Contemporary extracorporeal membrane oxygenation for adult respiratory failure: life support in the new era

Abstract

ECMO is safer, cheaper, and simpler than in previous eras. Both circuit and patient can be cared for by a single trained nurse. Additional prospective studies of ECMO for adult respiratory failure are underway. Contemporary ECMO in awake, potentially ambulant patients to provide short-term support for those with acute, reversible respiratory failure and as a bridge to transplantation in those with irreversible respiratory failure is now ready for widespread evaluation.

Respiratory extracorporeal membrane oxygenation for severe sepsis and septic shock in adults: a propensity score analysis in a multicenter retrospective observational study

“…Among these, age9, 18, 21, 22, 23, 24 and SOFA score21, 22, 23, 24 were found to be particularly closely associated with hospital mortality and were independent prognostic factors in ARDS patients receiving ECMO support. Roch et al 22.…”

“…Following the pandemic of influenza A (H1N1), however, few reports have explored the benefits of ECMO 8. Furthermore, in patients with severe sepsis, ECMO support has been historically regarded as a contraindication because of the high complication rate 9. Therefore, whether or not ECMO support is effective in patients with severe sepsis except for influenza A (H1N1) remains unclear.…”

Extracorporeal Membrane Oxygenation in Adults

“…Over the following decades, it became an universally accepted method in the treatment of severe forms of heart and respiratory failure in childhood; only in recent years has it become a common treatment modality in adult critical patients [3][4][5] .Thanks to the technical developments and growing experience, the results of ECMO treatment have been increasingly improving, and the indications were gradually extended [6][7][8][9][10] . Consequently, the number of patients treated with ECMO has been growing significantly every year.…”

ARDS: rest the lungs or the ventilator?

“…Both extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCOR) have the potential to better address the heterogeneity in lung injury, which is central to VILI and adverse outcomes. Equally these techniques are invasive, not widely available and have their own complications [5]. But with refinements in technology and clinical application, it would not be surprising if these risks eventually outweigh the benefits of persisting with potentially injurious ventilation.…”