JOURNAL ARTICLE
REVIEW

Right ventricular dysfunction during acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation

Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers, Dinis Reis Miranda
Journal of Thoracic Disease 2018, 10 (Suppl 5): S674-S682
29732186
Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined. The beneficial effect of veno-venous (VV) ECMO on RV function in these patients will be illustrated. Based on this, we will give recommendations regarding choice of ECMO modus and provide an algorithm for management of RV failure in VV ECMO supported patients.

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