Extracorporeal membrane oxygenation for respiratory failure: comparison of venovenous versus venoarterial bypass

Kiyohiro Oshima, Fumio Kunimoto, Hiroshi Hinohara, Makio Ohkawa, Norikatsu Mita, Yukio Tajima, Shigeru Saito
Surgery Today 2010, 40 (3): 216-22

PURPOSE: This study compared the respiratory status before and during extracorporeal membrane oxygenation (ECMO) in patients receiving venovenous (VV) and venoarterial (VA) ECMO to evaluate the choice of ECMO in patients with respiratory failure.

METHOD: Between January 2003 and December 2007, 16 patients with respiratory failure required ECMO. Venovenous bypass and VA bypass were used in 9 cases (VV group) and 7 cases (VA group), respectively. The respiratory status before and during ECMO was compared between the two groups.

RESULTS: The percentage of patients requiring renal replacement therapy prior to ECMO use was significantly higher in the VA group than in the VV group. There were no significant differences between the two groups in PaO(2)/FIO(2), AaDO(2), pulmonary compliance, and the lung injury score prior to ECMO use. These parameters gradually improved in both groups; however, no significant intergroup differences were seen for up to 96 h after ECMO introduction. There was also no significant difference between the two groups in ECMO removal rate (VV group: 56%, VA group: 43%).

CONCLUSION: These results suggest that VV ECMO is comparable to VA ECMO, and can maintain sufficient respiratory support when VV ECMO is introduced to respiratory failure patients lacking evidence of renal and/or heart failure.

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