PMID- 32393326
OWN - NLM
STAT- MEDLINE
DCOM- 20201229
LR  - 20240229
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 24
IP  - 1
DP  - 2020 May 11
TI  - Pulmonary complications associated with veno-arterial extra-corporeal membrane 
      oxygenation: a comprehensive review.
PG  - 212
LID - 10.1186/s13054-020-02937-z [doi]
LID - 212
AB  - Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving 
      technology that provides transient respiratory and circulatory support for 
      patients with profound cardiogenic shock or refractory cardiac arrest. Among its 
      potential complications, VA-ECMO may adversely affect lung function through 
      various pathophysiological mechanisms. The interaction of blood components with 
      the biomaterials of the extracorporeal membrane elicits a systemic inflammatory 
      response which may increase pulmonary vascular permeability and promote the 
      sequestration of polymorphonuclear neutrophils within the lung parenchyma. Also, 
      VA-ECMO increases the afterload of the left ventricle (LV) through reverse flow 
      within the thoracic aorta, resulting in increased LV filling pressure and 
      pulmonary congestion. Furthermore, VA-ECMO may result in long-standing pulmonary 
      hypoxia, due to partial shunting of the pulmonary circulation and to reduced 
      pulsatile blood flow within the bronchial circulation. Ultimately, these 
      different abnormalities may result in a state of persisting lung inflammation and 
      fibrotic changes with concomitant functional impairment, which may compromise 
      weaning from VA-ECMO and could possibly result in long-term lung dysfunction. 
      This review presents the mechanisms of lung damage and dysfunction under VA-ECMO 
      and discusses potential strategies to prevent and treat such alterations.
FAU - Roumy, Aurelien
AU  - Roumy A
AUID- ORCID: 0000-0003-4758-6654
AD  - Department of Cardiovascular Surgery, University Hospital, Lausanne, Switzerland. 
      aurelien.roumy@chuv.ch.
FAU - Liaudet, Lucas
AU  - Liaudet L
AD  - Department of Intensive Care Medicine, University Hospital, Lausanne, 
      Switzerland.
FAU - Rusca, Marco
AU  - Rusca M
AD  - Department of Intensive Care Medicine, University Hospital, Lausanne, 
      Switzerland.
FAU - Marcucci, Carlo
AU  - Marcucci C
AD  - Department of Anesthesiology, University Hospital, Lausanne, Switzerland.
FAU - Kirsch, Matthias
AU  - Kirsch M
AD  - Department of Cardiovascular Surgery, University Hospital, Lausanne, Switzerland.
LA  - eng
GR  - 310030_162629/Schweizerischer Nationalfonds zur Forderung der Wissenschaftlichen 
      Forschung/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20200511
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Ischemia/etiology/physiopathology
MH  - Parenchymal Tissue/injuries/physiopathology
MH  - *Respiratory Physiological Phenomena
PMC - PMC7216520
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Extracorporeal membrane oxygenation
OT  - Lung injury
COIS- The authors declare they have no competing interests.
EDAT- 2020/05/13 06:00
MHDA- 2020/12/29 06:00
PMCR- 2020/05/11
CRDT- 2020/05/13 06:00
PHST- 2019/12/14 00:00 [received]
PHST- 2020/04/30 00:00 [accepted]
PHST- 2020/05/13 06:00 [entrez]
PHST- 2020/05/13 06:00 [pubmed]
PHST- 2020/12/29 06:00 [medline]
PHST- 2020/05/11 00:00 [pmc-release]
AID - 10.1186/s13054-020-02937-z [pii]
AID - 2937 [pii]
AID - 10.1186/s13054-020-02937-z [doi]
PST - epublish
SO  - Crit Care. 2020 May 11;24(1):212. doi: 10.1186/s13054-020-02937-z.