Skip to main content
Erschienen in: Indian Journal of Surgery 2/2023

07.12.2022 | Review Article

Extracorporeal Membrane Oxygenation (ECMO) for Pulmonary and/or Cardiopulmonary Support—a Brief Review and Our Experience

verfasst von: Muralidhar Kanchi, Kedar Bangal, Prakash PVS, Sanjay Orathi Patangi

Erschienen in: Indian Journal of Surgery | Sonderheft 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Extracorporeal membrane oxygenation (ECMO) is a modality utilized for partially or completely supporting the cardiac and/or pulmonary function. There are multiple vascular access techniques depending upon the necessity and the mode of ECMO used. ECMO has evolved over the years as an integral part of the cardiac care discipline. Historically, this lifesaving modality began as an extension of cardiopulmonary bypass and was associated with adverse outcomes. Currently, ECMO has evolved as an accepted and viable solution to patients with severe cardiac/respiratory/cardiorespiratory failure that is refractory to conservative management. The outcomes of patients on ECMO are dependent on multiple factors originating from demographic and pathophysiological status of patients as well as the control of homeostasis during ECMO within the acceptable range. Various studies have been published by many practitioners over past decades since the dawn of ECMO era. A brief review of such experience is summated, and a conclusion is derived about the clinical course of the patients on ECMO, while adding the author’s experience about the same in a tertiary care large-volume center.
Literatur
1.
Zurück zum Zitat Kirklin JW, Donald D, Harshbarger H, Hetzel P, Patrick R, Swan H et al (1956) Studies in extracorporeal circulation. I. Applicability of Gibbon-type pump-oxygenator to human intracardiac surgery: 40 cases. Ann Surg 144(1):2-8.1PubMedPubMedCentralCrossRef Kirklin JW, Donald D, Harshbarger H, Hetzel P, Patrick R, Swan H et al (1956) Studies in extracorporeal circulation. I. Applicability of Gibbon-type pump-oxygenator to human intracardiac surgery: 40 cases. Ann Surg 144(1):2-8.1PubMedPubMedCentralCrossRef
2.
Zurück zum Zitat Hill JD, O’Brien TG, Murray JJ, Dontigny L, Bramson ML, Osborn JJ, Gerbode F (1972) Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 286(12):629–34PubMedCrossRef Hill JD, O’Brien TG, Murray JJ, Dontigny L, Bramson ML, Osborn JJ, Gerbode F (1972) Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 286(12):629–34PubMedCrossRef
4.
Zurück zum Zitat Surendranath KV, Shetty DP et al (1991) Long term cardiopulmonary support for children. Indian J Extracorp Technol 2(3):120 Surendranath KV, Shetty DP et al (1991) Long term cardiopulmonary support for children. Indian J Extracorp Technol 2(3):120
5.
Zurück zum Zitat Pooboni S (2020) ECMO in India, SWAAC ELSO: challenges and solutions. Indian J Thoracic Cardiovasc Surg 37(S2):344–350CrossRef Pooboni S (2020) ECMO in India, SWAAC ELSO: challenges and solutions. Indian J Thoracic Cardiovasc Surg 37(S2):344–350CrossRef
6.
Zurück zum Zitat Gattinoni L, Pesenti A, Rossi GP, Vesconi S, Fox U, Kolobow T et al (1980) Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO2. The Lancet 316:292–294CrossRef Gattinoni L, Pesenti A, Rossi GP, Vesconi S, Fox U, Kolobow T et al (1980) Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO2. The Lancet 316:292–294CrossRef
7.
Zurück zum Zitat Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F et al (1986) Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA 256:881–886PubMedCrossRef Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F et al (1986) Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA 256:881–886PubMedCrossRef
8.
Zurück zum Zitat Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM et al (2009) Efficacy and economic assessment of Conventional Ventilatory Support versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure (CESAR): a multicentre randomised controlled trial. Lancet 374(9698):1351–1363PubMedCrossRef Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM et al (2009) Efficacy and economic assessment of Conventional Ventilatory Support versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure (CESAR): a multicentre randomised controlled trial. Lancet 374(9698):1351–1363PubMedCrossRef
9.
Zurück zum Zitat Zapol WM, Snider MT, Hill JD et al (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure: a randomized prospective study. JAMA 242(20):2193–2196PubMedCrossRef Zapol WM, Snider MT, Hill JD et al (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure: a randomized prospective study. JAMA 242(20):2193–2196PubMedCrossRef
10.
Zurück zum Zitat Davies A, Jones D, Beca J, Blackwell N, Forrest P, Gattas D et al (2009) The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators*. Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 302(17):1888–1895. https://doi.org/10.1001/jama.2009.1535CrossRefPubMed Davies A, Jones D, Beca J, Blackwell N, Forrest P, Gattas D et al (2009) The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators*. Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 302(17):1888–1895. https://​doi.​org/​10.​1001/​jama.​2009.​1535CrossRefPubMed
11.
Zurück zum Zitat Combes A (2011) Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). The EOLIA (ECMO to rescue Lung Injury in severe ARDS) trial: a multicenter, international, randomized, controlled open trial [in French]. Reanimation 20:49–61CrossRef Combes A (2011) Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). The EOLIA (ECMO to rescue Lung Injury in severe ARDS) trial: a multicenter, international, randomized, controlled open trial [in French]. Reanimation 20:49–61CrossRef
12.
Zurück zum Zitat Raleigh L, Ha R, Hill C (2015) Extracorporeal membrane oxygenation applications in cardiac critical care. Semin Cardiothorac Vasc Anesth 19(4):342–352PubMedCrossRef Raleigh L, Ha R, Hill C (2015) Extracorporeal membrane oxygenation applications in cardiac critical care. Semin Cardiothorac Vasc Anesth 19(4):342–352PubMedCrossRef
13.
Zurück zum Zitat Brodie D, Slutsky AS, Combes A (2019) Extracorporeal life support for adults with respiratory failure and related indications: a review. JAMA 13;322(6):557–568CrossRef Brodie D, Slutsky AS, Combes A (2019) Extracorporeal life support for adults with respiratory failure and related indications: a review. JAMA 13;322(6):557–568CrossRef
14.
Zurück zum Zitat Merrill ED, Schoeneberg L, Sandesara P, Molitor-Kirsch E, O’Brien J, Dai H et al (2014) Outcomes after prolonged extracorporeal membrane oxygenation support in children with cardiac disease–Extracorporeal Life Support Organization registry study. J Thorac Cardiovasc Surg 148:582–588PubMedCrossRef Merrill ED, Schoeneberg L, Sandesara P, Molitor-Kirsch E, O’Brien J, Dai H et al (2014) Outcomes after prolonged extracorporeal membrane oxygenation support in children with cardiac disease–Extracorporeal Life Support Organization registry study. J Thorac Cardiovasc Surg 148:582–588PubMedCrossRef
15.
Zurück zum Zitat Aubron C, Cheng AC, Pilcher D, Leong T, Magrin G, Cooper DJ et al (2013) Factors associated with outcomes of patients on extracorporeal membrane oxygenation support: a 5-year cohort study. Crit Care 17:R73PubMedPubMedCentralCrossRef Aubron C, Cheng AC, Pilcher D, Leong T, Magrin G, Cooper DJ et al (2013) Factors associated with outcomes of patients on extracorporeal membrane oxygenation support: a 5-year cohort study. Crit Care 17:R73PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Smith M, Vukomanovic A, Brodie D, Thiagarajan R, Rycus P, Buscher H (2017) Duration of veno-arterial extracorporeal life support (VA ECMO) and outcome: an analysis of the Extracorporeal Life Support Organization (ELSO) registry. Smith et al. Critical Care 21:45PubMedPubMedCentralCrossRef Smith M, Vukomanovic A, Brodie D, Thiagarajan R, Rycus P, Buscher H (2017) Duration of veno-arterial extracorporeal life support (VA ECMO) and outcome: an analysis of the Extracorporeal Life Support Organization (ELSO) registry. Smith et al. Critical Care 21:45PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Gupta P, Robertson MJ, Beam B, Gossett JM, Schmitz ML, Carroll CL et al (2015) Relationship of ECMO duration with outcomes after pediatric cardiac surgery: a multi-institutional analysis. Minerva Anestesiol 81:619–627PubMed Gupta P, Robertson MJ, Beam B, Gossett JM, Schmitz ML, Carroll CL et al (2015) Relationship of ECMO duration with outcomes after pediatric cardiac surgery: a multi-institutional analysis. Minerva Anestesiol 81:619–627PubMed
18.
Zurück zum Zitat Camboni D, Philipp A, Lubnow M, Bein T, Haneya A, Diez C et al (2011) Support time-dependent outcome analysis for veno-venous extracorporeal membrane oxygenation. Eur J Cardiothorac Surg 40:1341–1347PubMed Camboni D, Philipp A, Lubnow M, Bein T, Haneya A, Diez C et al (2011) Support time-dependent outcome analysis for veno-venous extracorporeal membrane oxygenation. Eur J Cardiothorac Surg 40:1341–1347PubMed
19.
Zurück zum Zitat Staudacher DL, Bode C, Wengenmayer T (2016) Duration of extracorporeal membrane oxygenation is a poor predictor of hospital survival. J Crit Care 32:207–208PubMedCrossRef Staudacher DL, Bode C, Wengenmayer T (2016) Duration of extracorporeal membrane oxygenation is a poor predictor of hospital survival. J Crit Care 32:207–208PubMedCrossRef
20.
Zurück zum Zitat Schmidt M, Burrell A, Roberts L, Bailey M, Sheldrake J, Rycus PT, Hodgson C, Scheinkestel C, Cooper DJ, Thiagarajan RR, Brodie D, Pellegrino V, Pilcher D (2015) Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J 36(33):2246–2256PubMedCrossRef Schmidt M, Burrell A, Roberts L, Bailey M, Sheldrake J, Rycus PT, Hodgson C, Scheinkestel C, Cooper DJ, Thiagarajan RR, Brodie D, Pellegrino V, Pilcher D (2015) Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J 36(33):2246–2256PubMedCrossRef
21.
Zurück zum Zitat Xie A, Phan K, Tsai Y-C, Yan TD, Forrest P (2015) Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest: a metaanalysis. J Cardiothorac Vasc Anesth 29:637–645PubMedCrossRef Xie A, Phan K, Tsai Y-C, Yan TD, Forrest P (2015) Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest: a metaanalysis. J Cardiothorac Vasc Anesth 29:637–645PubMedCrossRef
22.
Zurück zum Zitat Akihiko Inoue MD, Toru Hifumi MD, Tetsuya Sakamoto MD, Yasuhiro Kuroda MD (2020) Extracorporeal cardiopulmonary resuscitation for out- of- hospital cardiac arrest in adult patients. J Am Heart Assoc 9(7):e015291PubMedPubMedCentralCrossRef Akihiko Inoue MD, Toru Hifumi MD, Tetsuya Sakamoto MD, Yasuhiro Kuroda MD (2020) Extracorporeal cardiopulmonary resuscitation for out- of- hospital cardiac arrest in adult patients. J Am Heart Assoc 9(7):e015291PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Swol J, Belohlavek J, Brodie D, Bellezzo J, Weingart SD, Shinar Z, Schober A, Bachetta M, Haft JW, Ichiba S et al (2018) Extracorporeal life support in the emergency department: a narrative review for the emergency physician. Resuscitation 133:108–117PubMedCrossRef Swol J, Belohlavek J, Brodie D, Bellezzo J, Weingart SD, Shinar Z, Schober A, Bachetta M, Haft JW, Ichiba S et al (2018) Extracorporeal life support in the emergency department: a narrative review for the emergency physician. Resuscitation 133:108–117PubMedCrossRef
24.
Zurück zum Zitat Otani T, Sawano H, Natsukawa T, Matsuoka R, Nakashima T, Takahagi M, Hayashi Y (2018) D- Dimer predicts bleeding complication in out- of- hospital cardiac arrest resuscitated with ECMO. Am J Emerg Med 36:1003–1008PubMedCrossRef Otani T, Sawano H, Natsukawa T, Matsuoka R, Nakashima T, Takahagi M, Hayashi Y (2018) D- Dimer predicts bleeding complication in out- of- hospital cardiac arrest resuscitated with ECMO. Am J Emerg Med 36:1003–1008PubMedCrossRef
25.
Zurück zum Zitat Alexandros Cavayas Y et al (2018) Intracranial hemorrhage in adults on ECMO. Perfusion 33:42CrossRef Alexandros Cavayas Y et al (2018) Intracranial hemorrhage in adults on ECMO. Perfusion 33:42CrossRef
26.
Zurück zum Zitat Biffi S, Di Bella S, Scaravilli V, Peri AM, Grasselli G, Alagna L, Pesenti A, Gori A (2017) Infections during extracorporeal membrane oxygenation: epidemiology, risk factors, pathogenesis and prevention. Int J Antimicrob Agents 50(1):9–16PubMedCrossRef Biffi S, Di Bella S, Scaravilli V, Peri AM, Grasselli G, Alagna L, Pesenti A, Gori A (2017) Infections during extracorporeal membrane oxygenation: epidemiology, risk factors, pathogenesis and prevention. Int J Antimicrob Agents 50(1):9–16PubMedCrossRef
27.
Zurück zum Zitat Bizzarro MJ, Conrad SA, Kaufman DA, Rycus P, Extracorporeal Life Support Organization Task Force on Infections, Extracorporeal Membrane Oxygenation (2011) Infections acquired during extracorporeal membrane oxygenation in neonates, children, and adults. Pediatr Crit Care Med 112:277CrossRef Bizzarro MJ, Conrad SA, Kaufman DA, Rycus P, Extracorporeal Life Support Organization Task Force on Infections, Extracorporeal Membrane Oxygenation (2011) Infections acquired during extracorporeal membrane oxygenation in neonates, children, and adults. Pediatr Crit Care Med 112:277CrossRef
28.
Zurück zum Zitat Schmidt M, Bréchot N, Hariri S, Guiguet M, Luyt CE, Makri R et al (2012) Nosocomial infections in adult cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation. Clin Infect Dis 55:1633–1641PubMedPubMedCentralCrossRef Schmidt M, Bréchot N, Hariri S, Guiguet M, Luyt CE, Makri R et al (2012) Nosocomial infections in adult cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation. Clin Infect Dis 55:1633–1641PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Makdisi G, Wang IW (2015) Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis 7(7):E166–E176PubMedPubMedCentral Makdisi G, Wang IW (2015) Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis 7(7):E166–E176PubMedPubMedCentral
30.
Zurück zum Zitat Kielstein JT, Heiden AM, Beutel G et al (2013) Renal function and survival in 200 patients undergoing ECMO therapy. Nephrol Dial Transplant 28:86–90PubMedCrossRef Kielstein JT, Heiden AM, Beutel G et al (2013) Renal function and survival in 200 patients undergoing ECMO therapy. Nephrol Dial Transplant 28:86–90PubMedCrossRef
31.
Zurück zum Zitat Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK et al (2015) Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 132(18 Suppl 2):S444–S464PubMed Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK et al (2015) Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 132(18 Suppl 2):S444–S464PubMed
32.
Zurück zum Zitat de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF et al (2015) Part 12: Pediatric advanced life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 132(18 Suppl 2):S526–S542PubMedPubMedCentral de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF et al (2015) Part 12: Pediatric advanced life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 132(18 Suppl 2):S526–S542PubMedPubMedCentral
33.
Zurück zum Zitat Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P et al (2015) European Resuscitation Council Guidelines for Resuscitation 2015: Section 3 Adult advanced life support. Resuscitation 95:10047CrossRef Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P et al (2015) European Resuscitation Council Guidelines for Resuscitation 2015: Section 3 Adult advanced life support. Resuscitation 95:10047CrossRef
34.
Zurück zum Zitat Zakhary B, Nanjayya VB, Sheldrake J, Collins K, Ihle JF, Pellegrino V (2018) Predictors of mortality after extracorporeal cardiopulmonary resuscitation. Crit Care Resusc 20(3):223–230PubMed Zakhary B, Nanjayya VB, Sheldrake J, Collins K, Ihle JF, Pellegrino V (2018) Predictors of mortality after extracorporeal cardiopulmonary resuscitation. Crit Care Resusc 20(3):223–230PubMed
35.
Zurück zum Zitat Holmberg MJ, Geri G, Wiberg S, Guerguerian A-M, Donnino MW, Nolan JP, Deakin CD, Andersen LW, International Liaison Committee on Resuscitation’s (ILCOR) Advanced Life Support and Pediatric Task Forces (2018) Extracorporeal cardiopulmonary resuscitation for cardiac arrest: A systematic review. Resuscitation 131:91–100PubMedPubMedCentralCrossRef Holmberg MJ, Geri G, Wiberg S, Guerguerian A-M, Donnino MW, Nolan JP, Deakin CD, Andersen LW, International Liaison Committee on Resuscitation’s (ILCOR) Advanced Life Support and Pediatric Task Forces (2018) Extracorporeal cardiopulmonary resuscitation for cardiac arrest: A systematic review. Resuscitation 131:91–100PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Chakravarthy M (2011) ECMO - the way to go. Ann Card Anaesth. 14:1–2PubMed Chakravarthy M (2011) ECMO - the way to go. Ann Card Anaesth. 14:1–2PubMed
37.
Zurück zum Zitat Barlett RH (2016) ECMO: the next 10 years. Egyp J Critical Care Med 4:7–10CrossRef Barlett RH (2016) ECMO: the next 10 years. Egyp J Critical Care Med 4:7–10CrossRef
38.
Zurück zum Zitat Dalia AA et al (2018) Extracorporeal membrane oxygenation is a team sport: institutional survival benefits of a formalized ECMO team. J Cardiothoracic Vasc Anesth 85:902 Dalia AA et al (2018) Extracorporeal membrane oxygenation is a team sport: institutional survival benefits of a formalized ECMO team. J Cardiothoracic Vasc Anesth 85:902
39.
Zurück zum Zitat Nwozuzu A, Fontes ML, Schonberger RB (2016) Mobile extracorporeal membrane oxygenation teams: the North American versus the European experience. J Cardiothoracic Vasc Anesth 30(6):1441-1448.86CrossRef Nwozuzu A, Fontes ML, Schonberger RB (2016) Mobile extracorporeal membrane oxygenation teams: the North American versus the European experience. J Cardiothoracic Vasc Anesth 30(6):1441-1448.86CrossRef
40.
Zurück zum Zitat Combes A et al (2014) Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med 190(5):488–496PubMedCrossRef Combes A et al (2014) Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med 190(5):488–496PubMedCrossRef
41.
Zurück zum Zitat Tseng YH, Wu MY, Tsai FC, Chen HJ, Lin PJ (2011) Costs associated with extracorporeal life support used in adults: a single-center study. Acta Cardiol Sin 27(4):221–228 Tseng YH, Wu MY, Tsai FC, Chen HJ, Lin PJ (2011) Costs associated with extracorporeal life support used in adults: a single-center study. Acta Cardiol Sin 27(4):221–228
42.
Zurück zum Zitat Dennis M, Zmudzki F, Burns B, Scott S, Gattas D, Reynolds C, Sydney ECMO Research Interest Group et al (2019) Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. Resuscitation 139:49–56PubMedCrossRef Dennis M, Zmudzki F, Burns B, Scott S, Gattas D, Reynolds C, Sydney ECMO Research Interest Group et al (2019) Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. Resuscitation 139:49–56PubMedCrossRef
43.
Zurück zum Zitat Jäämaa-Holmberg S, Salmela B, Suojaranta R, Lemstrom KB, Lommi J (2020) Cost-utility of venoarterial extracorporeal membrane oxygenation in cardiogenic shock and cardiac arrest. Eur Heart J Acute Cardiovasc Care 9(4):333–341PubMedCrossRef Jäämaa-Holmberg S, Salmela B, Suojaranta R, Lemstrom KB, Lommi J (2020) Cost-utility of venoarterial extracorporeal membrane oxygenation in cardiogenic shock and cardiac arrest. Eur Heart J Acute Cardiovasc Care 9(4):333–341PubMedCrossRef
Metadaten
Titel
Extracorporeal Membrane Oxygenation (ECMO) for Pulmonary and/or Cardiopulmonary Support—a Brief Review and Our Experience
verfasst von
Muralidhar Kanchi
Kedar Bangal
Prakash PVS
Sanjay Orathi Patangi
Publikationsdatum
07.12.2022
Verlag
Springer India
Erschienen in
Indian Journal of Surgery / Ausgabe Sonderheft 2/2023
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-022-03620-z

Weitere Artikel der Sonderheft 2/2023

Indian Journal of Surgery 2/2023 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.