TY - CHAP M1 - Book, Section TI - ECMO in Lung Transplantation A1 - Zwischenberger, Brittany A. A1 - Zwischenberger, Joseph B. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - Extracorporeal membrane oxygenation (ECMO) has continued to evolve since the 1950s when the pioneers of cardiac surgery, Gibbon and Lillehei, developed cardiopulmonary bypass. While the cardiopulmonary bypass circuit is used for hours during cardiac surgery, the ECMO circuit can last for days to weeks. For lung transplantation, ECMO is used pre-transplantation for acute deterioration (severe respiratory failure with hypoxia or hypercarbia), bridge to organ availability, intraoperatively for poor lung function immediately post-transplantation, and post-operatively for acute rejection, infection, and bridge to re-transplantation. An analysis of United Network of Organ Sharing (UNOS) data found that pre-transplantation mechanical ventilation was associated with a twofold higher risk of death in the first 6 months after transplant (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.3–2.8; p < 0.0005), particularly in patients with cystic fibrosis, idiopathic pulmonary fibrosis, and restrictive lung disease.1 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170413778 ER -