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Clinical significance of echocardiography in patients supported by venous–venous extracorporeal membrane oxygenation

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  • Artificial Lung / ECMO
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Abstract

Although there are extensive published data regarding venous–arterial (VA) ECMO, particularly in the pediatric population, there is a paucity of data (mainly including case reports and observational studies) delineating the role of echocardiography in the management of adult patients supported by venous–venous (VV) ECMO. The present review is aimed at specifically addressing the rationale for echocardiography use in patients supported by VV-ECMO and at summarizing the available evidence on this topic. Based on the available evidence and on the experience of our group, practical considerations on the use of echocardiography in adult patients on VV-ECMO support are reported. To date, echocardiography is mainly used for selecting the type of ECMO (VA vs VV), monitoring cannulation and the early detection of complications, but it is underused in patients supported by VV-ECMO. Nevertheless, in these patients, this methodology can provide useful information in monitoring cardiac function, cannula positioning, pericardial fluid (for early detection of tamponade) during ECMO support, and therefore it can contribute to the integrated assessment and management of these complex patients. There is a clinical need to elaborate shared protocols for echocardiography use during VV ECMO support, particularly at this time when advanced echocardiography is gaining interest among intensivists.

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Abbreviations

ECMO:

Extracorporeal membrane exygenation

VA:

Veno-arterial

VV:

Venous–venous

TEE:

Transesopheageal

TTE:

Transthoracic

IVC:

Inferior vena cava

SVC:

Superior vena cava

RV:

Right ventricle

LV:

Left ventricle

ICU:

Intensive care unit

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Authors and Affiliations

  1. Intensive Care Unit of Heart and Vessels Department, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy

    Chiara Lazzeri, Pasquale Bernardo, Serafina Valente & Gian Franco Gensini

  2. Anesthesia and Intensive Unit of Emergency Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Adriano Peris, Giovanni Cianchi, Manuela Bonizzoli & Stefano Batacchi

  3. Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, Fondazione Don Carlo Gnocchi IRCCS, Florence, Italy

    Gian Franco Gensini

Authors
  1. Adriano Peris
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  2. Chiara Lazzeri
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  3. Giovanni Cianchi
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  4. Manuela Bonizzoli
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Correspondence to Chiara Lazzeri.

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Peris, A., Lazzeri, C., Cianchi, G. et al. Clinical significance of echocardiography in patients supported by venous–venous extracorporeal membrane oxygenation. J Artif Organs 18, 99–105 (2015). https://doi.org/10.1007/s10047-015-0824-2

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