Partial or Total Extracorporeal Support

Nicolo Patroniti, Stefano Isgro, and Michela Bombino

Introduction

Extracorporeal membrane oxygenation (ECMO) is one of the terms used to describe a number of different techniques used for prolonged cardiac and/or respiratory support. During ECMO a fraction of the patient venous return is diverted through an artificial lung for gas exchange (oxygenation and CO2 removal) and then returned to the patient. Depending on the returning vessel (venous or arterial), ECMO can be used for cardiac (veno-arterial bypass (VA-ECMO)) or respiratory support. For respiratory support blood can be drained either from a venous vessel (veno-venous ECMO (VV-ECMO)) or from an arterial vessel (arteriovenous bypass (AV-ECMO)). During VV and VA-ECMO, the blood is withdrawn from the patient through the action of a pump, whereas during AV-ECMO, the blood flow is driven by the patient’s arterial pressure. For respiratory support in ARDS patients, VV-ECMO represents the simplest and more rational choice [1]. Depending on the extracorporeal blood flow (ECBF), VV-ECMO can be used to support both oxygenation and CO2 removal (ECBF 3-7 l/min, total extracorporeal support) or to provide mainly CO2 removal (ECBF 0.5-2.5 l/min, partial extracorporeal support). This chapter will focus mainly on the application of VV-ECMO in ARDS patient.

N. Patroniti (*)

School of Medicine and Surgery, University of Milan-Bicocca,

Via Cadore 48, Monza 20900 (MB), Italy

Department of Emergency and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza 20900 (MB), Italy e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

S. Isgro • M. Bombino

Department of Emergency and Intensive Care, San Gerardo Hospital,

Via Pergolesi 33, Monza 20900 (MB), Italy

e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it ; This email address is being protected from spam bots, you need Javascript enabled to view it

© Springer International Publishing Switzerland 2017 D. Chiumello (ed.), Acute Respiratory Distress Syndrome (ARDS), DOI 10.1007/978-3-319-41852-0_7

 
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