Right Ventricular Injury Definition and Management in Veno-Venous Extracorporeal Membrane Oxygenation
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.
Authors
- Prashant Nasa (ORCID: https://orcid.org/0000-0003-1948-4060)
- Marcus J. Schultz (ORCID: https://orcid.org/0000-0003-3969-7792)
- Abhijit Duggal (ORCID: https://orcid.org/0000-0003-4220-2359)
- Kiran Shekar (ORCID: https://orcid.org/0000-0002-1239-7514)
- Siddharth Dugar (ORCID: https://orcid.org/0000-0002-3243-1417)
- Mary Pat Harnegie (ORCID: https://orcid.org/0000-0003-2096-2357)
- Vasileios Zochios (ORCID: https://orcid.org/0000-0001-7654-933X)
- Daisuke Hasegawa (ORCID: https://orcid.org/0000-0001-7647-522X)
- Matthew Charlton (ORCID: https://orcid.org/0000-0003-3787-8418)
- Ryota Sato (ORCID: https://orcid.org/0000-0001-8806-2852)
- Hakeem Yusuff (ORCID: https://orcid.org/0000-0003-2553-0983)
- Matthieu Schmidt (ORCID: https://orcid.org/0000-0002-2931-4412)
- Marta Velia Antonini (ORCID: https://orcid.org/0000-0003-4276-3404)
- Kollengode Ramanathan
Institutions
- Bond University (AU)
- University of Modena and Reggio Emilia (IT)
- National Health Service (GB)
- Mount Sinai Beth Israel (US)
- Apple (Israel) (IL)
- Cleveland Clinic (US)
- University of Leicester (GB)
- Inserm (FR)
- Queensland University of Technology (AU)
- The University of Queensland (AU)
- National University of Singapore (SG)
- Mahidol University (TH)
- Glenfield Hospital (GB)
- Ider University (MN)
- Cleveland Clinic Lerner College of Medicine (US)
- Sorbonne Université (FR)
- University of Oxford (GB)
- Assistance Publique – Hôpitaux de Paris (FR)
- Queen's Medical Center (US)
- Azienda Unità Sanitaria Locale Della Romagna (IT)
- Prince Charles Hospital (AU)
- Mahidol Oxford Tropical Medicine Research Unit (TH)
- Dr. Vitthalrao Vikhe Patil Foundation’s Medical College (IN)
- National University Hospital (SG)
- Amsterdam University Medical Centers (NL)
- Fondation pour l’innovation en Cadiométabolisme et Nutrition (FR)
- Case Western Reserve University (US)
- Medical University of Vienna (AT)
Publication Details
- Journal
- ASAIO Journal
- Published
- 2025-01-09
- DOI
- https://doi.org/10.1097/mat.0000000000002369
- Citations
- 4
- Primary Topic
- Mechanical Circulatory Support Devices
- Type
- article
- Field-Weighted Citation Impact
- 2.70