• Christof Schmid, Alois Philipp, Michael Hilker, Leopold Rupprecht, Matthias Arlt, Andreas Keyser, Matthias Lubnow, and Thomas Müller.
• Department of Cardiothoracic Surgery, University Medical Center, Regensburg, Germany. christof.schmid@klinik.uni-regensburg.de
• J. Heart Lung Transplant. 2012 Jan 1;31(1):9-15.

BackgroundAcute lung failure (ALF) is an increasing problem that can be treated with venovenous extracorporeal membrane oxygenation (vv-ECMO). This report summarizes prospectively collected data of an institutional experience with vv-ECMO.MethodsFrom January 2007 to December 2010, 176 patients (mean age, 48 ± 16; range, 14-78 years) with ALF refractory to conventional therapy were supported with vv-ECMO. The general indication for vv-ECMO was a partial oxygen pressure/fraction of inspired oxygen (Fio(2)) < 80 mm Hg under a Fio(2) of 1.0, a positive end-expiratory pressure of 18 cm H(2)O, and refractory respiratory acidosis (pH < 7.25), despite optimization of conservative therapy.ResultsAll patients underwent peripheral cannulation. In 59 cases, vv-ECMO was placed in another facility with ECMO transport by helicopter or ambulance. The mean vv-ECMO support interval was 12 ± 9.0 days (range, 1-67 days). During ECMO, 12 patients (7%) could be extubated and stepwise mobilized. Cannula-related complications during long-term support occurred in 14%, which was mostly minor bleeding. Overall survival was 56%: 58 patients (33%) died during mechanical support, and 20 (11%) died after weaning from the system. The best outcome was noted in trauma patients. Risk factors were mainly advanced age and multiorgan failure.ConclusionModern vv-ECMO is an excellent treatment in patients with severe ALF and should be more liberally used.Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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