Navigation Links
Extracorporeal membrane oxygenation as a bridge to lung transplantation
Date:1/19/2012

Extracorporeal membrane oxygenation (ECMO) support in awake, non-intubated patients may be an effective strategy for bridging patients to lung transplantation, according to a new study from Germany.

"As waiting times for donor organs continue to increase, so does the need for bridging strategies for patients with end-stage lung disease awaiting transplantation," said Marius M. Hoeper, MD, professor of medicine at the Hannover Medical School in Hannover, Germany. "Our study shows that ECMO support in awake and non-intubated patients may be an alternative to intubation and mechanical ventilation, and may result in better survival."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

In the retrospective, single-center study of consecutive lung transplantation candidates with terminal respiratory or cardiopulmonary failure, 26 patients received awake ECMO and 34 control patients received conventional mechanical ventilation (MV) as a bridge to transplant. Median duration of ECMO support was 9 days (range 1-45) and median duration of MV was 15 days (range 1-71). Veno-arterial ECMO was used primarily in patients with right ventricular failure and/or profound hypoxemia while the veno-venous approach was used primarily in patients exhibiting hypoxemic and/or hypercapnic respiratory failure but stable hemodynamics.

Of 26 patients in the ECMO group, six (23%) died before a donor organ became available, compared with 10 of 34 (29%) patients in the MV group. Among the patients who reached transplantation, the survival rate at six months post-transplantation was significantly (p=.02) higher in the awake ECMO group (80%) compared with the MV group (50%). The six-month survival rate among awake ECMO patients who required secondary intubation dropped to 43%. Awake ECMO patents required significantly (p=.04) shorter postoperative mechanical ventilation and showed a trend towards shorter postoperative hospital stays.

ECMO-related complications included a fatal cardiac arrest after insertion of the venous ECMO cannulae in one patient. Intubation and mechanical ventilation was required 1-7 days after ECMO insertion in six patients. Blood transfusions due to bleeding complications were needed in eight patients. Of five patients who developed a sepsis-like syndrome, one recovered.

"Ours is the largest series of patients who underwent awake ECMO as a bridge to lung transplantation," said lead author Thomas Fuehner, MD. "In addition to the possibility that this approach may improve survival, one of the main benefits of using awake ECMO is the avoidance of the complications associated with general anesthesia, intubation, and long-term ventilation."

The study had a few limitations, including the small number of patients included and the retrospective nature of the analyses. "Awake ECMO may be an effective bridging strategy for lung transplantation candidates," said Dr. Hoeper. "This strategy, however, remains investigational and must be studied further to improve its safety and efficacy and examine how to tailor its use for specific patient populations."


'/>"/>
Contact: Nathaniel Dunford
ndunford@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. Pitt/Childrens Hospital team: Cell membrane proteins could provide targets for broader vaccines
2. When first-time mothers are induced, breaking the amniotic membrane shortens delivery time
3. Membrane molecule keeps nerve impulses hopping
4. Use of amniotic membrane may cause complications in strabismus surgery
5. Amniotic membrane used to repair human articular cartilage
6. Results of the BRIDGE trial reported at TCT 2011
7. Grant will help bridge digital divide for people with disabilities
8. Failing to bridge the gap between test tubes, animals, and human biology
9. Averting bridge disasters: New technology could save hundreds of lives
10. ESHRE bridges East and West for its 2012 Congress in Istanbul
11. Building a bridge with cross-cultural cancer education
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... Las Vegas, Nevada (PRWEB) , ... October 13, 2017 , ... ... of 7® Hemp CBD Oil utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum ... CBD dose required and providing a CBD form that can be easily incorporated into ...
(Date:10/13/2017)... N.J. (PRWEB) , ... October 13, 2017 , ... The ... Holly Day Market. Featuring a collection of specialty vendors and unique items from across ... personalized and quality-focused health and wellness services offered by the VNA. The boutique ...
(Date:10/13/2017)... ... October 13, 2017 , ... ... Software Development, has been awarded a contract by the Center for Medicare and ... aims to accelerate the enterprise use of Agile methodologies in a consistent and ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the largest and fastest ... to open a flagship location in Covington, LA at 401 N. U.S. Highway 190, ... next to Office Depot in the Holiday Square shopping center. Its location allows it ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... system that we intend to develop to enable prevention of a major side ... severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss is FDA ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... 2017  Caris Life Sciences ® , a leading ... of precision medicine, today announced that St. Jude Medical ... Alliance™ (POA) as its 17 th member. Through ... Crosson Cancer Institute will help develop standards of care ... profiling, making cancer treatment more precise and effective. ...
(Date:10/11/2017)... Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today provided an update ... Puerto Rico , where the company manufactures ... Following a comprehensive onsite assessment, the ... temporary loss of power and minimal water damage due ... have resumed, and the company expects to return to ...
(Date:10/10/2017)... 10, 2017   West Pharmaceutical Services, Inc. ... injectable drug administration, today shared the results of a ... improving the intradermal administration of polio vaccines. The study ... in May 2017 by Dr. Ondrej Mach , ... Health Organization (WHO), and recently published in the journal ...
Breaking Medicine Technology: