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- Title
The ICM research agenda on extracorporeal life support.
- Authors
Combes, Alain; Brodie, Dan; Chen, Yih-Sharng; Fan, Eddy; Henriques, José; Hodgson, Carol; Lepper, Philipp; Leprince, Pascal; Maekawa, Kunihiko; Muller, Thomas; Nuding, Sebastian; Ouweneel, Dagmar; Roch, Antoine; Schmidt, Matthieu; Takayama, Hiroo; Vuylsteke, Alain; Werdan, Karl; Papazian, Laurent; Henriques, José P S; Lepper, Philipp M
- Abstract
<bold>Purpose: </bold>This study aimed to concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to extracorporeal membrane oxygenation (ECMO).<bold>Methods: </bold>Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion.<bold>Results: </bold>The use of venovenous ECMO (VV-ECMO) is increasing in the most severe forms of acute lung injury. In patients with cardiogenic shock, short-term veno-arterial ECMO (VA-ECMO) provides both pulmonary and circulatory support. Technological improvements and recently published studies suggest that ECMO is able to improve patients' outcomes. There are, however, many uncertainties regarding the real benefits of this technique both in hemodynamic and respiratory failure, the territorial organization to deliver ECMO, the indications and the use of concomitant treatments.<bold>Conclusions: </bold>Although there have been considerable advances regarding the use of ECMO in critically ill patients, the risk/benefit ratio remains underinvestigated. ECMO indications, organization of ECMO delivery, and use of adjuvant therapeutics need also to be explored. Ongoing and future studies may be able to resolve these issues.
- Subjects
EXTRACORPOREAL membrane oxygenation; ADULT respiratory distress syndrome treatment; CARDIAC resuscitation; CARDIOGENIC shock; PHYSICAL therapy; LUNG transplantation; ARTIFICIAL respiration; PATIENTS; RESPIRATORY insufficiency treatment; CATASTROPHIC illness; ACUTE diseases; LUNG injuries; CARDIAC arrest; CLINICAL trials; LONGITUDINAL method; MEDICAL protocols; MEDICAL research; HEALTH outcome assessment; RETROSPECTIVE studies; THERAPEUTICS
- Publication
Intensive Care Medicine, 2017, Vol 43, Issue 9, p1306
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-017-4803-3