Comparison of Mechanical Cardiopulmonary Support Strategies During Lung Transplantation.

Comparison of Mechanical Cardiopulmonary Support Strategies During Lung Transplantation.
Expert Rev Med Devices. 2020 Oct 22;:
Authors: Weingarten N, Schraufnagel D, Plitt G, Zaki A, Ayyat K, Elgharably H
Abstract
Introduction Lung transplantation outcomes are influenced by the intraoperative mechanical cardiopulmonary support strategy used. This surgery was historically done either on cardiopulmonary bypass (CPB) or off pump. Recently, there has been increased interest in intraoperative support with veno-arterial (VA) or veno-venous (VV) extracorporeal membrane oxygenation (ECMO). However, there is a lack of consensus on the relative risks, benefits and indications for each intraoperative support strategy. Areas covered This review includes information from cohort studies, case-control studies, and case series that compare morbidity and/or mortality of two or more intraoperative cardiopulmonary support strategies during lung transplantation. Expert opinion The optimal strategy for intraoperative cardiopulmonary support during lung transplantation remains an area of debate. Current data suggest that off pump is associated with better outcomes and could be considered whenever feasible. ECMO is generally associated with preferable outcomes to CPB, but the data supporting this association is not robust. Interestingly, whether CPB is unplanned or prolonged might influence outcomes more than the use of CPB itself. These observations can h...

Source: Expert Review of Medical Devices - October 23, 2020 Category: Medical Devices Tags: Expert Rev Med Devices Source Type: research