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[Techniques of extracorporeal lung support]
Thomas Bein1, Steffen Weber-Carstens
1Klinik für Anästhesiologie, Universitätsklinikum Regensburg. thomas.bein@klinik.uni-regensburg.de
Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|November 20, 2008
Summary
Extracorporeal lung support, including extracorporeal membrane oxygenation (ECMO) and interventional lung assist (iLA), has evolved significantly over 30 years. Newer systems offer improved safety and targeted gas exchange for severe acute respiratory distress syndrome patients.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Biomedical Engineering
Background:
- Extracorporeal lung support techniques for severe acute respiratory distress syndrome (ARDS) have been available for three decades.
- Early veno-venous extracorporeal membrane oxygenation (ECMO) using roller pumps had a high complication rate.
- Advancements include miniaturized ECMO with centrifugal pumps and pumpless arterio-venous interventional lung assist (iLA).
Purpose of the Study:
- To review the technical aspects of extracorporeal lung support systems.
- To discuss clinical study results, complication rates, and usage algorithms.
- To compare the capabilities of ECMO and iLA in gas exchange.
Main Methods:
- Review of historical development of extracorporeal lung support.
- Analysis of clinical studies on veno-venous ECMO and iLA.
- Evaluation of technical specifications and safety profiles of different systems.
Main Results:
- Veno-venous ECMO provides complete extrapulmonary gas exchange.
- Interventional lung assist (iLA) is effective for CO(2)-elimination.
- Technological advancements have aimed to improve the safety and efficacy of these life support systems.
Conclusions:
- Extracorporeal lung support systems have evolved considerably, offering various options for ARDS management.
- The choice between ECMO and iLA depends on the specific clinical need for gas exchange or CO(2) removal.
- Further research and standardized algorithms are crucial for optimizing the clinical use of these technologies.
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