scholarly journals COVID‐19 case of ventilator‐induced lung injury on extracorporeal membrane oxygenation: Physicians' clinical struggle and ethical conflict in a novel pandemic

2021 ◽  
Vol 9 (12) ◽  
Author(s):  
Yoshiko Ishisaka ◽  
Nobuyuki Nosaka ◽  
Yuka Mishima ◽  
Takahiro Masuda ◽  
Michio Nagashima ◽  
...  
Keyword(s):  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Ethical Conflict ◽  
Membrane Oxygenation ◽  
Ventilator Induced Lung Injury

E-cigarette, or vaping, product use-associated lung injury (EVALI) treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO) and ultra-protective ventilator settings

2020 ◽  
Vol 13 (7) ◽  
pp. e234771
Author(s):  
Mazen Faris Odish ◽  
Amy Bellinghausen ◽  
Eugene Golts ◽  
Robert Llewellyn Owens
Keyword(s):  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Product Use ◽  
Ventilator Induced Lung Injury ◽  
Volume Ventilation ◽  
Protective Mechanical Ventilation ◽  
Vv Ecmo ◽  
Lung Protective Mechanical Ventilation

A 19-year-old man vaping with tetrahydrocannabinol presented with dyspnoea and right pneumothorax. History, imaging and negative infectious workup were consistent with E-cigarette, or vaping, product use-associated lung injury (EVALI). Treated with systemic steroids, he developed acute respiratory distress syndrome and was intubated requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO) by hospital day 3. Using VV-ECMO, very-low tidal volume ventilation of 1.5 cc/kg was achieved, as was daily ambulation. VV-ECMO was decannulated on hospital day 9 and the patient was extubated the next day. He was discharged home on hospital day 13 without oxygen. At post-intensive care unit clinic follow-up, he had lost 20 kg of weight while hospitalised and reported nightmares. Patients with EVALI may be supported with VV-ECMO, which allows ultra-lung-protective mechanical ventilation that may minimise ventilator-induced lung injury. Follow-up in patients with EVALI is essential to diagnose and treat comorbidities, follow lung function and prevent relapses.

scholarly journals Temporary extracorporeal membrane oxygenation in the treatment of acute traumatic lung injury

1998 ◽  
Vol 45 (11) ◽  
pp. 1097-1102 ◽  
Author(s):  
Wolfgang Voelckel ◽  
Volker Wenzel ◽  
Michael Rieger ◽  
Herwig Antretter ◽  
Stephan Padosch ◽  
...  
Keyword(s):  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Membrane Oxygenation

Bleomycin-induced lung injury treated with venovenous extracorporeal membrane oxygenation (ECMO) and ultra-protective ventilator settings

2020 ◽  
Vol 13 (11) ◽  
pp. e236474
Author(s):  
Mazen Faris Odish ◽  
William Cameron McGuire ◽  
Patricia Thistlethwaite ◽  
Laura E Crotty Alexander
Keyword(s):  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Case Reports ◽  
Rapid Onset ◽  
High Dose ◽  
Drug Induced ◽  
Membrane Oxygenation ◽  
Hypoxic Respiratory Failure ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Vv Ecmo

Bleomycin treats malignancies, such as germ cell tumours and Hodgkin lymphoma. While efficacious, it can cause severe drug-induced lung injury. We present a 42-year-old patient with stage IIB seminoma treated with radical orchiectomy followed by adjuvant chemotherapy with bleomycin, etoposide and cisplatin. His postbleomycin course was complicated by the rapid onset of hypoxic respiratory failure, progressing to acute respiratory distress syndrome and requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) support. Although the patient was treated with high dose systemic steroids and ultra-protective ventilator strategies to minimise ventilator-induced lung injury while on VV-ECMO, his lung injury failed to improve. Care was withdrawn 29 days later. Lung autopsy revealed diffuse organising pneumonia. We found six case reports (including this one) of bleomycin-induced lung injury requiring VV-ECMO with a cumulative survival of 33% (2/6). While VV-ECMO may be used to bridge patients to recovery or lung transplant, the mortality is high.

Does Earlier Cannulation With Veno-Venous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Distress Syndrome Decrease Duration of Artificial Mechanical Ventilation?

2020 ◽  
Vol 13 (2) ◽  
pp. 148-155
Author(s):  
Christine Hartner ◽  
Jacqueline Ochsenreither ◽  
Kenneth Miller ◽  
Michael Weiss
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Vv Ecmo

BackgroundAcute respiratory distress syndrome (ARDS) is characterized by an acute, diffuse, inflammatory lung injury, leading to increased alveolar capillary permeability, increased lung weight, and loss of aerated lung tissue (Fan, Brodie, & Slutsky, 2018). Primary treatment for ARDS is artificial mechanical ventilation (AMV) (Wu, Huang, Wu, Wang, & Lin, 2016). Given recent advances in technology, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) to treat severe ARDS is growing rapidly (Combes et al., 2014).ObjectiveThis 49-month quantitative, retrospective inpatient EMR chart review compared if cannulation with VV-ECMO up to and including 48 hours of admission and diagnosis in adult patients 30 to 65 years of age diagnosed with ARDS, decreased duration on AMV, as compared to participants who were cannulated after 48 hours of admission and diagnosis with ARDS.MethodsA total of 110 participants were identified as receiving VV-ECMO during the study timeframe. Of the 58 participants who met all inclusion criteria, 39 participants were cannulated for VV-ECMO within 48 hours of admission and diagnosis with ARDS, and 19 participants were cannulated with VV-ECMO after 48 hours of admission and diagnosis with ARDS.ResultsData collected identified no statistically significant (p < 0.579) difference in length of days on AMV between participant groups.ConclusionsFurther studies are needed to determine if earlier initiation of VV-ECMO in adult patients with ARDS decrease time on AMV.Implications for NursingAlthough the results related to length of time on AMV did not produce statistical significance, the decreased duration of AMV in the participants who were cannulated within 48 hours (21 days vs. 27 days) may support several benefits associated with this participant population including increased knowledge of healthcare providers, decreased lung injury, earlier discharge which decreases hospital and patient cost, ability for patients to communicate sooner, decreased risk of pulmonary infection, decreased length of stay, decreased cost, and improved patient and family satisfaction.

Extracorporeal Membrane Oxygenation (ECMO) for Lung Injury in Severe Acute Respiratory Distress Syndrome (ARDS): Review of the Literature

2016 ◽  
Vol 26 (6) ◽  
pp. 747-762 ◽  
Author(s):  
Summer Paolone
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Future Research ◽  
High Morbidity ◽  
Ecmo Circuit ◽  
Membrane Oxygenation

Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 26% to 58%. Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass circuit that serves as an artificial membrane lung and blood pump to provide gas exchange and systemic perfusion for patients when their own heart and lungs are unable to function adequately. ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure while minimizing iatrogenic ventilator-induced lung injury. In critical care settings, ECMO is proven to improve survival rates and outcomes in patients with severe ARDS. This review defines severe ARDS; describes the ECMO circuit; and discusses recent research, optimal use of the ECMO circuit, limitations of therapy including potential complications, economic impact, and logistical factors; and discusses future research considerations.

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