Chugging in patients on veno-venous extracorporeal membrane oxygenation

An under-recognized driver of intravenous fluid administration in patients with acute respiratory distress syndrome?

James McCauley Walter, Chitaru Kurihara, Thomas C Corbridge, Ankit Bharat

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. Objectives: To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. Methods: We use a clinical case to illustrate chugging and discuss potential management strategies. Results: Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation. Conclusions: Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS.

Original languageEnglish (US)
Pages (from-to)398-400
Number of pages3
JournalHeart and Lung
Volume47
Issue number4
DOIs
StatePublished - Jul 1 2018

Fingerprint

Extracorporeal Membrane Oxygenation
Adult Respiratory Distress Syndrome
Intravenous Administration
Severe Acute Respiratory Syndrome
Water-Electrolyte Balance
Catheterization
Albumins
Patient Care

Keywords

  • Acute respiratory distress syndrome
  • Chugging
  • Extracorporeal membrane oxygenation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Chugging in patients on veno-venous extracorporeal membrane oxygenation: An under-recognized driver of intravenous fluid administration in patients with acute respiratory distress syndrome?",
abstract = "Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. Objectives: To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. Methods: We use a clinical case to illustrate chugging and discuss potential management strategies. Results: Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation. Conclusions: Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS.",
keywords = "Acute respiratory distress syndrome, Chugging, Extracorporeal membrane oxygenation",
author = "Walter, {James McCauley} and Chitaru Kurihara and Corbridge, {Thomas C} and Ankit Bharat",
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T1 - Chugging in patients on veno-venous extracorporeal membrane oxygenation

T2 - An under-recognized driver of intravenous fluid administration in patients with acute respiratory distress syndrome?

AU - Walter, James McCauley

AU - Kurihara, Chitaru

AU - Corbridge, Thomas C

AU - Bharat, Ankit

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. Objectives: To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. Methods: We use a clinical case to illustrate chugging and discuss potential management strategies. Results: Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation. Conclusions: Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS.

AB - Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. Objectives: To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. Methods: We use a clinical case to illustrate chugging and discuss potential management strategies. Results: Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation. Conclusions: Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS.

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KW - Chugging

KW - Extracorporeal membrane oxygenation

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