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Previous Issues Volume 1, Issue 2 - 2017
Veno-Arterial Extracorporeal Membrane Oxygenation Using the Open Lung Approach for Ventilatory Support in a Case of Severe Acute Respiratory Distress Syndrome
Yoshitaka Hara1,Osamu Nishida1*,Hiroki Tsubouchi2,Tomoyuki Nakamura1,Naohide Kuriyama1,Daisuke Niimi3,Chizuru Yamashita1,Junpei Shibata1, Hidefumi Komura1
1Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake-city, Aichi, 470-1192, Japan.
2Department of Anesthesiology and Critical Care Medicine, Ichinomiyanishi Hospital, 1 Taira, Kaimei-Cho, Ichinomiya-City, Aichi 494-0001, Japan.
3Department of Anesthesiology and Critical Care Medicine, Nishichita General Hospital 3-1-1 Nakanoike, Tokai-city, Aichi 477-8522, Japan.
Corresponding Author: JOsamu Nishida, Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake-city, Aichi, 470-1192, Japan, Tel: +81-562-93-9008; E-Mail: [email protected]
Received Date: 07 Jul 2017
Accepted date: 17 Jul 2017
Published Date: 19 Jul 2017
Copyright © 2017 Osamu N
Citation: Osamu N, Hara Y, Tsubouchi H, Nakamura, et al. (2017). Veno-arterial Extracorporeal Membrane Oxygenation Using the Open Lung Approach for Ventilatory Support in a Case of Severe Acute Respiratory Distress Syndrome Mathews J Anesth. 1(2): 008.
ABSTRACT
Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) does not provide direct circulatory support, whereas veno-arterial (V-A) ECMO is reserved for severe circulatory failure. During ECMO, a mechanical ventilation setting with a strategy of lung rest is recommended, however, the specific setting is not clear. On the other hand, the beneficial effects of the open lung approach using a recruitment maneuver in patients with ARDS have been widely accepted and practiced as a lung-protective strategy. Here we report a case of ARDS associated with mild circulatory failure that was successfully treated by early veno-arterial (V-A) ECMO with high positive end-expiratory pressure (PEEP) as the open lung approach. This case indicates that this procedure may be effective for severe ARDS with preserved cardiac function.
KEYWORDS
Veno-Arterial Extracorporeal Membrane Oxygenation; Acute Respiratory Distress Syndrome; Open Lung Approach; Positive End-Expiratory Pressure; Recruitment Maneuver.
ABBREVIATIONS
V-V ECMO: Veno-venous extracorporeal membrane oxygenation,
V-A: veno-arterial,
ARDS: acute respiratory distress syndrome,
CESAR: conventional ventilatory support versus ECMO for severe adult respiratory failure,
PEEP: positive end-expiratory pressure
