Beatmung während der extrakorporalen Kreislaufunterstützung: Warum und wie

Translated title of the contribution: Ventilation during extracorporeal support: Why and how

A. Pesenti, E. Carlesso, T. Langer, T. Mauri

Research output: Contribution to journalArticlepeer-review

Abstract

The main target of extracorporeal support is to achieve viable gas exchange, while minimizing the risk of ventilator-induced lung injury, achieved through a decreased mechanical ventilation load on the natural lung. However, during veno-venous extracorporeal membrane oxygenation (ECMO), mechanical ventilation is still necessary in order to prevent lung collapse and/or if extracorporeal blood flow is not sufficient to guarantee adequate gas exchange. In this review, we will summarize the physiology of extracorporeal support and the rationale for continuing mechanical ventilation in this context. Furthermore, we will review the current clinical practice among ECMO centers and their suggestions regarding mechanical ventilator settings. While optimal ventilatory settings are still a matter of debate, the use of a strategy combining low tidal volume and limited inspiratory pressures is accepted worldwide. On the contrary, the choice of applied positive end-expiratory pressure (PEEP) varies between the total rest strategy and open lung strategy. Finally, the use of assisted or spontaneous ventilation will be discussed.

Translated title of the contributionVentilation during extracorporeal support: Why and how
Original languageGerman
Pages (from-to)26–30
Number of pages5
JournalMedizinische Klinik - Intensivmedizin und Notfallmedizin
Volume113
Issue numberSupplement 1
DOIs
Publication statusPublished - 2018

Keywords

  • Extracorporeal membrane oxygenation
  • Mechanical ventilation
  • Positive end expiratory pressure
  • Respiratory failure
  • Ventilator-induced lung injury

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine
  • Emergency
  • Critical Care and Intensive Care Medicine

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