TY  - BOOK
AU  - Ahmad, Sarah Aftab
AU  - Bernardo, Nelson L
AU  - Chen, Yuefeng
AU  - Edelman, J James
AU  - Hashim, Hayder
AU  - Javed, Hasan
AU  - Khalid, Nauman
AU  - Musallam, Anees
AU  - Rogers, Toby
AU  - Shlofmitz, Evan
AU  - Waksman, Ron
TI  - Analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience Database for Patient- and Circuit-Related Adverse Events Involving Extracorporeal Membrane Oxygenation
SN  - 1878-0938
PY  - 2020///
KW  - *Device Approval
KW  - *Extracorporeal Membrane Oxygenation/ae [Adverse Effects]
KW  - *Extracorporeal Membrane Oxygenation/is [Instrumentation]
KW  - *Heart Diseases/th [Therapy]
KW  - *Oxygenators, Membrane/ae [Adverse Effects]
KW  - *Product Surveillance, Postmarketing
KW  - *Respiratory Insufficiency/th [Therapy]
KW  - *United States Food and Drug Administration
KW  - Databases, Factual
KW  - Equipment Failure
KW  - Extracorporeal Membrane Oxygenation/mo [Mortality]
KW  - Heart Diseases/di [Diagnosis]
KW  - Heart Diseases/mo [Mortality]
KW  - Heart Diseases/pp [Physiopathology]
KW  - Hemodynamics
KW  - Humans
KW  - Patient Safety
KW  - Respiratory Insufficiency/di [Diagnosis]
KW  - Respiratory Insufficiency/mo [Mortality]
KW  - Respiratory Insufficiency/pp [Physiopathology]
KW  - Risk Assessment
KW  - Risk Factors
KW  - Treatment Failure
KW  - United States
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - BACKGROUND/PURPOSE: We assessed commonly reported patient- and circuit-related adverse events involving extracorporeal membrane oxygenation (ECMO) devices by analyzing post-marketing surveillance data from the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database. ECMO is a rescue therapy for critically ill patients requiring oxygenation and cardiopulmonary support. Key configurations include veno-venous (VV) ECMO for respiratory support and veno-arterial (VA) ECMO for cardio-respiratory support. Robust data on the most commonly reported complications associated with ECMO therapy are limited; CONCLUSIONS: Analysis of the MAUDE database demonstrates that in real-world practice, ECMO devices are associated with important complications. With broadened global utilization of ECMO devices, standard complication and failure reporting policies may improve patient selection, operator proficiency, and existing device technology; METHODS/MATERIALS: The MAUDE database was queried from January 1, 2009, through March 31, 2019, yielding 93 reports. After excluding duplicate reports, 82 reports were included in the final analysis; RESULTS: Percentages represent the proportion of total submitted MAUDE reports on ECMO. Of the reported cases, 24 were VV-ECMO, 8 were VA-ECMO, and the remainder were unspecified. The most commonly reported patient-related adverse events included hemodynamic decompensation of patients (12.2%), death (12.2%), atrial perforation (7.3%), and bleeding (7.3%). The most commonly reported failure modes were in the following circuit components: mechanical pump (19.5%, mostly due to technical failure or clots), membrane oxygenator (19.5%, mostly due to tear in the membrane or temperature probe), and access cannulae (18.3%, mostly due to structural damage); SUMMARY: An analysis of the Food and Drug Administration's Manufacturer and User Facility Device Experience database demonstrates that in real-world practice, extracorporeal membrane oxygenation devices are associated with serious complications. The most commonly reported patient-related adverse events were hemodynamic decompensation of patients and death, and the most commonly reported failure modes were in the device's mechanical pump and membrane oxygenator. Copyright (c) 2019 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.carrev.2019.11.011
ER  -