Extracorporeal Life Support in "Awake" Patients as a Bridge to Lung Transplant

The Thoracic and Cardiovascular Surgeon
Prashant N MohiteAndré R Simon

Abstract

Background Traditionally, patients on extracorporeal membrane oxygenation (ECMO) are sedated and mechanically ventilated, which increases risk of complications related to immobility and mechanical ventilation. The purpose of this study was to assess the feasibility and highlight the benefits of a bridge to lung transplant (LTx) using "awake ECMO" support. Methods The peripheral venovenous or venoarterial ECMO was implanted at a bedside. A retrospective study of patients undergoing LTx between January 2007 and March 2013 was performed. Outcomes in patients supported on ECMO as a bridge to LTx and kept "awake" (Group 1) were compared with the rest of the LTx patients (Group 2). Results In this period, 249 LTx were performed and in them 7 patients were bridged to LTx using "awake ECMO" strategy. Two patients were awake at ECMO implantation and throughout the therapy, and two patients were on ventilator support at the time of ECMO implantation who were extubated later and maintained awake until LTx. The remaining three patients were awake for some time during the ECMO. There was no statistically significant difference in most donor characteristics and recipient baseline characteristics as well as post-LTx parameters between the two...Continue Reading

Citations

Jul 1, 2016·Critical Care : the Official Journal of the Critical Care Forum·Thomas LangerLuciano Gattinoni
Aug 2, 2016·American Journal of Respiratory and Critical Care Medicine·Laveena Munshi, Eddy Fan
Mar 3, 2017·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Justyna SwolThomas A Schildhauer
Nov 16, 2017·Current Opinion in Critical Care·Darryl AbramsDaniel Brodie
Nov 11, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Benjamin HohlfelderJeremy R Degrado
Nov 11, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Kai VerkoyenJustyna Swol
Jun 16, 2018·Interactive Cardiovascular and Thoracic Surgery·Prashant N MohiteAndré R Simon
Aug 20, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Christine D FranciscovichElizabeth Ely
Oct 25, 2020·Artificial Organs·Justyna SwolRoberto Lorusso
Jul 9, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Dana BakdachIbrahim Hassan
Nov 16, 2021·Artificial Organs·Massimiliano PolastriAndrea Dell'Amore

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