Conclusion
ECMO patients with recovering left ventricular function and persistent gas exchange abnormalities are at risk for developing differential hypoxemia. We describe an approach to identifying and treating differential hypoxemia and prophylactically utilizing VA-V configuration when the likelihood of differential hypoxemia is extremely high.
References
Uncategorized References
1. Abrams D, Combes A, Brodie D. Extracorporeal Membrane Oxygenation in Cardiopulmonary Disease in Adults. Journal of the American College of Cardiology. 2014;63(25, Part A):2769-78.
2. Bartlett RH, Roloff DW, Custer JR, Younger JG, Hirschl RB. Extracorporeal Life SupportThe University of Michigan Experience. JAMA. 2000;283(7):904-8.
3. Bisdas T, Beutel G, Warnecke G, Hoeper MM, Kuehn C, Haverich A, et al. Vascular Complications in Patients Undergoing Femoral Cannulation for Extracorporeal Membrane Oxygenation Support. The Annals of Thoracic Surgery. 2011;92(2):626-31.
4. Brasseur A, Scolletta S, Lorusso R, Taccone FS. Hybrid extracorporeal membrane oxygenation. Journal of Thoracic Disease. 2018;10 (Suppl 5):S707-S15.
5. Brodie D, Bacchetta M. Extracorporeal Membrane Oxygenation for ARDS in Adults. New England Journal of Medicine. 2011;365(20):1905-14.
6. Combes A, Brodie D, Chen Y-S, Fan E, Henriques JPS, Hodgson C, et al. The ICM research agenda on extracorporeal life support. Intensive Care Medicine. 2017;43(9):1306-18.
7. Loftsgard TO, Newcome MD, Hanneman MR, Patch RK, 3rd, Seelhammer TG. Management of Neurogenic Pulmonary Edema and Differential Hypoxemia in an Adult Supported on Venoarterial Extracorporeal Membrane Oxygenation. J Cardiothorac Vasc Anesth. 2017;31(6):2170-4.
8. Mohite PN, Fatullayev J, Maunz O, Kaul S, Sabashnikov A, Weymann A, et al. Distal limb perfusion: Achilles’ heel in peripheral venoarterial extracorporeal membrane oxygenation. Artif Organs. 2014;38(11):940-4.
9. Sorokin V, MacLaren G, Vidanapathirana PC, Delnoij T, Lorusso R. Choosing the appropriate configuration and cannulation strategies for extracorporeal membrane oxygenation: the potential dynamic process of organ support and importance of hybrid modes. European Journal of Heart Failure. 2017;19(S2):75-83.
10. Biscotti M, Lee A, Basner RC, Agerstrand C, Abrams D, Brodie D, et al. Hybrid Configurations via Percutaneous Access for Extracorporeal Membrane Oxygenation: A Single-Center Experience. ASAIO Journal. 2014;60(6):635-42.
11. Werner NL, Coughlin M, Cooley E, Haft JW, Hirschl RB, Bartlett RH, et al. The University of Michigan Experience with Veno-Venoarterial Hybrid Mode of Extracorporeal Membrane Oxygenation. ASAIO Journal. 2016;62(5):578-83.
12. Gerke AK, Tang F, Cavanaugh JE, Doerschug KC, Polgreen PM. Increased trend in extracorporeal membrane oxygenation use by adults in the United States since 2007. BMC Research Notes. 2015;8(1):686.
13. Stöhr F, Emmert MY, Lachat ML, Stocker R, Maggiorini M, Falk V, et al. Extracorporeal membrane oxygenation for acute respiratory distress syndrome: is the configuration mode an important predictor for the outcome? Interactive CardioVascular and Thoracic Surgery. 2011;12(5):676-80.
14. Ius F, Sommer W, Tudorache I, Avsar M, Siemeni T, Salman J, et al. Veno-veno-arterial extracorporeal membrane oxygenation for respiratory failure with severe haemodynamic impairment: technique and early outcomes. Interactive CardioVascular and Thoracic Surgery. 2015;20(6):761-7.
15. Chamogeorgakis T, Lima B, Shafii A, Nagpal D, Pokersnik J, Navia J, et al. Outcomes of axillary artery side graft cannulation for extracorporeal membrane oxygenation. Journal of Thoracic and Cardiovascular Surgery. 2013;145:1088-92.