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Extracorporeal life support.

Sean C Skinner1, Ronald B Hirschl, Robert H Bartlett

  • 1Section of Pediatric Surgery, University of Michigan, Ann Arbor, Michigan 48109-0245, USA. rhirschl@umich.edu <rhirschl@umich.edu>

Seminars in Pediatric Surgery
|October 24, 2006
PubMed
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Extracorporeal life support (ECLS) provides advanced organ support beyond gas exchange. Future ECLS technology will expand its use to more patients, including premature newborns, by improving safety and simplifying application.

Area of Science:

  • Cardiovascular and Respiratory Medicine
  • Biomedical Engineering
  • Critical Care Medicine

Background:

  • Extracorporeal life support (ECLS) is a prolonged extracorporeal cardiopulmonary bypass for acute cardiac or respiratory failure.
  • ECLS technology has evolved to provide multi-organ support, including liver, renal, and cardiac functions.
  • Future developments aim to include immunologic support via ECLS.

Purpose of the Study:

  • To review the advancements and future directions of Extracorporeal Life Support (ECLS).
  • To explore how technological improvements in ECLS will broaden its application and patient populations.
  • To discuss novel ECLS approaches and their potential impact on treating organ system failure.

Main Methods:

  • Review of current ECLS technology and its applications.

Related Experiment Videos

  • Analysis of emerging ECLS devices and techniques.
  • Discussion of future trends in ECLS, including circuit simplification and auto-regulation.

    • Main Results:

    • Technological advancements are leading to improved ECLS devices with simplified circuits and auto-regulation.
    • Future ECLS applications will extend to currently excluded populations, such as premature newborns, through innovations like thromboresistant circuits.
    • New ECLS approaches like pumpless arteriovenous bypass, artificial placenta, arteriovenous CO(2) removal (AVCO(2)R), and intravenous oxygenators (IVOX) are emerging.

    Conclusions:

    • ECLS technology is advancing towards safer, simpler, and more broadly applicable methods for organ support.
    • Minimizing morbidity and mortality will lead to relaxed criteria for ECLS application.
    • The future of ECLS involves routine application for lung and other organ system failures, driven by technological innovation.