Tuberc Respir Dis.  2010 Feb;68(2):62-66. 10.4046/trd.2010.68.2.62.

Acute Respiratory Failure Treated with Veno-venous Extracorporeal Membrane Oxygenation

• Kim HS
• Han SJ
• Hong KS
• Yoon DH
• Lee CY
• Lee MG
• Hong WK
• Lee SH
• Kim KI
• Lee HS
• Cho SW

• KMID: 2050586
• DOI: http://doi.org/10.4046/trd.2010.68.2.62

Abstract

BACKGROUND
Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure.
METHODS
From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a PaO2/FiO2 ratio <100 mm Hg on FiO2 of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. EBS(R), Bio-pump(R), and Centrifugal Rotaflow pump(R) were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation.
RESULTS
Five of the 7 patients were male and the mean age was 46.3+/-18.3. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was 17.3+/-13.7 days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days.
CONCLUSION
The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

Keyword

Extracorporeal Membrane Oxygenation; Respiratory Distress Syndrome, Acute

MeSH Terms

Adult
Catheterization
Extracorporeal Membrane Oxygenation
Femoral Vein
Hemorrhage
Humans
Hydrogen-Ion Concentration
Hypercapnia
Liver Failure, Acute
Lung
Male
Near Drowning
Pneumonia
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Ventilators, Mechanical

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