Extracorporeal life support use in limited lung function: a narrative review

Area of Science:

• Cardiovascular and Respiratory System Support
• Thoracic Surgery Innovations
• Extracorporeal Life Support Technologies

Background:

• Thoracic surgery often involves complex scenarios requiring cardiorespiratory support.
• Advancements in technology have led to diverse extracorporeal life support (ECLS) systems.
• Difficult or impossible single lung ventilation presents a significant challenge in thoracic procedures.

Purpose of the Study:

• To review the application of various extracorporeal life support (ECLS) modalities in thoracic surgery.
• To highlight ECLS as a solution for complex surgeries with ventilation challenges.
• To describe ECLS use in patients unable to tolerate single lung ventilation.

Main Methods:

• Literature review conducted using specific search terms.
• Articles selected based on predefined inclusion criteria.
• Focus on studies detailing ECLS in thoracic surgery and pulmonary resection.

Main Results:

• Venovenous extracorporeal membrane oxygenation is the most utilized ECLS modality for lung support.
• ECLS is beneficial in lung resections post-pneumonectomy, severe hypercapnia, airway surgery, and trauma.
• Successful ECLS application requires multidisciplinary collaboration, patient selection, and meticulous surgical planning.

Conclusions:

• Understanding ECLS techniques is crucial for thoracic surgeons.
• ECLS should be considered for complex thoracic cases with ventilation difficulties or emergencies.
• ECLS provides a vital cardiorespiratory support option in challenging surgical situations.