Venovenöse extrakorporale Membranoxygenierung

Kernaussagen

• Ziel der venovenösen extrakorporalen Membranoxygenierung (VV-ECMO) ist die Versorgung des Körpers mit ausreichend oxygeniertem Blut.

• Indikationen zur VV-ECMO sind eine schwere Hypoxämie und/oder Hyperkapnie mit hohem Letalitätsrisiko.

• Es gibt jedoch bislang keine gesicherten Vorteile der VV-ECMO gegenüber der konventionellen Therapie des ARDS.

• Die VV-ECMO ermöglicht eine protektive Beatmung. Zur Frage der optimalen Beatmungsform gibt es keine Studiendaten.

• Unter Sedierung ist auch bei ECMO-Patienten eine regelmäßige Beurteilung von Delir, Schmerz und Sedierung obligat. Zur ECMO ist jedoch nicht zwingend eine Sedierung erforderlich.

• Technische Komplikationen sind selten, können aber gravierend sein. Die bei Weitem häufigste Komplikation unter ECMO ist die Blutung, die bei ca. der Hälfte der Patienten auftritt.

• Eine ECMO sollten nur Intensivstationen einsetzen, die die ELSO-Standards zur technischen und personellen Ausstattung erfüllen und über ein entsprechend geschultes Team verfügen.

• Literatur

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