Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | ECMO | Editorial

How I manage drainage insufficiency on extracorporeal membrane oxygenation

Authors: Bishoy Zakhary, Leen Vercaemst, Phillip Mason, Roberto Lorusso, Daniel Brodie

Published in: Critical Care | Issue 1/2020

Login to get access

Excerpt

While extracorporeal membrane oxygenation (ECMO) case volume continues to increase [1, 2], management of patients receiving ECMO remains technically challenging [2, 3]. Iatrogenic injury is a potential contributor to complications and poor outcomes [4‐7]. Drainage insufficiency, wherein limited pump preload leads to reduced circuit blood flow, is ubiquitous, yet there is no consensus regarding treatment. We propose a physiology-based algorithmic approach to the management of drainage insufficiency. …
Literature
1.
2.
Brodie D, Slutsky AS, Combes A. Extracorporeal life support for adults with respiratory failure and related indications: a review. JAMA. 2019;322(6):557–68.CrossRef
3.
Sidebotham D, McGeorge A, McGuinness S, Edwards M, Willcox T, Beca J. Extracorporeal membrane oxygenation for treating severe cardiac and respiratory failure in adults: part 2-technical considerations. J Cardiothorac Vasc Anesth. 2010;24(1):164–72.CrossRef
4.
Gross-Hardt S, Hesselmann F, Arens J, Steinseifer U, Vercaemst L, Windisch W, et al. Low-flow assessment of current ECMO/ECCO2R rotary blood pumps and the potential effect on hemocompatibility. Crit Care. 2019;23(1):348.CrossRef
5.
Shekar K, Brodie D. Should patients with acute respiratory distress syndrome on venovenous extracorporeal membrane oxygenation have ventilatory support reduced to the lowest tolerable settings? No Crit Care Med. 2019;47(8):1147–9.CrossRef
6.
Walter JM, Kurihara C, Corbridge TC, Bharat A. Chugging in patients on veno-venous extracorporeal membrane oxygenation: an under-recognized driver of intravenous fluid administration in patients with acute respiratory distress syndrome? Heart Lung. 2018;47(4):398–400.CrossRef
7.
Wang S, Chin BJ, Gentile F, Kunselman AR, Palanzo D, Undar A. Potential danger of pre-pump clamping on negative pressure-associated gaseous microemboli generation during extracorporeal life support--an in vitro study. Artif Organs. 2016;40(1):89–94.CrossRef
8.
Mc IRB, Timpa JG, Kurundkar AR, Holt DW, Kelly DR, Hartman YE, et al. Plasma concentrations of inflammatory cytokines rise rapidly during ECMO-related SIRS due to the release of preformed stores in the intestine. Lab Investig. 2010;90(1):128–39.CrossRef
9.
Pohlmann JR, Toomasian JM, Hampton CE, Cook KE, Annich GM, Bartlett RH. The relationships between air exposure, negative pressure, and hemolysis. ASAIO J. 2009;55(5):469–73.CrossRef
10.
Faghih MM, Sharp MK. Modeling and prediction of flow-induced hemolysis: a review. Biomech Model Mechanobiol. 2019;18(4):845–81.CrossRef
11.
12.
Staudacher DL, Bode C, Wengenmayer T. Fluid therapy remains an important cornerstone in the prevention of progressive chugging in extracorporeal membrane oxygenation. Heart Lung. 2018;47(4):432.CrossRef
13.
McCanny P, Smith MW, O'Brien SG, Buscher H, Carton EG. Fluid balance and recovery of native lung function in adult patients supported by venovenous extracorporeal membrane oxygenation and continuous renal replacement therapy. ASAIO J. 2019;65(6):614–9.CrossRef
14.
Schmidt M, Bailey M, Kelly J, Hodgson C, Cooper DJ, Scheinkestel C, et al. Impact of fluid balance on outcome of adult patients treated with extracorporeal membrane oxygenation. Intensive Care Med. 2014;40(9):1256–66.CrossRef
15.
Besnier E, Boubeche S, Clavier T, Popoff B, Dureuil B, Doguet F, et al. Early positive fluid balance is associated with mortality in patients treated with veno-arterial extra corporeal membrane oxygenation for cardiogenic shock: a retrospective cohort study. Shock. 2020;53(4):426–33.
Metadata
Title
How I manage drainage insufficiency on extracorporeal membrane oxygenation
Authors
Bishoy Zakhary
Leen Vercaemst
Phillip Mason
Roberto Lorusso
Daniel Brodie
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
ECMO
ECMO
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-02870-1

Other articles of this Issue 1/2020

Critical Care 1/2020 Go to the issue

Letter

Essential ICU drug shortages for COVID-19: what can frontline clinicians do?

Letter

Response to “Co-infections in COVID-19 critically ill and antibiotic management: a prospective cohort analysis”

Research

Local signs at insertion site and catheter-related bloodstream infections: an observational post hoc analysis using individual data of four RCTs

Research

Antibiotic-related gut dysbiosis induces lung immunodepression and worsens lung infection in mice

Editorial

Corticosteroids in severe COVID-19: a critical view of the evidence

Research Letter

Advanced respiratory monitoring in COVID-19 patients: use less PEEP!