Extracorporeal Life Support in Respiratory Failure

Briana Short; Kristin M Burkart

doi:10.1016/j.ccm.2022.05.006

Extracorporeal Life Support in Respiratory Failure

Clin Chest Med. 2022 Sep;43(3):519-528. doi: 10.1016/j.ccm.2022.05.006.

Authors

Briana Short¹, Kristin M Burkart²

Affiliations

¹ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians & Surgeons, 622 West 168th Street, PH 8 East, Room 101, New York, NY 10032, USA. Electronic address: [email protected].
² Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians & Surgeons, 622 West 168th Street, PH 8 East, Room 101, New York, NY 10032, USA.

Abstract

Extracorporeal life support (ECLS) has a role in different types of respiratory failure including acute respiratory distress syndrome (ARDS), decompensated pulmonary hypertension, bridge to lung transplantation, and primary graft dysfunction after lung transplantation. ECLS in ARDS allows for lung-protective ventilation with the goal to reduce the risk of ventilator-induced lung injury. ECLS use in severe ARDS should be considered when conventional management strategies are not sufficient to safely support gas exchange. More research is needed to identify optimal mechanical ventilation during ECLS, weaning ECLS support, strategies for mobilization, sedation and anticoagulation, and long-term outcomes post-ECLS.

Keywords: Extracorporeal life support (ECLS); Extracorporeal membrane oxygenation (ECMO); Respiratory failure.

Publication types

Review

MeSH terms

Anticoagulants
Extracorporeal Membrane Oxygenation*
Humans
Respiration, Artificial / adverse effects
Respiratory Distress Syndrome* / therapy
Respiratory Insufficiency* / etiology
Respiratory Insufficiency* / therapy

Substances

Anticoagulants