Details

Autor(en) / Beteiligte

• Schmid, Christof, MD
• Philipp, Alois
• Hilker, Michael, MD
• Rupprecht, Leopold, MD
• Arlt, Matthias, MD
• Keyser, Andreas, MD
• Lubnow, Matthias, MD
• Müller, Thomas, MD

Titel

Venovenous extracorporeal membrane oxygenation for acute lung failure in adults

Ist Teil von

• The Journal of heart and lung transplantation, 2012, Vol.31 (1), p.9-15

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Acute lung failure (ALF) is an increasing problem that can be treated with venovenous extracorporeal membrane oxygenation (vv-ECMO). This report summarizes prospectively collected data of an institutional experience with vv-ECMO. Methods From January 2007 to December 2010, 176 patients (mean age, 48 ± 16; range, 14–78 years) with ALF refractory to conventional therapy were supported with vv-ECMO. The general indication for vv-ECMO was a partial oxygen pressure/fraction of inspired oxygen (F io2 ) < 80 mm Hg under a F io2 of 1.0, a positive end-expiratory pressure of 18 cm H2 O, and refractory respiratory acidosis (pH < 7.25), despite optimization of conservative therapy. Results All patients underwent peripheral cannulation. In 59 cases, vv-ECMO was placed in another facility with ECMO transport by helicopter or ambulance. The mean vv-ECMO support interval was 12 ± 9.0 days (range, 1–67 days). During ECMO, 12 patients (7%) could be extubated and stepwise mobilized. Cannula-related complications during long-term support occurred in 14%, which was mostly minor bleeding. Overall survival was 56%: 58 patients (33%) died during mechanical support, and 20 (11%) died after weaning from the system. The best outcome was noted in trauma patients. Risk factors were mainly advanced age and multiorgan failure. Conclusion Modern vv-ECMO is an excellent treatment in patients with severe ALF and should be more liberally used.