Extracorporeal membrane oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO) is increasingly being employed in South African intensive care units for the management of patients with refractory hypoxaemia and for haemodynamic support, particularly following cardiothoracic procedures. ECMO is expensive, however, and there is a danger that this rescue modality may be abused or utilised unnecessarily or in situations where further intensive therapy is futile. This brief review provides an overview of the techniques available, and the recommended indications and exclusions for venovenous ECMO in particular.

[1]  M. Lamy,et al.  Effects of extracorporeal membrane oxygenation (ECMO) on pulmonary hemodynamics, gas exchange and prognose. , 1975, Transactions - American Society for Artificial Internal Organs.

[2]  R. Schears,et al.  Extracorporeal Life Support: Utilization, Cost, Controversy, and Ethics of Trying to Save Lives , 2009, Seminars in cardiothoracic and vascular anesthesia.

[3]  Extracorporeal Membrane Oxygenation for 2009 Influenza A ( H 1 N 1 ) Acute Respiratory Distress Syndrome , 2009 .

[4]  Robert H. Bartlett,et al.  Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database , 2009, Intensive Care Medicine.

[5]  Y. Toyoda,et al.  Initial experience with single cannulation for venovenous extracorporeal oxygenation in adults. , 2010, The Annals of thoracic surgery.

[6]  Thomas Langer,et al.  Clinical review: Extracorporeal membrane oxygenation , 2011, Critical care.

[7]  I. Lipkovich,et al.  Propensity score estimation with missing values using a multiple imputation missingness pattern (MIMP) approach , 2009, Statistics in medicine.

[8]  G. Schears,et al.  Optimal Time for Initiating Extracorporeal Membrane Oxygenation , 2009, Seminars in cardiothoracic and vascular anesthesia.

[9]  Sylvie Chevret,et al.  Extracorporeal membrane oxygenation for pandemic influenza A(H1N1)-induced acute respiratory distress syndrome: a cohort study and propensity-matched analysis. , 2013, American journal of respiratory and critical care medicine.

[10]  Diana Elbourne,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 , 2009, The Lancet.

[11]  Susanna Price,et al.  Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1). , 2011, JAMA.

[12]  Rupert G. Miller,et al.  Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. , 1979, JAMA.

[13]  J. Zwischenberger,et al.  Will CESAR answer the adult ECMO debate? , 2009, The Lancet.

[14]  T. Dorman,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 , 2011 .

[15]  E. Fan,et al.  Therapies for refractory hypoxemia in acute respiratory distress syndrome. , 2010, JAMA.

[16]  J. Younger,et al.  Extracorporeal life support: the University of Michigan experience. , 2000, JAMA.

[17]  Alain Vuylsteke,et al.  Extracorporeal Membrane Oxygenation for Adults , 2012, Respiratory Medicine.

[18]  J J Osborn,et al.  Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. , 1972, The New England journal of medicine.