS revealed more frequent survival 90 days after randomization among patients treated with VV-ECMO, compared to the control groups (36% vs. 48%; RR = 0.75 [95% confidence interval 0.6; 0.94]). For selected patients, after evaluation of the benefit-risk profile, VV-ECMO is a good treatment method for severe pulmonary failure, and ECLS for cardiogenic shock and resuscitation. The goal is to secure the circulation so that native heart function can be stabilized in the patient's further course or a permanent left-heart support system can be implanted, or else to support lung function until recovery.CONCLUSION: ECMO is a valid option in selected patients when conservative treatment has failed.
KW - Extracorporeal Membrane Oxygenation
KW - Humans
KW - Prospective Studies
KW - Respiratory Distress Syndrome/therapy
KW - Respiratory Insufficiency/etiology
KW - Retrospective Studies
KW - Shock, Cardiogenic/etiology
U2 - 10.3238/arztebl.m2022.0068
DO - 10.3238/arztebl.m2022.0068
M3 - SCORING: Review article
C2 - 35037618
VL - 119
SP - 235
EP - 244
JO - DTSCH ARZTEBL INT
JF - DTSCH ARZTEBL INT
SN - 1866-0452
IS - 13
ER -
