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©2013 Baishideng Publishing Group Co.
World J Crit Care Med. Nov 4, 2013; 2(4): 29-39
Published online Nov 4, 2013. doi: 10.5492/wjccm.v2.i4.29
Published online Nov 4, 2013. doi: 10.5492/wjccm.v2.i4.29
Factors | Veno venous | Veno arterial |
Systemic emboli | Lower rate unless intra cardiac shunt present | Increased rate of stroke and seizures with carotid cannulation, risk increases with patient age |
Limb ischemia with femoral arterial cannulation | ||
Cardiopulmonary support | Does not provide direct hemodynamic support | Provides full hemodynamic support |
Lower systemic oxygenation | High systemic oxygenation | |
Increased rate of hypertension during ECMO | Non pulsatile flow | |
Usually requires some degree of pulmonary gas exchange and lung recruitment | More commonly used with severe air leak | |
Indirect support with more oxygenated blood provided to pulmonary circulation | ||
Organ injury | Less acute kidney injury- preserved pulsatile blood flow | More acute kidney injury |
Less central nervous system injury risk | More central nervous system injury risk | |
Monitoring | Mixed venous oxygen saturation less reliable due to recirculation | Reliable mixed venous saturation measurements |
Bleeding | Increased cannula site bleeding | More bleeding with multiple site cannulation and femoral arterial cannulation compared to carotid |
Infection | Less risk with percutaneous and single cannula use | Greater rates of infection |
Rehabilitation | Less sedation use if adequate oxygen delivery possible | |
Mobilization of patients more feasible with single catheter neck catheter |
Factors | Increased survival | Increased death |
Age | Younger | Age > 10 yr |
Pulmonary process | Asthma | Pertussis |
Viral pneumonia/bronchiolitis | Sepsis | |
Aspiration pneumonia | Opportunistic infections | |
Organ dysfunction | Renal failure/dialysis | |
Liver injury | ||
Immune impairment/deficiency | ||
Cardiac arrest prior to ECMO | ||
Severity of ventilator associated lung injury prior to ECMO | Severe acidosis | |
High mean airway pressure | ||
Duration ventilation > 14 d | ||
Mode | VV | VA |
Complications during ECMO | Infection | |
Stroke | ||
Cardiac arrest | ||
Organ failure |
- Citation: Maslach-Hubbard A, Bratton SL. Extracorporeal membrane oxygenation for pediatric respiratory failure: History, development and current status. World J Crit Care Med 2013; 2(4): 29-39
- URL: https://www.wjgnet.com/2220-3141/full/v2/i4/29.htm
- DOI: https://dx.doi.org/10.5492/wjccm.v2.i4.29