Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined. The beneficial effect of veno-venous (VV) ECMO on RV function in these patients will be illustrated. Based on this, we will give recommendations regarding choice of ECMO modus and provide an algorithm for management of RV failure in VV ECMO supported patients.

Additional Metadata
Keywords Acute respiratory distress syndrome (ARDS), Cor pulmonale, Extracorporeal membrane oxygenation (ECMO), Heart failure, Human, Right sided, Veno-venous extracorporeal membrane oxygenation (VV ECMO)
Persistent URL dx.doi.org/10.21037/jtd.2017.10.75, hdl.handle.net/1765/105780
Journal Journal of Thoracic Disease
Citation
Bunge, J.J.H, Caliskan, K, Gommers, D.A.M.P.J, & dos Reis Miranda, D. (2018). Right ventricular dysfunction during acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation. Journal of Thoracic Disease (Vol. 10, pp. S674–S682). doi:10.21037/jtd.2017.10.75