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 M. Walter*, Chitaru Kurihara, Thomas C. Corbridge, Ankit Bharat

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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

Funding

Funding: This work is supported by Northwestern University's Lung Sciences Training Program 5T32HL076139-14 (JMW), NIH grant HL125940 and matching funds from Thoracic Surgery Foundation, research grant from Society of University Surgeons and John H. Gibbon Jr. Research Scholarship from American Association of Thoracic Surgery (AB).

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

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