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Ischemic and hemorrhagic brain injury during venoarterial-extracorporeal membrane oxygenation

for her assistance during the preparation of the manuscript. Competing interests Alain Combes has received fees from Maquet, manufacturer of ECMO pump and circuits. Alain Combes is the primary

Do we need randomized clinical trials in extracorporeal respiratory support? Yes

Extracorporeal respiratory support, also known as extracorporeal gas exchange, may be used to rescue the most severe forms of acute hypoxemic respiratory failure with high blood flow venovenous extracorporeal membrane oxygenation. Alternatively, lower flow extracorporeal carbon dioxide removal might be applied to reduce the intensity of mechanical ventilation in patients with...

Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) has known a growing interest over the last decades with promising results during the 2009 A(H1N1) influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance. Survival has steadily improved for a decade, reaching up to 65% at hospital...

Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) has known a growing interest over the last decades with promising results during the 2009 A(H1N1) influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance.Survival has steadily improved for a decade, reaching up to 65% at hospital...

Extracorporeal gas exchange for acute respiratory failure in adult patients: a systematic review

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2015. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com...

Sudden death in ICU: the Finnish experience

Alain Cariou David Bracco Alain Combes - limitations and DNAR (do not attempt resuscitation) in terms of cardiac arrest causes, incidence and outcome. policies, as supported by the proportion of

Extracorporeal membrane oxygenation for pheochromocytoma-induced cardiogenic shock

Background Pheochromocytoma, a rare catecholamine-producing tumor, might provoke stress-induced Takotsubo-like cardiomyopathy and severe cardiogenic shock. Because venoarterial-extracorporeal membrane oxygenation (VA-ECMO) rescue of pheochromocytoma-induced refractory cardiogenic shock has rarely been reported, we reviewed our ICU patients’ presentations and outcomes. Methods All...

Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome

Background Mechanical ventilation with a tidal volume (V T ) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (P plat ) lower than 30 cmH 2 O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low V T combined with extracorporeal...

Mechanical ventilation during extracorporeal membrane oxygenation

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed...

Propofol, midazolam, vancomycin and cyclosporine therapeutic drug monitoring in extracorporeal membrane oxygenation circuits primed with whole human blood

Introduction As a result of drug sequestration and increased volume of distribution, the extracorporeal membrane oxygenation (ECMO) procedure might lead to a decrease in drug concentrations during a patient’s treatment. The aim of this study was to evaluate sedative, antibiotic and immunosuppressive drug loss in ECMO circuit using ex-vivo and in-vitro experiments. Methods Blood...

Experts’ recommendations for the management of adult patients with cardiogenic shock

Chouihed Alain Combes Alexandre Mebazaa Bruno Megarbane Patrick Plaisance Alexandre Ouattara Christian Splaulding Jean-Louis Teboul Fabrice Vanhuyse Thierry Boulain Kaldoun Kuteifan 0 Intensive Care Service

The long and difficult road to better evaluation of outcomes of prolonged mechanical ventilation: not yet a highway to heaven

Combes 0 Universite Pierre et Marie Curie , Paris , France 1 Service de Reanimation Medicale, Hopital Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris, boulevard de l'Hopital , 75651, Paris