Venting during venoarterial extracorporeal membrane oxygenation

Enzo Lüsebrink; Leonhard Binzenhöfer; Antonia Kellnar; Christoph Müller; Clemens Scherer; Benedikt Schrage; Dominik Joskowiak; Tobias Petzold; Daniel Braun; Stefan Brunner; Sven Peterss; Jörg Hausleiter; Sebastian Zimmer; Frank Born; Dirk Westermann; Holger Thiele; Andreas Schäfer; Christian Hagl; Steffen Massberg; Martin Orban

doi:10.1007/s00392-022-02069-0

Venting during venoarterial extracorporeal membrane oxygenation

Standard

Venting during venoarterial extracorporeal membrane oxygenation. / Lüsebrink, Enzo; Binzenhöfer, Leonhard; Kellnar, Antonia; Müller, Christoph; Scherer, Clemens; Schrage, Benedikt; Joskowiak, Dominik; Petzold, Tobias; Braun, Daniel; Brunner, Stefan; Peterss, Sven; Hausleiter, Jörg; Zimmer, Sebastian; Born, Frank; Westermann, Dirk; Thiele, Holger; Schäfer, Andreas; Hagl, Christian; Massberg, Steffen; Orban, Martin.

In: CLIN RES CARDIOL, Vol. 112, No. 4, 04.2023, p. 464-505.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Lüsebrink, E, Binzenhöfer, L, Kellnar, A, Müller, C, Scherer, C, Schrage, B, Joskowiak, D, Petzold, T, Braun, D, Brunner, S, Peterss, S, Hausleiter, J, Zimmer, S, Born, F, Westermann, D, Thiele, H, Schäfer, A, Hagl, C, Massberg, S & Orban, M 2023, 'Venting during venoarterial extracorporeal membrane oxygenation', CLIN RES CARDIOL, vol. 112, no. 4, pp. 464-505. https://doi.org/10.1007/s00392-022-02069-0

APA

Lüsebrink, E., Binzenhöfer, L., Kellnar, A., Müller, C., Scherer, C., Schrage, B., Joskowiak, D., Petzold, T., Braun, D., Brunner, S., Peterss, S., Hausleiter, J., Zimmer, S., Born, F., Westermann, D., Thiele, H., Schäfer, A., Hagl, C., Massberg, S., & Orban, M. (2023). Venting during venoarterial extracorporeal membrane oxygenation. CLIN RES CARDIOL, 112(4), 464-505. https://doi.org/10.1007/s00392-022-02069-0

Vancouver

Lüsebrink E, Binzenhöfer L, Kellnar A, Müller C, Scherer C, Schrage B et al. Venting during venoarterial extracorporeal membrane oxygenation. CLIN RES CARDIOL. 2023 Apr;112(4):464-505. https://doi.org/10.1007/s00392-022-02069-0

Bibtex

@article{e22a5d0ec396424aa8fbc89c3f4e0707,

title = "Venting during venoarterial extracorporeal membrane oxygenation",

abstract = "Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering from these life-threatening entities. VA-ECMO provides temporary circulatory support until causative treatments are effective and enables recovery or serves as a bridging strategy to surgical ventricular assist devices, heart transplantation or decision-making. However, in-hospital mortality rate in this treatment population is still around 60%. In the recently published ARREST trial, VA-ECMO treatment lowered mortality rate in patients with ongoing cardiac arrest due to therapy refractory ventricular fibrillation compared to standard advanced cardiac life support in selected patients. Whether VA-ECMO can reduce mortality compared to standard of care in cardiogenic shock has to be evaluated in the ongoing prospective randomized studies EURO-SHOCK (NCT03813134) and ECLS-SHOCK (NCT03637205). As an innate drawback of VA-ECMO treatment, the retrograde aortic flow could lead to an elevation of left ventricular (LV) afterload, increase in LV filling pressure, mitral regurgitation, and elevated left atrial pressure. This may compromise myocardial function and recovery, pulmonary hemodynamics-possibly with concomitant pulmonary congestion and even lung failure-and contribute to poor outcomes in a relevant proportion of treated patients. To overcome these detrimental effects, a multitude of venting strategies are currently engaged for both preventive and emergent unloading. This review aims to provide a comprehensive and structured synopsis of existing venting modalities and their specific hemodynamic characteristics. We discuss in detail the available data on outcome categories and complication rates related to the respective venting option.",

author = "Enzo L{\"u}sebrink and Leonhard Binzenh{\"o}fer and Antonia Kellnar and Christoph M{\"u}ller and Clemens Scherer and Benedikt Schrage and Dominik Joskowiak and Tobias Petzold and Daniel Braun and Stefan Brunner and Sven Peterss and J{\"o}rg Hausleiter and Sebastian Zimmer and Frank Born and Dirk Westermann and Holger Thiele and Andreas Sch{\"a}fer and Christian Hagl and Steffen Massberg and Martin Orban",

note = "{\textcopyright} 2022. The Author(s).",

year = "2023",

month = apr,

doi = "10.1007/s00392-022-02069-0",

language = "English",

volume = "112",

pages = "464--505",

journal = "CLIN RES CARDIOL",

issn = "1861-0684",

publisher = "D. Steinkopff-Verlag",

number = "4",

}

RIS

TY - JOUR

T1 - Venting during venoarterial extracorporeal membrane oxygenation

AU - Lüsebrink, Enzo

AU - Binzenhöfer, Leonhard

AU - Kellnar, Antonia

AU - Müller, Christoph

AU - Scherer, Clemens

AU - Schrage, Benedikt

AU - Joskowiak, Dominik

AU - Petzold, Tobias

AU - Braun, Daniel

AU - Brunner, Stefan

AU - Peterss, Sven

AU - Hausleiter, Jörg

AU - Zimmer, Sebastian

AU - Born, Frank

AU - Westermann, Dirk

AU - Thiele, Holger

AU - Schäfer, Andreas

AU - Hagl, Christian

AU - Massberg, Steffen

AU - Orban, Martin

PY - 2023/4

Y1 - 2023/4

N2 - Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering from these life-threatening entities. VA-ECMO provides temporary circulatory support until causative treatments are effective and enables recovery or serves as a bridging strategy to surgical ventricular assist devices, heart transplantation or decision-making. However, in-hospital mortality rate in this treatment population is still around 60%. In the recently published ARREST trial, VA-ECMO treatment lowered mortality rate in patients with ongoing cardiac arrest due to therapy refractory ventricular fibrillation compared to standard advanced cardiac life support in selected patients. Whether VA-ECMO can reduce mortality compared to standard of care in cardiogenic shock has to be evaluated in the ongoing prospective randomized studies EURO-SHOCK (NCT03813134) and ECLS-SHOCK (NCT03637205). As an innate drawback of VA-ECMO treatment, the retrograde aortic flow could lead to an elevation of left ventricular (LV) afterload, increase in LV filling pressure, mitral regurgitation, and elevated left atrial pressure. This may compromise myocardial function and recovery, pulmonary hemodynamics-possibly with concomitant pulmonary congestion and even lung failure-and contribute to poor outcomes in a relevant proportion of treated patients. To overcome these detrimental effects, a multitude of venting strategies are currently engaged for both preventive and emergent unloading. This review aims to provide a comprehensive and structured synopsis of existing venting modalities and their specific hemodynamic characteristics. We discuss in detail the available data on outcome categories and complication rates related to the respective venting option.

AB - Cardiogenic shock and cardiac arrest contribute pre-dominantly to mortality in acute cardiovascular care. Here, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as an established therapeutic option for patients suffering from these life-threatening entities. VA-ECMO provides temporary circulatory support until causative treatments are effective and enables recovery or serves as a bridging strategy to surgical ventricular assist devices, heart transplantation or decision-making. However, in-hospital mortality rate in this treatment population is still around 60%. In the recently published ARREST trial, VA-ECMO treatment lowered mortality rate in patients with ongoing cardiac arrest due to therapy refractory ventricular fibrillation compared to standard advanced cardiac life support in selected patients. Whether VA-ECMO can reduce mortality compared to standard of care in cardiogenic shock has to be evaluated in the ongoing prospective randomized studies EURO-SHOCK (NCT03813134) and ECLS-SHOCK (NCT03637205). As an innate drawback of VA-ECMO treatment, the retrograde aortic flow could lead to an elevation of left ventricular (LV) afterload, increase in LV filling pressure, mitral regurgitation, and elevated left atrial pressure. This may compromise myocardial function and recovery, pulmonary hemodynamics-possibly with concomitant pulmonary congestion and even lung failure-and contribute to poor outcomes in a relevant proportion of treated patients. To overcome these detrimental effects, a multitude of venting strategies are currently engaged for both preventive and emergent unloading. This review aims to provide a comprehensive and structured synopsis of existing venting modalities and their specific hemodynamic characteristics. We discuss in detail the available data on outcome categories and complication rates related to the respective venting option.

U2 - 10.1007/s00392-022-02069-0

DO - 10.1007/s00392-022-02069-0

M3 - SCORING: Review article

C2 - 35986750

VL - 112

SP - 464

EP - 505

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 4

ER -