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[Extracorporeal lung support-news and future developments].

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  • 1Universitätsklinik für Innere Medizin I, Intensivstation 13.i2, Allgemeines Krankenhaus der Stadt Wien/Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. thomas.staudinger@meduniwien.ac.at.

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Summary

Extracorporeal gas exchange, including extracorporeal membrane oxygenation (ECMO), is safer and more widely used. New CO2 removal systems are expanding applications, with ongoing research into novel uses like avoiding mechanical ventilation.

Keywords:
ECCO2‑RECMOGas exchangeLung failureMechanical ventilation

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Area of Science:

  • Critical care medicine
  • Respiratory physiology
  • Cardiopulmonary support technologies

Background:

  • • Technical advancements and lessons from the 2009 influenza pandemic have improved the safety and application of extracorporeal gas exchange.
  • • The market introduction of new systems focused on CO2 elimination broadens options beyond traditional high-flow extracorporeal membrane oxygenation (ECMO).

Purpose of the Study:

  • • To review the expanding indications and evolving landscape of extracorporeal gas exchange.
  • • To highlight recent research into the pathophysiology and organism-device interactions.
  • • To discuss emerging applications such as avoiding intubation and reducing ventilation invasiveness.

Main Methods:

  • • Review of technical developments and clinical experiences.
  • • Analysis of market trends in extracorporeal gas exchange systems.
  • • Synthesis of recent research on pathophysiology and novel applications.

Main Results:

  • • Extracorporeal gas exchange is increasingly utilized, with enhanced safety profiles.
  • • New CO2 elimination systems are diversifying therapeutic options.
  • • Evidence for many expanded indications remains limited, necessitating further research.

Conclusions:

  • • The field of extracorporeal gas exchange is dynamic, driven by technological innovation and expanding clinical experience.
  • • Emerging applications, including non-invasive ventilation support, are under active investigation.
  • • Continued research and technical advancements promise to further shape the future of extracorporeal gas exchange.