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Extracorporeal membrane oxygenation (ECMO), is a form of extracorporeal life support, providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of oxygen, gas exchange or blood supply to sustain life. The technology for ECMO is largely derived from cardiopulmonary bypass, which ...
The main reason for the acute phase of ischemia-reperfusion injury is oxygen deprivation and, therefore, arrest of generation of ATP (cellular energy currency) by mitochondria oxidative phosphorylation. Tissue damage due to the general energy deficit during ischemia is followed by reperfusion (increase of oxygen level) when the injury is enhanced.
Oxygen supplementation has a variety of physiologic effects on the human body. Whether or not these effects are adverse to a patient is dependent upon clinical context. Cases in which an excess amount of oxygen is available to organs is known as hyperoxia. [35]
Extracorporeal life support (ECLS) systems differ from traditional, theatre based, cardiac bypass machines in that they are portable and utilise percutaneous access as opposed to catheters which are surgically inserted into an open chest. The first access enters the femoral vein at the groin and is extended superiorly to the right atrium.
Reperfusion therapy is a medical treatment to restore blood flow, either through or around, blocked arteries, typically after a heart attack (myocardial infarction (MI)). Reperfusion therapy includes drugs and surgery. The drugs are thrombolytics and fibrinolytics used in a process called thrombolysis.
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This reperfusion results in inflammatory injury through three overlapping mechanisms. Some complimentary combination of, first, mitochondrial damage and, second, endothelial activation , causes a release of reactive oxygen species (ROS), which initiates and/or exacerbates a pathophysiological inflammatory response.
Extracorporeal life support (ECLS), is a set of extracorporeal modalities that can provide oxygenation, removal of carbon dioxide, and/or circulatory support, excluding cardiopulmonary bypass for cardiothoracic or vascular surgery.