Right Ventricular Assist Device With an Oxygenator for the Management of Combined Right Ventricular and Respiratory Failure: A Systematic Review

被引:3
作者
Beaulieu, Juliette [1 ]
Vu, Christine [1 ]
Kalra, Sanjog [2 ]
Chahdi, Hamza Ouazani [1 ]
Cousineau, Julie [3 ]
Matteau, Alexis [4 ,5 ,6 ]
Mansour, Samer [4 ,5 ,6 ]
Jolicoeur, E. Marc [4 ,5 ,6 ]
Jacques, Sabrina [7 ]
Nauche, Benedicte [8 ,9 ]
Podbielski, Renata [8 ,9 ]
Ferraro, Pasquale [4 ,10 ,11 ]
Poirier, Charles [4 ,11 ,12 ]
Potter, Brian J. [4 ,5 ,6 ]
机构
[1] Univ Montreal, Ctr Hosp, Montreal, PQ, Canada
[2] Univ Hlth Network, Intervent Cardiol, Dept Med, Toronto, ON, Canada
[3] Univ Montreal, Ctr Hosp, Dept Med, Intens Care Med, Montreal, PQ, Canada
[4] CHUM Res Ctr, Montreal, PQ, Canada
[5] Univ Montreal, Ctr Hosp, Dept Med, Intervent Cardiol, Montreal, PQ, Canada
[6] Univ Montreal, Ctr Hosp, Dept Med, Cardiac Intens Care Unit, Montreal, PQ, Canada
[7] Univ Montreal, Ctr Hosp, Clin Perfus Serv, Montreal, PQ, Canada
[8] Univ Montreal, Ctr Hosp, Direct Enseignement, Bibliotheque, Montreal, PQ, Canada
[9] Univ Montreal, Acad Ctr Hosp, Montreal, PQ, Canada
[10] Univ Montreal, Ctr Hosp, Dept Surg, Thorac Surg, Montreal, PQ, Canada
[11] Univ Montreal, Ctr Hosp, Lung Transplant Program, Montreal, PQ, Canada
[12] Univ Montreal, Ctr Hosp, Dept Med, Respirol, Montreal, PQ, Canada
关键词
EXTRACORPOREAL MEMBRANE-OXYGENATION; LUNG TRANSPLANTATION; HEART-FAILURE; SUPPORT; CANNULA; OXYRVAD; RVAD;
D O I
10.1016/j.cjca.2024.03.028
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Severe lung disease frequently presents with both refractory hypoxemia and right ventricular (RV) failure. Right ventricular assist device with an oxygenator (OxyRVAD) is an extracorporeal membrane oxygenation (ECMO) configuration of RV bypass that also supplements gas exchange. This systematic review summarises the available literature regarding the use of OxyRVAD in the setting of severe lung disease with associated RV failure. Methods: PubMed, Embase, and Google Scholar were queried on September 27, 2023, for articles describing the use of an OxyRVAD configuration. The main outcome of interest was survival to intensive care unit (ICU) discharge. Data on the duration of OxyRVAD support and device-related complications were also recorded. Results: Out of 475 identified articles, 33 were retained for analysis. Twenty-one articles were case reports, and 12 were case series, representing a total of 103 patients. No article provided a comparison group. Most patients (76.4%) were moved to OxyRVAD from another type of mechanical support. OxyRVAD was used as a bridge to transplant or curative surgery in 37.4% and as a bridge to recovery or decision in 62.6%. Thirty-one patients (30.1%) were managed with the dedicated single-access dual-lumen ProtekDuo cannula. Median time on OxyRVAD was 12 days (interquartile range 8-23 days), and survival to ICU discharge was 63.9%. Device-related complications were infrequently reported. Conclusion: OxyRVAD support is a promising alternative for RV support when gas exchange is compromised, with good ICU survival in selected cases. Comparative analyses in patients with RV failure with and without severe lung disease are needed.
引用
收藏
页码:1732 / 1741
页数:10
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