Skip to main content

Echocardiography in Venoarterial and Venovenous ECMO

  • Chapter
  • First Online:

Abstract

After worldwide successes with ECMO for the 2009 pandemic influenza H1N1 [1, 2], and publication of the results of the Conventional Ventilatory Support Versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure trial that showed a survival advantage for ECMO over conventional ventilator management for severe respiratory failure [3], there has been renewed enthusiasm for venovenous ECMO (VV ECMO) for pulmonary support. Similarly, venoarterial ECMO (VA ECMO) for acute cardiogenic shock is also becoming a more commonly used tool in the early management of critically ill patients as part of a treatment strategy to bridge to recovery, ventricular assist device implantation, or transplantation. Algorithms that incorporate early VA ECMO as part of the treatment for witnessed cardiopulmonary arrest (ECMO-assisted cardiopulmonary resuscitation) are also becoming more common and have resulted in a twofold increase in neurologically intact patients surviving to discharge [4] (Table 31.1).

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   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
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. Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N et al, Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators (2009) Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 302:1888–1895

    Google Scholar 

  2. Firstenberg MS, Blais D, Louis LB, Stevenson KB, Sun B, Mangino JE (2009) Extracorporeal membrane oxygenation for pandemic (H1N1) 2009. Emerg Infect Dis 15:2059–2060

    Article  PubMed Central  PubMed  Google Scholar 

  3. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM et al, CESAR Trial Collaboration (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374:1351–1363

    Google Scholar 

  4. Cardarelli MG, Young AJ, Griffith B (2009) Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies. ASAIO J 55:581–586

    Article  PubMed  Google Scholar 

  5. Koenig PR, Ralston MA, Kimball TR, Meyer RA, Daniels SR, Schwartz DC (1993) Balloon atrial septostomy for left ventricular decompression in patients receiving extracorporeal membrane oxygenation for myocardial failure. J Pediatr 122:S95–S99

    Article  CAS  PubMed  Google Scholar 

  6. O’Connor TA, Downing GJ, Ewing LL, Gowdamarajan R (1993) Echocardiographically guided balloon atrial septostomy during extracorporeal membrane oxygenation (ECMO). Pediatr Cardiol 14:167–168

    Article  PubMed  Google Scholar 

  7. Avalli L, Maggioni E, Sangalli F, Favini G, Formica F, Fumagalli R (2011) Extracorporeal Membrane Oxygenation: An Alternative to Surgical and Transeptal Venting in Adult Patients. ASAIO J 57:38–40

    Article  CAS  PubMed  Google Scholar 

  8. Sedgwick JF, Burstow DJ, Platts DG (2010) The role of echocardiography in the management of patients supported by extracorporeal membranous oxygenation (ECMO). Int J Cardiol 147(Suppl):S16

    Google Scholar 

  9. Platts DG, Sedgwick JF, Burstow DJ, Mullany DV, Fraser JF (2012) The role of echocardiography in the management of patients supported by extracorporeal membrane oxygenation. J Am Soc Echocardiogr 25:131–141

    Google Scholar 

  10. Chen Y-S, Lin J-W, Yu H-Y, Jerng J-S, Ko W-J, Chang W-T et al (2008) Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 372:554–561

    Article  PubMed  Google Scholar 

  11. Scherer M, Sirat AS, Moritz A, Martens S (2011) Extracorporeal membrane oxygenation as perioperative right ventricular support in patients with biventricular failure undergoing left ventricular assist device implantation. Eur J Cardiothorac Surg 39:939–944

    Article  PubMed  Google Scholar 

  12. Santelices LC, Wang Y, Severyn D, Druzdzel MJ, Kormos RL, Antaki JF (2010) Development of a hybrid decision support model for optimal ventricular assist device weaning. Ann Thorac Surg 90:713–720

    Article  PubMed Central  PubMed  Google Scholar 

  13. Konishi H, Misawa Y, Nakagawa Y, Fuse K (1999) Doppler aortic flow pattern in the recovering heart treated by cardiac extracorporeal membrane oxygenation. Artif Organs 23:367–369

    Article  CAS  PubMed  Google Scholar 

  14. Aissaoui N, Guerot E, Combes A, Delouche A, Chastre J, Leprince P et al (2012) Two-dimensional strain rate and Doppler tissue myocardial velocities: analysis by echocardiography of hemodynamic and functional changes of the failed left ventricle during different degrees of extracorporeal life support. J Am Soc Echocardiogr 25:632–640

    Article  PubMed  Google Scholar 

  15. Marasco SF, Lukas G, McDonald M, McMillan J, Ihle B (2008) Review of ECMO (extra corporeal membrane oxygenation) support in critically ill adult patients. Heart Lung Circ 17(Suppl):S41–S47

    Article  PubMed  Google Scholar 

  16. Avalon Laboratories. Avalon Elite_ bi-caval dual lumen catheter. Available at: http://www.avalonlabs.com/html/pulmonary_support.html. Accessed 25 Nov 2011

  17. Javidfar J, Wang D, Zwischenberger J, Costa J, Mongero L, Sonett J et al (2011) Insertion of bicaval dual lumen extracorporeal membrane oxygenation catheter with image guidance. ASAIO J 57:203–205

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabio Sangalli .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Bianco, N., Avalli, L., Sangalli, F. (2014). Echocardiography in Venoarterial and Venovenous ECMO. In: Sangalli, F., Patroniti, N., Pesenti, A. (eds) ECMO-Extracorporeal Life Support in Adults. Springer, Milano. https://doi.org/10.1007/978-88-470-5427-1_31

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5427-1_31

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5426-4

  • Online ISBN: 978-88-470-5427-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics