Advertisement

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

  • Eric T. ChangEmail author
  • Lena M. Napolitano
Chapter
  • 11 Downloads

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.

Keywords

Extracorporeal membrane oxygenation Acute respiratory distress syndrome Severe hypoxemia Acute respiratory failure Extracorporeal CO2 removal COPD Lung recovery 

References

  1. 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.CrossRefGoogle Scholar
  2. 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.CrossRefGoogle Scholar
  3. 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.CrossRefGoogle Scholar
  4. 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.CrossRefPubMedGoogle Scholar
  5. 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.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 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.CrossRefPubMedGoogle Scholar
  8. 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.CrossRefPubMedGoogle Scholar
  9. 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.CrossRefPubMedGoogle Scholar
  10. 10.
    Obi A, Park PK, Rectenwald J, et al. Inferior vena cava filter placement before ECMO decannulation. ASAIO J. 2012;58:622–5.CrossRefGoogle Scholar
  11. 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.CrossRefPubMedGoogle Scholar
  12. 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. CrossRefPubMedGoogle Scholar
  13. 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.CrossRefPubMedGoogle Scholar
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefPubMedGoogle Scholar
  16. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 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.CrossRefGoogle Scholar
  19. 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. CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of MichiganAnn ArborUSA
  2. 2.Department of Surgery, Division of Acute Care Surgery, Trauma and Surgical Critical CareUniversity of Michigan Health SystemAnn ArborUSA

Personalised recommendations