PMID- 36012973
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220830
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 11
IP  - 16
DP  - 2022 Aug 13
TI  - Management of High-Risk Pulmonary Embolism: What Is the Place of Extracorporeal 
      Membrane Oxygenation?
LID - 10.3390/jcm11164734 [doi]
LID - 4734
AB  - Pulmonary embolism (PE) is a common disease with an annual incidence rate ranging 
      from 39-115 per 100,000 inhabitants. It is one of the leading causes of 
      cardiovascular mortality in the USA and Europe. While the clinical presentation 
      and severity may vary, it is a life-threatening condition in its most severe 
      form, defined as high-risk or massive PE. Therapeutic options in high-risk PE are 
      limited. Current guidelines recommend the use of systemic thrombolytic therapy as 
      first-line therapy (Level Ib). However, this treatment has important drawbacks 
      including bleeding complications, limited efficacy in patients with recurrent PE 
      or cardiac arrest, and formal contraindications. In this context, the use of 
      venoarterial extracorporeal membrane oxygenation (VA-ECMO) in the management of 
      high-risk PE has increased worldwide in the last decade. Strategies, including 
      VA-ECMO as a stand-alone therapy or as a bridge to alternative reperfusion 
      therapies, are associated with acceptable outcomes, especially if implemented 
      before cardiac arrest. Nonetheless, the level of evidence supporting ECMO and 
      alternative reperfusion therapies is low. The optimal management of high-risk PE 
      patients will remain controversial until the realization of a prospective 
      randomized trial comparing those cited strategies to systemic thrombolysis.
FAU - Assouline, Benjamin
AU  - Assouline B
AD  - Medecine Intensive Reanimation, Institut de Cardiologie, Assistance 
      Publique-Hopitaux de Paris, 75013 Paris, France.
FAU - Assouline-Reinmann, Marie
AU  - Assouline-Reinmann M
AD  - Cardiology Department, AP-HP, Sorbonne Universite, Pitie-Salpetriere University 
      Hospital, 75013 Paris, France.
FAU - Giraud, Raphael
AU  - Giraud R
AUID- ORCID: 0000-0001-5956-8643
AD  - Intensive Care Unit, Geneva University Hospitals, 1205 Geneva, Switzerland.
AD  - Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
FAU - Levy, David
AU  - Levy D
AD  - Medecine Intensive Reanimation, Institut de Cardiologie, Assistance 
      Publique-Hopitaux de Paris, 75013 Paris, France.
FAU - Saura, Ouriel
AU  - Saura O
AD  - Medecine Intensive Reanimation, Institut de Cardiologie, Assistance 
      Publique-Hopitaux de Paris, 75013 Paris, France.
FAU - Bendjelid, Karim
AU  - Bendjelid K
AUID- ORCID: 0000-0002-7921-7207
AD  - Intensive Care Unit, Geneva University Hospitals, 1205 Geneva, Switzerland.
AD  - Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
FAU - Combes, Alain
AU  - Combes A
AD  - Medecine Intensive Reanimation, Institut de Cardiologie, Assistance 
      Publique-Hopitaux de Paris, 75013 Paris, France.
AD  - Sorbonne Universite, GRC 30, RESPIRE, UMRS 1166, ICAN Institute of 
      Cardiometabolism and Nutrition, 75013 Paris, France.
FAU - Schmidt, Matthieu
AU  - Schmidt M
AUID- ORCID: 0000-0002-2931-4412
AD  - Medecine Intensive Reanimation, Institut de Cardiologie, Assistance 
      Publique-Hopitaux de Paris, 75013 Paris, France.
AD  - Sorbonne Universite, GRC 30, RESPIRE, UMRS 1166, ICAN Institute of 
      Cardiometabolism and Nutrition, 75013 Paris, France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220813
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC9409813
OTO - NOTNLM
OT  - ECPR
OT  - VA-ECMO
OT  - high-risk pulmonary embolism
OT  - massive pulmonary embolism
OT  - reperfusion therapy
COIS- A.C. has received grants from Getinge, and personal fees from Getinge, Baxter, 
      and Xenios outside the submitted work. M.S. has received personal fees from 
      Getinge, Drager, and Xenios, outside the submitted work.
EDAT- 2022/08/27 06:00
MHDA- 2022/08/27 06:01
PMCR- 2022/08/13
CRDT- 2022/08/26 01:27
PHST- 2022/07/08 00:00 [received]
PHST- 2022/08/02 00:00 [revised]
PHST- 2022/08/10 00:00 [accepted]
PHST- 2022/08/26 01:27 [entrez]
PHST- 2022/08/27 06:00 [pubmed]
PHST- 2022/08/27 06:01 [medline]
PHST- 2022/08/13 00:00 [pmc-release]
AID - jcm11164734 [pii]
AID - jcm-11-04734 [pii]
AID - 10.3390/jcm11164734 [doi]
PST - epublish
SO  - J Clin Med. 2022 Aug 13;11(16):4734. doi: 10.3390/jcm11164734.