AI Article Synopsis
- VV-ECMO is a treatment used for severe respiratory distress in COVID-19 patients, but it's not commonly needed.
- Changing the oxygenator in the VV-ECMO setup can lead to complications like temporary low oxygen levels and reduced heart function, especially in patients who are already critically ill.
- A case study is presented to demonstrate how these hemodynamic changes affect patient outcomes during the process of exchanging the oxygenator.
Article Abstract
Few patients with coronavirus disease 2019-associated severe acute respiratory distress syndrome (ARDS) require veno-venous extracorporeal membrane oxygenation (VV-ECMO). Prolonged VV-ECMO support necessitates repeated oxygenator replacement, increasing the risk for complications. Transient hypoxemia, induced by VV-ECMO stop needed for this procedure, may induce transient myocardial ischemia and acutely declining cardiac output in critically ill patients without residual pulmonary function. This is amplified by additional activation of the sympathetic nervous system (tachycardia, pulmonary vasoconstriction, and increased systemic vascular resistance). Immediate reinjection of the priming solution of the new circuit and induced acute iatrogenic anemia are other potentially reinforcing factors. The case of a critically ill patient presented here provides an instructive illustration of the hemodynamic relationships occurring during VV-ECMO support membrane oxygenator exchange.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932605 | PMC |
| http://dx.doi.org/10.1177/02676591211056564 | DOI Listing |
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