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Am J Respir Crit Care Med. 2014 Sep 1;190(5):497-508. doi: 10.1164/rccm.201404-0736CI.

Extracorporeal life support in critically ill adults.

Author information

1
1 Division of Pulmonary, Critical Care, and Sleep, Rhode Island Hospital, Departments of Medicine and Health Services, Policy, and Practice, and.

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 that characterized the 2009 influenza A(H1N1) pandemic have stimulated renewed interest in the use of venovenous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal 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 recovery or to lung transplantation. The use of venoarterial ECMO has been expanded and applied to critically ill adults with hemodynamic compromise from a variety of etiologies, beyond postcardiotomy failure. Although 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:

ARDS; extracorporeal circulation; extracorporeal membrane oxygenation

PMID:
25046529
PMCID:
PMC4214087
DOI:
10.1164/rccm.201404-0736CI
[Indexed for MEDLINE]
Free PMC Article

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