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http://dx.doi.org/10.4046/trd.2010.68.2.62

Acute Respiratory Failure Treated with Veno-venous Extracorporeal Membrane Oxygenation  

Kim, Hyoung-Soo (Department of Thoracic & Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Han, Sang-Jin (Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Hong, Kyung-Soon (Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Yoon, Duck-Hyoung (Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Lee, Chang-Youl (Department of Pulmonology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Lee, Myung-Goo (Department of Pulmonology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Hong, Won-Ki (Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Lee, Sun-Hee (Department of Thoracic & Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine)
Kim, Kun-Il (Department of Thoracic & Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
Lee, Hee-Sung (Department of Thoracic & Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine)
Cho, Sung-Woo (Department of Thoracic & Cardiovascular Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.68, no.2, 2010 , pp. 62-66 More about this Journal
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.
Keywords
Extracorporeal Membrane Oxygenation; Respiratory Distress Syndrome, Acute;
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Times Cited By SCOPUS : 0
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1 Madershahian N, Wittwer T, Strauch J, Franke UF, Wippermann J, Kaluza M, et al. Application of ECMO in multitrauma patients with ARDS as rescue therapy. J Card Surg 2007;22:180-4.   DOI   ScienceOn
2 Eich C, Brauer A, Kettler D. Recovery of a hypothermic drowned child after resuscitation with cardiopulmonary bypass followed by prolonged extracorporeal membrane oxygenation. Resuscitation 2005;67:145-8.   DOI   ScienceOn
3 Thalmann M, Trampitsch E, Haberfellner N, Eisendle E, Kraschl R, Kobinia G. Resuscitation in near drowning with extracorporeal membrane oxygenation. Ann Thorac Surg 2001;72:607-8.   DOI   ScienceOn
4 Peralta R, Ryan DP, Iribrane A, Fitzsimons MG. Extracorporeal membrane oxygenation and $CO_{2}$ removal in an adult after near drowning. J Extra Corpor Technol 2005;37:71-4.
5 Ho BS, Lin JL, Huang CC, Tsai YH, Lin MC. Mercury vapor inhalation from Chinese red (Cinnabar). J Toxicol Clin Toxicol 2003;41:75-8.   DOI   ScienceOn
6 Lim HE, Shim JJ, Lee SY, Lee SH, Kang SY, Jo JY, et al. Mercury inhalation poisoning and acute lung injury. Korean J Intern Med 1998;13:127-30.   DOI
7 Campione A, Agostini M, Portolan M, Alloisio A, Fino C, Vassallo G. Extracorporeal membrane oxygenation in respiratory failure for pulmonary contusion and bronchial disruption after trauma. J Thorac Cardiovasc Surg 2007;133:1673-4.   DOI   ScienceOn
8 Rhee I, Gwon HC, Choi J, Sung K, Lee YT, Kwon SU, et al. Percutaneous cardiopulmonary support for emergency in-hospital cardiac arrest or cardiogenic shock. Korean Circ J 2006;36:11-6.   DOI
9 Lee KH, Lee SM, Chung YK, Kim KW, Ham BM, Moon HS, et al. Prolonged extracorporeal lung heart assist (extracorporeal membrane oxygenation): 4 cases report. Korean J Anesthesiol 1992;25:424-32.   DOI
10 Rhee I, Kwon SU, Sung K, Cho SW, Gwon HC, Lee YT, et al. Experiences with emergency percutaneous cardiopulmonary support in in-hospital cardiac arrest or cardiogenic shock due to the ischemic heart disease. Korean J Thorac Cardiovasc Surg 2006;39:201-7.   과학기술학회마을
11 Extracorporeal Life Support Organization. ELSO education page [Internet]. Ann Arbor (MI): Extracorporeal Life Support Organization; c2009 [Cited 2009 Sep 21]. Available from: http://www.elso.med.umich.edu/guide. htm.
12 Maclaren G, Butt W. Extracorporeal membrane oxygenation and sepsis. Crit Care Resusc 2007;9:76-80.
13 Gattinoni L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V, et al. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med 2001;345:568-73.   DOI   ScienceOn
14 The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342:1301-8.   DOI   ScienceOn
15 Bernard GR. Acute respiratory distress syndrome: a historical perspective. Am J Respir Crit Care Med 2005;172: 798-806.   DOI   ScienceOn
16 Kallet RH. Evidence-based management of acute lung injury and acute respiratory distress syndrome. Respir Care 2004;49:793-809.
17 Hemmila MR, Rowe SA, Boules TN, Miskulin J, McGillicuddy JW, Schuerer DJ, et al. Extracorporeal life support for severe acute respiratory distress syndrome in adults. Ann Surg 2004;240:595-605.