Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jun 2010
Evaluation of prognosis in patients with respiratory failure requiring venovenous extracorporeal membrane oxygenation (ECMO).
In this study, we analyzed the respiratory status and the prognosis of patients, including adults with acute respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV ECMO) to maintain respiratory status. We then evaluated the differences between patients who could be removed from VV ECMO and those who could not. ⋯ The early introduction of ECMO may be desirable if the causes of respiratory failure are recoverable. It is presumed that VV ECMO removal will be difficult if the ECMO flow cannot be weaned within 48 hours after ECMO introduction in patients with severe respiratory failure.
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Ann Thorac Cardiovasc Surg · Jun 2010
ReviewAdditional lung-protective perfusion techniques during cardiopulmonary bypass.
Postoperative cardiopulmonary bypass (CPB)-induced lung dysfunction still remains as a serious complication that could lead to life-threatening problems. CPB is associated with a whole-body inflammatory response. The contact of blood components with the artificial surface of the bypass circuit causes activation of complements, upregulation of cytokines and adhesion molecules, and induction of oxygen-free radicals. ⋯ Thus the systemic inflammatory response and ischemia-reperfusion during CPB constitute a vicious network in the pathogenesis of CPB-derived lung injury. Accordingly, it is postulated that additional pulmonary perfusion could alleviate CPB-induced lung damage. This review article summarizes recent literature on the mechanisms involved in lung dysfunction after CPB, and it also summarizes current reports on lung-protective perfusion techniques.