Photo Credit: Pijitra Phomkham

The following is a summary of “Liberation From Venovenous Extracorporeal Membrane Oxygenation for Respiratory Failure: A Scoping Review,” published in the November 2023  issue of Pulmonology by Teijeiro-Paradis, et al.

Getting out of venovenous extracorporeal membrane oxygenation (ECMO) as soon as possible and safely should reduce the length of time, chance of problems, and cost of ECMO. However, more research must be done on successfully freeing people from venovenous ECMO. For a study, researchers sought to understand the evidence about getting out of continuous ECMO. 

They carefully looked through Medline and EMBASE for important articles about getting out of continuous ECMO. The papers were cited if they had any criteria for ready for liberation, a liberation process, or a description of what a successful decannulation or decannulation failure means. Their search included randomized trials, observational trials, story reviews, recommendations, opinions, and comments. They didn’t include single case reports or sources for which they couldn’t find the full text. 

They looked through 1,467 links to find 39 important papers on getting out of continuous ECMO. After that, they summed up the information into five main groups: existing methods for liberation, criteria used to determine readiness for liberation, running liberation trials, criteria used to continue with decannulation, and factors used to predict the results of decannulation. Liberation from venovenous ECMO is done in many different ways, and many of them depend on what the doctor wants.  More studies needed to be done on liberation levels to find the best liberation methods and fill in the gaps in their knowledge about important aspects of freedom from continuous ECMO.

Source: sciencedirect.com/science/article/abs/pii/S0012369223008978