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Veno-arterial-ECMO in the intensive care unit: From technical aspects to clinical practice

The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting..

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Advanced mechanical circulatory support for post-cardiotomy cardiogenic shock: a 20-year outcome analysis in a non-transplant unit

Background Post-cardiotomy cardiogenic shock (PCCS) has an incidence of 2–6 % after routine adult cardiac surgery. 0.5–1.5 % are refractory to inotropic and intra-aortic balloon pump (IABP) support. Advanced mechanical circulatory support..

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International survey on the management of mechanical ventilation during ECMO in adults with severe respiratory failure

BACKGROUND: No consensus exists on the optimal settings of mechanical ventilation during veno-venous extracorporeal membrane oxygenation (ECMO). Our aim was to describe how mechanical ventilation and related interventions are managed..

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“Awake” extracorporeal membrane oxygenation (ECMO): pathophysiology, technical considerations, and clinical pioneering

Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the..

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Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we?

Currently, many centers use venovenous extracorporeal membrane oxygenation (VV-ECMO) as an adjunctive means of gas exchange to mechanical ventilation (MV) in patients with severe ARDS and refractory hypoxemia. One of..

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Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO)

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..

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COVID-19 and ECMO: An Unhappy Marriage of Endothelial Dysfunction and Hemostatic Derangements

Severe respiratory syndrome coronavirus-2 is responsible for coronavirus disease 2019 (COVID-19), which may lead to acute respiratory failure. In its most severe manifestation including refractory hypoxemia and/or hypercapnia, it can..

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Inter-hospital COVID ECMO Air Transportation

The Coronavirus Disease 2019 (COVID-19) pandemic has required rapid and effective protocol adjustments at every level of healthcare. The use of extracorporeal membrane oxygenation (ECMO) is pivotal to COVID-19 treatment..

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Successful Use of An Automated Proning System to Achieve Prone Positioning in A Patient with Severe ARDS Requiring Veno-Venous ECMO

Abstract A morbidly obese middle aged woman in her 40's presented to another hospital with  and subsequently developed severe . Her oxygenation demonstrated no improvement with low  ventilation, paralysis, or prostagladin therapy. She..

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Pediatric Intensive Care Preparedness and ECMO Availability in Children With COVID-19: An International Survey

Abstract Since the beginning of the pandemic Coronavirus Disease 2019 (COVID-19), calls were made for informed allocation of costly, limited health care resources such as extracorporeal membrane oxygenation (ECMO). At..

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Extracorporeal Life Support for Cardiogenic Shock with Either A Percutaneous Ventricular Assist Device or An Intra-Aortic Balloon Pump

Abstract Extracorporeal life support (ECLS) can result in complications due to increased left ventricular (LV) afterload. The percutaneous ventricular assist device (PVAD) and intra-aortic balloon pump (IABP) are both considered..

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Evaluation of Recirculation During Venovenous Extracorporeal Membrane Oxygenation Using Computational Fluid Dynamics Incorporating Fluid-Structure Interaction

Abstract Recirculation in venovenous extracorporeal membrane oxygenation (VV ECMO) leads to reduction in gas transfer efficiency. Studies of the factors contributing have been performed using in vivo studies and computational..

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Practical Management of ECPELLA

Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) is a strong mechanical circulatory device for patients with hemodynamic deterioration due to cardiogenic shock, but its drawback is an increase in left ventricular..

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