Skip to main content

Extracorporeal Membrane Oxygenation (ECMO) and Extracorporeal CO2 Removal (ECCO2R)

  • Chapter
  • First Online:
  • 261 Accesses

Abstract

Extracorporeal membrane oxygenation (ECMO) should be considered in cases of severe hypoxemia usually related to severe acute respiratory distress syndrome (ARDS) of many etiologies. ECMO replaces pulmonary function, allows ultra-protective mechanical ventilation settings, and may facilitate lung healing. Extracorporeal CO2 removal (ECCO2R) is an emerging respiratory support strategy that is being studied in patients with chronic obstructive pulmonary disease in an effort to avoid intubation and mechanical ventilation. This chapter reviews how extracorporeal pulmonary support is provided, clinical trial data and outcome prediction.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Definition Task Force ARDS, Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526–33. https://doi.org/10.1001/jama.2012.5669.

    Article  CAS  Google Scholar 

  2. Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with tranditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8.

    Article  Google Scholar 

  3. Teman N, Haft J, Napolitano LM. Optimal endovascular methods for placement of bicaval dual-lumen cannulae for venovenous extracorporeal membrane oxygenation. ASAIO J. 2013;59:442–7.

    Article  CAS  Google Scholar 

  4. Brogan TV, Thiagarajan RR, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database. Intensive Care Med. 2009;35(12):2105–14. https://doi.org/10.1007/s00134-009-1661-7.

    Article  CAS  PubMed  Google Scholar 

  5. Schmidt M, Bailey M, Sheldrake J, et al. Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure: the respiratory extracorporeal membrane oxygenation survival prediction (RESP) score. Am J Respir Crit Care Med. 2014;189(11):1374–82. https://doi.org/10.1164/rccm.201311-2023OC.

    Article  PubMed  Google Scholar 

  6. Davies A, Jones D, Bailey M, et al. Extracorporeal membrane oxygenation for 2009 influenza a(H1N1) acute respiratory distress syndrome. JAMA. 2009;302(17):1888–95. https://doi.org/10.1001/jama.2009.1535.

    Article  CAS  PubMed  Google Scholar 

  7. Noah MA, Peek GJ, Finney SJ, et al. Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza a(H1N1). JAMA. 2011;306(15):1659–68. https://doi.org/10.1001/jama.2011.1471.

    Article  CAS  PubMed  Google Scholar 

  8. Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009;374(9698):1351–63. https://doi.org/10.1016/S0140-6736(09)61069-2.

    Article  PubMed  Google Scholar 

  9. Paden ML, Conrad SA, Rycus PT, Thiagarajan RR. Extracorporeal life support organization registry report 2012. ASAIO J. 2013;59:202–10. https://doi.org/10.1097/MAT.0b013e3182904a52.

    Article  PubMed  Google Scholar 

  10. Obi A, Park PK, Rectenwald J, et al. Inferior vena cava filter placement before ECMO decannulation. ASAIO J. 2012;58:622–5.

    Article  Google Scholar 

  11. Kluge S, Braune SA, Engel M, et al. Avoiding invasive mechanical ventilation by extracorporeal carbon dioxide removal in patients failing noninvasive ventilation. Intensive Care Med. 2012;38(10):1632–9. https://doi.org/10.1007/s00134-012-2649-2.

    Article  PubMed  Google Scholar 

  12. Burki NK, Mani RK, Herth FJF, et al. A novel extracorporeal CO(2) removal system: results of a pilot study of hypercapnic respiratory failure in patients with COPD. Chest. 2013;143(3):678–86. https://doi.org/10.1378/chest.12-0228.

    Article  CAS  PubMed  Google Scholar 

  13. Abrams DC, Brenner K, Burkart KM, et al. Pilot study of extracorporeal carbon dioxide removal to facilitate extubation and ambulation in exacerbations of chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2013;10(4):307–14. https://doi.org/10.1513/AnnalsATS.201301-021OC.

    Article  CAS  PubMed  Google Scholar 

  14. Hermann A, Staudinger T, Bojic A, et al. First experience with a new miniaturized pump-driven venovenous extracorporeal CO2 removal system (iLA Activve): a retrospective data analysis. ASAIO J. 2014;60(3):342–7. https://doi.org/10.1097/MAT.0000000000000073.

    Article  CAS  PubMed  Google Scholar 

  15. Bryner B, Cooley E, Copenhaver W, et al. Two decades’ experience with Interfacility transport on extracorporeal membrane oxygenation. Ann Thorac Surg. 2014;98(4):1363–70. https://doi.org/10.1016/j.athoracsur.2014.06.025.

    Article  PubMed  Google Scholar 

  16. Posluszny J, Rycus PT, Bartlett RH, Engoren M, Haft JW, Lynch WR, Park PK, Raghavendran K, Napolitano LM, ELSO Member Centers. Outcome of adult respiratory failure patients receiving prolonged (≥14 days) ECMO. Ann Surg. 2015;. [Epub ahead of print]

    Google Scholar 

  17. Mitchell MD, Mikkelsen ME, Umscheid CA, Lee I, Fuchs BD, Halpern SD. A systematic review to inform institutional decisions about the use of extracorporeal membrane oxygenation during the H1N1 influenza pandemic. Crit Care Med. 2010;38(6):1398–404. https://doi.org/10.1097/CCM.0b013e3181de45db.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Combes A, Hajage D, Capellier G, EOLIA Trial Group, REVA, and ECMONet, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med. 2018;378(21):1965–75.

    Article  Google Scholar 

  19. Fan E, Pham T. Extracorporeal membrane oxygenation for severe acute respiratory failure. Crit Care. 2000;4(3):156–68. https://doi.org/10.1186/cc689.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric T. Chang .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chang, E.T., Napolitano, L.M. (2020). Extracorporeal Membrane Oxygenation (ECMO) and Extracorporeal CO2 Removal (ECCO2R). In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_90

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-26710-0_90

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics