Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma
Near-fatal asthma (NFA) is the most severe presentation of asthma. It is characterized by hypoxemic and hypercapnic respiratory failure requiring ventilatory assistance, including non-invasive ventilation and mechanical ventilation. However, NFA has a high mortality rate despite conventional therapy...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007123001582 |
| _version_ | 1827576520713961472 |
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| author | Shameek Gayen Stephen Dachert Erica Kim Matthew Gordon Kartik Shenoy Parag Desai |
| author_facet | Shameek Gayen Stephen Dachert Erica Kim Matthew Gordon Kartik Shenoy Parag Desai |
| author_sort | Shameek Gayen |
| collection | DOAJ |
| description | Near-fatal asthma (NFA) is the most severe presentation of asthma. It is characterized by hypoxemic and hypercapnic respiratory failure requiring ventilatory assistance, including non-invasive ventilation and mechanical ventilation. However, NFA has a high mortality rate despite conventional therapy. Extracorporeal membrane oxygenation (ECMO) is a treatment modality that is increasingly being utilized as rescue therapy in patients with NFA that is refractory to mechanical ventilation. Prior analyses of the international Extracorporeal Life Support Organization (ELSO) registry data showed a survival rate of over 83% in patients placed on venovenous (VV) ECMO for NFA, but with notable rate of hemorrhagic complications. We report seven cases of adults with NFA requiring ECMO support at our large quaternary care institution between the years 2019 and 2022. All seven patients presented with respiratory failure in the setting of asthma exacerbation that progressed despite standard pharmacotherapy and mechanical ventilation. All patients survived to hospital discharge after ECMO support without hemorrhagic complications, highlighting the effectiveness and safety of ECMO when appropriately used in this population. |
| first_indexed | 2024-03-08T21:12:41Z |
| format | Article |
| id | doaj.art-b710e8383a144c5b92e4ed4b881c987c |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-03-08T21:12:41Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-b710e8383a144c5b92e4ed4b881c987c2023-12-22T05:33:03ZengElsevierRespiratory Medicine Case Reports2213-00712023-01-0146101963Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthmaShameek Gayen0Stephen Dachert1Erica Kim2Matthew Gordon3Kartik Shenoy4Parag Desai5Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, USA; Corresponding author. Department of Thoracic Medicine and Surgery, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA, 19140, USA.Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, USADepartment of Internal Medicine, Temple University Hospital, Philadelphia, PA, USADepartment of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, USADepartment of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, USADepartment of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, USANear-fatal asthma (NFA) is the most severe presentation of asthma. It is characterized by hypoxemic and hypercapnic respiratory failure requiring ventilatory assistance, including non-invasive ventilation and mechanical ventilation. However, NFA has a high mortality rate despite conventional therapy. Extracorporeal membrane oxygenation (ECMO) is a treatment modality that is increasingly being utilized as rescue therapy in patients with NFA that is refractory to mechanical ventilation. Prior analyses of the international Extracorporeal Life Support Organization (ELSO) registry data showed a survival rate of over 83% in patients placed on venovenous (VV) ECMO for NFA, but with notable rate of hemorrhagic complications. We report seven cases of adults with NFA requiring ECMO support at our large quaternary care institution between the years 2019 and 2022. All seven patients presented with respiratory failure in the setting of asthma exacerbation that progressed despite standard pharmacotherapy and mechanical ventilation. All patients survived to hospital discharge after ECMO support without hemorrhagic complications, highlighting the effectiveness and safety of ECMO when appropriately used in this population.http://www.sciencedirect.com/science/article/pii/S2213007123001582AsthmaHypercapniaMechanical ventilationRespiratory acidosisRespiratory failureVenovenous ECMO |
| spellingShingle | Shameek Gayen Stephen Dachert Erica Kim Matthew Gordon Kartik Shenoy Parag Desai Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma Respiratory Medicine Case Reports Asthma Hypercapnia Mechanical ventilation Respiratory acidosis Respiratory failure Venovenous ECMO |
| title | Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma |
| title_full | Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma |
| title_fullStr | Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma |
| title_full_unstemmed | Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma |
| title_short | Single-institution experience of extracorporeal membrane oxygenation for near-fatal asthma |
| title_sort | single institution experience of extracorporeal membrane oxygenation for near fatal asthma |
| topic | Asthma Hypercapnia Mechanical ventilation Respiratory acidosis Respiratory failure Venovenous ECMO |
| url | http://www.sciencedirect.com/science/article/pii/S2213007123001582 |
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