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Journal ArticleDOI

First experiences with a combined usage of veno-arterial and veno-venous ECMO in therapy-refractory cardiogenic shock patients with cerebral hypoxemia

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TLDR
The veno-veno-arterial ECMO setup is described in full detail and different venous cannulas are discussed and a remarkable improvement of all oxygenation parameters is achieved.
Abstract
The use of extracorporeal membrane oxygenation (ECMO) is becoming a popular tool in the treatment of cardiogenic shock. We present two case reports where classical veno-arterial peripherally cannulated ECMO therapy proved insufficient with profuse cerebral hypoxemia. After augmenting the setting into veno-veno-arterial ECMO, we achieved a remarkable improvement of all oxygenation parameters. The simultaneous use of veno-venous and veno-arterial ECMO might display as a novel strategy to counteract the coronary and cerebral hypoxemia in veno-arterial ECMO therapy in patients with therapy-refractory cardiogenic shock or in combined cardiopulmonary failure. In this manuscript, the veno-veno-arterial ECMO setup is described in full detail and different venous cannulas are discussed.

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Citations
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Journal ArticleDOI

Cannulation strategies for percutaneous extracorporeal membrane oxygenation in adults

TL;DR: A nomenclature which uses “A” and all following letters for supplying cannulas and all letters before ‘A’ for draining cannulas is proposed, which covers both dual and triple ECMO cannulation strategies (VV, VA, VVA, VAV).
Journal ArticleDOI

Neurologic Complications of Extracorporeal Membrane Oxygenation: A Review

TL;DR: ECMO can be lifesaving and is being used increasingly for severe respiratory and/or cardiac failure, however, it remains associated with significant neurologic morbidity and mortality.
Journal ArticleDOI

Veno-veno-arterial extracorporeal membrane oxygenation for respiratory failure with severe haemodynamic impairment: technique and early outcomes

TL;DR: Veno-veno-arterial ECMO is a technically feasible rescue strategy in treating patients presenting with combined respiratory and haemodynamic failure and can be bridged to recovery and to lung transplantation.
Journal ArticleDOI

Veno-venous extracorporeal membrane oxygenation: cannulation techniques

TL;DR: The authors focus on the indications for VV-ECMO, patient assessment prior to cannulation, the role of ultrasound-guided vessel puncture, double lumen single bicaval cannulations, and finally triple cannulation in VV -ECMO.
Journal ArticleDOI

Controlled flow diversion in hybrid venoarterial-venous extracorporeal membrane oxygenation.

TL;DR: Non-invasive monitoring of flow rates within the supplying cannulae of VAV-ECMO and the use of partial occlusion for venous-supplying cannula enable individualized patient management and effective weaning from VAV -ECMO.
References
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Journal ArticleDOI

Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

TL;DR: Guidelines and Expert Consensus Documents summarize and evaluate all available evidence to assist physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome and the risk–benefit ratio of diagnostic or therapeutic means.
Journal ArticleDOI

Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock

TL;DR: In patients with cardiogenic shock, emergency revascularization did not significantly reduce overall mortality at 30 days, but after six months there was a significant survival benefit, and earlyRevascularization should be strongly considered for patients with acute myocardial infarction complicated by cardiogenesis.
Journal ArticleDOI

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

TL;DR: The use of intraaortic balloon counterpulsation did not significantly reduce 30-day mortality in patients with cardiogenic shock complicating acute myocardial infarction for whom an early revascularization strategy was planned.
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