1. Veno-arterial-ECMO in the intensive care unit: From technical aspects to clinical practice
- Author
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Jean Mantz, Arnaud Follin, Bernard Cholley, Romain Pirracchio, Arthur Le Gall, Nadia Aissaoui, Service d'Anesthésie-Réanimation [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine (M3DISIM), Laboratoire de mécanique des solides (LMS), École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Service de réanimation médicale [CHU HEGP], École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine ( M3DISIM ), Laboratoire de mécanique des solides ( LMS ), École polytechnique ( X ) -MINES ParisTech - École nationale supérieure des mines de Paris-Centre National de la Recherche Scientifique ( CNRS ) -École polytechnique ( X ) -MINES ParisTech - École nationale supérieure des mines de Paris-Centre National de la Recherche Scientifique ( CNRS ) -Inria Saclay - Ile de France, and Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institut National de Recherche en Informatique et en Automatique ( Inria )
- Subjects
medicine.medical_specialty ,Critical Care ,medicine.medical_treatment ,Salvage therapy ,Disease ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,law ,Multidisciplinary approach ,medicine ,Extracorporeal membrane oxygenation ,Humans ,Medical history ,Intensive care medicine ,business.industry ,Cardiogenic shock ,Extracorporeal circulation ,030208 emergency & critical care medicine ,General Medicine ,[ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.disease ,Intensive care unit ,3. Good health ,Intensive Care Units ,surgical procedures, operative ,Anesthesiology and Pain Medicine ,business - Abstract
International audience; The use of Veno-Arterial ExtraCorporeal Membrane Oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasizing the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximize the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental. Hence, to be successful, VA-ECMO should be used by teams with sufficient experience and initiated after a thorough multidisciplinary discussion considering patient’s medical history, pathology as well the anticipated evolution of the disease.
- Published
- 2018
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