Prone and ECMO – a contradiction per se?

Acute respiratory distress syndrome (ARDS) still represents a serious problem in clinical routine and is associated with a high mortality. Several concepts are known for special treatment, but, in some instances, the application of an extracorporeal membrane oxygenation (ECMO) is necessary for both...

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Bibliographic Details
Published in:Perfusion 2012-01, Vol.27 (1), p.78-82
Main Authors: Litmathe, J, Sucker, C, Easo, J, Wigger, L, Dapunt, O
Format: Article
Language:English
Subjects:
Extracorporeal Membrane Oxygenation - adverse effects
Female
Humans
Male
Middle Aged
Prone Position
Respiratory Distress Syndrome, Adult - therapy
Risk Factors
Treatment Outcome
Young Adult
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Summary:Acute respiratory distress syndrome (ARDS) still represents a serious problem in clinical routine and is associated with a high mortality. Several concepts are known for special treatment, but, in some instances, the application of an extracorporeal membrane oxygenation (ECMO) is necessary for both the improvement of oxygenation and the elimination of carbon dioxide (CO2). One basic aspect in lung protective ventilation in this context is alveolar recruitment, which can be achieved by different approaches, such as “the open lung concept”, according to Lachmann, or by additional kinetic therapy. The most exposed feature of this entity is ‘prone’, which may be quite challenging in patients requiring extracorporeal support or organ replacement therapy under ongoing critical illness. We report two outstanding cases of prone under conditions of a veno-venous ECMO therapy which improved significantly under this position. Furthermore, we reflect critically possible risk factors and adverse events of such procedures and afford a current view from the literature.
ISSN:0267-6591
1477-111X
DOI:10.1177/0267659111424640