tetano
Editor, Senior Moderator
Am J Respir Crit Care Med. 2014 Jul 21. [Epub ahead of print]
Extracorporeal Life Support in Critically Ill Adults.
Ventetuolo CE1, Muratore CS.
Author information
Abstract
Extracorporeal life support (ECLS) has become increasingly popular as a salvage strategy for critically ill adults. Major advances in technology and the severe acute respiratory distress syndrome (ARDS) that characterized the 2009 influenza A (H1N1) pandemic have stimulated renewed interest in the use of veno-venous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R) to support the respiratory system. Theoretical advantages of ECLS for respiratory failure include the ability to rest the lungs by avoiding injurious mechanical ventilator settings and the potential to facilitate early mobilization, which may be advantageous for bridging to lung transplantation. The use of veno-arterial (VA) ECMO has been expanded and applied to critically ill adults with hemodynamic compromise from a variety of etiologies, beyond post-cardiotomy failure. While technology and general care of the ECLS patient have evolved, ECLS is not without potentially serious complications and remains unproven as a treatment modality. The therapy is now being tested in clinical trials, although numerous questions remain about the application of ECLS and its impact on outcomes in critically ill adults.
KEYWORDS:
adult respiratory distress syndrome; extracorporeal circulation; extracorporeal membrane oxygenation
PMID:
25046529
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25046529
Extracorporeal Life Support in Critically Ill Adults.
Ventetuolo CE1, Muratore CS.
Author information
Abstract
Extracorporeal life support (ECLS) has become increasingly popular as a salvage strategy for critically ill adults. Major advances in technology and the severe acute respiratory distress syndrome (ARDS) that characterized the 2009 influenza A (H1N1) pandemic have stimulated renewed interest in the use of veno-venous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R) to support the respiratory system. Theoretical advantages of ECLS for respiratory failure include the ability to rest the lungs by avoiding injurious mechanical ventilator settings and the potential to facilitate early mobilization, which may be advantageous for bridging to lung transplantation. The use of veno-arterial (VA) ECMO has been expanded and applied to critically ill adults with hemodynamic compromise from a variety of etiologies, beyond post-cardiotomy failure. While technology and general care of the ECLS patient have evolved, ECLS is not without potentially serious complications and remains unproven as a treatment modality. The therapy is now being tested in clinical trials, although numerous questions remain about the application of ECLS and its impact on outcomes in critically ill adults.
KEYWORDS:
adult respiratory distress syndrome; extracorporeal circulation; extracorporeal membrane oxygenation
PMID:
25046529
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25046529