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      Venovenous Extracorporeal Membrane Oxygenation Therapy in Adults

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          Abstract

          Extracorporeal membrane oxygenation (ECMO) therapy is used as supportive therapy for patients with respiratory failure, cardiac failure, and cardiopulmonary failure. Venovenous extracorporeal membrane oxygenation (VV-ECMO) is one subtype used for respiratory failure as a supportive treatment for critically ill patients. The principle behind it is that the membrane lung (oxygenator) is placed sequentially with the normal lungs rather than in parallel like with cardiopulmonary bypass, therefore, the lungs do not have to work as hard to oxygenate the blood. Then using a drainage cannula, blood is drained from the right atrium (RA) and after going through the membrane lung, the newly oxygenated blood is returned back to the RA. Because of this, there is enough systemic oxygen delivery to manage metabolism and preserve the airway even at lower tidal volume ventilation settings. With ventilator settings placed at lower tidal volume, there is less risk of barotrauma. This is a review article discussing VV-ECMO therapy with adult patients. It will also go into detail regarding its indications, contraindications, configurations, patient assessment, vascular access, and complications.

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          Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists.

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            Age, PaO2/FIO2, and Plateau Pressure Score: A Proposal for a Simple Outcome Score in Patients With the Acute Respiratory Distress Syndrome.

            Although there is general agreement on the characteristic features of the acute respiratory distress syndrome, we lack a scoring system that predicts acute respiratory distress syndrome outcome with high probability. Our objective was to develop an outcome score that clinicians could easily calculate at the bedside to predict the risk of death of acute respiratory distress syndrome patients 24 hours after diagnosis.
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              Definition of ALI/ARDS.

              Although acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are caused by different injuries and conditions, their similar clinical picture makes a compelling case for them to be studied as a single entity. An array of potential specific targets for pharmacologic intervention can be applied to ALI/ARDS as one disease. Although a working definition of ALI/ARDS that includes pulmonary and extrapulmonary causes can have benefit in standardizing supportive care, it can also complicate assessments of the efficacy of therapeutic interventions. In this article, definitions that have been recently used for ALI/ARDS in various clinical studies are discussed individually. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                11 August 2019
                August 2019
                : 11
                : 8
                : e5365
                Affiliations
                [1 ] Internal Medicine, Northern California Kaiser Permanente, Fremont, USA
                [2 ] Internal Medicine, Southern Medical University, Guangzhou, CHN
                [3 ] Pulmonary Medicine, Marshall University School of Medicine, Huntington, USA
                [4 ] Pulmonary Medicine, Veterans Affairs Medical Center, Huntington, USA
                Author notes
                Article
                10.7759/cureus.5365
                6692097
                31423406
                32441a8c-bbab-462a-9baa-73507dad3900
                Copyright © 2019, Patel et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 July 2019
                : 11 August 2019
                Categories
                Internal Medicine
                Pulmonology

                venovenous extracorporeal membrane oxygenation (vv-ecmo),extracorporeal membrane oxygenation (ecmo),membrane lung,barotrauma,acute respiratory distress syndrome (ards),seldinger technique,semi-seldinger technique,murray score,age-adjusted oxygenation index,apss

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