2016年2月10日 · Veno–veno–arterial (VVA) ECMO may offer effective oxygenation and hemodynamic support without differential hypoxia by regulating the return of oxygenated blood to the underperfused coronary and cerebral circulation [3–5]. Therefore, VVA mode can be an alternative treatment modality for ARDS patients with severe septic shock.

2015年12月1日 · Patients receiving circulatory support with peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are at risk of developing differential hypoxia. This phenomenon occurs in patients with concomitant respiratory failure. Poorly oxygenated blood, ejected into the ascending aorta from the left ventricle, competes with retrograde flow from the ECMO circuit, potentially causing ...

2019年8月7日 · We do not deny the clinical importance of hypoxemia in the pathophysiological context of ARDS as a VV ECMO indication, but certainly a more realistic approach should look beyond the classical criteria to start ECMO therapy and take into account the heart-lung interactions its effects and implications in the prognosis of patients with acute respiratory failure.

2019年2月8日 · Thus, “VVA” or “VAV” may be used in the same center for VA ECMO with dual return cannulae, depending on whether the initial mode was VV or VA . Separately, smaller catheters may be placed to promote distal perfusion of a cannulated lower extremity, e.g., on the arterial side [ 11 , 12 ], or to improve drainage or release congestion of ...

2023年10月27日 · Dual circulation is a common but underrecognized physiological occurrence associated with peripheral venoarterial extracorporeal membrane oxygenation (ECMO). Competitive flow will develop between blood ejected from the heart and blood travelling retrograde within the aorta from the ECMO reinfusion cannula. The intersection of these two competitive flows is referred to as the “mixing point ...

2017年3月28日 · Background Despite quick implementation of reperfusion therapies, a few patients with high-risk, acute, massive, pulmonary embolism (PE) remain highly hemodynamically unstable. Others have absolute contraindication to receive reperfusion therapies. Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) might lower their right ventricular overload, improve hemodynamic status, and restore ...

2024年6月20日 · ECMO management also varied, with LV venting performed in 22% of patients in one trial and in 6% in another . Similar concerns apply to network meta-analyses [ 12 ]. Moreover, disease severity is rarely reported or adjusted for but can impact mortality and hence influence the results.

2017年3月6日 · Background Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is an effective rescue therapy for severe cardiorespiratory failure, but morbidity and mortality are high. We hypothesised that survival decreases with longer VA ECMO treatment. We examined the Extracorporeal Life Support Organization (ELSO) registry for a relationship between VA ECMO duration and in-hospital mortality, and ...

2021年1月4日 · Background Extracorporeal membrane oxygenation (ECMO) support in acute respiratory failure may be lifesaving, but bleeding and thromboembolic complications are common. The optimal anticoagulation strategy balancing these factors remains to be determined. This retrospective study compared two institutional anticoagulation management strategies focussing on oxygenator changes and both bleeding ...

2024年3月21日 · Peripheral VA-ECMO increases left ventricular (LV) afterload, potentially impairing myocardial recovery and leading to poor outcomes. Intra-aortic balloon pump (IABP) has been suggested as an approach to unload LV in patients supported by VA-ECMO . However, the effectiveness of IABP combined with VA-ECMO remains controversial [2,3,4]. Using the ...