(BQ) Part 1 book Extracorporeal life support for adults'' has contents: Physiology of extracorporeal life support; hypoxemic respiratory failure - evidence, indications, and exclusions; cardiogenic shock - evidence, indications, and exclusions,... and other contents.
Respiratory Medicine Series Editor: Sharon I.S Rounds Gregory A Schmidt Editor Extracorporeal Life Support for Adults Respiratory Medicine Series Editor : Sharon I.S Rounds More information about this series at http://www.springer.com/series/7665 Gregory A Schmidt Editor Extracorporeal Life Support for Adults Editor Gregory A Schmidt, MD Division of Pulmonary Diseases, Critical Care, and Occupational Medicine Department of Internal Medicine University of Iowa Iowa City, IA, USA ISSN 2197-7372 ISSN 2197-7380 (electronic) Respiratory Medicine ISBN 978-1-4939-3004-3 ISBN 978-1-4939-3005-0 (eBook) DOI 10.1007/978-1-4939-3005-0 Library of Congress Control Number: 2015950466 Springer New York Heidelberg Dordrecht London © Springer Science+Business Media New York 2016 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made Printed on acid-free paper Humana Press is a brand of Springer Springer Science+Business Media LLC New York is part of Springer Science+Business Media (www.springer.com) To William R Lynch, MD, who built and nurtured an outstanding program, exhibited remarkable vision in how to advance ECLS care, and opened my eyes to its new possibilities Preface Extracorporeal life support (ECLS) consists of using an external gas-exchanging membrane to support oxygenation or carbon dioxide removal (or both), at times including circulatory assistance ECLS has been used in severe hypoxemic respiratory failure (ARDS, pneumonia); diseases dominated by ventilatory failure such as status asthmaticus and COPD; cardiogenic shock; following cardiothoracic surgery complicated by circulatory or gas exchange failure; and as a bridge to lung transplant Historically, ECLS has been used sparingly, often as a last resort, and in few centers with the requisite expertise Three factors have combined to change this First, technological improvements in membranes, pumps, circuits, and cannulas have led to more efficient and safer ECLS Second, the CESAR trial has shown that, for adults with severe ARDS, referral to an ECLS center improves outcomes Finally, the adverse consequences of conventional management of lung failure, including ventilator-induced lung injury, ICU-acquired weakness, and nosocomial infection, have become abundantly clear Some of these may be ameliorated by using ECLS in preference to conventional care As perceptions of the role of ECLS have evolved, more practitioners and more centers are developing ECLS capability or positioning themselves to offer ECLS The aim of this book is to deliver a concise, evidence-based review of ECLS for adult disease Adult medicine (rather than neonatal and pediatric disease, where ECLS has an established but limited role) represents the growth area for ECLS Chapters are devoted to describing the complex physiology and technology; the evidence base in varied clinical conditions; how to obtain vascular access; daily management of the circuit and patient; guidance regarding the weaning and decannulation process; and recommendations for crisis management and rehabilitation related to ECLS The text concludes with a fascinating historical review, showing just how far we’ve come This text has been written for practicing physicians, nurses, perfusion specialists, therapists, and critical care trainees who are considering whether to refer their patients for ECLS, debating whether to offer ECLS capability to their patients, or are already providing ECLS but seek a practical reference to best practices and updated information It could never have been completed without the inspiration vii viii Preface from my colleagues at Iowa who strive daily to save the sickest patients; the trainees whose curiosity makes us all want to know more; my contributors who are at the forefront of a truly challenging field; and our publisher at Springer-Link who pushed for this important book Finally, I recognize all those who the hard work: the nurses, perfusionists, and therapists who dedicate their lives to the critically ill This is an exciting time, ripe with change and opportunity We seek a path forward for the benefit of all our patients Iowa City, IA, USA Gregory A Schmidt, MD Contents Physiology of Extracorporeal Life Support (ECLS) Matthew J Brain, Warwick W Butt, and Graeme MacLaren Hypoxemic Respiratory Failure: Evidence, Indications, and Exclusions Darryl Abrams, Matthew Bacchetta, and Daniel Brodie Cardiogenic Shock: Evidence, Indications, and Exclusions Nicolas Bréchot and Alain Combes ECCO2R in Obstructive Diseases: Evidence, Indications, and Exclusions Lorenzo Del Sorbo and V Marco Ranieri 61 73 87 ECLS as a Bridge to Lung Transplantation 105 Christian Kuehn Modes of ECLS 117 L Keith Scott and Benjamin Schmidt Vascular Access for ECLS 133 Steven A Conrad Circuits, Membranes, and Pumps 147 Bradley H Rosen Ventilator Management During ECLS 163 Antonio Pesenti, Giacomo Bellani, Giacomo Grasselli, and Tommaso Mauri 10 Daily Care on ECLS 181 Giles J Peek 11 Crises During ECLS 193 Cara L Agerstrand, Linda B Mongero, Darryl Abrams, Matthew Bacchetta, and Daniel Brodie ix Modes of ECLS 131 23 Pierrakos CN, Bonios MJ, Drakos SG, Charitos EI, Tsolakis EJ, Ntalianis A, et al Mechanical assistance by intra-aortic balloon pump counterpulsation during reperfusion increases coronary blood flow and mitigates the no-reflow phenomenon: an experimental study Artif Organs 2011;35:867–74 doi:10.1111/j.1525-1594.2011.01241.x 24 Mohammadzadeh A, Jafari N, Hasanpour M, Sahandifar S, Ghafari M, Alaei V Effects of pulsatile perfusion during cardiopulmonary bypass on biochemical markers and kidney function in patients undergoing cardiac surgeries Am J Cardiovasc Dis 2013;3(3):158–62 25 Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P, Smit DV, Kaye DM Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial) Resuscitation 2014 pii: S0300-9572(14)00751-5 doi:10.1016/j.resuscitation.2014.09.010 [Epub ahead of print] 26 Moisan M, Lafargue M, Calderon J, Oses P, Ouattara A Pulmonary alveolar proteinosis requiring ‘hybrid’ extracorporeal life support, and complicated by acute necrotizing pneumonia Ann Fr Anesth Reanim 2013;32(4):e71–5 27 Nakamura H, Yamaguchi H, Amano A, Nakao T Venovenous extracorporeal membrane oxygenation is effective against post-cardiotomy acute respiratory failure in adults Gen Thorac Cardiovasc Surg 2013;61(7):402–8 28 Hoopes CW, Gurley JC, Zwischenberger JB, Diaz-Guzman E Mechanical support for pulmonary veno-occlusive disease: combined atrial septostomy and venovenous extracorporeal membrane oxygenation Semin Thorac Cardiovasc Surg 2012;24(3):232–4 29 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? Interact Cardiovasc Thorac Surg 2011;12(5):676–80 30 Conrad SA, Brown EG, Grier LR, Baier J, Blount J, Heminc T, Zwischenberger JB, Bidani A Arteriovenous extracorporeal carbon dioxide removal: a mathematical model and experimental evaluation ASAIO J 1998 http://journals.lww.com/asaiojournal/Fulltext/1998/07000/ Arteriovenous_Extracorporeal_Carbon_Dioxide.7.aspx Accessed 16 May 2014 31 Conrad SA, Zwischenberger JB, Grier LR, Alpard SK, Bidani A Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study Intensive Care Med 2001;27:1340–51 32 Jr B, Robert L, Tao W, Bidani A, Alpard SK, Traber DL, et al Prolonged hemodynamic stability during arteriovenous carbon dioxide removal for severe respiratory failure J Thorac Cardiovasc Surg 1997;114(6):1107–14 33 Mauri T, Zanella A, Pesenti A Extracorporeal gas exchange: present and future In: Vincent J-L, editor Annual update in intensive care and emergency medicine 2013 Berlin Heidelberg: Springer; 2013 p 609–19 ... times that of dissolved oxygen: [O2 ] = 1. 38 ´ 10 -3 ´ 90 mmHg = 0 .12 42 mmolL -1 Or 0.0278 mLdL -1 (1. 6) [CO2 ] = 3.08 ´ 10 -2 ´ 40 mmHg = 1. 232 mmolL -1 Or 2.7 mLdL -1 It should be noted that this does... of a term for the effective diffusivity of a membrane exposed to a turbulent bovine blood stream [18 , 19 ]: DEff = ( 2 .13 - 0.0092 × %Hct ) ´ 10 -5 ( cm -1 s ) (1. 10) The Driving Force for Diffusive... (SC, mmol·L 1 mmHg 1) already defined and effective diffusivity (DEff, cm2·s 1) having the units mol·cm 1 s 1 mmHg 1 [20]: J = - k O2 × A PO2 ( Gas) - PO2 ( Plasma ) Dl (1. 11) 14 M.J Brain