• CastroDiana MoralesDMInterdepartmental Division of Critical Care Medicine, Toronto General Hospital.Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada., Idunn Morris, Ricardo Teijeiro-Paradis, and Eddy Fan.
• Interdepartmental Division of Critical Care Medicine, Toronto General Hospital.
• Curr Opin Crit Care. 2022 Jun 1; 28 (3): 348359348-359.

Purpose Of ReviewExtracorporeal membrane oxygenation (ECMO) offers advanced mechanical support to patients with severe acute respiratory and/or cardiac failure. Ensuring an adequate therapeutic approach as well as prevention of ECMO-associated complications, by means of timely liberation, forms an essential part of standard ECMO care and is only achievable through continuous monitoring and evaluation. This review focus on the cardiorespiratory monitoring tools that can be used to assess and titrate adequacy of ECMO therapy; as well as methods to assess readiness to wean and/or discontinue ECMO support.Recent FindingsSurrogates of tissue perfusion and near infrared spectroscopy are not standards of care but may provide useful information in select patients. Echocardiography allows to determine cannulas position, evaluate cardiac structures, and function, and diagnose complications. Respiratory monitoring is mandatory to achieve lung protective ventilation and identify early lung recovery, surrogate measurements of respiratory effort and ECMO derived parameters are invaluable in optimally managing ECMO patients.SummaryNovel applications of existing monitoring modalities alongside evolving technological advances enable the advanced monitoring required for safe delivery of ECMO. Liberation trials are necessary to minimize time sensitive ECMO related complications; however, these have yet to be standardized.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

28 keywords...

hide…