TAILIEUCHUNG - Extracorporeal life support in adults with ECMO: Part 2

(BQ) Continued part 1, part 2 of the document Extracorporeal life support in adults with ECMO has contents: Lung reconditioning, haemodynamic monitoring, complications of extracorporeal support and their management, troubleshooting common and less common problems,. and other contents. Invite you to refer. | Part III ECMO for Respiratory Support Ventilatory Management of ARDS Before and During ECMO 20 Giacomo Bellani Giacomo Grasselli and Antonio Pesenti What Is Acute Respiratory Distress Syndrome ARDS Definition The first report of adult respiratory distress syndrome ARDS the term adult was later replaced with acute acknowledging that the syndrome could also occur in children was published by Ashbaugh and coworkers in 1967 1 . ARDS is characterized by an acute onset of respiratory failure with arterial hypoxemia and lung stiffening not arising from cardiac failure but rather due to a massive lesional . caused by an increased permeability of the alveolar-capillary membrane pulmonary edema. While the main features of the syndrome are well recognized its formal definition remains more elusive. In 1994 the American European consensus conference gave the first definition of ARDS 2 which was updated almost 30 years later by the ARDS Definition Task Force with the so-called Berlin definition 3 which is reported in Table . Pathophysiology ARDS can be seen as the result of a stereotyped response of the lungs to one or more inflammatory stimuli originating primarily from the lungs . pneumonia or from another organ . sepsis . The inflammatory response causes the recruitment of G. Bellani MD PhD A. Pesenti MD Department of Health Science University of Milan-Bicocca Via Cadore 48 Monza MB 20900 Italy Department of Emergency San Gerardo Hospital Via Pergolesi 33 Monza MB 20900 Italy e-mail G. Grasselli MD Department of Emergency San Gerardo Hospital Via Pergolesi 33 Monza MB 20900 Italy e-mail jaku71@ F. Sangalli et al. eds. ECMO-Extracorporeal Life Support in Adults DOI 978-88-470-5427-1_20 Springer-Verlag Italia 2014 239 240 G. Bellani et al. Table Berlin definition of ARDS Timing Within 1 week of a known clinical insult or new or worsening respiratory symptoms Chest .

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• Less common problems
• Troubleshooting common
• Lung reconditioning
• Haemodynamic monitoring
• Neurological monitoring during ECMO
• Respiratory monitoring during VA ECMO