Right Ventricular Injury Definition and Management in Veno-Venous Extracorporeal Membrane Oxygenation.

IF 3.1 3区医学 Q2 ENGINEERING, BIOMEDICAL

ASAIO Journal Pub Date : 2025-01-07 DOI:10.1097/MAT.0000000000002369

Siddharth Pawan Dugar, Ryota Sato, Matthew Charlton, Daisuke Hasegawa, Marta Velia Antonini, Prashant Nasa, Hakeem Yusuff, Marcus J Schultz, Mary Pat Harnegie, Kollengode Ramanathan, Kiran Shekar, Matthieu Schmidt, Vasileios Zochios, Abhijit Duggal

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引用次数: 0

Abstract

Right ventricular injury (RVI) in respiratory failure receiving veno-venous extracorporeal membrane oxygenation (VV ECMO) is associated with significant mortality. A scoping review is necessary to map the current literature and guide future research regarding the definition and management of RVI in patients receiving VV ECMO. We searched for relevant publications on RVI in patients receiving VV ECMO in Medline, EMBASE, and Web of Science. Of 1,868 citations screened, 30 studies reported on RVI (inclusive of right ventricular dilation, right ventricular dysfunction, and right ventricular failure) during VV ECMO. Twenty-three studies reported on the definition of RVI including echocardiographic indices of RV function and dimensions, whereas 13 studies reported on the management of RVI, including veno-pulmonary (VP) ECMO, veno-arterial (VA) ECMO, positive inotropic agents, pulmonary vasodilators, ultra-lung-protective ventilation (Ultra-LPV), and optimization of positive end-expiratory pressure (PEEP). The definitions of RVI in patients receiving VV ECMO used in the literature are heterogeneous. Despite the high incidence of RVI during VV ECMO support and its strong association with mortality, studies investigating therapeutic strategies for RVI are also lacking. To fill the existing knowledge gaps, a consensus on the definition of RVI and research investigating RV-targeted therapies during VV ECMO is urgently warranted.

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静脉-静脉体外膜氧合右室损伤的定义和处理。

接受静脉-静脉体外膜氧合（VV ECMO）的呼吸衰竭患者右心室损伤（RVI）与显著的死亡率相关。有必要进行范围回顾，以绘制当前文献并指导未来关于接受VV ECMO患者RVI的定义和管理的研究。我们在Medline、EMBASE和Web of Science中检索了有关VV ECMO患者RVI的相关出版物。在筛选的1868篇引用中，30篇研究报道了VV ECMO期间RVI（包括右室扩张、右室功能障碍和右室衰竭）。23项研究报道了RVI的定义，包括RV功能和尺寸的超声心动图指标，而13项研究报道了RVI的管理，包括静脉-肺（VP） ECMO，静脉-动脉（VA） ECMO，正性肌力药物，肺血管扩张剂，超肺保护性通气（Ultra-LPV）和优化呼气末正压（PEEP）。文献中使用的VV ECMO患者RVI的定义是不同的。尽管在VV ECMO支持期间RVI的发生率很高，并且与死亡率有很强的相关性，但关于RVI治疗策略的研究也很缺乏。为了填补现有的知识空白，迫切需要就RVI的定义和VV ECMO期间RVI靶向治疗的研究达成共识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ASAIO Journal 医学-工程：生物医学

CiteScore

6.60

自引率

7.10%

发文量

651

审稿时长

4-8 weeks

期刊介绍： ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.