SYSTEMATIC REVIEW OF THE LITERATURE ON THE MEASURES USED IN EXTRACORPOREAL VENOUS-VENOUS MEMBRANE AND MECHANICAL VENTILATION AND FOR THE MANAGEMENT OF PATIENTS WITH RESPIRATORY DISTRESS SYNDROME

Main Article Content

Diana Gabriela Tonato Toapaxi
Johana Michelle Ocapana Taco
Andrea Elizabeth Villarroel Quispe
Christian David Vaca Pillana
Lisbeth Josefina Reales Chacón

Keywords

Artificial respiration, Extracorporeal membrane oxygenation, Respiratory failure, Adult respiratory distress syndrome

Abstract

Objective: To establish criteria for the management of mechanical ventilation parameters and extracorporeal venous-venous membrane for the treatment of patients with ARDS.


Methods: Two searches were conducted in the PubMed database, from March 29 to April 30, 2019, the process followed the PRISMA guidelines for systematic reviews and meta-analyzes.


Results: 58 articles were identified, 5 met the inclusion and exclusion criteria. Hypercapnia was corrected with blood flow (FS) rates of 750 to 1000 ml / min and lung surface area (SP) ≥ 0,8 m2. The SP of 0.4 m2 didn't normalize the pH, even with FS rates of 1000 ml / min. The increase in the sweep gas flow (  FGB) from 2 to 8 l / min increased the CO2 removal from 55 ± 9 to 70 ± 14 ml  / min. The passage from ECMO-VV to VMI was made with the progressive decrease of FGB from 4 to 0 l / min with constant FS.


Conclusion: A good elimination of CO2 and oxygen supply will be achieved only when the triad of gas flow, blood flow and membrane surface is adequate.

Abstract 183 | pdf Downloads 193

References

1. Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA. 2016 Feb 23;315(8):788-800.
2. Estenssoro E, Dubin A. ACUTE RESPIRATORY DISTRESS SYNDROME. 2016;7.
3. Mora-Arteaga JA, Bernal-Ramirez OJ, Rodriguez SJ. Effect of mechanical ventilation in the prone position in patients with acute respiratory distress syndrome. A systematic review and meta-analysis. Med Intensive. 2015 Aug 1;39(6):352-65.
4. rr152h.pdf [Internet]. [cited April 5, 2019]. Available in:
http://www.medigraphic.com/pdfs/residente/rr-2015/rr152h.pdf
5. Liu L, Yang Y, Gao Z, Li M, Mu X, Ma X, et al. Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study. Journal of Thoracic Disease. 2018 Sep 27;10(9):5394- 5404-5404.
6. Franchineau G, Luyt CE, Combes A, Schmidt M. Ventilator-associated pneumonia in extracorporeal membrane oxygenation-assisted patients. Ann Transl Med [Internet]. November 2018 [cited 27 December 2018];6(21). Available from:
https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC6275411/
7. Patroniti N, Bonatti G, Senussi T, Robba C. Mechanical ventilation and respiratory monitoring during extracorporeal membrane oxygenation for respiratory support. Ann Transl Med. October 2018;6(19):386.
8. Crotti S, Bottino N, Spinelli E. Spontaneous breathing during veno-venous extracorporeal membrane oxygenation. J Thorac Dis. 2018 Mar;10(Suppl 5):S661-9.
9. Extracorporeal ventilation in severe respiratory failure and ARDS. Current situation and clinical applications | Archives of Bronchopulmonology [Internet]. [cited January 23, 2019]. Available in:http://www.elsevier.es/es-journal-archives-bronchopulmonology-6-article-respiratory-extracorporeal-care-respiratory-insufficiency-S0300289610001407?referer=search engine
10. Noah MA, Peek GJ, Finney SJ, Griffiths MJ, Harrison DA, Grieve R, et al. Referral to an Extracorporeal Membrane Oxygenation Center and Mortality Among Patients With Severe 2009 Influenza A(H1N1). JAMA. 2011 Oct 19;306(15):1659-68.
11. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. The Lancet. 2009 Oct 17;374(9698):1351-63.
12. ELSO Guidelines For Adult Respiratory Failure 1_4.pdf [Internet]. [cited February 9, 2019]. Available in:
https://www.elso.org/Portals/0/ELSO%20Guidelines%20For%20Adult%20Respirator and%20Failure%201_4.pdf
13. Annich GM, Lynch WR, MacLaren G, Wilson JM, Bartlett RH. ECMO: Extracorporeal Cardiopulmonary Support in Critical Care. University of Washington Press; 2018. 766 p.
14. Mechanical ventilation in patients treated with extracorporeal oxygenation membrane (ECMO) | Intensive Care Medicine [Internet]. [cited January 21, 2019]. Available in:
http://www.elsevier.es/es-revista-medicina-intensiva-64-articulo-ventilation-mechanical-patients-treated-with- S0210569117300062?referer=finder
15. Liberati A, Altman D, Tetzlaff J, Mulrow C, Gøtzsche C P, Ioannidis J, et al. The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. Journal of clinical epidemiology. 1 Aug 2009;62:E1-34.
16. Karagiannidis C, Strassmann S, Brodie D, Ritter P, Larsson A, Borchardt R, et al. Impact of membrane lung surface area and blood flow on extracorporeal CO2 removal during severe respiratory acidosis. Intensive Care Medicine Experimental. 2017 Aug 1;5(1):34.

17. Strassmann S, Merten M, Schäfer S, de Moll J, Brodie D, Larsson A, et al. Impact of sweep gas flow on extracorporeal CO2 removal (ECCO2R). Intensive Care Med Exp. 25 March 2019;7(1):17.
18. Lehle K, Philipp A, Hiller K-A, Zeman F, Buchwald D, Schmid C, et al. Efficiency of gas transfer in venovenous extracorporeal membrane oxygenation: analysis of 317 cases with four different ECMO systems. Intensive Care Med. 2014 Dec;40(12):1870-7.
19. Roman ES, Venuti MS, Ciarrocchi NM, Ceballos IF, Gogniat E, Villarroel S, et al. Implementation and results of a new ECMO program for lung transplantation and acute respiratory distress. Brazilian Journal of Intensive Therapy. 2015 June;27(2):134-40.
20. Ali HS, Hassan IF, George S. Extra corporeal membrane oxygenation to facilitate lung protective ventilation and prevent ventilator-induced lung injury in severe Pneumocystis pneumonia with pneumomediastinum: a case report and short literature review. BMC Pulmonary Medicine. 14 apr 2016;16(1):52.
21. Study Quality Assessment Tools | National Heart, Lung, and Blood Institute (NHLBI) [Internet]. [cited April 5, 2019]. Available in: https:// www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools?fbclid=IwAR24Qslfb4xbQf4MDZXkn6i8rWzhcSn5et9BewWzsd_3qIIKAh4nfkinIY
22. Ottawa Hospital Research Institute [Internet]. [cited May 13, 2019]. Available in: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
23. Torregrosa S, Fuset-Cabanes M, Castelló A, Mata D, Heredia T, Bel A, et al. Extracorporeal membrane oxygenation for cardiac or respiratory support in adults. Cardiovascular Surgery. 1 April 2009;16.
24. Spanish Journal of Perfusion 62. :22.
25. A novel pump-driven veno-venous gas exchange system during extracorporeal CO2-removal. - PDF Download Free [Internet]. docksci.com. [cited May 19, 2019]. Available in: https://docksci.com/a-novel-pump-driven-veno-venous-gas-exchange-system-during-extracorporeal-co2- re_5a34c9e6d64ab2a3cdedd136.html

26. López Sanchez M. Mechanical ventilation in patients treated with extracorporeal oxygenation membrane (ECMO). Med Intensive. 2017 Nov 1;41(8):491-6.
27. Schmidt M, Pellegrino V, Combes A, Scheinkestel C, Cooper DJ, Hodgson C. Mechanical ventilation during extracorporeal membrane oxygenation. Crit Care. 2014 Jan 21;18(1):203.
28. Fanelli V, Ranieri MV, Mancebo J, Moerer O, Quintel M, Morley S, et al. Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome. Crit Care [Internet]. 10 February 2016 [cited 19 May 2019];20. Available in:
https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC4748548/
29. Millar JE, Bartnikowski N, von Bahr V, Malfertheiner MV, Obonyo NG, Belliato M, et al. Extracorporeal membrane oxygenation (ECMO) and the acute respiratory distress syndrome (ARDS): a systematic review of pre-clinical models. Intensive Care Medicine Experimental. 2019 Mar 25;7(1):18.