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Life span of different extracorporeal membrane systems for severe respiratory failure in the clinical practice

  • Over the past decade, veno-venous extracorporeal membrane oxygenation (vvECMO) has been increasingly utilized in respiratory failure in patients. This study presents our institution´s experience focusing on the life span of ECMO systems reflecting the performance of a particular system. A retrospective review of our ECMO database identified 461 adult patients undergoing vvECMO (2010-2017). Patients that required more than one system and survived the first exchange >24 hours (n = 139) were included. Life span until the first exchange and exchange criteria were analyzed for all systems (PLS, Cardiohelp HLS-set, both Maquet Cardiopulmonary, Rastatt, Germany; Deltastream/Hilite7000LT, iLA-activve, Xenios/NovaLung, Heilbronn, Germany; ECC.O5, LivaNova, Mirandola, Italy). At our ECMO center, the frequency of a system exchange was 30%. The median (IQR) life span was 9 (6-12) days. There was no difference regarding the different systems (p = 0.145 and p = 0.108, respectively). However, the Deltastream systems were exchanged more frequently due to elective technical complications (e. g. worsened gas transfer, development of coagulation disorder, increased bleedings complications) compared to the other exchanged systems (p = 0.013). In summary, the used ECMO systems are safe and effective for acute respiratory failure. There is no evidence for the usage of a specific system. Only the increased predictability of an imminent exchange preferred the usage of a Deltastream system. However, the decision to use a particular system should not depend solely on the possible criteria for an exchange.

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Metadaten
Author:Alois Philipp, Filip de SomerORCiD, Maik FoltanORCiD, Andre BredthauerORCiD, Lars KrenkelORCiDGND, Florian Zeman, Karla LehleORCiD
DOI:https://doi.org/10.1371/journal.pone.0198392
Parent Title (English):PLOS ONE
Publisher:PLOS
Document Type:Article
Language:English
Year of first Publication:2018
Release Date:2022/03/29
Tag:ECMO SYSTEMS; Equipment Failure Analysis/statistics & numerical data; Extracorporeal Membrane Oxygenation/instrumentation; Flow; MULTIDETECTOR COMPUTED-TOMOGRAPHY; Membrane/classification/standards/statistics & numerical data; OXYGENATION; Primary Health Care/statistics & numerical data; Respiratory Distress Syndrome/therapy; Retrospective Studies; Severity of Illness Index; THROMBOTIC DEPOSITS; Time factors
Volume:13
Issue:6
Article Number:e0198392
First Page:1
Last Page:10
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Fakultät Maschinenbau / Labor Biofluidmechanik
Begutachtungsstatus:peer-reviewed
OpenAccess Publikationsweg:Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium
research focus:Lebenswissenschaften und Ethik
Licence (German):Creative Commons - CC BY - Namensnennung 4.0 International