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Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we?
Minerva Anestesiol. 2015 Dec; 81(12):1369-76.MA

Abstract

Currently, many centers use venovenous extracorporeal membrane oxygenation (VV-ECMO) as an adjunctive means of gas exchange to mechanical ventilation (MV) in patients with severe ARDS and refractory hypoxemia. One of the most interesting and controversial issues in the management of these patients is how to set the ventilatory strategy. The support provided by VV-ECMO makes the balance between risks and benefits of MV remarkably different from the conventional setting, since the need for MV to facilitate oxygenation and carbon dioxide clearance is greatly reduced or abolished during VV-ECMO. Therefore, the risks of causing ventilator-induced lung injury are of foremost importance; however, the issue of the optimum ventilatory strategy during VV-ECMO has not received sufficient consideration. This paper will describe the diverse MV strategies applied during VV-ECMO in clinical practice and will highlight specific pathophysiological considerations that are crucial in the process of defining optimal ventilation settings in patients with ARDS supported with VV-ECMO.

Authors+Show Affiliations

Del Sorbo L
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada - slutskya@smh.ca.
Goffi A
No affiliation info available
Goligher E
No affiliation info available
Fan E
No affiliation info available
Slutsky AS
No affiliation info available

MeSH

AdultExtracorporeal Membrane OxygenationHumansRespiration, ArtificialRespiratory Distress SyndromeVentilator-Induced Lung Injury

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25300627

Citation

Del Sorbo, L, et al. "Setting Mechanical Ventilation in ARDS Patients During VV-ECMO: Where Are We?" Minerva Anestesiologica, vol. 81, no. 12, 2015, pp. 1369-76.
Del Sorbo L, Goffi A, Goligher E, et al. Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we? Minerva Anestesiol. 2015;81(12):1369-76.
Del Sorbo, L., Goffi, A., Goligher, E., Fan, E., & Slutsky, A. S. (2015). Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we? Minerva Anestesiologica, 81(12), 1369-76.
Del Sorbo L, et al. Setting Mechanical Ventilation in ARDS Patients During VV-ECMO: Where Are We. Minerva Anestesiol. 2015;81(12):1369-76. PubMed PMID: 25300627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we? AU - Del Sorbo,L, AU - Goffi,A, AU - Goligher,E, AU - Fan,E, AU - Slutsky,A S, Y1 - 2014/10/10/ PY - 2014/10/11/entrez PY - 2014/10/11/pubmed PY - 2017/1/27/medline SP - 1369 EP - 76 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 81 IS - 12 N2 - Currently, many centers use venovenous extracorporeal membrane oxygenation (VV-ECMO) as an adjunctive means of gas exchange to mechanical ventilation (MV) in patients with severe ARDS and refractory hypoxemia. One of the most interesting and controversial issues in the management of these patients is how to set the ventilatory strategy. The support provided by VV-ECMO makes the balance between risks and benefits of MV remarkably different from the conventional setting, since the need for MV to facilitate oxygenation and carbon dioxide clearance is greatly reduced or abolished during VV-ECMO. Therefore, the risks of causing ventilator-induced lung injury are of foremost importance; however, the issue of the optimum ventilatory strategy during VV-ECMO has not received sufficient consideration. This paper will describe the diverse MV strategies applied during VV-ECMO in clinical practice and will highlight specific pathophysiological considerations that are crucial in the process of defining optimal ventilation settings in patients with ARDS supported with VV-ECMO. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/25300627/Setting_mechanical_ventilation_in_ARDS_patients_during_VV_ECMO:_where_are_we DB - PRIME DP - Unbound Medicine ER -