An International Survey on Ventilator Practices Among Extracorporeal Membrane Oxygenation Centers

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Christopher L JenksLakshmi Raman

Abstract

Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective was to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices. Extubation practices are increasing among all types of ECMO centers, representing 27% of all patients in pediatric centers, 41% of all patients in mixed centers, and 52% of all patients in adult centers. The most common mode of ventilation during ECMO is pressure control. There is a trend toward increased use of bilevel ventilation particularly for lung recruitment. Additionally, there is a trend toward increase in performance of bronchoscopy (pediatrics: 69%, mixed centers: 81%, adults: 76%) and tracheostomy. Among the centers performing tracheostomies, 45% reported the percutaneous method (pediatric: 31%, mixed: 46%, adult: 57%), 19% reported the open method (pediatric: 9%, mixed: 27%, adult: 24%)...Continue Reading

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Citations

Oct 19, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Mani A Daneshmand, Carmelo A Milano
Feb 25, 2020·Expert Review of Respiratory Medicine·Soo Jin Na, Kyeongman Jeon
Oct 8, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roberto LorussoDavid A D'Alessandro
Oct 7, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Roberto LorussoDavid A D'Alessandro
Jan 23, 2021·Heart & Lung : the Journal of Critical Care·Monika Tukacs, Kenrick D Cato
Dec 22, 2020·The American Surgeon·Katherine M KelleyJay Menaker
Oct 12, 2020·The Journal of Thoracic and Cardiovascular Surgery·Roberto LorussoDavid A D'Alessandro
Oct 20, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Mirko BelliatoRoberto Lorusso
Aug 2, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Carson WelkerHarish Ramakrishna

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