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Review
. 2018 Mar;10(Suppl 5):S683-S691.
doi: 10.21037/jtd.2017.10.08.

Adjunctive therapies during veno-venous extracorporeal membrane oxygenation

Federico Pappalardo  1 , Andrea Montisci  2
Affiliations
Review

Adjunctive therapies during veno-venous extracorporeal membrane oxygenation

Federico Pappalardo et al. J Thorac Dis. 2018 Mar.

Abstract

Veno-venous extracorporeal membrane oxygenation (VV ECMO) restores gas exchanges in severely hypoxemic patients. The need for adjunctive therapies usually originates either from refractory hypoxemia during ECMO (defined as the persistence of low blood oxygen levels despite extracorporeal support) or from the attempt to give a specific therapy for acute respiratory distress syndrome (ARDS). In this review, therapeutic strategies to treat refractory and persistent hypoxemia during ECMO are evaluated. In the second part, therapies that can be added on top of VV ECMO to address inflammation and altered vascular permeability in ARDS are examined. The therapies currently available often allow for an effective treatment of hypoxemia during ECMO. ARDS is still lacking a specific therapy, with low-grade evidence sustaining the majority of currently used drugs.

Keywords: Veno-venous extracorporeal membrane oxygenation (VV ECMO); acute respiratory distress syndrome (ARDS); hypoxemia.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

References

    1. Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med 2017;377:562-72. 10.1056/NEJMra1608077 - DOI - PubMed
    1. Montisci A, Maj G, Zangrillo A, et al. Management of refractory hypoxemia during venovenous extracorporeal membrane oxygenation for ARDS. ASAIO J 2015;61:227-36. 10.1097/MAT.0000000000000207 - DOI - PubMed
    1. Moerer O, Tonetti T, Quintel M. Rescue therapies for acute respiratory distress syndrome: what to try first? Curr Opin Crit Care 2017;23:52-9. 10.1097/MCC.0000000000000374 - DOI - PubMed
    1. Henig NR, Pierson DJ. Mechanisms of hypoxemia. Respir Care Clin N Am 2000;6:501-21. 10.1016/S1078-5337(05)70087-3 - DOI - PubMed
    1. Abdelsalam M, Cheifetz IM. Goal-Directed Therapy for Severely Hypoxic Patients With Acute Respiratory Distress Syndrome: Permissive Hypoxemia. Respir Care 2010;55:1483-90. - PubMed

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