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ECMO for ARDS

ECLS can be a life-saver for ARDS patients

Despite advances in treatment options, mortality and morbidity in patients with acute respiratory distress syndrome (ARDS) remain high. Extracorporeal membrane oxygenation (ECMO) has emerged as a promising intervention. [1] Improvements in technology have made ECMO safer and easier to use, allowing for the potential of more patients with ARDS receiving this therapy.

Why ECMO for ARDS?

In the setting of severe ARDS, oxygen delivery can become insufficient to satisfy the body's demand. The main purpose of respiratory ECMO is to maintain oxygenation of the organs. It can stabilize gas exchange and minimize hemodynamic compromise, thus preventing further organ damage.[2]

ECMO is not a treatment for the underlying cause of ARDS. It allows time for investigation and to develop a specific treatment strategy targeted at the underlying disease.[2]

Read the abstract about ECMO for ARDS
Cardiohelp System

What is ECMO?

ECMO refers to a circuit that directly oxygenates and removes carbon dioxide from blood through an extracorporeal gas exchange device, commonly referred to as a membrane oxygenator. Two catheters or cannulas are inserted at the initiation of ECMO with their drainage and reinfusion ports located in central vessels. Deoxygenated blood is drained from the body by an external pump, it passes through the membrane oxygenator and is then reinfused back into the patient. Respiratory or venovenous ECMO which provides only gas exchange support.

About extracorporeal membrane oxygenation (ECMO)

The use of extracorporeal membrane oxygenation (ECMO) for the treatment of ARDS was introduced in the early 70‘s with the aim of guaranteeing a protective ventilation and minimizing the risk for the ventilator induced lung injury [3]. It works similar to an artificial lung providing adequate blood CO removal and oxygenation thus minimizing mechanical ventilation. [4] [5]

Cardiohelp System

Supports pulmonary function

The veno-venous use of the Cardiohelp System ensures an effective oxygen supply and/or the reduction of blood CO2 levels in intensive care patients suffering from ARDS, sepsis or other conditions associated with acute respiratory failure. In this way the Cardiohelp System facilitates protective ventilation strategies even in the most severe cases. [6]

Moreover, Cardiohelp prevents circulatory shock or damage to internal organs, minimizing follow-up costs associated with irreversible organ damage. The use of this therapy option therefore saves valuable time, which can then be used to treat the actual cause of an organ failure. [7]

Getinge Cardiohelp helicopter transport

Transport on ECMO

Because ECMO is considered an advanced therapy, it requires training in the necessary techniques and the formation of a network of hospitals to manage these patients is essential. In cases of severe ARDS, ECMO transport may be safer than transport on ventilation when transferring to an ECMO management center is necessary. [8]

Learn more about transport on ECMO

Literature list
  • Performance and Safety of an Integrated Portable Extracorporeal Life Support System for Adults. Alwardt CM, Wilson DS, Alore ML, Lanza LA, Devaleria PA, Pajaro OE. J Extra Corpor Technol. 2015 Mar;47(1):38-43.
  • Portable miniaturized extracorporeal membrane oxygenation systems for H1N1-related severe acute respiratory distress syndrome: a case series. Roncon-Albuquerque R Jr, Basílio C, Figueiredo P, Silva S, Mergulhão P, Alves C, Veiga R, Castelo-Branco S, Paiva L, Santos L, Honrado T, Dias C, Oliveira T, Sarmento A, Mota AM, Paiva JA. J Crit Care. 2012 Oct;27(5):454-63. doi: 10.1016/j.jcrc.2012.01.008. Epub 2012 Mar 3
  • First experience with the ultra compact mobile extracorporeal membrane oxygenation system Cardiohelp in interhospital transport. Philipp A, Arlt M, Amann M, Lunz D, Müller T, Hilker M, Graf B, Schmid C. Interact Cardiovasc Thorac Surg. 2011 Jun;12(6):978-81. doi: 10.1510/icvts.2010.264630. Epub 2011 Mar 8
  •  Hand-held minimised extracorporeal membrane oxygenation: a new bridge to recovery in patients with out-of-centre cardiogenic shock. Arlt M, Philipp A, Voelkel S, Camboni D, Rupprecht L, Graf BM, Schmid C, Hilker M. Eur J Cardiothorac Surg. 2011 Sep;40(3):689-94. doi: 10.1016/j.ejcts.2010.12.055. Epub 2011 Feb 23.
  • Temporary Venoarterial Extracorporeal Membrane Oxygenation: Ten-Year Experience at a Cardiac Transplant Center. Tran BG, De La Cruz K, Grant S, Meltzer J, Benharash P, Dave R, Ardehali A, Shemin R, Depasquale E, Nsair A. J Intensive Care Med. 2016 Jun 14. pii: 0885066616654451. [Epub ahead of print
  • Extracorporeal membrane oxygenation 2016: an update. Butt W, MacLaren G. F1000Res. 2016 Apr 26;5. pii: F1000 Faculty Rev-750. doi: 10.12688/f1000research.8320.1. eCollection 2016. Review. PMID: 27158464

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Alle referanser

  1. Ventetuolo CE, Muratore CS. Extracorporeal life support in critically ill adults. Am J Respir Crit Care Med. 2014;190(5):497–508.

  2. Extracorporeal membrane oxygenation for acute respiratory distress syndrome, Journal of Intensive Care, 2015, DOI: 10.1186/s40560-015-0082-7

  3. Fan E, Brodie D, Slutsky AS. Acute Respi­ratory Distress Syndrome: Advances in Diagnosis and Treatment. JAMA. 2018 Feb 20;319(7):698-710.

  4. Michele Umbrello, Paolo Formenti, Luca Bolgiaghi, and Davide Chiumello | Current Concepts of ARDS: A Narrative Review. | Int J Mol Sci. 2016 Dec 29;18(1). pii: E64. doi: 10.3390/ijms18010064

  5. Steven A. Conrad , L. Mikael Broman , Fabio S. Taccone , Roberto Lorusso , Maximilian V. Malfertheiner , Federico Pappalardo , Matteo Di Nardo , Mirko Belliato , Lorenzo Grazioli , Ryan P. Barbaro , D. Michael McMullan , Vincent Pellegrino , Daniel Brodie , Melania M. Bembea , Eddy Fan , Malaika Mendonca , Rodrigo Diaz , and Robert H. Bartlett | The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A Position Paper of the Extracorporeal Life Support Organization | All ajrccm Issues Vol. 198, No. 4 | Aug 15, 2018

  6. Müller T, Bein T, Philipp A, Graf B, Schmid C, Riegger G (2013) Extracorporeal pulmonary support in severe pulmonary failure in adults—a treatment rediscovered. Dtsch Arztebl Int 2013; 110(10): 159–66. DOI: 10.3238/arztebl.2013.0159

  7. Performance and Safety of an Integrated Portable Extracorporeal Life Support System for Adults. (2015) Alwardt CM, Wilson DS, Alore ML, Lanza LA, Devaleria PA, Pajaro OE.J Extra Corpor Technol. 2015 Mar;47(1):38-43.

  8. Toshiyuki Aokage, Kenneth Palmér, Shingo Ichiba and Shinhiro Takeda | Extracorporeal membrane oxygenation for acute respiratory distress syndrome | Journal of Intensive Care20153:17

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