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Mechanical ventilation during extracorporeal membrane oxygenation. An international survey
- Source :
- Annals of the American Thoracic Society. 11(6)
- Publication Year :
- 2014
-
Abstract
- In patients with severe, acute respiratory failure undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO), the optimal strategy for mechanical ventilation is unclear.Our objective was to describe ventilation practices used in centers registered with the Extracorporeal Life Support Organization (ELSO).We conducted an international cross-sectional survey of medical directors and ECMO program coordinators from all ELSO-registered centers. The survey was distributed using a commercial website that collected information on center characteristics, the presence of a mechanical ventilator protocol, ventilator settings, and weaning practices. E-mails were sent out to medical directors or coordinators at each ELSO center and their responses were pooled for analysis.We analyzed 141 (50%) individual responses from the 283 centers contacted across 28 countries. Only 27% of centers reported having an explicit mechanical ventilation protocol for ECMO patients. The majority of these centers (77%) reported "lung rest" to be the primary goal of mechanical ventilation, whereas 9% reported "lung recruitment" to be their ventilation strategy. A tidal volume of 6 ml/kg or less was targeted by 76% of respondents, and 58% targeted a positive end-expiratory pressure of 6-10 cm H2O while ventilating patients on VV-ECMO. Centers prioritized weaning VV-ECMO before mechanical ventilation.Although ventilation practices in patients supported by VV-ECMO vary across ELSO centers internationally, the majority of centers used a strategy that targeted lung-protective thresholds and prioritized weaning VV-ECMO over mechanical ventilation.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
Cross-sectional study
medicine.medical_treatment
Extracorporeal
law.invention
Extracorporeal Membrane Oxygenation
law
Surveys and Questionnaires
Extracorporeal membrane oxygenation
Ventilator settings
Tidal Volume
Medicine
Humans
Aged
Mechanical ventilation
Respiratory Distress Syndrome
business.industry
International survey
Middle Aged
medicine.disease
Respiration, Artificial
Cross-Sectional Studies
Treatment Outcome
Life support
Ventilation (architecture)
Female
Medical emergency
business
Subjects
Details
- ISSN :
- 23256621
- Volume :
- 11
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Annals of the American Thoracic Society
- Accession number :
- edsair.doi.dedup.....e5e9a829242446f7fb376aa84a5d61b5