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Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO).
Med Intensiva. 2017 Nov; 41(8):491-496.MI

Abstract

Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Although numerous trials have investigated different ventilation strategies in patients with ARDS, consensus is lacking on the optimal MV settings during venovenous ECMO. Although the concept of "lung rest" was introduced years ago, there are no evidence-based guidelines on its use in application to MV in patients supported by ECMO. How MV in ECMO patients can promote lung recovery and weaning from ventilation is not clear. The purpose of this review is to describe the ventilation strategies used during venovenous ECMO in clinical practice.

Authors+Show Affiliations

Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. Electronic address: martalopez@humv.es.

Pub Type(s)

Journal Article
Review

Language

eng spa

PubMed ID

28188062

Citation

López Sanchez, M. "Mechanical Ventilation in Patients Subjected to Extracorporeal Membrane Oxygenation (ECMO)." Medicina Intensiva, vol. 41, no. 8, 2017, pp. 491-496.
López Sanchez M. Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO). Med Intensiva. 2017;41(8):491-496.
López Sanchez, M. (2017). Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO). Medicina Intensiva, 41(8), 491-496. https://doi.org/10.1016/j.medin.2016.12.007
López Sanchez M. Mechanical Ventilation in Patients Subjected to Extracorporeal Membrane Oxygenation (ECMO). Med Intensiva. 2017;41(8):491-496. PubMed PMID: 28188062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO). A1 - López Sanchez,M, Y1 - 2017/02/08/ PY - 2016/11/07/received PY - 2016/12/13/revised PY - 2016/12/14/accepted PY - 2017/2/12/pubmed PY - 2018/7/24/medline PY - 2017/2/12/entrez KW - Acute respiratory distress syndrome KW - Driving pressure KW - Extracorporeal CO2 removal KW - Extracorporeal membrane oxygenation KW - Lesión pulmonar asociada a ventilación mecánica KW - Lung rest KW - Mechanical ventilation KW - Membrana de oxigenación extracorpórea KW - Membrana de oxigenación extracorpórea venovenosa KW - Protective ventilation KW - Sistemas depuradores de carbónico KW - Síndrome de distrés respiratorio agudo KW - Ultraprotective ventilation KW - Venovenous extracorporeal membrane oxygenation KW - Ventilación mecánica KW - Ventilación protectora KW - Ventilación ultraprotectora KW - Ventilator induced lung injury SP - 491 EP - 496 JF - Medicina intensiva JO - Med Intensiva VL - 41 IS - 8 N2 - Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Although numerous trials have investigated different ventilation strategies in patients with ARDS, consensus is lacking on the optimal MV settings during venovenous ECMO. Although the concept of "lung rest" was introduced years ago, there are no evidence-based guidelines on its use in application to MV in patients supported by ECMO. How MV in ECMO patients can promote lung recovery and weaning from ventilation is not clear. The purpose of this review is to describe the ventilation strategies used during venovenous ECMO in clinical practice. SN - 1578-6749 UR - https://www.unboundmedicine.com/medline/citation/28188062/Mechanical_ventilation_in_patients_subjected_to_extracorporeal_membrane_oxygenation__ECMO__ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0210-5691(17)30006-2 DB - PRIME DP - Unbound Medicine ER -