A new miniaturized system for extracorporeal membrane oxygenation in adult respiratory failure

Published: August 13, 2010
Source: Crit Care. 2009; 13(6): R205. Published online 2009 December 17. doi: 10.1186/cc8213. PMCID: PMC2811933 Copyright ©2009 Müller

Introduction
Mortality of severe acute respiratory distress syndrome in adults is still unacceptably high. Extracorporeal membrane oxygenation (ECMO) could represent an important treatment option, if complications were reduced by new technical developments.

Methods
Efficiency, side effects and outcome of treatment with a new miniaturized device for veno-venous extracorporeal gas transfer were analysed in 60 consecutive patients with life-threatening respiratory failure.

Results
A rapid increase of partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) from 64 (48 to 86) mmHg to 120 (84 to 171) mmHg and a decrease of PaCO2 from 63 (50 to 80) mmHg to 33 (29 to 39) mmHg were observed after start of the extracorporeal support (P < 0.001). Gas exchange capacity of the device averaged 155 (116 to 182) mL/min for oxygen and 210 (164 to 251) mL/min for carbon dioxide. Ventilatory parameters were reduced to a highly protective mode, allowing a fast reduction of tidal volume from 495 (401 to 570) mL to 336 (292 to 404) mL (P < 0.001) and of peak inspiratory pressure from 36 (32 to 40) cmH2O to 31 (28 to 35) cmH2O (P < 0.001). Transfusion requirements averaged 0.8 (0.4 to 1.8) units of red blood cells per day. Sixty-two percent of patients were weaned from the extracorporeal system, and 45% survived to discharge.

Conclusions
Veno-venous extracorporeal membrane oxygenation with a new miniaturized device supports gas transfer effectively, allows for highly protective ventilation and is very reliable. Modern ECMO technology extends treatment opportunities in severe lung failure.

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Extracorporeal membrane oxygenation (ECMO) in patients with Influenza A (H1N1)

Published: May 10, 2010
Source: Excerpted from American Thoracic Society

Extracorporeal membrane oxygenation (ECMO) provides continuous cardiopulmonary support on a long-term basis, typically on the order of days to weeks, as adjunctive management of severe respiratory and cardiac failure. The goal of therapy is to minimize ventilator-induced lung injury while allowing additional time to treat the underlying disease process and to permit recovery from acute injury. ECMO is a complex technique and requires…

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First Airmed–ECMO Advantage transport a success

Published: March 24, 2010
Source: Way Point Magazine

Fixed-wing air ambulance firm AirMed International of Birmingham, Alabama, US, has reported on its first successful mission carried out with the Tennessee-based ECMO Advantage. The two companies have formed…

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