PMID- 37043003
OWN - NLM
STAT- MEDLINE
DCOM- 20230421
LR  - 20230518
IS  - 1432-1750 (Electronic)
IS  - 0341-2040 (Linking)
VI  - 201
IP  - 2
DP  - 2023 Apr
TI  - Pulmonary Protection from Left Ventricular Distension During Venoarterial 
      Extracorporeal Membrane Oxygenation: Review and Management Algorithm.
PG  - 119-134
LID - 10.1007/s00408-023-00616-8 [doi]
AB  - The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adults 
      for refractory cardiogenic shock has risen exponentially during the prior decade. 
      Although VA-ECMO provides cardiopulmonary support, it can alter left ventricular 
      (LV) loading conditions leading to LV distension, which makes the lungs 
      susceptible to congestion and promotes intracardiac thrombosis. These conditions 
      can be alleviated by pharmacologic and mechanical unloading, but gaps in 
      knowledge remain on optimal timing and methods of this approach. This review 
      provides an overview of the epidemiology of VA-ECMO, describes pathophysiology 
      and methods for monitoring and reducing LV loading and summarizes contemporary 
      studies examining the association between LV unloading and adverse events. We 
      offer a simple protocol for implementing LV unloading during VA-ECMO to provide 
      pulmonary protection and improve outcomes.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Saeed, Omar
AU  - Saeed O
AD  - Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert 
      Einstein College of Medicine, 3400 Bainbridge Avenue, Bronx, NY, 10023, USA. 
      osaeed@montefiore.org.
FAU - Nunez, Jose I
AU  - Nunez JI
AD  - Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert 
      Einstein College of Medicine, 3400 Bainbridge Avenue, Bronx, NY, 10023, USA.
FAU - Jorde, Ulrich P
AU  - Jorde UP
AD  - Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert 
      Einstein College of Medicine, 3400 Bainbridge Avenue, Bronx, NY, 10023, USA.
LA  - eng
GR  - NIH145140/NH/NIH HHS/United States
GR  - K23 HL145140/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
DEP - 20230412
PL  - United States
TA  - Lung
JT  - Lung
JID - 7701875
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/adverse effects/methods
MH  - Shock, Cardiogenic/etiology/therapy
MH  - Lung
MH  - *Thrombosis
MH  - Heart Ventricles/diagnostic imaging
OTO - NOTNLM
OT  - Extracorporeal membrane oxygenation
OT  - Left ventricular unloading
OT  - Pulmonary edema
OT  - Pulmonary hemorrhage
EDAT- 2023/04/13 06:00
MHDA- 2023/04/21 06:41
CRDT- 2023/04/12 11:15
PHST- 2023/01/25 00:00 [received]
PHST- 2023/03/22 00:00 [accepted]
PHST- 2023/04/21 06:41 [medline]
PHST- 2023/04/13 06:00 [pubmed]
PHST- 2023/04/12 11:15 [entrez]
AID - 10.1007/s00408-023-00616-8 [pii]
AID - 10.1007/s00408-023-00616-8 [doi]
PST - ppublish
SO  - Lung. 2023 Apr;201(2):119-134. doi: 10.1007/s00408-023-00616-8. Epub 2023 Apr 12.