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ECMO as a Bridge to Lung Transplantation

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Difficult Decisions in Cardiothoracic Critical Care Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Extracorporeal membrane oxygenation (ECMO) has evolved as an excellent alternative to support patients with end-stage lung disease until viable donated lungs become available for transplantation. Over the last decade, key innovations have enhanced the attractiveness of ECMO as a suitable bridging platform to lung transplant, thereby expanding the possibilities available to select patients. ECMO cannulation strategies can be adjusted according to the needs of the patient, and typically veno-venous ECMO is employed. The findings of retrospective series over the last 8 years have made it clear that less than ideal outcomes after ECMO support should not be a deterrent to pretransplant ECMO support in patients who require a bridge to lung transplantation. As ECMO technology improves, ECMO support without invasive mechanical ventilation and sedation has been applied an increasing number of patients. Newer veno-venous cannulation strategies utilizing a single, dual-lumen ECMO cannula allow the possibility of mobilization and rehabilitation.

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Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Christian A. Bermudez

  2. Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    JaBaris D. Swain

Authors
  1. Christian A. Bermudez
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  2. JaBaris D. Swain
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Correspondence to Christian A. Bermudez .

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Editors and Affiliations

  1. University of Chicago Medicine, Chicago, IL, USA

    Vassyl A. Lonchyna

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Bermudez, C.A., Swain, J.D. (2019). ECMO as a Bridge to Lung Transplantation. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_18

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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