title: Venovenous Extracorporeal Membrane Oxygenation in Intractable Pulmonary Insufficiency: Practical Issues and Future Directions.
abstract: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is a highly invasive method for organ support that is gaining in popularity due to recent technical advances and its successful application in the recent H1N1 epidemic. Although running a vv-ECMO program is potentially feasible for many hospitals, there are many theoretical concepts and practical issues that merit attention and require expertise. In this review, we focus on indications for vv-ECMO, components of the circuit, and management of patients on vv-ECMO. Concepts regarding oxygenation and decarboxylation and how they can be influenced are discussed. Day-to-day management, weaning, and most frequent complications are covered in light of the recent literature.
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands; Department of Intensive Care, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: T S R
authors.initials: TS
authors.lastname: Delnoij
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands; Department of Intensive Care, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Driessen
authors.affiliation: Department of Cardiothoracic Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: A S
authors.initials: AS
authors.lastname: Sharma
authors.affiliation: Department of Anesthesiology, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: Bouman
authors.affiliation: Department of Intensive Care, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: U
authors.initials: U
authors.lastname: Strauch
authors.affiliation: Department of Intensive Care, Maastricht University Medical Center, 6202 AZ Maastricht, Netherlands.
authors.forename: P M
authors.initials: PM
authors.lastname: Roekaerts
mesh_terms: D019317:Evidence-Based Medicine; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D005544:Forecasting; D006440:Hemofiltration / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D006801:Humans; D015272:Pulmonary Medicine / Q000639:trends; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000009:adverse effects / Q000379:methods* / Q000639:trends